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They never wanted to have a child, until they did. And then they couldn't.

For four years, this San Carlos couple struggled with infertility. Now, their child is growing inside a woman they have never met, in India, a country they have never seen.

This is the story of Jennifer Benito-Kowalski, 39, and Steve Kowalski, 40, who are trying to start a family 8,200 miles from the Bay Area.

It is also the story of a developing nation where hundreds of women, for a price, are opening their wombs to fulfill the dreams of aspiring parents around the world.

Commercial surrogacy became legal in India a decade ago in an effort to stimulate medical tourism, the emerging practice of travel across international borders to obtain cheaper health care. The Confederation of Indian Industry estimates the market will generate $2.3 billion this year.

Surrogacy is rapidly growing in popularity, as couples from the United States and other countries, desperate to have a child, turn to India. No national registry exists, but conservative estimates suggest that the annual number of...