New Strict Surrogacy Bill On The Anvil, Clinics Shut Shop

Mumbai, 16 Nov 2019:

Shutters are coming down on surrogacy in India, with several fertility clinics across Mumbai, Hyderabad and New Delhi refusing fresh cases as the new Surrogacy (Regulation) Bill, 2019, is set to be tabled in Rajya Sabha during winter session starting November 18. Lok Sabha has already passed the Bill.

Aimed at prohibiting commercial surrogacy, the Bill has had doctors and clinics rethinking surrogacy cases. Doctors across India handle about 2,000 surrogacy cases every year, the majority of which go unrecorded.

The National ART Registry of India (NARI) maintained by the Indian Society for Assisted Reproduction (ISAR) is the nodal agency tasked with recording surrogacy cases. But infertility expert Dr Nayana Patel, known for handling Asia’s first surrogacy case in 2003, said this data is partially accurate as it reflects only the information voluntarily uploaded by clinics across India, many of which are not registered with ISAR.

With the Bill, IVF clinics are in limbo on their surrogacy cases. “The Bill lacks clarity, so we stopped accepting new cases since September,” Dr Samit Sekhar, owner of Hyderabad’s Kiran Infertility Centre, said. “The Bill’s clauses are fraught with issues impossible to adhere to. The onus of verification, for instance, lies entirely on us. How can we ascertain if the surrogate is indeed a close relative of the couple or is a first-timer — two main criteria in the Bill,” he said.

But there are others who feel the Bill is a must. Author and activist Pinki Virani, who has been calling for a stop to the “unethical trade”, had told TOI the Bill has loopholes, but these are “pluggable”. What is important to understand is that “the abetted human reproduction industry involves high stakes, made higher by a failure rate of 75%”. “Practitioners set themselves up as benevolent fertility fairies even as they perpetuate patriarchy, making a woman feel worthless if she doesn’t have a child. Many feel the need to believe them. They don’t seem to mind the higher-than-average risk of cancers afterwards. It doesn’t seem to matter that more convoluted the process of starting a tiny human in a lab, more complex is the after-effect on that child,” she said.

Until August, Sekhar’s centre handled 15 to 20 cases of surrogacy every month. “We have to refuse couples though for many — including women battling cancer or who’ve undergone hysterectomy — surrogacy is a real option,” he added.

Doctors TOI spoke to in Mumbai and Delhi said the situation was much the same. The count of surrogacy cases, which reduced to a trickle since the drafting of the new Bill, has tapered off, claimed a specialist at a reputed hospital in Mumbai. “For us, it isn’t logistically possible to accept new cases as preparation takes two to three months. Since chances are the Bill will become law by the year-end, we don’t want to take a risk,” said the doctor, on the condition of anonymity. He added, “If those couples don’t fit the bill under the new guidelines, we might have to terminate the process midway.”

Couples who are set on surrogacy and can afford it are looking to Ukraine and Georgia for surrogacy services. There are also pockets in the US where commercial surrogacy is still legal. While charges in India range between Rs 12.5 lakh and Rs 15 lakh, overseas it may cost anything from Rs 25 lakh to Rs 31 lakh, travel, accommodation and other expenditures not included.

“We spent the last few weeks working out the finances. We have connected with some clinics in Ukraine. Nothing is less than $45,000 (about Rs 32 lakh),” said Manav (36) from Hyderabad. “Worse, this is the cost of a single cycle, which means if the embryos from the first attempt don’t lead to a successful pregnancy there’ll be no second chance. In India, the total cost covers multiple cycles.”

Doctors themselves have been suggesting the new destinations to couples. “At Bengaluru centre too we have couples who are now mulling going abroad for surrogacy,” Sekhar said. In Gujarat, Dr Patel said tie-ups were the only option. “We have no choice,” she said.

Among couples affected are 36-yearold Krishna (name changed) and his wife whose multiple attempts at conceiving, even with IVF treatment, failed. In a letter to the Union health minister, they wrote that the Bill may be well-intended but has distressed them. They shared their fear about the “altruistic surrogacy” clause that they said would encourage “secret financial arrangements within family (and) malpractices”.

Such stories are aplenty at International Fertility Centre in Delhi as well, said Dr Rita Bakshi. She either turns down new patients or asks them to sign a mandatory affidavit before even considering their case. “We are making an exception only in very dire cases. But they are all being asked to sign an understanding that states we may not be able to proceed with the surrogacy if the Bill is passed,” Dr Bakshi said.

Dr Bakshi disagrees with parts of the Bill, but acknowledges the need for regulation. “It could have been drafted to ensure surrogate mothers are not exploited and couples opting for it follow due diligence,” she said. “On the one hand you decriminalise Section 377, and on the other you deny LGBTQ people the right to a child. It is absurd,” she added.

According to the Bill, only couples married for at least five years can opt for surrogacy. There is no room for single parents either. Their only option will be adoption, once Rajya Sabha passes the Bill. But adoptions in India aren’t easy.

Srikanth and Sandhya (names changed) may well be among the last surrogate parents in this country. Waiting for their child to be delivered by April 2020, the software engineers are grateful for the window they got.

“Though the new Bill provides for a 10-month breather — for those like us who opted for surrogacy before August — we are still jittery,” said 42-year-old Srikanth. “My wife has undergone multiple abortions and failed treatments, even via surrogacy, in the past. This is our absolute last shot. If something goes wrong along the way, we’ll be left with no hope.” The Times Of India