BEIJING - For decades China has been a top destination for Americans seeking to adopt a child from abroad, but now its own citizens are making the reverse trek across the Pacific to fulfil their parental dreams - through surrogacy.
After cancer left her unable to bear her own children three years ago, one Chinese woman in her late 30s - who asked for anonymity - decided to research her options.
Her eggs were still viable, but her choices were few with surrogacy illegal in China, so she and her husband set their sights abroad, ultimately deciding on the US.
After a trip to Los Angeles last year to transfer their eggs and sperm and an extended visit to their surrogate's home state Tennessee for the birth and subsequent formalities, she and her husband are now the happy parents of three-month-old twins, at a cost of US$150,000 (S$188,000).
"I wanted to do everything properly," she said by phone from the US. "We have a lot of underground (fertility) therapy agencies in China, but I just don't trust the doctors." With the cost standing at around 34 times average urban incomes in China it is a process reserved mainly for the rich.
A dozen US-based surrogacy agencies contacted by Agence France-Presse say they have seen a marked rise in Chinese clients over the past three years.
The Agency for Surrogacy Solutions in Encino, California, recently had its contract translated into Chinese and is working with a Chinese-speaking consultant to recruit potential customers.
"A third of our clients are Chinese," said its president Kathryn Kaycoff-Manos, up from virtually none three years ago. "It's huge. And we get calls every day."
Stuart Bell, the co-owner of Los Angeles-based Growing Generations, one of the world's largest surrogacy agencies, added Beijing and Shanghai to his Asia itinerary for the first time in September, meeting about 10 potential clients in each.
"There seems to be a lot of infertility going on in China," he said, and frustration over the options available.
The Chinese Population Association estimates 40 million people are infertile in the country - one in eight of the child-bearing population, four times the proportion 20 years ago.
Two-thirds of the semen at Shanghai's main sperm bank failed to meet World Health Organisation standards, the Shanghai Morning Post reported, with experts citing heavy pollution as a main contributing factor.