Surrogacy Business

Give Money get Baby

Tabassum Aara, 22, lives with her husband and 18-month-old son in their rented one-room flat in Loni on the outskirts of Ghaziabad, Uttar Pradesh. Her husband, a daily wage labourer, earns about Rs200 a day, barely enough for food and rent.
Four months ago, Tabassum heard about the “easy, reliable and dignified” way to earn some extra money from her neighbour Nazma, 29. Nazma recently bought a semi-automatic washing machine, a Panasonic television, a Hero Honda bike and they are soon going to buy a house of their own. “She delivered a baby for a couple who could never get a baby on their own,” says Tabassum, who is three-months pregnant. “It's such a sacred work. We decided to do it. If you do it for them, you will get what you want.”
Tabassum is not the only one renting her womb in this village. Every fourth house has an aspiring surrogate mother. For them, it is the quickest way to improve their quality of life. A surrogate mother can earn up to Rs3 lakh for the delivery, plus a monthly allowance of Rs10,000 towards her diet and other needs during the pregnancy. In case of twins or triplets, she gets 11 lakh extra per child. A caesarean section adds another Rs50,000 to the purse.

No wonder, there is a waiting list, which surrogacy agents sort out on a first-come-first-serve basis. “A 2sq.m plot in Loni costs around Rs2 lakh, another Rs15,000 goes towards the construction of a room. So, even after buying land and constructing a house of their own, the surrogate is left with enough money to realise their dreams,” says Sonu, who runs a surrogacy agency at his home in Tabassum's village.
Till four years ago, Sonu was the local electrician. Today, he is called ‘doctor saab' by most of the surrogates. He owns a three-storey house, a plot of land, a new Indica car and a second-hand Zen. His house is done in ceramic tiles and his bedroom on the second floor boasts a fancy music system, a refrigerator and wide-screen television. Sonu's job is to finalise the deal between surrogates and clients, and ensure the surrogates get their routine medical check-ups. He earns up to Rs1 lakh as commission for every successful delivery.
Farida, 33, who delivered twins for an Indian couple, sent her two sons to a public school, after she conceived for a Swedish couple. “We get Rs10,000 every month. Even after spending Rs5,000 on the food prescribed by my doctor we can afford to send our sons to a good school. We invested money we got at the time of my delivery in a small business and have got a source of regular income. What more can I ask for?” says Farida, sitting in her one-room flat in Loni.
Seeing the business potential, some big-time players have also ventured into surrogacy. Wyzax Surrogacy Consultants, a pharmaceutical company which started a surrogacy agency two years ago, claims to have corporatised surrogacy in India. Says Jagatjeet Singh, a founder member of Wyzax Surrogacy Consultants: “I went through a horrible time while searching for a surrogate mother for my friend four years ago. I realised both surrogates and the intended parents were exploited in the process. So I decided to start a surrogacy agency with an aim to make the whole process systematic and transparent. We follow standardised operation protocols, which strictly comply with the Indian Council of Medical Research's guidelines on surrogacy,” says Singh.
The company offers some readymade packages and also customises them according to their clients' needs. The package starts from Rs8 lakh, which includes an IVF cycle by a specialist, lodging of the surrogate and her fees, and the cost of a normal delivery. “If the couple wants to attempt a second cycle of IVF, we don't charge them for the extraction of eggs,” says Singh.
The company also arranges for egg donors, who are required in at least 60 per cent of the cases. The charge varies depending on the kind of donor the parents want. For example, an Indian donor charges from Rs40,000 to Rs75,000, while a Caucasian donor may charge over Rs5,76,000 per attempt. “Couples generally want the egg donor to look similar to them,” says Singh. “Besides similar looks, her religion, education and medical history matter. Lately, people have also started to ask for a surrogate who has young children (preferably less than three years old). It is a tough hunt, but we try to satisfy our clients.”
Besides, the company claims to know the best IVF specialists in town and can prescribe a specialist according to the client's need. “An IVF specialist needs expertise in various sub-branches of IVF. Being in the gynaecological business, we can judge a doctor's capability. It is as complicated as other surgical fields of medicine,” says Singh.
The surrogates are taken care of through the ‘tripod system', which involves social workers, field coordinators and case managers, says Singh. The social workers help in spotting an aspiring surrogate, while the field coordinators take care of all the arrangements at a surrogate's home—from food to electricity. They also help the surrogate mother find a suitable school for her children. All the talking is left to the case managers, who are responsible for taking care of the legal aspects of the deal.
Surrogacy is a long process which starts with the counselling of the intended parents. Counsellors check the mental and financial stability of the person or the couple seeking surrogacy. The hunt for the surrogate mother begins after the legal matters are taken care of. The surrogate mother and client meet to finalise the deal. The surrogate undergoes a series of medical tests to rule out the possibility of any disorder and deficiency before she undergoes embryo transfer. If it succeeds, she is  moved to a surrogate home with her children, where she lives till the  delivery. She undergoes weekly check-ups in the first three months and fortnightly check-ups thereafter.
The surrogate homes are generally one-room apartments, where a surrogate spends 10 to 11 months. These apartments are complete with television, refrigerator and coolers. They can also be single rooms, one-bedroom flats or a big house with separate rooms for each surrogate depending on the surrogacy agency. Surrogates live with their children and husbands, and relatives are allowed to visit during the day. There are some surrogate agencies like Surrogacy India that allow husbands to stay with surrogates. “We believe that surrogate should not be deprived of a normal life during this process. And having their family around keep them happy,” says Dr Yashoda, director, Surrogacy India, a surrogate consultancy, Mumbai. Apart from a hygienic environment, they are taken care of by surrogate social workers. These social workers' responsibility includes ensuring the surrogate has meals and medicines on time and taking them for their scheduled medical check-ups.
For many surrogate mothers, it is an opportunity to take care of their own health, too. For the nine months that they are pregnant, they are given milk twice a day with protein powder, fresh fruits, green leafy vegetables, vitamin and mineral supplements in a hygienic environment. Nazma, 29, who gave birth to a child two years ago, says since she delivered the child, she has been feeling healthier and wants to attempt it again.
Even IVF specialists and gynaecologists dealing with surrogate mothers feel that if done in a transparent manner, surrogacy screens them for all their medical problems. “They are screened for their vitamin and hormonal deficiencies and many dormant medical problems get diagnosed and are taken care of during their pregnancy. Around 30 per cent of the aspiring surrogates are found to be anaemic and suffer from hypothyroidism. These problems go unnoticed otherwise, given their socio-economic background,” says Dr Archana Dhawan Bajaj of Nurture Fertility Clinic, Delhi.

Doctors believe that surrogacy is increasingly becoming more acceptable for both the intended parents and surrogate mothers. Aamir Khan's public acceptance about his baby being born with the help of a surrogate mother also seems to have changed the surrogacy scene for good in India. Doctors of many major corporate hospitals such as Sir Ganga Ram Hospital and Fortis Hospitals recommend surrogacy as an option to childless couples.
Dr Hrishikesh Pai, an IVF expert with Fortis La Femme, Delhi, and Lilavati Hospital, Mumbai, feels that there is nothing wrong in someone paying a surrogate mother, given the intended parents have no other means to have their biological child. Around 10 per cent of people who need IVF as a fertility treatment need a surrogate.
Multiple fibroids, absence of uterus, malignancies and tuberculosis can damage the reproductive abilities of a person. Also, in couples who could not conceive even after 10 IVF attempts, surrogacy is the only option left if they want a biological child. “Eighty per cent of my clients are Indian. The rest are foreigners who come for three reasons: easy availability of surrogates, affordability, and state-of-the-art medical facility,” says Pai.
Interestingly, with more awareness and acceptability, parents feel morally obliged to the surrogate mothers and also do something beyond the original business arrangement. Many couples go out of their way to ensure that the benefits reach the surrogate. Delhi-based dentist couple  Dr Dheeraj Chopra and his wife got their twins with the help of IVF surrogacy. As they were not sure whether her share of money would reach the surrogate mother, they handed it to her themselves. They also took up the responsibility of the education of her three children. Even a year after the baby was born, Chopra visits the surrogate mother. “We continue to feel obliged, even though it was a clear business arrangement. The surrogate mother does not feel attached to my kids, but still she gave us the happiness of our lives. We can at least do this much to change her life,” says Chopra.
Like Chopra, Alex of Australia continues to be in touch with the surrogate who gave birth to her baby. Alex, 40, got a baby through IVF surrogacy two years ago. She comes to India from Australia every six months just to meet the surrogate mother. She brings her baby along and does not mind him sharing a bond with the woman who kept him in his womb for nine months.

Manpreet and Paul Lice did everything they could to have a baby of their own. But when nothing, including three cycles of IVF, worked, the couple decided to opt for surrogacy. They wanted an Indian mother and contacted Dr Shivani Sechdev Gaur's ISIS Fertility Clinic in Delhi. The couple is now the proud parents of a two-month-old baby girl, Samaira. The couple says the support of their families went a long way in making the whole process a success.
Besides money, a surrogate mother learns the importance of hygiene, clean water, diet and education. Rahima, a 22-year-old from a village near Delhi, believes that three months into surrogacy has empowered her. “I interacted with other surrogate mothers and learnt how those who have delivered the child spent their money,” says Rahima, who is at a surrogate home near Janakpuri in Delhi. “I know what I want to do with the money. I have got a bank account in my name and deposit my monthly allowance in it.”

ICMR guidelines

* The proposed ART Rules and Bill legalise surrogacy and state that a surrogate mother can get monetary compensation for carrying the child, in addition to health care and expenses during pregnancy.
* The surrogate mother has to relinquish all the paternal rights over the child once the amount is transferred. The birth certificate will be in the name of the genetic parents.
* Surrogate mothers should be in the age group of 21 to 45 years and should have children of their own.
* They should not attempt more than three cycles of IVF in their lifetime.
* Single parents can also have children using a surrogate mother.
* Foreign couples seeking surrogacy should first register with their respective embassies.

Business of bearing

 * The package starts from 18 lakh, goes up to 115 lakh for an Indian couple. There are customised packages, too.
* Surrogacy consultants provide surrogates, IVF specialists, 
counsellors, boarding and lodging for the couple as well as 
surrogates, medical care, egg and sperm donors, and even arrange tour packages.
* A Caucasian donor charges $15,000. An Indian donor charges 
anywhere from Rs40,000 to Rs75,000 per attempt. For an egg donor, apart from her looks, her religion, education and medical 
history matter.
* Sperm donors charge Rs1,000 to Rs10,000, depending on their educational qualification.
* A surrogate mother is paid around Rs10,000 per month during pregnancy and Rs2.5 lakh to Rs3 lakh at the time of delivery.
* Surrogacy consultants get Rs1 lakh to Rs1.5 lakh per case as 
commission.

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