Thursday, 29 October 2015

India’s ‘rent-a-womb’ industry could close doors to foreigners

Soon foreign couples won’t be able to pay surrogate mothers in India to have babies for them — if the Indian government has its way.

India is one of the top countries in the world for couples searching for surrogacy that can be done far more cheaply than in the United States and elsewhere. It is a booming — and largely unregulated — business in India, with thousands of clinics forming the backbone of an estimated $400 million-a-year industry, according to a study by Sama, a New Delhi-based advocacy group for women and children.

Critics have long said that fertility clinics and their clients exploit surrogate mothers — often poor and illiterate women from rural areas who are paid little. A surrogate mother profiled in The Washington Post was paid $8,000: an amount 12 times what she made as a garment worker.

Abuses abound, however, and the practice has been derided as “rent-a-womb.” India’s Supreme Court recently labeled it “surrogacy tourism” and called for a ban.

[Scandal in Thailand ends surrogacy]

The government submitted an affidavit to the Supreme Court on Wednesday saying that it “does not support commercial surrogacy” and that “no foreigners can avail surrogacy services in India,” although the service would still be available to Indian couples.

India has been trying to pass an Assisted Reproductive Technology (Regulation) bill since 2010, and a draft of the legislation up for public comment through Nov. 15 does not specify the ban on foreign couples. But it suggests stricter regulations on the practice, such as limiting the number of surrogate births from a mother to one.

However, the Ministry of Health and Family Welfare is pushing for an outright ban on allowing foreign couples to hire Indian surrogates, activists say. In 2012, the government banned single and gay people from abroad from coming to India to use surrogates.

“In meetings, officials have said foreign nationals are exploiting our women,” said Manasi Mishra, who did a survey on surrogacy for the Center for Social Research in New Delhi and has been involved in discussions on the new legislation.

“We don’t agree there should be a ban on foreign nationals coming here for surrogate babies. We have been asking for regulating the industry. The industry has grown so much. If you ban it, everything will go underground and illegal.”

[Babies as business]

India and the United States are among a handful of countries where the practice of in-vitro fertilization and embryo transfer is allowed. Thailand banned it recently. More than 6,000 surrogate babies are born in India per year, about half of them to foreign couples, according to one industry estimate.

“We are taken aback by the government’s stand against foreign nationals,” said Jagatjeet Singh, a surrogacy consultant in New Delhi. “On one hand, the government is promoting foreign investment and the medical tourism industry. And on the other, they are talking of banning foreign nationals from coming to India for surrogate babies. There are dual standards."

Monday, 26 October 2015

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.

Wednesday, 21 October 2015

Families lose hope as Australian babies born via surrogacy remain stuck in Nepal

Australian families stuck for weeks in Nepal after the country changed its stance on surrogacy are at "breaking point", unsure if they will be allowed home with their babies.
"There's a sense of desperation, a sense of complete despair," said one father, Nick Martin*. Families are running out of vital supplies for their newborns; Mr Martin has had to rely on "complete strangers" flying to Nepal from Australia, contacted through social media, to deliver formula for his seven-week-old twins.  
Dozens of Australians began the surrogacy process when it was legal in Nepal. But on August 25 the Supreme Court suspended commercial surrogacy, without directing what should happen to babies already conceived or born. Nepali officials have interpreted the order as applying retrospectively and will not issue exit visas for the children.
Foreign Minister Julie Bishop said the status of surrogacy arrangements commissioned in Nepal before the ban remained unclear, despite attempts by the Australian government to clarify them.
"We will continue to encourage the Government of Nepal to put arrangements in place as soon as possible, allowing for the departure of Australian citizens," she said. "However, there are limits to what the Australian Government can do to influence the laws of a foreign country."
Mr Martin said up to 15 babies with Australian passports were "virtually prisoners" in Kathmandu. Families from the United States, United Kingdom, Israel, Ireland, Brazil and Serbia were also in limbo, and "for all involved they are at breaking point".
"What we parents are seeking is international awareness and pressure on the Nepal Government to allow these innocent babies to leave Nepal," he said. "This is not a political or surrogacy debate, it is a humanitarian issue for these children."
Health problems forced Lisa McDonald* to return home without her baby son, leaving him in Kathmandu with her husband. She said with no resolution in sight, families felt abandoned and were losing hope.
"We're just average people who had the audacity to want a baby," she said.
Nepal is still recovering from devastating earthquakes and is in a state of unrest, with key government ministers resigning after a new constitution was adopted and violent protests disrupting the supply of food, fuel and other essentials from India.
"The new government is dealing with so many other pressing issues … these little Australians are way down their list," Mr Martin said. "Will the Australian government not go in to bat for its citizens?"
The Department of Foreign Affairs and Trade's Smartraveller website advises that the Nepali Department of Immigration will not issue exit permits until written clarification is received from the Ministry of Health and Population and "we do not know how long this will take".
"International commercial surrogacy is a complex area which raises significant legal and social considerations and is illegal in many jurisdictions, including some Australian states and territories," a DFAT spokesman said.

"Smartraveller advice has consistently strongly cautioned Australians to consider all legal and other risks involved in pursuing international surrogacy, and recommends that commissioning parents not consider surrogacy in Nepal."

Saturday, 17 October 2015

Future of surrogacy legislation

The government has committed to introduce legislation on assisted human reproduction, surrogacy and gamete donation following a November 2014 Supreme Court decision on surrogacy. The Supreme Court ruled that a genetic mother of twins born to a surrogate is not entitled to be registered as their legal mother on the birth certificates.

The case had been appealed by the state from a March 5 2013 High Court decision, in which the High Court ruled that the genetic mother of twins born to a surrogate was entitled to be recognised as their legal mother. The High Court found that motherhood is based on genetic links. The chief registrar of births, deaths and marriages had originally refused to enter the genetic mother's details on the birth certificates of twins born to a surrogate.

In the Supreme Court appeal, the state argued that the High Court decision had 'massive' implications that would affect mothers who bore children using donated eggs, regarding the children's citizenship and succession rights.

The Supreme Court decided by a six-to-one majority to allow the appeal. A variety of approaches were taken by the judges as to how they reached their conclusions. However, a common theme through all seven judgments was the observation that this area lacks legislation. Chief Justice Denham acknowledged that there was a lacuna in the law, which had arisen from radical developments in assisted human reproduction. The Supreme Court signalled clearly that it is for the Oireachtas to determine policy and introduce legislation in this area.

In the aftermath of the Supreme Court decision, the government committed to introduce legislation on assisted human reproduction, surrogacy and gamete donation and the cabinet has now authorised the Department of Health to prepare this legislation. The department will draft the heads of the bill before inviting submissions from interested parties as part of a public consultation process. The Oireachtas Joint Committee on Health and Children will also be invited to hold public hearings on the matter and subject the draft to scrutiny. The draft will include proposals for a regulator to promote patient safety and good clinical practice in assisted human reproduction.

The urgent need for legislation was demonstrated in a recent High Court decision where a woman – whose child was born through a surrogacy arrangement – lost her legal challenge over a refusal to pay her maternity benefits. She claimed that the state's refusal to pay her maternity leave allowance because she did not bear the child amounted to unlawful discrimination. Justice Iseult O'Malley found that the Equal Status Act cannot be used to "fill the gap" caused by the ongoing absence of legislation regarding surrogate births.

While the legality of surrogacy varies from country to country, much of the European Union favours a restrictive approach, either banning surrogacy entirely or allowing for it in only limited and closely regulated circumstances. It is hoped that this legislation will end the regulatory vacuum in Ireland regarding this complex area.

Thursday, 15 October 2015

Embryo vitrification ‘necessary’ due to low birth-rate from IVF

In 2014, only 8% of IVF pregnancies led to births: health secretary Chris Fearne says parents should be allowed to choose embryo freezing
The live-birth rate of Malta’s current system of assisted reproduction – oocyte vitrification – stands at just 8% of the 51 IVF cycles completed on the national health service between January 2014 and January 2015.

The low rate of births from the system of freezing the ova, as opposed to embryo freezing, is one of the factors informing the government’s legislative drive to widen access to assisted reproductive technology.

“The rate of completed pregnancies is too small and we cannot leave it like this, especially with the availability of technology that can assist us,” parliamentary secretary for health Chris Fearne said.

Fearne told MaltaToday that vitrification provides a higher survival rate, and minimal deleterious effects on embryos when they are thawed, improving clinical outcomes. “Nine out of 10 embryos can survive the process in vitrification,” the health secretary said.

Additionally, there will be limits on the number of eggs that can be fertilised and implanted.

Thursday, 8 October 2015

Virgin Births: Women Become Impregnated Thanks To IVF Treatment At British Clinics

Baby At least 25 young British women who have never had sexual intercourse with a male partner have become impregnated through in vitro fertilization in the past five years.
A number of young women in the United Kingdom have given birth over the last five years despite not having had any sexual intercourse with a male partner.
Clinics in the country revealed that around 25 virgin women have been impregnated in the past few years through in vitro fertilization (IVF). They said some of their clients are willing to pay £5,000 (more than $7,500) for the procedure to have children now but save themselves for their ideal partner.
Supporters of the traditional family system, however, have blasted the "distorted" move, stating that it was turning young children into "teddy bears" that are to be "picked off the shelf."
Some religious groups have also claimed that the move undermines the value of having children brought up in a stable marriage, while one leading psychotherapist has warned that a mother who has never been in a relationship could potential harm the development of the child.
Maha Ragunath, medical director of One is Care Fertility's Nottingham clinic, said that the number of single women seeking IVF treatment has doubled in the last 10 years, accounting for as much as 10 percent of Ragunath's patients.
She said that instead of career women who have been too focused on their work, many of her clients are in their 20s and either still in school or employed in very ordinary jobs.
When asked about their reason for undergoing IVF treatment, clients often respond by saying that they are prepared to have a child and they do not want to wait for an ideal partner.
Ragunath added that a small number of her IVF patients have never been in a relationship and never had any sexual intercourse.
Ragunath has had three single virgin patients undergo IVF treatment in the past three years. All of her patients became mothers.
Josephine Quintavalle, a representative from the Comment on Reproductive Ethics group, criticized the development, claiming that nature's message is for a man and a woman to have child. She said that the move diminishes the role of the father in the development of the child.
Bishop James Newcome of Carlisle said that any move that supports the idea that women do not need to have a family to have a child would result in adverse implications for society.
Imam Suhaib Hasan, head of the Islamic Sharia Council in the UK, accused doctors engaged in providing IVF treatment to patients of acting like God.
Hasan said that when the man is removed from the aspect of a family, the woman becomes merely a breeding machine. He added that it effectively denies the right of the child to have a father.

National Gamete Donation Trust chief executive Laura Witjens asserted that these young women have the right to choose to have the treatment if they want to. She said that IVF clinics, however, have the responsibility to evaluate why their patients want to do so.
Witjens said that society has a tendency to overreact regarding single women choosing to become mothers. She pointed out that such women are often much better prepared to become a single parent emotionally, socially and financially compared to those who became single mothers because of a failed relationship.
Dilys Daws, a child psychotherapist, said that young virgin women who resort to IVF treatment could potentially be not matured enough emotionally to become close to someone else, which is a crucial aspect of bringing up a child.
She said this suggests that the woman is afraid of having a close physical relationship with others. This could result in the child not being brought up with love.
IVF clinics emphasized that before a patient can undergo the fertilization procedure, she is required to see a counselor first to help her understand the treatment and effects of using sperm from a donor.

Children born through in vitro fertilization have the right to find out who their biological father is once they reach 18 years old. Clinics said they place great importance on the child's welfare as well.