• Kyodo

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In a revelation that has stunned experts, Japan’s first surrogate mother gave birth at a maternity clinic in Nagano Prefecture this spring for a woman whose uterus had been surgically removed, the clinic said Saturday.

More than 10 Japanese babies have reportedly been born since 1991 by surrogate mothers in the United States, where the practice is not prohibited.

However, the first surrogate birth in Japan is certain to provoke nationwide debate as a Health, Labor and Welfare Ministry panel recommended last December that the practice be banned, calling it the “use of humans as a tool for reproduction,” experts said.

The surrogate mother, a younger sister of the biological mother, gave birth at Suwa Maternity Clinic in the town of Shimosuwa, Nagano Prefecture.

The clinic’s director, Yahiro Netsu, defended his actions Saturday, telling a news conference at the clinic that “someone had to be the first” to perform the procedure “for the sake of the patients.”

Netsu said he performed in vitro fertilization using an egg and sperm of a couple and transplanted the fertilized egg into the womb of the woman’s sister.

The baby is in good health, the clinic said, but refused to disclose the baby’s sex or other details.

According to the doctor, the woman’s sister asked that he help her sister, whose womb was removed after a miscarriage, and volunteered to become the surrogate mother.

“I could not lie to her that I cannot perform this procedure as it is technically possible. I had to do it, applying the standards of my common sense, despite the ministry’s policy,” Netsu told Kyodo News earlier.

Although the practice is not restricted by federal legislation in the United States, surrogate mothers and the biological parents have in some cases gone to court over custody rights. The practice is banned in Germany, France and China.

Netsu said he asked the couple and the sister to sign a written oath in order to prevent any dispute over custody of the baby.

“I don’t know how you can stop such a self-sacrificing person like the sister. If the ministry still insists on banning the practice it should take away my medical license, so I wouldn’t be tormented (with the need to make such decisions),” he said.

The doctor said he previously performed the fertilization procedure for four other couples over the past three years, but that the surrogate mothers — all sisters of the women concerned — had all miscarried.

He also explained that he drew up his own set of “guidelines” under which he would agree to perform the procedure when undertaking the process with the second couple.

According to Netsu’s guidelines, the couple wanting the child needs to be legally married and both able to donate sperm and eggs. The substitute mother also has to be married and already have children of her own.

In addition, the surrogate mother must agree not to make any demands in connection with the child or accept any money for her help, while the baby will be registered as being her child but adopted by the biological parents.

The clinic charges 300,000 yen for the fertilization process, the same amount as for in vitro fertilization, according to the doctor.

“Patients do not have a say (in what the government decides), so I had no choice but to act on their behalf,” Netsu said, adding that he hopes the health ministry will change its position on the issue before making a final ruling.

He also said that at present, he does not intend to carry out similar procedures for couples out of wedlock.

Tsutomu Araki, chairman of the Japan Society of Obstetrics and Gynecology and a professor at Nippon Medical School, said Netsu’s actions were deeply regrettable, pointing out that the baby was born before Japan has set up a framework to protect the rights of children conceived in such a manner.

“If it comes to the point at which (doctors) can do anything if they are strongly pressured to do so by patients, it could lead to problems as some actions might violate ethics,” Araki said.

“I fear that some society members may feel the urge to conduct such fertility treatment and I would like some form of reconfirmation of the organization’s policy on surrogate mothers.”

Netsu became the first doctor to be expelled from the Japan Society of Obstetrics and Gynecology in August 1998 after revealing in June the same year that he had conducted three extramarital in vitro fertilization procedures. The society only permits such fertilization between married couples.

Despite his expulsion from the organization, Netsu has continued to perform the fertilization procedure since there are no laws in Japan restricting it.

He has said that surrogate mothers should be permitted to help women who are unable to conceive children naturally.

In January last year, Netsu said he was preparing for births by surrogate mothers in response to requests from patients, adding that he had already been approached by about 10 couples.

There are two types of surrogate motherhood, experts say. The first type, as in the latest case, borrows the womb of a surrogate mother, into which the egg of a woman fertilized by her husband’s sperm is transplanted.

The second type involves a surrogate mother’s egg which is artificially fertilized using sperm of the husband of a sterile woman, according to the experts.

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