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Society
Want A Baby? India Beckons
by Taru Bahl
An advertisement which
said "Choose from a bevy of healthy super-ovulated women to make your
family complete" encouraged Audrey and Derek (names changed), residents
of New Castle, UK, to go doctor shopping for a baby across four
continents. Finally, they zeroed in on Dr Aniruddha Malpani, who runs
the Malpani Infertility Clinic in Mumbai.
Audrey was on the verge of a nervous breakdown, having gone through
multiple cycles of fertility treatment without any results. The couple
had spent nearly 50,000 pounds in the eight years that they had been
desperately trying for a baby. From swanky doctor studios they had even
done the rounds of astrologers, herbal doctors and miracle-promising
mendicants, driven by a single-minded obsession to become parents the
biological way. This cycle of hope-disappointment-hope was finally
broken when they had Derek Jr. through In-Vitro Fertilization (IVF)
treatment in Mumbai.
Audrey and Derek are one of the many childless couples who come to India
with the hope of going back home with their very own bundle of joy.
Fertility tourism is big business now - the industry reportedly brings
in hundreds of millions of dollars into the county. In fact, reports
also suggest that the number of such cases has more than doubled in the
last three years. The reasons: pocket-friendly treatment, world-class
heath care facilities, a large base of English-speaking doctors,
relatively fewer legal hurdles... the list is long.
Dr Vibha Bansal, a Delhi-based gynecologist, elaborates, "Fertility
tourism has received a great deal of media attention of late. The cost
of IVF in the West is astronomical and countries enact laws that
drastically curtail women's access to assisted reproduction. However,
countries like Thailand, Russia, China and India, where such treatments
are easily accessible, see people not only from the developed world
seeking treatment but also from places like Nepal, Bhutan and
Afghanistan, where such options either do not exist, entail long waiting
periods or are not of a satisfactory quality." She adds that the
government has made things easier by not cluttering the space with too
much legalese.
According to Dr Malpani, "IVF, embryo adoption and egg donation are very
popular and a major reason for this is its cost effectiveness." Take a
look at the monetary contrast: At private clinics in the US, which do 70
per cent of all IVF treatment, costs can run up to $18,000 a cycle.
Indian clinics offer the same at around $7,200. And to make the deal
even more irresistible, many fertility centres offer package deals,
throwing in plane tickets and hotel stay as well.
Other than the cost factor, Dr Malpani believes "foreigners choose India
because doctors here are known to be more caring". Also, while British
clinics may allow doctors to implant only two embryos in a surrogate's
uterus, in India this can go up to six embryos at a time - increasing
the chances of conception. But Dr Amudha Hari, Consultant Gynecologist
and Laparoscopic Surgeon in Chennai, doesn't see this as positive
development. She believes that there will always be doctors who agree to
treat women deemed too old or too overweight by western standards for
IVF, never mind the resultant medical complications. Which is why a
patient must do a thorough recce and demand to get all his/her questions
answered before going in for treatment. "Infertility is like a chronic
illness and couples invest a lot of time, energy and money to fulfill
their desire of building a family," says Dr Hari.
After three failed rounds of IVF treatment, Bhaskar and Anita, Non
Resident Indians (NRIs) in the US, found the answer to their problem in
an advertisement. It led them to Nisha, 23, from Nagapattinam, Tamil
Nadu, who was willing to be a surrogate. Everything seemed compatible,
she was of the same build and skin color, except for the fact that she
was not married. The issue posed an ethical dilemma for the couple but
it was resolved when they were convinced that she was not under any
duress but wanted to fund her education to be a nurse. Anita sent her Rs
20,000 every month until the baby was born. She even monitored Nisha's
diet and doctor's visits. Their son Rohan's birth, says Anita, was
"nothing short of a miracle. We had lost all hope of becoming parents
and are now considering having another child after three years, the same
way."
Infertility treatments, whether through IVF or surrogacy, creates
families. In the process, they also help surrogates find stability in
life. In fact, surrogacy has helped poor people pay off debts and get
out of the vicious cycle of poverty and, in Nisha's case, get her an
education.
But, unfortunately, this exercise is not all about gains. If driven
solely by commercial interests, fertility treatments can have dangerous
consequences. There is always the question of high-risk pregnancies.
Sometimes women have to go through repeated surrogacies, getting
injected with hormones and the like without proper medical surveillance.
All this means compromising dangerously with their health.
Dr Hari recalls a case where a woman in a Mumbai slum had been pushed by
her husband to attempt surrogacy for the 18th time. The husband had made
this into a kind of domestic enterprise, albeit a failed one, since the
poor woman suffered from tuberculosis and was unable to deliver a child
successfully. Luckily, a local NGO got a wind of what was going on and
took her into a rehab where she is now recovering.
Besides the health risks, there is the issue of adoption. "The many
steps involved in adoption once the child is born can be a problem,"
says Dr Hari. The Indian Council of Medical Research has not issued any
guidelines to help deal with foreign clients using Indian surrogates. So
the child has to be adopted under Indian law and all procedures outlined
in the Hague Convention on inter-country adoption have to be adhered to.
Experts are quick to point out that the global capital generated by the
burgeoning fertility tourism market may thwart any concerted
international response to the inequities and exploitation that arise in
this context.
The key to ensuring that the treatment process is relatively hassle-free
is to choose the right clinic, one that lays down protocols and
guidelines, advises Dr Hari. Doctor shopping can be a very taxing
experience. However, a welcome trend is the easy availability of
information on the Internet, making it possible for potential clients to
connect with doctors and seek referrals. Blogs and e-mail are handy
tools in this regard.
However, Dr Abha Majumdar, Head Ultrasound at the IVF Unit in the New
Delhi-based Sir Gangaram Hospital, believes that the entire fertility
tourism debate is over hyped. She says that the majority of those
reaching out to her or those referred from other clinics are Indians
(including NRIs) - foreigners make up just 10-15 per cent of that
number.
May 31, 2009
By arrangement with
WFS
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