Wombs for cash: Surrogate mother ‘renting’ womb for £8,500 implanted with embryo created from an HIV+ father

A Mexican woman who agreed to be a surrogate mother and ‘rent’ her womb for £8,500 was implanted with an embryo created from an HIV+ father without her consent.

Alejandra Mendiola, a 36-year-old single mother of four, agreed to carry a baby made from donated sperm and eggs for an American client because she desperately needs the money.

‘I am six months pregnant and I only found out a few weeks ago that the man who is paying me to carry his child is HIV+,’ she told Channel 4’s Unreported World.

‘I am scared and unsure what is going to happen to me and my children.

‘I only did this because I wanted to secure their future – now I’m frightened for my future, and my children’s.’

Global commercial surrogacy, where a woman is paid to carry an embryo with which she shares no genetic link, is an exploding industry estimated to be worth up to £1.3 billion.

In Britain, paying for surrogacy is illegal and contracts between parents and a surrogate mother are not legally enforceable. Women who carry babies for other people can only do so altruistically, receiving only very basic expenses.

This means many British people desperate to have a family look abroad.

Until recently, Thailand and India were the top destinations for international surrogacy.

But earlier this year, the Thai government banned non-Thai and gay couples from accessing surrogacy services after an Australian couple allegedly abandoned a baby with Down’s syndrome while taking home his healthy twin sister.

Clarity sought on Centre’s ban on surrogacy for foreigners New directive of ICMR leaves Indians married to outsiders and NRIs in a fix

A recent notice (dated October 10) from the Indian Council of Medical Research (ICMR) to leading In Vitro Fertilisation (IVF) clinics in Hyderabad has become a source of anguish for the Chowdhary couple. The cause for worry is the ICMR directive to clinics that said ‘surrogacy will be limited to Indian married couples only and not to foreigners’.

“I am a person of Indian origin and my parents are from Hyderabad. I am settled in New Zealand but my father, mother and other relatives live here. What should I do now? Will the Indian government consider me a foreigner?” asks an upset Ramesh Chowdhary (first name changed on request).

The couple from New Zealand had come to Hyderabad and underwent IVF treatment in the hope of having a child. And when IVF failed, surrogacy was the only option left. The recent decision of the Union government to ban surrogacy for foreigners has put the couple and the IVF clinic in a fix, prompting the clinic management to write a letter to the ICMR seeking clarification on the classification of foreigners.

The decision to ban surrogacy among foreigners has raised some prickly questions among IVF clinics in Telangana because there is no clarity whether surrogacy facilities can be extended to Indians married to foreigners, NRIs and persons of Indian origin.

Commercialisation

Then, there are also the questions of commercialisation, involvement of third party (known as agents) and exploitation of the gullible people that have been largely left unanswered.

“I am not sure how this decision to ban surrogacy for foreigners will help. However, there is a definite need to strengthen regulatory aspects of commercialisation, involvement of agents and the threat of exploitation of families. There is also a lot of clarity needed on issuing of visas for the baby born out of surrogacy for a foreign couple,” says Dr. K. Anuradha of the Anu Test Tube Baby Centre.

Many also cite the lack of clarity on legal issues pertaining to surrogacy.

“There is no clarity of rules on surrogacy. Moreover, there is a thin line that divides altruistic and commercial surrogacy. Many couples prefer to bring their close relatives as surrogates who can bear children for them. However, not all are lucky. Such persons do try to opt the commercial way of surrogacy,” says Dr. P Praveena, Baby’s Life Hospital, Hanamkonda, Warangal.

Specialists in the sector agree to the fact that in developed countries, IVF and surrogacy are prohibitively expensive, which drives foreigners to destinations like India and Thailand.

Deep-rooted issues

However, they point out that banning surrogacy to foreigners does not necessarily address the deep-rooted issues like the health of a surrogate mother, who will take responsibility of the surrogate infant in case they have a congenital condition or an abnormality.

IVF specialists also draw attention towards family disputes related to property etc. “There is definitely two sides to the story. What if the surrogate mother after few years decides to claim the surrogate child? However, for women from poor families, it could be a good option,” says Dr. E. Kavitha Reddy, senior Gynaecologist and IMA secretary from Nizamabad.

“What is the need of the hour is to regulate third party reproduction protecting all stakeholders, not ban a technology which can help infertile couple,” said co-chairman, Nova IVI Fertility Centre, India, Dr. Manish Banker.

(With inputs from Gollapudi Srinivas Rao in Warangal and P. Ram Mohan in Nizamabad)

Can We Turn Stem Cells Into Eggs?

Northwestern University biologist Jonathan Tilly is certain he’s found egg-making stem cells in adult mice. If he’s right, it would refute decades-old work that showed female mammals finish making all their eggs before or shortly after birth. This might make it possible to grow new eggs inside the ovaries of older women.

In a feature for Science last week, Jennifer Couzin-Frankel wrote about the ongoing scepticism many reproductive biologists have towards both Tilly’s work and OvaScience, the fertility-treatment company he helped found.

Tilly says he’s proven the existence of these stem cells by every method imaginable. But sceptics, and there are many, argue that he has relied chiefly on appearance and genetic markers to identify them. Most reproductive biologists insist that the cells be caught in the act of undergoing meiosis, the cell division unique to sperm and eggs in which bits of DNA are swapped between chromosomes. They also want to see that the resulting eggs can be fertilised and create offspring.

In short, before reproductive biologists are willing to agree that Tilly has found precursors of eggs, they want to see evidence that these cells actually turn into eggs.

Nevertheless, OvaScience has pressed on: it now offers their first modification of standard IVF based on the disputed research in Canada, Panama, Spain, Turkey, and Dubai. In the AUGMENT treatment, mitochondria are isolated from the putative immature egg cells and injected into a patient’s egg along with a sperm cell.

AUGMENT costs $US25,000 on top of the astronomical costs of a ‘normal’ round of IVF, and although the company claims the technique can give older eggs additional energy for early development, so far all of its successes have been in younger women. Some critics say AUGMENT’s chances of success are no different than normal IVF: if true, women using it could be doubling the price of their treatment for no good reason.

Legal experts seek new surrogacy law

Eminent legal experts and jurists have called upon Parliament to enact a new law to deal with issues concerning surrogacy and inter-country adoption.

Referring to the government’s move to bring a law on surrogacy to prohibit commercial surrogacy, the speakers said the need of the hour was to enact a comprehensive law which will also deal with problems of inter-country adoption.

The Assisted Reproductive Technology (Regulation) Bill, 2014 proposes to regulate and supervise surrogacy clinics, prevent misuse of ART technology, besides advocating safe and ethical practices of ART services.

The seminar was held in the capital last Friday to coincide with the release of a book, Surrogacy in India: A Law in the making — Revisited, authored by advcoates Anil and Ranjit Malhotra by Justice A.K. Sikri of the Supreme Court. The book examines this journey of surrogacy in India from 2005 to 2015. Former Attorney General Soli Sorabjee, Lord Diljit Rana, British Member of Parliament and Dr. Kavita A. Sharma, President, South Asian University, were the special invitees.

Speakers said the Bill contemplates that surrogacy shall be available to married Indian infertile couples only. It is proposed that foreigners, whether single or couples, with the exception of OCIs, NRIs, PIOs and foreigners married to Indian citizens, will be disallowed surrogacy in India. They said in reality, commercial surrogacy is in existence for the past over ten years and has become an unregulated medical tourism industry.

The speakers said inter-parental child removal from one country to another is not defined in any Indian legislation and is not specified as an offence under any statutory law.

The problem is compounded by the fact that India is not a signatory to the Hague Convention on Civil Aspects of International Child Abduction, 1980, which is acceded to by 93 countries worldwide. Hence, inter-parental child custody conflicts are invariably decided by Indian Courts on the principle of the welfare of the child as a paramount consideration in the best interest of the child.

A fugitive non-resident Indian parent declared a proclaimed offender in matrimonial proceedings may not even be able to see or talk to his children removed to India. An anguished parent armed with a foreign Court order and unsuccessful in its enforcement in India, attempts to abduct his own child in an attempt to repeat what the other parent did. They wanted a uniform line of thinking to give consistency in dispensation of justice till a legislative solution emerges.

SOME YOGA A DAY TO HELP IN THE FAMILY WAY

Some yoga a day to help in the family way

Yoga should be prescribed to women having fertility treatment to help boost their chance of conception, according to experts. A study revealed doing yoga for 45 minutes a week for six weeks cut anxiety levels by 20 per cent. Being relaxed has previously been found to improve the likelihood of conceiving. Based on results found by researchers at the Fertility Centres of Illinois, experts said that yoga could also help reduce the number of couples quitting IVF because of the stress. Dr Jennifer Hirshfeld-Cytron, who led the study at the Fertility Centres of Illinois, described the findings as "exciting".

She added, "We have shown a decrease in anxiety of patients that utilised the yoga program. This is particularly exciting given that others have shown a statistical increase in anxiety for infertility patients undergoing infertility treatment. In the US, cost remains a top reason couples stop infertility treatment, but close behind remains emotional distress. We believe yoga can help to alleviate this stress and allow couples to stay in treatment."

Yoga is an ancient form of exercise that focuses on strength, flexibility and breathing to boost physical and mental wellbeing. The main components of yoga are postures and breathing. The practice originated in India around 5,000 years ago. Fertility expert Dr Stuart Lavery, from the Department of Reproductive Medicine at London's Hammersmith Hospital, described the findings as "promising". He added, "Anything that helps patients cope during a difficult and stressful time can only be good."

ART Bill may close doors to surrogacy for foreigners

With the Centre’s proposed Assisted Reproductive Technology (ART) Bill likely to be tabled in the winter session of Parliament, foreigners and those not included in the “couple” category may be unable to avail the services of an Indian surrogate.

Simply put, the Bill narrows the services to Indian couples or a foreigner married to an Indian citizen. This will put the brakes on the surrogacy business, which currently stands at Rs. 900 crore and is a growing industry.

Also, by defining a couple as a married man and woman, the proposed Bill shuts the door on homosexuals and people in live-in relationships.

“Surrogacy is a method of assisted reproduction. The Assisted Reproductive Technology (ART) industry has evolved into a multi-billion rupee industry. India is internationally known as a booming centre of a fertility market. The industry is growing fast because of cutting-edge technology, trained medical staff, availability of rented wombs, and the fact that it offers very competitive pricing,” said Dr. Rita Bakshi, a member of the Indian Society of Third Party Assisted Reproduction (INSTAR).

India is among a handful of countries — which includes Georgia, Russia, Thailand, Ukraine and a few States in the US — where women can be paid to carry a couple’s genetic child through a process of in-vitro fertilisation (IVF) and embryo transfer.

Dr. Bakshi added that if the Bill comes into force, fertility tourism in India will slip to the back seat.

“At present, close to 20 per cent of the intended parents seeking surrogates in India are foreigners. The Indian surrogacy market is pegged to be around Rs. 900 crore. According to a 2012 study by the Confederation of Indian Industry (CII), around 10,000 foreign couples visit India to commission surrogacy,” said Dr. Bakshi.

According to fertility experts, “transparency, ethical guidelines, regulated environment and enhanced clinical practice are the need of the hour”. They say that the business, driven by sound medical facilities, is based on simple economics.

Mr. Vivek Kohli, who runs Baby Joy IVF Centre, says the proposed Bill will lead to discrimination among Indian and foreigners and directly affect medical tourism in India.

“These days India has become the hub of medical tourism. People travel from across the world for medical treatment. If organ transplant is fine, then why this double standard for surrogacy?” Mr. Kohli asks.

However, some people have come out in support of the proposed Bill. Dr. (Brig) R.K Sharma, HOD at IVF Primus Super Speciality Hospital said: “We are fortunate that we are in this noble work where we can provide the joy of parenthood to people not only from our own country, but from people all around the world. But, indirectly it creates a negative impact about our country that our women are so poor that they rent there womb for survival. If this is banned, it would be beneficial for our image.”

Many legal experts also feel that it is “poverty, illiteracy and the lack of power that women have over their own bodies”, which is the driving force behind the surrogacy market.

Women rights groups, too, believe that the draft Bill is a step in the right direction as it will end the present confusion and help regulate the functioning of IVF centres, besides ensuring quality checks and accountability of ART clinics.

“It will also be a step forward in protecting the interest and health of the surrogate mother,” says the All India Democratic Women’s Association (AIDWA).

Dr. Richa Sharma of INSTAR, meanwhile, said that what the industry needed was a strong regulation “to streamline the ART process and stop unethical practices being carried out”.

“Often we have heard episodes of harvesting of multiple oocytes for egg extraction, implantation of multiple embryos, and the practice of embryo donation or sharing. All of these require women to undergo hormonal interventions. It is exploitation that needs to be stopped, not services,” she said.

Foreigners may no longer hire wombs in India

Foreign national couples may no longer be able to choose India as their destination to bring them the joy of parenthood. The government, in its newly-drafted Assisted Reproductive Technology (ART) (Regulation) Bill, 2014, has proposed to bar foreigners from commissioning surrogacy in India.

Instead, the government has proposed allowing surrogacy only to couples who live together legally as per the Indian Consititution — Overseas Citizens of India (OCI), People of Indian origin (PIO), Non-Resident Indian’s (NRIs) and a foreigner married to an Indian citizen.

Contrary to the recommendation of the Women and Child Development (WCD) ministry, which had earlier proposed the health ministry to widen the definition of “couples by allowing surrogacy to everyone who wants to avail ARTs and surrogacy, irrespective of marriage”, the new draft remains quiet on live-in relationships, unmarried couples and single parents.

According to the draft, being put up for suggestions and comments by the Department of Health Research under the Union health ministry, OCIs, PIOs and foreigner married to an Indian citizen, commissioning surrogacy in India shall be married and the marriage should have sustained at least for two years.

They will have to submit a certificate conveying that the woman is unable to conceive their own child and the certificate shall be attested by the appropriate government authority of that country.

Those seeking surrogacy will also have to appoint a local guardian who shall be legally responsible for taking care of the surrogate during and after the pregnancy etc.

As per the draft if OCI, PIO and a foreigner married to an Indian citizen seeks sperm or egg donation, or surrogacy in India, and a child or children are born as a consequence, the child or children, even though born in India, shall not be an Indian citizen but shall be entitled to Overseas Citizenship of India under Section 7A of the Citizenship Act, 1955.

The draft also proposed that only Indian citizens shall have a right to act as a surrogate, and no assisted reproductive technology bank or assisted reproductive technology clinic shall receive or send an Indian woman for surrogacy abroad. The draft also states that no ART procedure shall be performed on a man and a woman below the age of 23 years and above the age of fifty years in case of women and 55 years in case of men.

According to the new draft, surrogate mother shall be an ever married Indian woman with minimum 23 years of age and shall have at least one live child of her own with minimum age of three years. “No woman shall act as a surrogate for more than one successful live birth in her life and with not less than two years interval between two deliveries. The surrogate mother shall be subjected to maximum three cycles of medications while she is acting as surrogate mother,”says the draft copy.

In the event that the man intending to act as sperm donor is married, the consent of his spouse shall be required before he may act as sperm donor, it adds.

The draft makes it mandatory for all those commissioning couple including OCI,PIO, NRIs and foreigner married to an Indian citizen who have availed of the services of a surrogate to accept the custody of the child or children irrespective of any abnormality that the child or children may have. “Commissioning couple shall submit a certificate indicating that the child/children born in India through surrogacy is/are genetically linked to them and they will not involve the child/children in any kind of pornography or paedophilia,” it further says.