The dear grandmother does not know how far science and technology have progressed. She is unaware about the advancement in Assisted Reproductive Technology (ART) which includes in vitro fertilisation (IVF) , intra-cytoplasmic sperm injection (ICSI) or the billion dollar industry of commercial surrogacy.
With changes in the gender equation over time, lifestyle and rising incomes, the assisted reproductive technologies have aided those who were not able to have an offspring and also those who did not have time to devote to the process of reproducing a baby.
“Two months back, a couple from Karnal (Haryana) came to us to enquire about the various methods through which they could have a baby. They were both young, below 34 years of age, well-educated and very successful in their careers. They made it clear that they have no ‘financial’ problem. After a while, they said they want to have a baby through a surrogate mother. As per Indian Council of Medical Research (ICMR) guidelines followed by our centre, there has to be a medical condition to adopt such method. But to my shock, they were perfectly healthy and fertile. When asked why they wanted to go for surrogacy, they said they did not have the time,” said a source from a premier medical institution.
The source further said, the couple was then counselled and asked if they couldn’t take out time for having a baby, then how did they plan to take care of their child?
“They insisted for a while. They explained how their parents would look after the child, and they could also afford a governess. But they told it was hard for them to take a break for one year, or even for a few months, from their busy schedules,” said the source.
Commercial surrogacy – better known as gestational surrogacy in medical terms – is a booming industry in India, which generates revenue worth about $6 billion per year. While official statistics on the number of surrogacies being arranged in India are not available, evidences suggest that the number of IVF cycles have increased from an estimated 7,000 cycles in 2001 to 85,000 in 2011. The number of clinics offering these services has shot up from 59 in 2001 to close to 600 by 2011.
“Career orientation can be one of the reasons behind such cases. There are also cases in which couples want to have a baby under immense social pressure even if they are not ready. Many a times, there is lot of pressure from in-laws side especially in which couples go through ‘other’ procedures to have a baby,” said the source.
“Some couples may go for surrogacy despite being fertile but the occurrence of such cases is more in Mumbai as compared to Delhi. It may be attributed to a more glamorous life people want to lead there,” said Vinod (name changed), the agent based in Haryana, who acts as the conduit between the surrogate mothers and the intended parents.
The ART clinics, according to ICMR guidelines, can’t allow surrogacy until and unless there is a medical condition like absence or malformation of uterus, recurrent pregnancy losses, severe damage to uterus because of infections, damage due to chemotherapy or other radiations due to which a couple cannot have a baby.
“People with money will always break the rules and also there lot of unregistered private ART clinics which might aid them,” said a doctor working in field of IVF and surrogacy at All India Institute of Medical Sciences (AIIMS).
The rates to have one complete cycle, which involves embryo being planted in the uterus of surrogate mother vary depending upon the doctor who is treating the surrogate, agent and how much intended parents (couple who pays to have a baby through surrogacy) are willing to pay.
“The doctors who treat our surrogates are from Max Hospital, Sir Ganga Ram Hospital, Neelkanth Hospital among others. So, the doctors’ fee is relatively high. Moreover, the intended parents have to pay not only for surrogate, but all medicals bills and her stay in surrogate shelter homes. If desired, intended parents from time to time, also shower the surrogate with gifts. So, the cost goes up to Rs 10-12 lakh and may vary along ART clinics. Out of this, around Rs 2-2.5 lakh is paid to surrogate mothers in instalments. Every month we pay them Rs10,000 and rest after the completion of process,” said Vinod.
In India surrogacy costs up to $20,000 whereas in the Western countries the cost may go up to $60,000. “India accounts for 20 per cent of the revenue generated worldwide by the surrogacy industry. We generally have our sub-agents (agents appointed by agents) in villages near Kapaseda who are community members only. They persuade women to rent their wombs. We get at least 10-12 surrogate mothers and sometimes even more adily. For a single intended parent, we take three –four surrogate mothers to doctors. After the medical examination, newly formed embryo is planted in the surrogate mother, who is best suited for the process,’ said Vinod.
“The couples who desperately need a child just want that surrogate the mother is healthy. While some couples also demand that surrogate mother is well educated, fair and healthy so that she can take care of herself properly. We do have some young women less than 30 years of age who are well educated from reputed colleges, who agree to be in the business for money,” said Vinod.
As per ICMR guidelines, surrogate mothers must be between 21 and 35 years. There should be a surrogacy agreement between the surrogate and intended parents including financial details, affidavit of surrogate mother’s husband relinquishing rights on the child, declaration of intent, details of IVF procedure, confirmation of gametes used by IVF doctor (own eggs/ donor eggs, husband sperm/donor sperm). Also, there are additional charges for caesarean delivery vs normal delivery, twins vs single baby and such.
“As we follow the guidelines, so we make sure there is an agreement signed by both parties. Surrogates mothers live in the shelter home as per the agreed arrangement. Depending upon will of both parties, that is, surrogate mothers and intended parents, they meet occasionally,” said Arveen Poonia, counsellor at Vansh Surrogacy Consultants, Gurgaon.
He further said that surrogate mothers want that intended parents should pay them regular visits. ‘Once a surrogate mother came to me and said that she felt sad that the intended parents did not come even once to meet her. So, we arranged a meeting. At times, if surrogate mother does not feel comfortable, we have to refuse intended parents for a meeting,’ said Arveen Poonia. While intended parents might be happy to have a baby, health experts suggest that children born out of surrogacy might have divided feelings. “At times, the child may feel neglected, yearn for love, have lack of confidence, suffer from anxiety and may have to deal with other forms of crises. Parents, who can’t give enough time to their children and often hire nannies may feel guilty for the same. This might affect their professional as well as personal lives,’ said Aarti Anand, psychiatrist at Sir Ganga Ram Hospital.
Gujarat and Surrogacy
It was in 2003, a child named Akanskha was born to an NRI surrogate grandmother, who did it to save her daughter’s marriage that changed the scenario for Anand, a district in Gujarat.
In Gujarat, women from lower income groups earn up to Rs 3 lakh to Rs 4.5 lakh by renting wombs to deliver children for foreign couples.
Now, popularly known as Surrogacy capital or Baby Farm, Gujarat has become a destination for couples seeking wombs on rent. It is estimated that Gujarat contributes 40 per cent of total surrogacy market in India.
Gujarat besides being the leading state in the field, has also managed to grab attention worldwide for the same. Featured on Oprah Winfrey show in 2006, Nayna Patel, the medical director of Akanskha Infertility Centre (named after the surrogate child), almost became an institution, instrumental in all landmark cases involving surrogacy up until now.
Even with an impending Surrogacy bill to be passed in Parliament, presence of many IVF clinics and high availability of surrogates in Gujarat has ensured that surrogacy has picked up majorly there. It is reported that Akanskha clinic has delivered 735 babies through IVF treatment in 11 years and has at least 75 ongoing surrogacies at any given time at her clinic in Anand, for couples from all over the world. A third of the children born here have gone to Indian couples, another third to NRIs and the others to foreigners from over 34 different nations.