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Intersono was one of those which closed its premises, only completing egg donation and surrogacy programmes that were initiated before the quarantine began. The clinic reopened in May. According to Dorofeyeva, all ten babies that were born to surrogate mothers during this time were successfully collected by their parents, and most of them have already left Ukraine.

Dr. Vladyslav Svyrydyuk, the director of IVMed clinic in Kyiv, had a similar experience. His clinic, too, did not initiate any new egg donation or surrogacy programmes after the border closures. All four of the foreign couples whose babies were born in his clinic during the quarantine have arrived in Ukraine, and two of them have already left with their babies. The newborns remained in the maternity ward while awaiting their parents.

Dorofeyeva claims that there were fewer hurdles to commissioning parents’ arrival than expected: they often arrived on charter flights or by car from nearby countries (borders with neighbouring countries such as Belarus were not closed to private passengers arriving by car). She recalls that an Israeli couple were able register their child at the embassy in a single day and headed back home – weekly flights to Israel continued despite the quarantine.

While IVF clinics are licensed and clearly indicate their responsibilities in their statutes, they often are responsible only for the medical part of the surrogacy process. The organisational needs are covered by surrogacy agencies, which recruits surrogates, signs contracts with them and with the IVF clinic, arranging prenatal care, maternity ward stays, and arranges for commissioning parents to arrive and register their children.

The pandemic revealed the problematic aspect of these middlemen, who are often not officially registered and cannot be held accountable. For example, couples that connected with their surrogate mothers and clinics through surrogacy agencies were not always helped in arriving to Ukraine or registering their children. Similarly, surrogate mothers who gave birth during the quarantine, such as Lesya’s friend Anna, had to take care of the babies without being paid compensation.

“If these agencies exist, they need to be strictly regulated with clear areas of responsibility,” says Dorofeyeva.

A need for new rules

Ukraine’s fertility specialists appreciate that their field is not strictly regulated and that the state does not intervene in it. On the other hand, they often express a desire for more regulation and control to weed out the irresponsible players and clarify the rules of the game. As Dorofeyeva emphasises: “The fact that our field is quite self-organised is both an advantage and a disadvantage. On our local level we can make all the decisions regarding medical algorithms and processes, and which international treatment protocols to follow. It is good that we have this freedom, but the practice shows that not all parties prioritise the right things: safety and quality. Some prioritise profit and quantity. This needs to have some external control.”

But it’s unclear what public authority would be able to step in. Moreover, experts fear that the involvement of the state may lead to undesirable restrictions. “The first reaction of our politicians is to ban the practice, because they do not have expertise in the topic. They cannot know the needs of the field if they never cooperated with it before,” remarks Dorofeyeva.

The dramatic consequences of the closure of borders for Ukraine’s export-oriented surrogate industry reveals its profound dependency on unrestricted cross-border mobility. Many of the solutions depended on informal connections; Dorofeyeva believes that the industry’s failure to articulate its concerns and proactively offer recommendations was largely to blame for the lack of state assistance.