Surrogacy doctors from India discuss – surrogacy in India, the cost of a surrogate mother, laws/formalities, and the process related to bringing a surrogate-born child back to the home country (USA, UK, Israel). The experts talk about the surrogacy clinic, egg donor, IVF and other fertility treatments that are performed in India.
Below is a transcript of the interview with Dr Kaushal Kadam and Dr Pratik Tambe:
Dr Kadam: Hi, I am Dr Kaushal Kadam. I am the scientific advisor at the Rotunda Center for Human Reproduction. I graduated from the B.Y.L. Nair Medical College, Bombay, seven years ago, after which, I joined Rotunda, and have been doing fertility practice since then. At Rotunda, we excel in third party reproduction.
We have a number of successful cases of donor egg IVF and surrogacy. Rotunda, in India, is offering surrogacy to innumerable patients.
Dr Tambe: I am Dr Pratik Tambe. I am the clinical associate here, at the Rotunda Center for Human Reproduction. I graduated from the KEM Hospital and the Nowrosjee Wadia Maternity Hospital 8 years ago.
Since then, I have had 5 years of experience in infertility and obstetric surgeries. I have recently joined Rotunda, about a year ago, and I am responsible for co-coordinating
the surrogacy program here.
Rotunda surrogacy clinic is one of the leading centers in India that is offering surrogacy to heterosexual as well as gay couples.
Dr Kadam: At Rotunda, once the patient gets in touch with us, we initially review the entire medical history of the patient and get to know why exactly they need surrogacy. We require a letter from their reproductive endocrinologist, stating that they are not able to carry their pregnancy to term and hence they need surrogacy.
Once the history is reviewed, they have to go through a battery of tests and investigations to confirm whether they are eligible for surrogacy. Once the tests are done, we ask them to register with our program. It then takes about 4-6 weeks before we can provide a surrogate. We e-mail the patient a profile of the surrogate along with a picture. The profile contains various data, such as, the height of the surrogate, the weight, her education, occupation, the number of children she has had, her complete obstetric history, her menstrual history, and the current pathology results.
Once the patient confirms the surrogate, we then plan and co-ordinate a cycle, give them dates for them to travel and ask them to book their tickets accordingly.
Dr Tambe: Surrogacy in India does not have any law as such, governing it, currently. There are some ICMR guidelines which will soon be enacted as laws with minor modifications. Dr Gautam Allahbadia is on the drafting committee of this law.
When we recruit or screen a surrogate, there are a number of factors that we look at. First, the age, height and weight of the surrogate, whether she has a proper BMI, whether she has had children in the past. The maximum age of a surrogate is 35. We also do extensive screening for genetic and family diseases, and an extensive screening for infectious diseases. All the data is provided to the patient, that is, the client.
The surrogate profile includes a picture of the surrogate, and when the patient lands up here, the surrogate is introduced to them for closer interaction.
Dr Kadam: We are also now doing a psychological evaluation for the surrogates, where we evaluate their IQ test.
The other thing that we are starting is Skype Surrogate Connect Program wherein we have the surrogate come in each month and let the intended parents have a look (through Skype) at how the surrogate is progressing each month.
Dr Tambe: Along with this, we have an anonymous donor egg IVF program. We extensively screen them for infectious diseases and any family history of diseases. And, of course, all our donors are below the age of 30, and they have had at least one child previously. So, depending on the criteria the recipient is looking for, religious background, a particular height, weight, complexion, we try and allocate a suitable egg donor for them. They have at least 3-4 to choose from. Finally, when the recipient selects a donor, we confirm the dates with the donor and plan the cycle accordingly.
It is an anonymous program, i.e., the client does not know the name of the egg donor, but they have initials, which are usually short forms of the donor’s name. They also have a profile which shows the complete profile of the egg donor, a family history, and they have a picture as well.
A majority of our cases come from the U.S. and UK. We have also had cases from France, Spain, and from other countries within Europe such as Italy and Germany. We have many enquiries coming in from Singapore and the Far East such as Japan
and Korea. We have also had patients come in from Australia in the last 6 months.
All our surrogates are handled by a single obstetrician so that there is a continuity of care. When the surrogate goes into labor, if it is at term, then usually the intended parents are present in the city. If not, we give them a call and ask them to make arrangements to fly down to Mumbai as soon as possible.
Depending on certain parameters, the obstetrician decides if it’s going to be a normal or a Cesarean delivery.
Dr Kadam: The child is handed over to the genetic or intended parents immediately after birth if they are present. The surrogate does not keep the baby with her even if the parents are yet to come in. The baby is under the care of the neonatologist and the obstetrician till the genetic parents arrive.
The genetic parents then fill in a form at the hospital, which then goes to the Municipal Ward Office. And the birth certificate is issued from there. As per the ICMR guidelines, the birth certificate is issued in the name of the genetic or intended parents. It takes about a week to ten days to get the birth certificate.
Dr Tambe: The birth certificate nowhere mentions that the baby is born out of surrogacy. That is a very important factor. No where in the certificate will the name of the egg donor, if any, or of the surrogate be mentioned. The names mentioned are clearly of the genetic or the intended parents. If it’s a single parent, then it is the name of the father or the mother. If it’s a heterosexual couple, it would be the name of the mother and the father.
Dr Kadam: For patients coming from the US, the procedure is very straightforward as stipulated by the US Consulate. They require a copy of the birth certificate, a DNA-IV check to confirm the genetic link to the baby, a copy of the surrogacy agreement and they then register at the Council of Registry for Birth Abroad at the US Consulate. Most patients are out of the country within 3 weeks with the passport for the baby.
For patients coming from the UK, the procedure is a bit complicated. It takes at least six weeks to two months. The UK Consulate again requires a copy of the birth certificate, a copy of the surrogacy agreement, the DNA-IV check, as well as a copy of the consent forms. Some couples from the UK are required to undergo what is called the ‘Parental Order’ once they go back to the UK.
As far as Spain is concerned, the Consulate requires the necessary documents and a passport is issued for the baby and then they go back home. The procedure takes about 6 weeks.
Dr Tambe: The DNA-IV check is a very simple test. It involves taking swabs of the baby and the parents. We take 5 swabs, seal it in an envelope, and courier it to an independent accredited laboratory in Chicago. This is accepted by the U.S. and U.K. consulates for the purpose of maternity and paternity testing. The turnaround is usually two weeks, at the most. You can
even ask for a fax report. Once the test reports come in, it is a mere formality for the baby to get the passport.
Dr Kadam: As far as Israel is concerned, they require a copy of the surrogacy agreement, the DNA-IV check. They also require the surrogate to visit the Israeli Embassy and certify that she forfeits all her rights over the baby. The egg donor is also required to sign an authorized certificate that states that she gives away all her rights over the baby.
I would definitely say that Rotunda has an edge over all other clinics, as we provide the best facilities and services. Once the patient walks in, there is no need to visit any other center, for any other procedure. All procedures are taken care of, under one roof. Regular updates are given to the parents about the progress of the surrogate and their baby. Utmost care is taken of
the surrogate so that the parents can rest assured that the baby is in good hands.
Dr Tambe: Rotunda is an ISO-certified organization. We have complete and thorough documentation of all our procedures. We aim to provide the best possible service depending on what is the requirement of the patient. There is individualized treatment for everyone and we aim to provide the best that they can get in this country. We have everything under one roof. We hope to see you here soon.
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