Desperate mothers fuel India's 'baby factories'
Desperate mothers fuel India's 'baby factories'
'Even grandmother can be mother' at unregulated clinics
— Anoop Gupta slumps in his swivel chair and surveys what the day has
brought his Delhi fertility clinic: a rich housewife who wants to check
on the pregnancy of her 21-year-old peasant surrogate; a rural farming
couple, both past middle age and seeking an heir after their son was
killed in an accident, who need an egg donor; a mother of a
developmentally delayed teenager shepherding the surrogate carrying the
quadruplets that will maximize her chance for a "normal boy;" a British
IT consultant who needs a hormone injection as part of in-vitro
fertilization that would cost five times more back home; a Montreal
woman who wants profiles of egg donors; and a Toronto mother of two
toddler girls who wants a male embryo implanted.
It's a regular day in his packed and humming clinic, where poor women in
bright saris and tribal jewellery wait beside women whose vast Louis Vuitton
handbags spill over the sides of their chairs.
When 60-year-old Ranjit Hayer gave birth to twins in Calgary two weeks
ago - babies conceived with donor eggs collected, fertilized and implanted
in India - the news caused an uproar in Canada.
A woman of Ms. Hayer's age would not be treated at a Canadian
assisted-reproduction facility; she suffered potentially life-threatening
pregnancy complications linked with her age, and her children were seven
ut here in his thriving Delhi clinic, Dr. Gupta often sees 10 women like Ms.
Hayer before lunch. His clinic literature boasts of 500 post-menopausal
pregnancies; "even grandmother can be mother," it says.
Canadians may have been caught off guard by Ms. Hayer's imported embryos, but
in the global community of infertility, India is the salvation destination, the
country where an unregulated reproductive-technology sector makes anything
possible. Mr. Gupta's practice is just one of an estimated 150 clinics across
India offering assisted reproduction.
"Total madness is prevailing," said Imrana Qadeer, a professor of public
health at Jawaharlal Nehru University and a campaigner for regulated assisted
reproduction. "It is a totally unregulated thing ... in India the doctors get
away with a lot of things because people trust them and also there is lot of
ignorance about technologies. ... Women are vulnerable, they can be pressured,
and it's spreading like wildfire."
The surrogacy business is worth an estimated $500-million a year. And while
the private clinics in India do not provide any figures on the number of other
procedures they perform or the income they generate, no one disputes that the
baby-making business is enormously lucrative. Behind the counter at Dr. Gupta's
Delhi IVF & Fertility Research Centre, a staff member sits counting huge bricks
of rupees; the lineup to pay for drugs or scans or embryos snakes all the way
down the staircase.
Dr. Gupta, a genial workaholic with a zealot's admiration for the
possibilities of assisted reproduction, considers himself a sort of Santa Claus
figure. He promises the endless stream of anxious women that his success rate is
about 50 per cent, that they too will have babies. "I feel very happy, very
satisfied - if you see so many happy patients who are blessed - they cannot
forget you in a lifetime."
But with the babies come a passel of ethical questions. How old a mother is
too old? Who looks out for the rights of surrogates, who are usually poor women,
often unable to read the contracts they sign with a thumbprint? Where is the
line between commissioning an embryo to avoid passing on hereditary disease, and
Patients are drawn to Dr. Gupta's clinic, in an upscale quarter of the
capital city, because they have heard he has the best success rates. But if he
turns them away - too old, too poor - there are plenty of alternatives. Patients
report hearing of other clinics where the doctor will inseminate a woman who is
65, will let a woman carry triplets, will find a surrogate they can afford.
Dr. Gupta said 10 per cent of his clients are foreign; most are like Ms.
Hayer, people of Indian origin now living abroad. His clinic has policies, as
all are supposed to, under a non-binding directive from the Medical Council of
India: he said his cut-off age for women bearing children is 50.
But minutes later he happily reported on the case of a 59-year-old woman in
whom he implanted embryos the day before; he made her walk 10 kilometres a day
for a month to prove she was fit enough. "You could not say she is 59 from
looking at her, her system is immaculate."
Does he have qualms about creating a mother that old - who may not even live
to see her child into adulthood? "These days, children want to leave their
parents by the time they are 15 anyway," he chirped.
"I considered turning that couple away but I thought it would be giving them
stress rather than happiness, so that's why I did it."
Dr. Gupta, who works with his wife, Alka Gupta, the clinic's "chief
embryologist," is particularly excited about the chance to offer donor egg
embryos or surrogacy to women whose first-born children have some sort of
congenital problem. "All these people with abnormal babies - thalassemia [a
blood disorder], juvenile diabetes, a Mongol child [Down syndrome]," he
enthused. "We can help them."
Surrogacy for foreign parents attracts the most attention in India; the
practice was pioneered by a Gujarat doctor named Nayna Patel in 2003. Her clinic
in the small town of Anand has an adjacent hostel where dozens of village women,
many seeking a way to pay to educate their own children, wait out their
pregnancies, hot and bored, before they deliver babies for North Americans and
Europeans. The total cost is about $10,000, compared with $50,000 to $70,000 in
the United States. (Commercial surrogacy is illegal in Canada).
"These surrogate mothers are just being kept there like baby factories," said
Nandita Rao, a lawyer pushing for regulation of the fertility industry. "The
women are just sitting there producing that child with no rights on that child
and no rights on their health - the contract says if you don't produce the
child, you don't get the money - so they go on with a pregnancy no matter what
[the risk] and there is no maximum number on the times they can do this. In
India, which is so fiercely patriarchal, many families are using their
daughters-in-law as baby-churning factories."
Many of the best-known Indian fertility clinics offer a roster of surrogate
profiles from which to choose. Better educated women command a higher price -
perhaps a $7,000 fee, compared to $3,000 for a village woman in Gujarat. The
buyer also pays medical and living costs.
One of Dr. Gupta's clients, Anita, a Delhi private-school teacher who didn't
want her surname published, found her surrogate through an ad in a women's
magazine. At 38, she had failed at IVF herself and sought a young woman to carry
a baby made with donor eggs and her husband's sperm. The ad was placed by the
surrogate's husband; the woman, Puja, 21, said quietly that she didn't like the
idea and it took her three months to agree, that she gave in because her
father-in-law has left the family with debts that they must pay. She has two
small children of her own. Anita comes to hover over her ultrasounds; asked how
Puja felt about carrying the twins developing in her womb, Anita replied
blithely, "Oh, we haven't told her yet."
A year ago, Anita had another surrogate pregnancy under way with a woman she
brought to stay at her home, but six months in, Anita began to suspect the
surrogate was stealing. "We lost confidence in her, so we terminated that
pregnancy," she said calmly.
It is part of the standard Gupta clinic surrogacy contract that a surrogate
must terminate a pregnancy if the doctor directs her to do so. "We were more
careful choosing someone this time," Anita added.
Yet if surrogacy is getting the most attention, much more of the other forms
of assisted reproduction are going on here - for example, egg donation has shot
up with the economic downturn, Dr. Gupta said.
Dr. Gupta won't allow clients to select the gender of their babies, but there
are few other requests he will turn down. "Everyone can afford surrogacy," he
said; many of his clients are rural farmers or the urban poor, people who have
borrowed money or sold land to pursue IVF. "They feel they are nothing without a
child," he said. "I ask, 'Can you sell [an acre]?' Invariably the reply is yes.
'Then you can get a baby.' "
The Satyanarayans had no qualms. They are seeking a son to replace their
teenage boy who died last year. "We have land and we want someone to have it
when we go," Satyabati Satyanarayan said a few minutes after Dr. Gupta assessed
her readiness for the donor eggs they will pay $6,500 to have fertilized and
While a Canadian IVF clinic will not implant more than two embryos in a woman
under 37 for fear of creating a multiple-gestation pregnancy, Dr. Gupta's policy
is less strict. "You can get a 40-50 per cent success by implanting three or
four, and if they are multiple, we reduce the number - if more than two is [not
desired]," he said. "Except with Muslims - they make a fuss [about aborting some
of the embryos]."
He said that while he has created only four sets of triplets, his clients
have given birth to more than 1,000 sets of twins. "It's a two-for-one bonus,"
he said with a grin.
Dr. Gupta sees 100 patients each day; counselling for assisted reproduction
consists of a few minutes of chat with women about their options to maximize the
chances of pregnancy. Upstairs, his wife merges the eggs he harvests in the
early morning with sperm collected from sheepish men emerging from a room with a
selection of DVDs. In her spotless lab, the only quiet place in the teeming
three-storey clinic, dozens of embryos grow each day. Downstairs, her husband
decides who will get them. "There is no regulation, so you do the most ethical
thing you can," he said.
Assisted reproduction includes a host of procedures and techniques, some
common and some still experimental. These are among those offered in Indian
IN VITRO FERTILIZATION
This is one of the most commonly used procedures. A woman's eggs are combined
with a man's sperm in a dish in a laboratory. Once fertilization has occurred,
the resulting embryos develop for 3 to 5 days before being placed in a woman's
A man's sperm is placed into a woman's egg with a microscopic needle, rather
than many sperm positioned close to the outside of the egg, as in IVF, in a dish
in a lab. Once fertilization occurs, the resulting embryo is placed in a woman's
DONOR EGG OR EMBRYO
An egg donated by one woman is mixed with a man's sperm and the resulting
embryo is implanted in another woman's uterus. This procedure also can be done
with a donated embryo.
One woman agrees to carry an embryo to term and give the baby to another
woman after birth.
In a lab, one of the outer layers of an early embryo is perforated by
chemical, mechanical, or laser-assisted methods to assist in implantation of the
embryo in the uterus.
IN VITRO MATURATION
A process that matures a woman's eggs in the lab, rather than naturally in
Commentary by the Ottawa Mens Centre
Just one little problem, most men in any western country know that if they
donate sperm, odds are there is going to be a child growing up without a father
and increasingly, most men are revolted by the idea and refuse. That means, you
will see white Caucasian same sex couples giving birth to a mixed race child or
a child that looks nothing like his or her biological parents.
Canadian family courts are increasingly saying that DNA means next to nothing,
one little problem with that is, at the same time, mothers go to court and
regardless of the father's willingness to be an unwitting sperm donor he will be
ordered to pay support. At the same time, any father who finds out he is not the
father but has spent time with the child will be found to have acted as the
parent, to fund the mother. That is if you are a mother, you have the law
working for you regardless of dna, regardless of how much you flagrantly abuse
the child's right to a relationship with both biological child.
Canada is turning into a sick society, where DNA means next to nothing, a
child's biological relationship with parents apparently also means diddly squat
unlike the USA and other countries.
Our society is likely to get even more ethically and morally corrupt before
society understands that the lack of ethics and morals has resulted in a
negative birth rate that is probably the greatest long term economic threat to
Canada than any depression.
The only solution is a legal presumption of equal parenting after separation and
the recognition that a child has a right to know his or her biological parents
absent extraordinary circumstances.