Thursday, 10 December 2015

Litter of seven puppies are first born through IVF

Nineteen embryos, seven pregnancies, one female beagle ... scientists say procedure could save endangered species and prevent genetic disorders.



From the paint on their toes and the tips of their tails, the puppies stand out as unusual. But the litter of seven will go down in history for more than the colours that tell them apart. Now five months old and doing well, the dogs are the first to be born through IVF.
The healthy delivery of the dogs by caesarean section on 10 July marks a success that has eluded scientists for 40 years since efforts began in the mid-1970s. The procedure could transform attempts to save endangered dog species, and potentially help prevent the genetic disorders that afflict so many breeds.
Born to the same beagle mother, the puppies included two produced from a different beagle mother and a cocker spaniel father, and five from two other pairings of beagles. The seven pregnancies came after 19 IVF embryos were transferred to the mother, according to a report in Plos One.
“We had people lined up, each with a towel, to grab a puppy and rub them and warm them up,” said Alex Travis, a specialist in reproductive biology at Cornell University, in Ithaca, New York. “When you hear that first cry and they start wriggling a bit, it’s pure happiness. You’re ecstatic that they’re all healthy and alive and doing well.”
The team used small daubs of coloured nail varnish to tell the dogs apart. Since they were born, all but one has been adopted. Their names are Ivy, Cannon, Beaker, Buddy, Nelly, Red and Green. Travis gave a home to Red and Green, and while Red’s name honours the informal name for the Cornell sports teams, Travis says Green has yet to be renamed because his children cannot reach a consensus. Nelly will be homed after she has had her own litter of puppies.
The struggle to make IVF work in dogs is down to the curiosities of the canine reproductive system. Dogs ovulate only once or twice a year and the eggs they release are very immature. They are also unhelpfully dark, thanks to fatty molecules inside them, making them hard to work with under a microscope. The list of problems goes on.
Travis and his colleaues first worked out how to obtain eggs that were mature enough to fertilise. The solution turned out to be leaving the eggs in the dogs’ oviducts – the canine equivalent of human fallopian tubes – for a day longer than usual, allowing them to reach a later stage of natural development.
The next hurdle was mimicking the effect of the female reproductive tract, which prepares incoming sperm for fertilisation. Jennifer Nagashima and Skylar Sylvester, researchers in Travis’s lab, found that adding magnesium to the sperm culture did the job. With those two changes, the scientists achieved fertilisation rates of better than 80%.
The final part of the process was to freeze the embryos, so they can be stored until the surrogate mother is at the right stage in her reproductive cycle. Travis had worked out how to do this before, and in 2013 oversaw the birth of the first dog, named Klondike, from a frozen embryo.
Travis said the breakthrough could help conserve threatened and endangered species of dogs in captivity. “If you are managing a species such as the African painted dog, and a male dies, you can collect sperm. And if a female dies, you can collect ovarian follicles from the ovaries and try to mature oocytes in vitro. But then what? To be able to use these resources, you need IVF to be able to produce an embryo from the sperm and eggs,” he said.
Travis added: “Because dogs share so many genetic traits and diseases with people – over 350, which is vastly more than any other species – this technique also gives us new opportunities both to study genetic disease, and with gene editing, potentially prevent it from happening. This will have important implications for both veterinary and human medicine.”

Source: http://www.theguardian.com

Monday, 7 December 2015

Should the NHS pay for womb transplants?

The first womb transplants are due to take place in 2016. The experimental programme could allow 10 women with damaged or missing uteruses to give birth. If successful, the procedure is likely to be made available to more women who suffer from this particular type of infertility. But should such operations be made available freely on the NHS?

Another argument is that the NHS shouldn't spend money on treating
 because it isn't a disease. This view is out of line with most official classification systems – but some people remain sceptical. One reason for this is that infertility only harms people who want children. People sometimes think of alleviating infertility as being more a way of satisfying a desire for a certain lifestyle than of treating a disease.There are a number of arguments that people who feel uneasy about this prospect might make. One seemingly obvious objection that can be applied to publicly funding any fertility treatments is that they don't save lives. But this argument simply doesn't work. Some of the most important things the NHS does are quality-of-life interventions such as cataract operations, hip replacements and general pain relief. So the fact that fertility treatments are designed to improve rather than extend lives doesn't make them different from widely accepted NHS procedures and isn't a reason not to fund.
But while infertility is only directly harmful to those people who want children, that doesn't mean that it can't be a disease. Whether something is a disease is partly a matter of whether the person's body is functioning as it normally would at any given stage of their life. So we expect a 25-year-old woman's body to be capable of conception and pregnancy – if it is not, this is a pathological state, regardless of whether she wants children. Unwanted infertility can also have very serious psychological side-effects such as anxiety, depression and stress.
Overpopulation
Another approach is to argue  shouldn't be provided because of overpopulation. World population grew from 1.6 to 6.1 billion during the 20th century and, as well as pressures on food and water supplies, increasing global population makes it ever harder to tackle climate change. Therefore (so the argument goes) it would be incoherent for governments to expend resources tackling  while at the same time spending public money on what is, in effect, creating extra people.
But restricting infertility services is unlikely to be a fair or effective means of achieving environmental goals. Treating infertile couples makes a comparatively small contribution to population size. In the UK in 2012, just 2% of births resulted from IVFand the figure for womb transplants would only ever be a tiny fraction of this.
Then there are questions of fairness. People who are biologically infertile are suffering from a medical condition that our health system has the technical ability to treat. Given this, denying them such treatment on environmental grounds seems ethically problematic. It would arbitrarily single out people with a particular disability (infertility) and require them to bear costs others don't face. They would then either have to fund treatment themselves or, if they can't afford it, be deprived of the opportunity to be a parent. Whereas if everyone paid evenly spread environmental taxes instead, no single person would need to bear such a high cost.
Adoption and surrogacy
Another suggestion is that, just as paying for everyone to have gold fillings rather than cheaper alternatives would be a waste of NHS resources, womb transplants are a wasteful solution to infertility when adoption and surrogacy arrangements are possible alternatives. But are these really adequate alternatives? Certainly not for those women who attach great value to the experience and process of pregnancy and childbirth.
In any case, adoption and surrogacy can be problematic. Potential adopters must often be willing and able to parent older children, missing out on the early months and years of development and precluding the chance to have their own "genetic child". Surrogacy arrangements, meanwhile, are not legally enforceable in the UK – the surrogate mother can choose to keep the baby even if they are not genetically related. The ban on payments also makes it harder to find willing surrogates.
As with any medical treatment, womb transplants must first be shown to be cost-effective and safe. But if this can be done, there is no good reason to rule out NHS funding.

Source: http://medicalxpress.com/

Unheard story of surrogate mothers

29-year-old Lakshmi hails from a remote village in Anantapur and is a victim of the ills that any woman born into a poor family in India can suffer. She had rented her womb once for the money to clear her weaver husband’s loans. Despite knowing that the process is fraught with dangers, she is ready to do it yet again, this time to get her step daughter married
Only her eyes and nose were visible. The scarf that she wrapped around her head concealed most of her features. Her moistened eyes revealed her helplessness and pain.  “The physical and mental trauma that one goes through during childbirth has repercussions beyond money. I wouldn’t want any woman driven by poverty renting her womb, if she can help it,” her simple words were conveyed in a voice choked with emotion at a panel discussion on commercial surrogacy. 
29-year-old Lakshmi hails from a remote village in Anantapur and is a victim of the ills that any woman born into a poor family in India can suffer. She has never been to school, was married off before she was a major to a maternal uncle twice her age, and is mother to two young boys of her own as well as a teenage daughter of her husband from his previous marriage.
Her husband, a weaver, is partially blind and has no steady income. “Reddy Anna”, the agent who looks for women in need of money promised to get her a princely sum of three-and-half lakh rupees, an offer that would enable her to clear her husband’s loans if she rented her womb. After the required tests were conducted at a Hyderabad clinic, she was under medical supervision.
“I was surprised to see so many women like me and was told that it was one of many centres. I was anaemic but was provided good care till the baby boy was delivered. I cried uncontrollably after giving away the child that had grown inside me. To everyone else it was just a commercial transaction almost like renting a car park,” says Lakshmi. 
All deliveries of this nature as a rule are conducted through the C-section. The surrogate mother receives no post- operative care with the entire paraphernalia disappearing as quickly as they came once the baby is delivered and bundled away to distant lands.
Like clinical trials, surrogacy is a lucrative option for most foreigners who view India as the ideal place for “reproductive tourism”.  The low cost of in-vitro fertilisation and the lack of a stringent regulatory framework to protect the rights of surrogate mothers and babies is being viewed as a serious flaw in India, one of the few countries where commercial surrogacy is legal. 
Lakshmi has seen cases where surrogates have died as a result of complications during pregnancy or inadequate post-natal care. There are also horror stories of multiple embryos being implanted in the womb for higher chances of success. The worst case scenario is where babies born with disabilities are abandoned by the biological parents.
The estimated 9 billion dollar industry is at present a boon for the tourism and hotel industry, fertility clinics and brokers like “Reddy Anna” who make enough commission to have them permanently scouting for “rented wombs”.
The Indian government is in the process of finalising the draft of the Assisted Reproductive Techniques (regulation) Bill with greater attention to the rights of surrogate mothers. The government’s decision to prevent foreigners using India as a cheap “baby market” and importing embryos is however coming under fire.
Driving the lucrative foreign market underground is fraught with risks, say experts. While the rights of “needy infertile married couples” for surrogacy termed as “altruistic surrogacy” are being accepted unquestioningly, fertility experts and women’s organisations feel commercial surrogacy definitely needs a proper legal framework and regulation.
A total ban may not be the answer, they feel. With no health insurance care or policy for children born with disabilities, poor lives are being compromised in the present state of affairs. “There is no exploitation. This is a voluntary business contract between human beings involving exchange of money,” says a fertility expert, whose practise revolves around women like Lakshmi.
The cost of having a surrogate baby for foreign couples is a round 18,000 to 25,000 dollars, a third of what it costs in a developed country like the United States and poor women are paid for their services she reasons.
The question is, do we “ban commercial surrogacy”, which is a billion dollar business and risk black market operations or ensure greater regulation and protection for our poor women? Even as the debate goes on, Lakshmi has rejected her own advice and agreed to rent her womb yet again. This time to get her step-daughter married. “I know my life is at risk. Show me an alternative way of earning this money and I won’t do this again,” she says. I have no answer at least for now and neither does the government.

Source: http://www.thehansindia.com/

New Delhi: Government for commercial surrogacy ban to guard surrogate mothers

Government has proposed to ban commercial surrogacy to prevent exploitation of surrogate mothers through a legislation, Lok Sabha was informed today.

New Delhi: Government has proposed to ban commercial surrogacy to prevent exploitation of surrogate mothers through a legislation which is under inter-ministerial consultation, Lok Sabha was informed today.

"Department of Health Research (DHR) has drafted a comprehensive legislation, Surrogacy (Regulation) Bill) which is under ministerial consultation to prevent exploitation of surrogate mothers," Health Minister JP Nadda said.

He said that government had issued notices to DHR conveying ban on import of human embryos except for research purposes and Ministry of Home Affairs asking them to not grant visa to foreign national (including Oversees Citizen of India) intending to visit India for commissioning surrogacy.

"The state governments have been asked to constitute regulatory authorities to regulate surrogacy as per the National Guidelines for Accreditation Supervision and Regulation of ART clinics issued by government in 2005," he said.

Provisions will also be made in the draft Surrogacy (Regulation) Bill to ensure medical, nutrition and overall health care of surrogate mothers in consultation with the Ministry of Women and Child Development.

Source: http://health.economictimes.indiatimes.com/

Wednesday, 2 December 2015

Needed, an Assisted Reproduction Law that Doesn’t Discriminate Against Single Women

Throughout the draft ART (Regulation) Bill, the role and importance of the husband has been over-emphasised. It debars single women from availing ART services, violating their fundamental right to procreation

Over the past few years, Assisted Reproductive Technologies (ARTs) –  a group of technologies that assist in conception – have led to the phenomenal growth in the Indian ‘fertility industry’. The ART business is an integral part of India’s booming medical market and medical tourism industry. However, there is no law so far to regulate and monitor the functioning of the ever increasing number of ART clinics. In 2005, the Indian Council of Medical Research (ICMR) issued guidelines for the accreditation, supervision, and regulation of ART clinics. However, these guidelines are not legally binding on ART clinics. Several studies and media reports have highlighted the rampant unethical and illegal practices of ART clinics where they exploit desperate infertile couples and vulnerable surrogate mothers for commercial gain.
The ART (Regulation) Bill, 2014 – now placed in the public domain by the Ministry of Health and Family Welfare for comments and suggestions – proposes to establish a National Advisory Board, State Advisory Boards and a National Registry for the accreditation, regulation and supervision of ART clinics and ART banks. The core responsibility of these regulatory bodies, according to the draft Bill, is to prevent the misuse of ARTs and ensure safe and ethical ART services. The scope is ambitious and a mammoth infrastructure with matching human resources will be needed to operationalise the proposed regulatory bodies.
In a significant move, the proposed law has placed the onus on ART clinics to prove their innocence in case of the death or disability of either the oocyte donor or surrogate mother. It has also proposed a system of graded penalties/ compensation depending on the degree of negligence. Currently, there is no system in place to address the issue of medical risks including deaths occurring during oocyte donation or surrogacy. There have been instances of deaths of oocyte donors during the procedure. In 2014, Yuma Sherpa, an egg donor for s surrogate, died just after she went through an oocyte retrieval procedure at a fertility clinic in Delhi. The proposed legislation promises to address the rampant malpractices prevalent in the ART industry.
Notwithstanding the urgent need to regulate and monitor the ART industry, the draft Bill, which embodies several problematic clauses, requires certain fundamental changes, corrections and improvements before it is made into a law. One of the major problems is that the draft Bill is premised on patriarchal values and identifies women based on the narrow definition of their marital status.
Single women shut out
Throughout the draft Bill, the role and importance of the husband has been over-emphasised. It debars single women from availing ART services, violating their fundamental right to procreation. In fact, this clause is in contradiction to the existing law which allows a single woman to adopt a child.
Similarly, the draft Bill prohibits unmarried women from becoming oocyte donors or surrogate mothers. Only married women with proven fertility can become surrogate mothers or donate their eggs. On the other hand, when it comes to semen donation there are no such restrictions on men.
In similar vein, mandatory consent of the oocyte donor’s spouse should be deleted from the Bill. A woman has her own individuality and can take decisions for herself and consent to it too. In any event, it would be discriminatory to require the woman to get consent of her spouse for donating her oocytes, when a man is not required to get the consent of his spouse for donating sperms. Further, single women – who may have never married, or be ‘ever married’ (including divorcees, widows, separated women, etc.) should also be allowed to donate under the Bill. How can such women get consent from their spouse, and why should they? These restrictive clauses, which reflect the dominant patriarchal values of our society, need to be reconsidered in favor of respecting the autonomy and freedom of women’s reproductive choices. In addition, one of the clauses of the draft Bill which prohibits a surrogate mother and her husband from having an extramarital relationship during the gestation period violates the rights of the surrogate and their family
Taint of eugenics
Certain clauses of the ART (Regulation) Bill are reflective of eugenic thinking, which has the potential to further reinforce and propagate prejudices and discriminations based on class, caste, gender and ethnicity.
Although the proposed law prohibits ART banks from disclosing the names, identities and addresses of gamete donors and surrogate mothers, it allows the commissioning couples to seek information regarding height, weight, ethnicity, skin color, educational qualification, medical history of the donor, etc. Parliamentarians need to seriously reflect on these clauses, as they have the potential to promote eugenic practices.
ARTs, including in the context of surrogacy, are highly invasive procedures which pose serious health risks to oocyte donors and surrogate mothers. It is, therefore, extremely necessary that the proposed law makes it mandatory for ART clinics and banks to inform oocyte donors and surrogate mothers about the potential health risks associated with the ART procedures. Currently the draft Bill only talks about seeking consent – which is qualitatively different from a comprehensive informed consent procedure.
The draft Bill has proposed to make the Aadhar card the primary identification document for gamete donors and surrogate mothers. The law makers should revisit this clause as it may lead to exclusion and discrimination. Making Aadhar mandatory under this law is in any case violative of the directives of the Supreme CourtThere are many identity proofs used officially, and any of them may be used as a proof. This clause should be deleted or amended appropriately,
Given the exponential growth of the ART industry in the last one decade, its regulation and monitoring has become the need of the hour. Past experiences teach us that the creation of parallel administrative and regulatory structures and bodies do not necessarily lead to better results. We have seen how the PC&PNDT Act created separate bodies and institutions to curb the menace of sex selection, whose satisfactory implementation continues to pose a huge challenge. Making a law is one thing but implementing it has always posed a serious challenge. While it is important to enact a law and create and implement regulatory mechanisms to monitor ART clinics and surrogacy arrangements, the understanding and emphasis on upholding the rights of women and children located in this industry – including egg donors and surrogates – will make the real difference.
Source: http://thewire.in/

China struggles with IVF demand as one-child policy ends

The Nanfang clinic in China's southern Guangdong province says it offers Chinese patients seeking in-vitro fertilization (IVF) the chance to choose the gender of their child, avoid stringent approval checks and snarling queues.
It has to advertise this with caution. China's strict regulation of its IVF market forbids gender selection, requires birth licenses and proof of marriage, and prohibits some more advanced procedures - rules that have pushed patients to go overseas or seek treatment in unregulated clinics at home.
Demand for IVF in China is expected to rise after Beijing scrapped its controversial one-child policy in October, which will strain already-crowded state-run hospitals but create opportunities for overseas health centers, firms helping train local doctors - and underground clinics.
"Here we can do IVF with gender selection and you don't need lots of documentation," a doctor at the Guangdong clinic surnamed Hao told Reuters, adding there had been a 50 percent jump in consultations since the one-child policy announcement.
She said many of her patients were younger women opting for IVF so they could choose a boy, a traditional preference. The doctor did not give her full name and "Nanfang" is a common name for businesses in southern China.
Beijing's tight control makes it hard for private firms to operate IVF clinics in the country, but growing demand for doctors and specialists has created other gaps in the market.
"Training to help up-skill clinicians and embryologists to treat the patients is definitely a big growth area," said Jason Spittle, global director of training at U.S. medical device maker Cook Medical, which has a reproductive health unit.
"China is set to be the biggest IVF market in the world, probably within the next couple of years."
Looking overseas
Chinese couples who have the financial means often go abroad to the United States, Australia, Thailand and Vietnam for IVF.
"The biggest driver is that there are so many hoops to jump through to get IVF treatment here," said Mr Lei, a China-based intermediary who helps patients go to Thailand, who like many Chinese was reluctant to give his full name to a reporter.
Rising Chinese demand for fertility treatments is therefore good news for overseas clinics such as Australia-based Monash IVF Group and Virtus Health or Superior A.R.T. in Thailand, where 30-40 percent of patients come from China.
"Our clinic has prepared Chinese-speaking staff to coordinate with rising number of Chinese patients," said Superior A.R.T. deputy manager Arnon Sinsawasdi, adding the end of the one-child policy should give business a boost.
IVF Australia, part of Virtus Health, plays on Chinese demand for the latest procedures with a Chinese-language website advertising its "cutting-edge technology" to help parents "achieve their dream of having a child".
"Lots of patients go to these places just because they have unique demands. For example domestically they can't do things like surrogacy or gender selection," said Li Yuan, director of reproductive medicine center at Beijing Chaoyang Hospital.
Non-commercial surrogacy is allowed in Australia, while the United States permits gender selection. Thailand, though, has been cracking down on both practices to close loopholes that have lured patients from overseas.
Overloaded clinics
Patients and doctors in China said state IVF centers were often over-stretched - little surprise given each clinic serves around 3.8 million people, compared with 700,000 people per clinic in the United States, health ministry data show.
"Clinics are so busy it's unbearable. Whichever hospital you go to it's always rammed with people," said a junior doctor at an IVF clinic in Shanghai, who asked not to be named.
This creates a market for unregulated providers, who advertise their offerings online and on social media platforms, while avoiding detection by overworked watchdogs despite a recent crackdown on the market.
"In the past few years our checks in some areas haven't been strict enough, routine oversight has been lax, and strikes against illegal behavior have fallen short," China's health ministry said in a statement in July.
"That's led to chaos in the assisted reproduction market."
Patient numbers are still climbing too. There were nearly half a million treatment "cycles" in 2013 at 356 approved clinics, compared with just under 200,000 cycles that year in the higher-value U.S. market.
Despite the growth, though, many still struggle to get access to IVF at all: poorer provinces have few clinics and many can't afford a pricetag that starts at 30,000 yuan ($4,697).
"You can't use state insurance, it's all paid out-of-pocket," said Ms Cui, 37, a financial worker in Dalian who underwent successful IVF treatment in 2013.
"I was lucky that it worked in one go, but many people try a number of times which mean it's even more expensive."

Source: http://www.thanhniennews.com

Sunday, 29 November 2015

A setback for surrogacy in India

sending my child to hostel, I will work full-time. If my husband and I work, we will be able to ensure that my child becomes a doctor and escapes this life of struggle,” she explains. “After all, we have no pension or government security in our old age. Who knows if our children will take care of us? It’s only prudent to save for the future. Motherhood and the ability to have children is a gift that nature has given to lucky women... I don’t think there is anything wrong in ‘gifting’ and ‘sharing’ this divine power and engaging in something that is mutually beneficially to all the parties involved,” she adds.

The arguments are not new. A group of surrogate mothers has moved the Supreme Court seeking a withdrawal of the November 4 circular banning foreign commissioning parents.

Grey area

Commercial surrogacy, largely an unregulated grey area, has been allowed in India since 2002. The Supreme Court (2008) called surrogacy a medical procedure legal in several countries including India. The surrogacy debate started with the Baby Manji Yamada case in which the commissioning parents divorced during the pregnancy and the commissioning mother refused to accept the baby. The court finally granted custody to the baby’s grandmother. In 2008, another case, on the citizenship of surrogate babies, led the Gujarat High Court to state that there is “extreme urgency to push through legislation” which addresses issues that arise out of surrogacy.

A draft ART Bill, pending in Parliament since 2010, is now expected to be taken up in the on-going winter session.

It is India’s first attempt at regulating the surrogacy industry which was earlier guided by the National Guidelines for Accreditation, Supervision and Regulation of ART Clinics in India, 2005, and subsequently amended in 2008, 2010 and 2013.

It is being seen as a setback for commissioning parents. After being married for over a decade, Dr. R, a British passport holder and a gastroenterologist of Indian-origin came back to India to “complete his family”.

“Adoption wasn’t an option,” says Mrs. L as she hugs her newborn child. Now a mother after a year of the surrogacy process was initiated at a Delhi clinic, she is very clear about why she and her husband came to India. “The country offers the best in terms of medical advancement, it’s reliable, cheap and world class. Besides, surrogate mothers are available here in India which isn’t the case in most parts of the world.”

Almost all surrogate mothers and commissioning parents this correspondent spoke to agree that foreign surrogacy should not be stopped. The association of medical practitioners providing fertility treatments are concerned that the government, instead of effecting better regulation, has imposed a blanket ban on a section of customers. Dr. Shivani Sachdev Gour, secretary, Indian Society for Third Party Assisted Reproduction (Instar) said, “We feel the new restrictions are too binding. You have to understand that surrogacy needs a more humane approach and more individual case-by-case attention. We cannot have a single blanket rule to govern the ethical and legal nuances of surrogacy.”

But women’s rights organisations say that “poor” women should not be exploited in the name of noble work. Dr. Ranjana Kumari, director, Centre for Social Research said, “There are many issues besides sex selection and exploitation of the poor surrogate mothers. There are countries that do not allow surrogacy. What would the nationality of the child be when the intended parents are from that country? About 48 per cent couples opting for surrogacy are foreigners.”

Dr. Kumari notes that surrogates aren’t given their due. “Though the couple who wants to have a baby through a surrogate mother pays anything between Rs.2 lakh to Rs.5 lakh to agents, the woman who delivers the baby gets only Rs.75,000 to Rs.1 lakh,” she says.

Cheap medical facilities, advanced reproductive technological knowhow, coupled with poor socio-economic conditions and a lack of regulatory laws in India are what make India an attractive option.

In India, the business of providing “wombs on rent” is now valued at $500 million. The number of cases of surrogacy is believed to be increasing at a galloping rate,” says Dr.Kumari.

Indian Council of Medical Research (ICMR) data says that approximately 2,000 babies are born every year through commercial surrogacy. Confederation of Indian Industry (CII) figures claim that surrogacy is a $2.3 billion industry in India, because it is largely unregulated and cheap. Clinics function in tight cliques; unrelated centres like dental clinics sometimes assist fertility clinics, say experts.

ICMR says that professional surrogates need to “protected against exploitation”. A senior official said, “We hope to ensure accountability of the ART banks and ensure that the malpractices — private clinics advertise for surrogates and the money paid is arbitrary — is eliminated altogether. Also, [the] rights of the commissioning couples will be protected and the industry will be streamlined and brought under the preview of proper rules and regulations.”


Source: http://www.thehindu.com/


NZ couple in surrogacy baby mix-up

WELLINGTON - A New Zealand couple who travelled to Thailand to have a surrogate child had their embryos swapped in a mix-up at a fertility hospital and were given someone else's child.

The couple — referred to as Mr and Mrs N — say they love their adopted son "like one of their own" and have become legal guardians after a torturous inter-country adoption process. 

But Mr N said their attempts to find out what happened to their eggs have been met with silence — and intimidation — from the hospital. Mr N is calling on anyone who has been through fertility treatment... 

Mr N is calling on anyone who has been through fertility treatment five years ago in Thailand to check they haven’t been caught up in the mistake. 

The couple went for IVF treatment at the hospital in 2010, and in April 2011, what they thought was their child was born to a surrogate mother. When they went for a DNA test to satisfy New Zealand Immigration... 

The couple were then refused access to the child's birth records by the hospital, which feared negative publicity. They were forced to sign a settlement to get the necessary paperwork to bring the baby... 

Four years later, and with the child, who they have nicknamed "Nemo", finally obtaining New Zealand citizenship, the father finally feels secure that their child cannot be taken from them. 

It is only now they feel they can speak out about their ordeal, in the hope they can find Nemo's biological parents, and also discover if they have a child out there. "I do believe my flesh and blood... 

"I do believe my flesh and blood is out there somewhere. Three embryos don't just disappear." 

The father, who asked not to be named to protect his children’s privacy, said the emotional, physical and financial toll the case has taken on his family has been extreme. 

He recalls hearing that the DNA samples didn’t match. 

"I was like, 'what’s going on here?' Straight away I was on the phone to the lawyers ... they were trying to calm me down. There must have been a mistake." 

Still reeling from the shock, they completed another test — then tried two more DNA testing companies. All the results came back the same. 

He said the family were pressured into striking a deal with the hospital to be paid about 2.8 million baht, and waive any rights to prosecute or sue the hospital. 

"They basically screwed us," he said. "My wife was distraught, she was stuck in Thailand. We were told you can’t prosecute them criminally. They said it was best for our lawyers to step aside, and they... 

"There was a verbal threat made to my wife. They said: ‘I don’t want to revisit this again, and if anything ever comes out about this again, I know people who will make your lives very difficult.'" 

"There was a verbal threat made to my wife. They said: ‘I don’t want to revisit this again, and if anything ever comes out about this again, I know people who will make your lives very difficult.'" 

It is only now they feel they can speak out about their ordeal, in the hope they can find Nemo's biological parents, and also discover if they have a child out there. "I do believe my flesh and blood...

"I do believe my flesh and blood is out there somewhere. Three embryos don't just disappear."

The father, who asked not to be named to protect his children’s privacy, said the emotional, physical and financial toll the case has taken on his family has been extreme.

He recalls hearing that the DNA samples didn’t match.

"I was like, 'what’s going on here?' Straight away I was on the phone to the lawyers ... they were trying to calm me down. There must have been a mistake."

Still reeling from the shock, they completed another test — then tried two more DNA testing companies. All the results came back the same.

He said the family were pressured into striking a deal with the hospital to be paid about 2.8 million baht, and waive any rights to prosecute or sue the hospital.

"They basically screwed us," he said. "My wife was distraught, she was stuck in Thailand. We were told you can’t prosecute them criminally. They said it was best for our lawyers to step aside, and they...

"There was a verbal threat made to my wife. They said: ‘I don’t want to revisit this again, and if anything ever comes out about this again, I know people who will make your lives very difficult.'"

"There was a verbal threat made to my wife. They said: ‘I don’t want to revisit this again, and if anything ever comes out about this again, I know people who will make your lives very difficult.'"

It is only now they feel they can speak out about their ordeal, in the hope they can find Nemo's biological parents, and also discover if they have a child out there. "I do believe my flesh and blood...

"I do believe my flesh and blood is out there somewhere. Three embryos don't just disappear."

The father, who asked not to be named to protect his children’s privacy, said the emotional, physical and financial toll the case has taken on his family has been extreme.

He recalls hearing that the DNA samples didn’t match.

"I was like, 'what’s going on here?' Straight away I was on the phone to the lawyers ... they were trying to calm me down. There must have been a mistake."

Still reeling from the shock, they completed another test — then tried two more DNA testing companies. All the results came back the same.

He said the family were pressured into striking a deal with the hospital to be paid about 2.8 million baht, and waive any rights to prosecute or sue the hospital.

"They basically screwed us," he said. "My wife was distraught, she was stuck in Thailand. We were told you can’t prosecute them criminally. They said it was best for our lawyers to step aside, and they...

"There was a verbal threat made to my wife. They said: ‘I don’t want to revisit this again, and if anything ever comes out about this again, I know people who will make your lives very difficult.'"

"There was a verbal threat made to my wife. They said: ‘I don’t want to revisit this again, and if anything ever comes out about this again, I know people who will make your lives very difficult.'" 
The doctor said they had been unable to contact a couple who had an embryo transfer on the same day as their surrogate, and added "it might not be wise to pursue DNA testing of the couple".

After exhausting all further legal avenues to find out what happened, the father said they had decided to speak out to warn other families who have been through the clinic.

"Any child that went through the clinic since August 2010 could potentially have their eggs mixed up. It could be a sequential mix-up. I would encourage every parent to get a DNA test.

"They can contact us and we will provide a DNA test. When this gets out, every family that's been to this clinic since 2010 is going to ask: ‘Is this my child?'"

New Zealand's Ministry of Social Development director of operational risk international casework Paula Attrill said the case highlighted the "considerable risks" of international surrogacy. "This is a distressing set of circumstances for this little boy and his parents. Throughout, the parents have focused on the welfare and best interests of their little boy." 



Source: http://www.bangkokpost.com

Saturday, 21 November 2015

Judge forces mom to give her baby to homosexual couple: the latest case of surrogacy’s folly



LONDON, November 20, 2015 (LifeSiteNews) – A convoluted custody dispute over an artificially conceived child has left the mother bereft and homosexual and Christian activists at loggerheads.
The case of "H versus S" ended when the 44-year-old mother, "S," breastfed her 15-month old child for the last time in the courthouse cafeteria and handed him over to the waiting sperm donor dad, "H," and his homosexual partner.
Both Romanian immigrants, H and S were also longtime friends who had informally agreed to conceive a child artificially together using a home insemination kit. But the relationship broke down, the mother denied the father and his lover parenting rights, and the courts took over.
The judge who ruled on the appeal in the homosexual couple's favor, Alison Russell, has used the case to call for legislation, as in the United States, forcing those involved in surrogacy arrangements to agree to formal legal contracts.
"The UK however does not have such an approach in place, meaning that … if a surrogate mother was to change her mind the only recourse for the other parties involved would be to head to the courts," stated the judge in her ruling.
"Considering how emotionally draining and time-consuming a legal battle of this nature can prove to be, this case perhaps indicates that the time is now right for the current legislation in this area to be reviewed."
But Paul Tully of the Society for the Protection of Unborn Children told LifeSiteNews that the case exposes the problems with the "commodification of life and children" inherent in in vitro fertilization and other methods of conception.
His organization has opposed artificial approaches to conception not only because of commodification in general, but because individual unborn babies deemed surplus to parental needs are sacrificed.
As well, "in this case and in many cases there is the issue of adoption by same-sex couples," Tully said. "We believe what is best for the child's welfare is to be brought up by his or her biological mother and father."
The parents had agreed to share custody, but now the mother claims that having the child was her idea and her old friend from Romania was simply a sperm donor with visiting rights because she thought it a good idea her child have a father figure. "I was having this baby for myself," she told the Daily Mail last week, after a publication ban was finally lifted on the dispute. The father, H, told the court the idea for a baby came from him and his lover, who approached S to be the surrogate mother.
But there is no doubt from the plentiful e-mail messages between the litigants that the same-sex couple were acting like concerned parents even before the child was born, and the judge ultimately not only preferred their version of events to the mother's, but also found their attitude more child-centered, while hers was slanted by "homophobia." So despite the hardship to the child and the heartache to her, the same-sex couple were awarded custody.
Tully carefully avoids taking sides in the dispute itself but observes, "The mother was deeply misguided and ill-advised to undertake the role of being a surrogate mother. But whatever bad decisions she made, one can certainly feel for her now."
Surrogacy conflicts with natural parental affections, said Tully, such that some surrogate mothers abort the children they have contracted to bear if the contracting couple back out because, for example, the child has disabilities. "Surrogacy can encourage a hardened attitude."
Tully's main concern about the case is that it has triggered a call for contract legislation. Currently, in great Britain, surrogate mothers cannot charge for bearing the children of others, though they can be paid for their expenses. Legislation, Tully warns, could pave the way for the commercialization of surrogacy and for "turning children into a manufactured product."

Source:  https://www.lifesitenews.com

Report calls for urgent legal reform for surrogacy

Far fewer Britons seek surrogacy overseas than previously thought
A new report, published by Surrogacy UK, claims to dispel many of the myths concerning international surrogacy and brings into focus the practice of surrogacy in the UK. The report, endorsed by Mary Warnock, Professor Margot Brazier and Professor Susan Golombok. calls for reform of surrogacy law.

According to the report – Surrogacy in the UK: Myth busting and reform – written by Dr Kirsty Horsey of University of Kent, far fewer Britons seek surrogacy overseas than had been previously thought, so dispelling the myth that international surrogacy has become commonplace for intended parents from the UK.

The report also shows that there is widespread rejection of any move towards commercialisation of surrogacy. The overwhelming majority of surrogacy in the UK is undertaken by women on an altruistic basis with most UK surrogates receiving less than £15,000 for out-of-pocket expenses incurred, demonstrating that surrogacy is a relationship and not a transaction.

Also highlighted by the report is the overwhelming support (75% of survey respondents) for legal reform in order better to represent how UK surrogacy works in practice. The report shows that both surrogates and intended parents want to remove the legal uncertainty over parenthood at the point of birth. At the moment legal parenthood rests with the surrogate at birth. The intended parents must apply after birth for a parental order, which can take several months. In the meantime they have no legal rights and the child is left in legal limbo. The report finds that 69% of surrogates are opposed to being able to change their mind about giving a baby back to its intended parents. Only 5% believe that a surrogate should be able to change her mind at any point.

Surrogacy UK has set up a working group on surrogacy reform consisting of: Natalie Smith, trustee, Surrogacy UK; Sarah Jones, chairperson, Surrogacy UK; Dr Kirsty Horsey, senior lecturer, Kent Law School; Louisa Ghevaert, partner, Michelmores LLP; and Sarah Norcross, director, Progress Educational Trust.

Recommendations for reform include:
  • The principle of altruistic surrogacy, which operates in the UK must be protected to reflect that surrogacy is a relationship, not a transaction.
  • Parental orders should be pre-authorised so that legal parenthood is conferred on intended parents at birth.
  • Intended parents should register the birth.
  • Parental orders should be available to single people who use surrogacy.
  • Parental orders should be available to IPs where neither partner has used their own gametes ('double donation').
  • The time limit for applying for a parental order should be removed.
  • Parental order/surrogacy birth data should be centrally and transparently collected and published annually.
  • IVF surrogacy cycles and births should be accurately recorded by fertility clinics/ Human Fertilisation and Embryology Authority (HFEA).
  • NHS funding should be made available for IVF surrogacy in line with NICE guidelines.
  • The rules on surrogacy-related advertising and the criminalisation of this should be reviewed in the context of non-profit organisations.
The following actions for government are recommended:
  • The Department of Health, in consultation with the surrogacy community, should draft and publish a 'legal pathway' document for IPs and surrogates.
  • The Department of Health should produce guidance for professionals in the field, written in consultation with the surrogacy community for midwives and hospitals, Children and Family Court Advisory and Support Service (Cafcass) and clinics.
  • Surrogacy should be included in schools' sex and relationships education (SRE) classroom curriculum (from primary) – linked to awareness of (in)fertility, family options for same sex partners etc.
Source:  http://www.familylawweek.co.uk

When it comes to IVF, reproductive policing can improve reproductive rights

It is hardly news when women’s bodies, and reproductive rights, are policed by the state, by the courts, by our culture and, sometimes, by our own partners. But what does it mean when a woman seemingly agrees to some iteration of this kind of limitation – and then changes her mind?
That was the question put before a San Francisco judge who ruled this week that there are no take-backs.
Judge Anne-Christine Massullo was asked to consider the case of Dr Mimi Lee and Stephen Findley, who created, froze and stored embryos after Lee was diagnosed with breast cancer but before she began treatment. In the course of their efforts to preserve their ability to have a child together, they both signed off on the consent form presented to them by their fertility clinic, in which they stated that they had mutually agreed to have any remaining embryos destroyed should the two no longer be married.
The couple separated in 2013 and divorced in 2015, and they went to court over Lee’s desire to keep the embryos herself and use them to attempt a pregnancy.
In an 83-page decision, Massulo wrote: “It is a disturbing consequence of modern biological technology that the fate of nascent human life, which the embryos in this case represent, must be determined in a court by reference to cold legal principles.” But it is perhaps even more disturbing to argue the opposite – that the embryos Lee and Findley created are, as Massullo implies, life just casually discarded because of the flippancy of the law.
This seeming form of reproductive policing – making women and men sign away their rights to their own genetic material – is actually a safeguard to ensure that women continue to be guaranteed basic reproductive rights and, indeed, rights to their own bodies and genetic material). Paradoxically, letting someone lay claim to embryos that they have legally consented to discard in the event of divorce is just one small step from stopping someone from being able to freely choose what exactly happens with and to their own bodies and healthcare decisions.
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Earlier this year, actress Sofia Vergara faced a similar legal battle, when a judge ruled that the Modern Family star’s ex-fiance, Nick Loeb, had a right to sue Vergara for “custody” over their unused, frozen embryos that were created when the two were still a couple.
At the time of the Vergara ruling, Cecile Richards, the president of Planned Parenthood Federation of America and the Planned Parenthood Action Fund, said in a statement: “Every woman should be able to decide whether and how to have children, without coercion, shame, or judgment.” She added that litigation like that faced by Vergara constituted a form of “bullying” that attempted “to force someone to have children against her will ... These are deeply personal decisions for women, and they should be respected.”
And indeed, it seems to follow that Findley’s decision to not have a child with Lee should garner the same respect as Vergara’s decision to not have a child with Loeb. The alternative could be significant limitations on both women’s reproductive rights and on the ability of women and men to access reproductive assistance.
Too often, the questions surrounding the outcomes for unused frozen embryos feed directly into the debate about fetalpersonhood” – the belief that legal rights should be extended to fertilized eggs and embryos. In recent years, many rightwing lawmakers have introduced legislation that would grant rights to embryos, which, though designed to criminalize abortion, would also make IVF treatment illegal as a result, since the process often creates embryos that would never be transferred or given the opportunity to continue their “life” at it were.
So, while Lee pleaded with the judge to let her have what she called “her babies”, had the judge ruled in her favor, those who oppose the procedure entirely would have had legal ammunition to challenge it, and women’s reproductive rights more broadly, in court.
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Though Lee claimed in court not to have understood the legal papers she signed before undergoing IVF which forced the judge to rule in her ex-husband’s favor, as someone who’s undergone IVF, I find that a bit hard to believe. The Society for Assisted Reproductive Technology crafted a “declaration of intent” years ago that is made available to all of its member practices nationwide; few reputable practices would ever allow patients to undergo IVF without a similarly informed consent process.
Patients sign, in the presence of a notary, documents which explain what they would like to happen to any unused embryos under numerous circumstances, ranging from death to divorce to non-payment of frozen embryo storage fees.
The declaration of intent makes clear that the options for patients regarding unused embryos are “discarding the cryopreserved embryo(s)”, “donating the cryopreserved embryo(s) for approved research studies”, “donating the cryopreserved embryos to another couple in order to attempt pregnancy”, or “use by one partner with the contemporaneous permission of the other for that use”.
Furthermore, the declaration of intent is explicit in its statement that embryos “cannot be used to produce pregnancy against the wishes of the partner” – the circumstances in which Lee and Findley found themselves.
If you want children, being able to have them is a tremendous gift. If you want children and, for any reason, are unable to do so, the effect can be devastating, heart-breaking, agonizing, maddening. And so while, as someone who has struggled with infertility in my own right, I empathize with Lee’s desire to build a family on her own terms, I am relieved the judge on her case ruled how she did. To have allowed Lee to rescind her consent for the disposal of her embryos could have meant an all-out elimination of the reproductive rights and options of others.

Source:  http://www.theguardian.com

Monday, 16 November 2015

Gov’t to Crack Down on Surrogacy Clinics


Fleeing strict new laws at home, surrogacy companies are moving their “wombs for rent” services from Thailand to Cambodia, causing some analysts to raise concerns that would-be parents could be swindled by the little-regulated industry.

Surrogacy and assisted reproductive technology are still in a legal gray area, as they are not explicitly protected or outlawed by Cambodian law. But this legal free-for-all may not last long. Government officials yesterday told Khmer Times that they plan to classify surrogacy as a form of human trafficking.

If the government imposes new regulations, they could prevent children born to surrogate mothers from leaving the country, meaning that would-be parents could find themselves unable to bring their newborn home.

Shift from Thailand

Despite the risks, surrogacy is booming in Cambodia. Sixteen surrogacy clinics have opened in the country since the Thai government imposed strict new anti-surrogacy laws early this year. Demand from foreign couples, especially Chinese and Australian ones, is high. With other popular surrogacy destinations like Nepal and India closing their borders, Cambodia has become one of the few nations in the region open to couples seeking to have a child through surrogacy.

Surrogacy clinics, long tolerated by the Thai government, were kicked out after a pair of high-profile scandals last year. The first occurred when an Australian biological father left behind a baby born with Down’s Syndrome, while taking the boy’s healthy twin sister home to Australia.

The “Baby Gammy” case, as it came to be known, prompted further investigation into Thailand’s surrogacy industry, uncovering more sordid details. Investigators found that a Japanese businessman had fathered 16 children through different Thai surrogates, four of whom he took to Cambodia, in what local media described as a possible attempt to begin a child-trafficking ring.

In the wake of the scandals, the Thai government imposed a law banning foreign couples from seeking surrogacy in the country. Employees at companies there that provide surrogacy for profit are now faced with the threat of a 10-year prison sentence.

Many companies in Thailand’s lucrative surrogacy business have simply moved across the border into Cambodia. Last November, the Cambodian government issued a warning saying that surrogacy was illegal, but as of yet there are no formal laws banning it. A source who asked to remain confidential said that at least 20 couples from Australia alone have contracted with surrogacy companies in Cambodia.

Cambodia used to lack the high-tech equipment necessary for artificial fertilization, but the country now has modern in-vitro fertilization (IVF) equipment at several hospitals and clinics. That, combined with a lax legal system and cheap prices, draws couples to the Kingdom. Surrogacy services start at around $40,000 in Cambodia, compared to $120,000 in the United States.

“Other Asian nations have closed their borders, and the prices being offered [in Cambodia] are attractive,” said Sam Everingham, director of the Australian company Families through Surrogacy. Unscrupulous surrogacy companies can add to the appeal of Cambodia as a surrogacy destination, advertising it as a safe place to have a child while neglecting to mention the legal perils.

On its website the company Sensible Surrogacy advertises Cambodia as a perfect alternative to more expensive Western surrogacy programs, saying “Many couples are now finding that surrogacy in Cambodia is the most affordable and secure option to start their new families.”

Mr. Everingham said it is common for companies to downplay the risks. “Many of the clinics have a business model where they take advantage of being able to take clients to a country with a legal loophole,” he said, “until it’s no longer there, and then they have to move somewhere else.”

Cambodian surrogacy has in fact become so popular that the Australian tourism website, smarttraveller.gov.au, issued a warning about the possible legal pitfalls of surrogacy in the Kingdom. “Australians are advised not to visit Cambodia for the purpose of engaging in commercial surrogacy arrangements,” the site warns.

Meanwhile, the Cambodian government is scrambling to create new laws to stop the fast-growing surrogacy industry before it expands. Touch Channy, spokesman for the Ministry of Social Affairs, said that government ministries will discuss how to manage the growing numbers of surrogacy clinics. “The ministries need to work together to ensure that this case doesn’t happen in Cambodia,” he said.


Though surrogacy sites advertise Cambodia as a safe option, Mr. Everingham argues that it is anything but. “It’s highly precarious based on what we’ve seen occurring in countries that have similar laws,” he said. “Thailand, India, and Nepal have all closed their borders [to people seeking surrogacy]. It’s highly likely that Cambodia will do the same.”

New technology beating IVF failure struggles An incipient hope for those who dream to have children

DR. SAMER TARAKJI
Despite numerous developments in IVF, the implantation rate of the replaced embryos remains low, some infertile patients undergo many IVF cycles and produce embryos, but the embryos consistently fail to implant for unexplained reasons. This is called IVF failure. It is a very frustrating problem for married couples who can’t have children. The chances of successfully conceiving through IVF decline with age, but it remained more successful than natural reproduction that achieved no pregnancy.
If there is an embryo transfer done, the reason that IVF fails is because of embryo implantation failure. However, we do not know whether the failure to implant was due to a problem with the embryos or a problem with the uterus. Most fertility specialists believe that in more than 95% of IVF failures it is due to arrest of the embryos
With the advancements in technology, the field of the Laser Assisted Hatching (AH) a technology which helps embryos to attach to the womb of the woman - has emerged as an art that gives best possible results. It has boosted the hopes of many infertile couples who have repeatedly failed by using traditional IVF methods.
Especially women older than 37 years of age, have a tendency to produce eggs with a harder egg coat (zona pellucida) than younger women. The same applies for women treated with higher doses of follicle stimulating hormone (FSH).
When Assisted Hatching is performed using a laser it does not have to be removed from its culture dish and placed in a separate “hatching plate”. The laser is attached directly to the microscope as an objective. The embryo is positioned for AH and the laser is applied 2 or 3 times until a hole is made through the shell. There is no exposure to chemicals, and the time the embryo spends outside the incubator is significantly less than when AH is performed using the Acid-Method.
Recent researches showed that women, who have undergone repeated IVF treatments without results, double their chances of a pregnancy by use of assisted laser hatching

Eventually, there are no consequences for this method. So in other words, it’s the safest method for both the embryo and the mother. Infertile couples or women who experienced frequent IVF failures should not bear any worries because their dream of having children will come true, moreover, researchers are still working on developing further advanced techniques and solutions.