/ 29 March 2006

India’s growing ‘rent a womb’ trade

Daksha, a shy Gujarati woman in her early 30s, wants a child — but not for herself. The baby is for the ”Britishers”, the couple seated in the lobby of the Indian fertility clinic.

It is the first time that the British Asian couple, Ajay and Saroj Shah, from Leicester in central England, have met Daksha. The 31-year-old is ”loaning” her womb to them for 150 000 rupees (about £2 000) and is candid about needing the money. Her shop job pays only 2 000 rupees a month.

She says her friend was a surrogate mother. ”She was paid well. I am not rich so the money will help me a lot. I do not need another child. I have two of my own.”

For the Shahs, who have spent six years and £60 000 on fertility treatment in Britain with little success, the mixture of money, science and light regulation in India has reignited the hope that they will have children.

The British couple appear to be part of a flourishing trade in reproductive tourism in India, which has a more relaxed attitude to paying women for pregnancy, a practice prohibited in many other countries.

Indian clinics report that the incidence of surrogacy has more than doubled in the past three years, with the demand driven by fertility requests from abroad and the decision by some professional women to delay trying for a family until their late 30s.

The treatment is becoming big business in India and is worth about 20-billion rupees (£250-million) a year. The increase in requests from abroad is partly fuelled by the relatively cheap costs. At about £3 000 in Britain, an IVF cycle costs five times what you might pay in India. In addition, in Britain, the Human Fertilisation and Embryology Authority (HFEA) has outlawed payments, but a surrogate can be reimbursed up to £10 000 for expenses.

India’s newspapers have highlighted the trend. A case picked up by papers concerned Lin and David Lee, a Singapore couple, who compared California prices — for egg donor, fertilisation and surrogate payment — with the costs in Mumbai. They opted for Indian clinics to save 2,5-million rupees (£31 000). The Lees are now expecting a baby through a local surrogate.

The Shahs, who are both in their 40s, decided to turn to surrogacy when British doctors told Mrs Shah that she could not bear children.

”We were at the desperate stage,” says Mr Shah. ”We met a doctor from India who came to give a talk about surrogacy. She [said] it is easier to get an Asian donor here.”

Six months later the couple attended Kaival hospital, in Anand, in the Indian state of Gujarat — a hospital that has found seven surrogate mothers in the past 18 months for British and American couples of Indian descent.

The clinic finds surrogates and matches them with prospective parents in India and overseas. Doctors track the progress of the surrogates and keep the paying couples informed.

The hospital’s medical director, Nayna Patel, says she has 20 surrogates. But she says that convincing mothers to take part is still difficult. ”Indian society is still quite conservative and questions get asked. So often these women will just move out of the local area to have the child,” she says.

Apart from the lower costs of surrogacy in India, there are other factors drawing patients from abroad. Indian medical guidelines allow doctors to implant five embryos into a surrogate mother; in Britain, the maximum is two and many European countries are moving towards a single transfer.

In India, the surrogate mother’s right to the child is not given the same importance as in the West — she signs away her rights to the baby as soon as the child is born. By contrast, British law says that a surrogate mother who has provided the egg can claim the baby as her own at any time during the first two years of the child’s life.

”It is a big relief for the foreigners who come to us,” says Dr Patel. ”The whole experience places a strain on the couple and they do not want to be worrying about these things too.”

Campaigners in Britain question the ethics of such businesses.

”What is missing here is a debate about not protecting the rights of the surrogate mother,” says Susan Seenan, of Infertility Network UK. ”It does not matter where you are — in the UK, US or India — giving up a child is a terribly emotional issue. We have seen that here in Britain and I am not sure the Indian system has addressed that.”

What is being created is a global baby industry that is regulated nationally, leaving loopholes that can be exploited by those willing to travel, she adds.

The Indian Medical Research Council, which oversees medicine in the country, does not have any guidelines to deal with foreign clients using Indian surrogates. But a study is being prepared to assess the issue.

Officials at Britain’s HFEA say there is little that can be done. British immigration law, however, does provide some restraint, as a child born to an Indian woman would not automatically get a British passport. Dr Patel says that this problem came to light in 2004 when she helped an Indian grandmother have a baby for her British daughter.

”They had twins but it was not until late last year that they were given British citizenship. It was a difficult time for everybody,” says Dr Patel. They had been refused British passports because they were born in India and their host mother was not a British citizen. A spokesperson for the British High Commission in Delhi said that families who sought surrogate mothers in India should contact immigration officials to ”better understand the process”.

This cuts little ice with the Shahs. ”This is our last chance to have a family,” says Mr Shah. ”We will manage … even if we have to adopt our own kid.” — Â