At the same time, thousands of young Ukrainian women have relied on the fertility industry for survival. BioTexCom advertises on buses, via social media and employs agents to recruit young women across Ukraine, according to women who worked as surrogates. WELT interviewed seven Ukrainian surrogates for BioTexCom, on the condition of anonymity to discuss a sensitive matter. The majority said they regret their decision.

Victoria said she had left her abusive partner and needed the money to pay for a house. She told WELT that BioTexCom paid her a total of €12,000 — or roughly $15,000 — in 2018 for three attempts at pregnancy, one of which was eventually successful. After the child was born, Victoria was entirely kept away from the baby; she said she was not allowed to feed him or visit him, which was jarring and upsetting for her.

“The child was not put on my chest, I had no right to feed him, I had no right to visit him,” she said. “I gave birth, gave everything and that’s all. I cried, I screamed in that ward. I couldn’t bear it, I felt bad, I dreamed about this child.”

Still, she added, once she saw the baby’s father she calmed down: “I knew that I didn’t do it in vain, I made two people happy who dreamed of a child all their lives,” she said.

Tatiana, a 41-year-old woman from the northern Ukrainian city of Chernihiv, said she developed numerous health issues after her surrogacy in 2014-2015. “I look at people who want to get out of poverty and go to the [surrogacy] program to earn money, to buy a house, and so that it doesn’t turn out like it happened to me, I want to warn them,” she said.

She claimed BioTexCom officials laughed when they were asked for help to pay for necessary medication. In 2018, she joined other former surrogates in sharing their complaints with the prosecutor’s office, in the case that never made it to court. Tatiana said doctors removed her cervix, uterus and ovaries. She has since had 20 radiation treatments and started chemotherapy for cancer. “I had diseases of the stomach, bladder, kidneys, spleen,” she said.

Tochilovsky, in his statement, said the company provides sufficient medical care for surrogates, and rejected their complaints.

Olga, from the Zhytomyr region approximately 140 kilometers west of Kyiv, said after the baby she was carrying died during pregnancy in 2014, doctors removed her uterus entirely. Her complaint to prosecutors was part of the investigation that was later dropped. Another former surrogate, Nadia, filed a lawsuit against the clinic for health damages. It is officially registered and is still before one of the Kyiv courts, she said.

Anna, a former BioTexCom nurse who lives near the city of Rivne, 330 kilometers west of Kyiv, told WELT that she adopted a sick child after Chinese biological parents refused to take it home. She said it’s a common occurrence if babies are born with medical or health conditions.

WELT obtained a tranche of BioTexCom documents from 2014 to 2017 showing just how little surrogates were paid. Women received €100-200 (or roughly $120-$240) for each embryo transfer, then for a successful pregnancy and examinations. Egg donations were priced at €500 (or roughly $600) per egg, compared with up to $10,000 per egg in the U.S. Each contract varied but on average, surrogates were paid €8,000 to €12,000 (roughly $9,600-$14,400) for carrying a child to birth. BioTexCom often charged clients five times that amount.

Another set of documents, known as “protocols,” shows how five women between the ages of 27 and 35 agreed to several embryo transfers, a procedure known to come with a higher risk of complications. The one-page consent form included phrases like: “in the event of unforeseen situations or complications, I agree in advance to use all necessary measures to eliminate complications.” The form also states: “complications, risks and further consequences” are “possible” but it does not outline what the health risks are nor explain their potential long-term impacts.

But some former surrogates claimed in the former prosecutor’s investigation that BioTexCom never paid them and failed to take responsibility for their health problems, having not adequately warned them of the risks they faced by becoming surrogates.

Tochilovsky, in his written statement, did not respond to specific cases but acknowledged that some women have complained about the company. Many of them, he claimed, were coached by overzealous prosecutors.

“We have a number of complaints of the surrogate mothers who claim that they were forced by the prosecutors to say what the prosecutors wanted to hear, not the information the surrogates actually wanted to express,” he said.

In fact, he said, the company is concerned about the well-being of the surrogates, takes their medical care seriously and has recently raised their compensation to a level closer to $20,000.

“All the surrogate mothers undergo comprehensive checkups and interviews with the medical team, and they receive all the necessary information,” Tochilovsky said.

Nonetheless, outside experts say the process of carrying a baby to term and then giving it up carries the risk of both physical and psychological complications, and some expressed worry about the lack of oversight in Ukraine.

Katie Hasson, associate director of the Center for Genetics and Society in Oakland, Calif., has spent years focused on the ethical aspects of human genetic and reproductive technologies. She said surrogacy has become a hot topic as it becomes part of mainstream fertility practice. “Advocates for women’s health and women’s rights all raise Ukraine’s lack of regulation to safeguard surrogates and egg providers as a serious concern,” she said. “It is a real worry.”

More specifically, Hasson said, some medical procedures offered by BioTexCom and other global surrogacy firms pose significant health risks to the women. Implanting several embryos in surrogates to increase the chances of a successful pregnancy or because would-be parents want two children, she said, significantly increases the risk of complications for both the babies and the women carrying them.

And as fertility science advances, the need for safeguards becomes greater.

“The unproven and risky techniques known as ‘mitochondrial transfer,’ for example, involves combining materials from the eggs of two different women,” she said. “It is banned in the U.S., but in Ukraine some clinics have promoted it as a way to address general infertility, though there is no evidence for this claim.”

On May 9 this year, the Guardian newspaper reported the UK’s first baby was born with DNA from three people via mitochondrial transfer.

There are also concerns, however, that allowing these types of procedures could open the door to heritable genetic modifications, or “designer babies,” Hasson said.

‘No safe places’

The war in Ukraine has exposed the harsh realities of surrogacy in the eastern European country that remained largely hidden or glossed over during peacetime. Maryna Legenka, vice president of the human rights NGO La Strada-Ukraine, questioned the safety of surrogacy during the war despite the potential happiness it can bring would-be parents. “There are no safe places in Ukraine today,” she said. “And all the clinics faced very serious problems.”

Legenka, whose NGO has supported hundreds of surrogates, said most Ukrainians do not agree with the surrogacy business and that there is a stigma attached to women who choose to do it. “The vast majority of women who carry a child, who are surrogate mothers, hide from society that they are in the surrogate motherhood program. Moreover, they quite often hide such facts even from their own families,” she said.