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Cradling her baby, Oliver, Alison, 31, happily strokes his head, holds his hands and feeds him from a bottle, like any proud new mother. But for the Australian primary-school teacher and her 35-year-old British husband, William, the birth of their son has followed a long and desperate medical struggle in which both had almost given up hope of having a child.

William and Alison live in London, but Oliver was born here, in Anand, Gujarat, in a clinic filled with barefoot women in flowing saris, in a remote rural community in India. It was an unusual entry into the world, but Oliver’s entire conception had been far from ordinary. The tiny boy, born five weeks prematurely, was conceived through an egg donor and in-vitro fertilisation; he was carried by an Indian surrogate mother whom his parents had met just two days before his birth.

Oliver was born to a woman from Anand, a small town at the forefront of India’s booming reproductive tourism market, where foreign couples flock for infertility treatments. The chaotic, dusty backwater, where rickshaws, cows and street...