Below is the video & transcript of an interview with Dr Gautam Allahbadia, ART (Assisted Reproductive Technology) expert from India who discusses surrogacy. He is vice president of the World Association of Reproductive Medicine.
In addition to a very successful surrogacy & fertility treatment practice in India, he is a visiting lecturer at Tel Aviv University, Israel. He has published more than 120 papers & several text books in the field of human reproduction and has helped many couples realize the dream of becoming parents.
“My field of interest is third party reproduction and embryo transfer. I have, in fact, written a book, edited a monogram on embryo transfer, which is sold all over the world.
“All our expertise is dedicated to third party reproduction including donor egg, IVF and gestational surrogacy. We, at Rotunda, are the only clinic in India that is LGBT-friendly. We offer treatment to same sex couples as per the drafted Indian guidelines.
“We have a large surrogacy program that runs under the purview of the ICMR guidelines. That means, we can offer surrogacy to a heterosexual couple, to a woman who would otherwise not have achieved pregnancy or carried her pregnancy to term due to some serious or debilitating medical condition. This would include women who are born without a uterus, or have undergone a removal of uterus (hysterectomy) due to some problem with child birth or a malignancy; women who have severe arthritis, or some other medical condition which does not allow them to carry a pregnancy to term.
“We ask these patients to provide a certificate from their physician, that says that they would otherwise never have got pregnant, and that, gestational surrogacy is the only way to have a baby.
“The other equally large group, is, same sex couples or homosexual couples, who will never achieve pregnancy without the help of gestational surrogacy.
“The third group of patients, that is now becoming considerably large, is single men. ICMR guidelines allow us to offer gestational surrogacy to single men.
“The third group of patients, that is now becoming large, is single men. ICMR guidelines allow us to offer gestational surrogacy to single men.
“Today, we have treated patients successfully from over 19 countries. We have been covered by at least seven TV channels from Denmark, and Sweden. A U.S. T.V. channel has featured us in a documentary called ‘Made in India’. They follow a U.S. couple on their journey to get a baby from gestational surrogacy in India.
“We’ve got good press, brilliant feedback and word-of-mouth publicity. We are leaders in the field of gestational surrogacy.
“There are always voices of protest against anything new. When IVF started in 1978, Patrick Steptoe and Robert Edwards were castigated. Even frontline newspapers were telling them that what they were doing was absolutely unethical, and today, 30 years down the line, IVF is considered absolutely normal. Even a schoolchild knows what IVF is.
“Similarly, I feel that gestational surrogacy has been unnecessarily hyped by the media. It has been offered since the early 1980s. It is just that, now it is getting politicized. Some women’s organizations and NGOs say that foreigners should not be offered surrogacy in India. What we are doing is absolutely legal and is within the purview of the guidelines laid down by the ICMR. I feel it’s a win-win situation for all: somebody doesn’t have an uterus, a gay couple who would never have been able to complete their family gets a chance to complete the family, and the surrogate who comes from a weaker economic background gets the money to pay for her children’s education or buy a new house, and move on to a better life.
“With surrogacy, you are actually helping two families to progress. So, I don’t think it is unethical.
“The other programs are now benchmarking themselves with our success rates. Annually we have a success rate of about 50%, when we consider that we have patients who are women aged 38 or 39 who want to get surrogacy done. With young and healthy donors, we have 60% success rates. In the last six months, we have even touched 72% pregnancy rates; we also had success rates as low as 38% when we had older women. So, on an average, the success rate is about 50%.
“I have no competition with other people who want to charge less. We are the first people to organize a separate hostel facility for the surrogates. We have our own nurses and nutritionists who take care of the pregnant surrogate’s needs. It is a voluntary program. We don’t confine them forcefully. Right in the beginning, some surrogates move in to the hostel, sometimes with their children, and some surrogates who have family compulsions stay at home.
“We have dedicated a software to give updates to the intended parents. We send regular ultrasound reports to the parents. We have a team of 5 people dedicated to managing the surrogacy aspect of assisted reproduction.
“We don’t cut corners. There are all sorts of clinics and we have positioned ourselves as a premium clinic with a no-nonsense approach. We work 365 days, 24×7. We have two senior doctors always on call. You can call them in the middle of the night and they will talk to you.
“It is not overnight that we have achieved this. From 2005, when surrogacy was opened up for a myriad of indications, for out-of-town and out-of-country patients, we were the first ones to set standards.
“We are continuously on the look out, to give value add-ons to the program. I have been asked this many times, ‘This clinic is 20% cheaper than your clinic. Why is yours more expensive?’ I tell them to try out these cheaper clinics, try interacting with them and they will know for themselves.
“The parents are going to be in another continent, miles away, and their child is growing here in another womb in India, they need interaction. Today, we are the first ones to tie up with DHL for the Rotunda-DHL Cryo-Ship Program where clients could send their frozen gametes or frozen embryos to India.
“We are also, starting the Skype Surrogate Connect Program where we get the surrogate here in the clinic to talk to the intended parents in the States. We connect them through Skype video-conferencing. So, that the parents will have a good idea of how well the pregnancy is going and how well the surrogate is being looked after.
“Every six months, we try to add more to the program.
“This year, we have got enquiries for surrogacy from 30 countries. The only hitch is that according to the new guidelines, before you initiate surrogacy the parents have to give an affidavit saying they have talked to their respective consulate and that it is their responsibility to take the baby back to their country.
“Many of the queries that we have got this year are from countries like Spain, and Portugal,.where they are still battling with their own consulates to figure out how to take the baby back, how to get a passport done for the baby.
“I feel that once these things are sorted out, we could be a very well-known brand across the globe.
“Surrogacy is the combined decision of the husband and wife. They sign a contract, everything is put on paper. There is a schedule of payments which is also outlined. Nothing is hidden.
“From 2005 till date, we have had over 30 deliveries and we haven’t had a single problem – medical or medico-legal. The program is growing well. The surrogates who had delivered in 2005 are now coming back to be surrogates again. Only if the program is fair and good, surrogates come back for a second time.
“I remember a slogan coined by our tourism ministry a couple of years ago at a medical tourism conference in India: ‘First World Treatment at Third World Price. Price is a large constraint for many couples in the West, both in North America and Europe. Here, there are Western-trained doctors, and English-speaking doctors.
“In North America, a surrogacy cycle could set you back by $100,000 or $150,000. In India, the price would range from $25,000 – $30,000, depending on which hotel you stay at, how you travel, etc. Even with travel, stay, and coming to India twice, it would come up to not more than $30,000 per surrogacy cycle.
“What we are careful about is that before we start the procedure, we have to confirm whether the baby will be able to go back. For instance, in Portugal, surrogacy is illegal and a child born from surrogacy is not recognized by the state. So, those problems have to be sorted out before we start.
“Another aspect is that Indian surrogate mothers have to be married women above the age of 21, according to the guidelines. Most of them have had children of their own. In India, it is unheard of, for a middle-class woman to be drinking or smoking. A lot of our Western clients have tried or investigated eastern European programs and then have come back to India.
“Medico-legal problems or litigations are infrequent. This is not a litigious society.”
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