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For thousands of well-off childless couples, the dream of having a baby is often realized in places like Thailand and India. Ready to help them are young women who become paid surrogates, their wombs offered up as vessels that can safely carry the babies until they are born.

Most of the time, it's a bargain that suits both parties — unless something goes wrong.

The case of an Australian couple accused of abandoning their baby with his Thai surrogate mother after discovering the child had Down syndrome — and taking home his healthy twin— has cast unfavorable light on the largely unregulated business of commercial surrogacy.

The suggestion that the Australian biological parents wanted to raise only the healthy child and left behind her blond, brown-eyed brother, who also has a congenital heart condition, sparked outrage worldwide.

Couples seek surrogacy away from home mainly for legal and financial reasons. Some nations tightly restrict surrogacy, or ban it outright. Others have no surrogacy laws, though national medical boards often deal with it in their codes of ethics.

Laws vary...