Wombs for Rent
by Gagandeep Kaur

The term surrogacy is generally associated with women unable to bear children of their own because of medical complications. However, an increasing number of healthy, married working women are now making inquires about surrogate motherhood. Keen to be mothers and yet not willing to put their careers on hold during the childbearing months, these career-driven women have given a new twist to the concept of outsourcing.  
Says Dr Sunita Tandulwadkar, Chief IVF (In-Vitro Fertilisation) Consultant and Endoscopist at Ruby Hall Clinic, Pune: "We have got two queries in the recent past by career women who wanted to go for surrogate wombs so that there wouldn't be any break in their careers. One of these women is a 32-year-old woman based in Singapore. She has taken the surrogate woman with her to Singapore for delivery. The second is a woman based in South India and working in the IT industry."

Dr Tandulwadkar is not the only one to record this unusual trend. "In the last couple of months, we have received four inquiries in which the reasons for surrogacy were other than medical. Two were career women who didn't want to hinder their career. However, we never entertain surrogacy for such causes and only medically-indicated genuine cases are taken up for surrogacy," says Dr Nayna Patel of Akansha Infertility and IVF Clinic in Anand, Gujarat. This largely seems to be the response of the medical fraternity. "We advise these women not to go in for surrogacy since medically they can conceive and deliver babies. We also tell them that a bond is formed between mother and child during pregnancy, " says Dr Tandulwadkar.

But, how is the surrogate mother selected and what is the health/age/social checklist when choosing a surrogate? Primarily there are two ways: one, where the doctor helps in the selection of a surrogate mother; and two, the prospective couples place an advertisement in the newspapers. After the surrogate mother is identified - she should be above 18 years of age - the doctor does a thorough medical examination to check for past ailments. The candidate is also checked for HIV/AIDS.

This emerging trend raises a number of sociological issues: Are women trying to sidestep the challenge of bearing children? Has the pressure of balancing a home and career begun to take its toll? Are working women forced to behave like men in a man's world? Do people believe that in an era of consumerism, everything can be bought?

While the issues are discussed and debated, India continues to become a popular destination for surrogacy - affordable expenses being just one of the reasons. In India, the entire cost of a surrogate pregnancy comes to around Rs.2,25,000 (approximately US$5,000) - around US $35,000 cheaper than the cost abroad. Excellent medical treatment and the easy availability of surrogate mothers has also resulted in an increasing number of childless foreigners coming to India for surrogate babies.

While career conscious women and, of course, childless couples have their own reasons for surrogacy, women who lend their wombs for the IVF treatment to eventually bear another's child generally do so for money. As per the IVF technique, the egg of the biological mother is fertilized with sperms of the father in a test tube. The embryo is then transferred into the uterus of the surrogate mother.

Take the case of Pushpa Jagdish Pandya of Anand, who has become a surrogate for the second time. Pushpa, who has two children of her own, was paid Rs 1.5 lakh for lending her womb. "It was mainly for purchasing a house and for the future of my kids that I decided to do this. Of course, it is difficult to give away the child... you become attached... but I also know that the couple badly wanted a child and they will look after it well. However, this is the last time that I am doing it," says Pandya, who has received the support of her husband and family.

Interestingly, over the last two years, six women have acted as surrogates in Anand alone. "They (surrogate mothers) initially do it for monetary gain but as they come in contact with the infertile couple, their main aim is to give joy to the infertile couple. Initially, it was very difficult to convince women to become surrogate mothers, but now... the idea is becoming more acceptable," says Dr Patel. However, she believes that relatives make better surrogate mothers but that they should totally believe in the idea.

Incidentally, with a growing number of women giving priority to their professional lives over childbearing by outsourcing a womb, surrogacy may just add to the coffers India's health industry - slated to be worth $2.3 billion by 2012.   

May 5, 2007

I-Day miracle at city hospital

16 Aug 2005
Indian Express

PUNE: Two years ago, on Independence Day, Ruby Hall Clinic?s In-Vitro Fertilization (IVF) centre had its first test tube baby. This year, the centre created a record on August 15, as a post-menopausal 50-year-old woman, in a highly complicated case, gave birth to twins.
Bhomi Bhote, CEO of Ruby Hall Clinic said that the woman had approached Dr Sunita Tandulwadkar at the IVF centre. During her first visit she was detected with a large fibroid and she also suffered from uncontrolled diabetes and hypertension.
She was advised against pregnancy, due to high risk factors like age and other health problems. In addition, she would also require a major surgery, laparoscopic myomectomy, before planning a pregnancy.
It took two months to her control diabetes and hypertension. She also underwent a myomectomy to take care of the large fibroid. The wounds took nearly four months to heal and then she was taken up for the IVF programme, where two quality embryos were transferred. Although in her first attempt she conceived twins, continuing the pregnancy was a challenge.
There was constant threat of rupture of the uterus. Due to her menopausal condition, the size of the uterus was smaller than those of a reproductive age, said Dr Tandulwadkar. However, untiring efforts by Dr Ajit Tambolkar of Poona Hospital and Research Centre and Dr Abhay Mutha of Ruby Hall Clinic, the diabetes and blood pressure were controlled with insulin and anti-hypertension drugs.

The pregnancy was uneventful for 36 weeks when the delivery was performed by C-section. The twins weighed 1.9 kg and 1.5 kg respectively.

IVF babies now healthier with blastocyst transfer
14 May, 2003 l 0643 hrs ISTlHUNED CONTRACTOR/TIMES NEWS NETWORK

AT 5.30 pm on Monday evening, gynaecological endoscopist and chief IVF consultant of Ruby Hall clinic, Dr Sunita Tandulwadkar, is a bit tense as she waits for a television screen to come alive. A few seconds later, it does and the image produces a whoosh of excitement in her.

“Yes, we are doing great,” gushes Dr Tandulwadkar, referring to the growth of an embryo that has been monitored for the past three days. The situation is important because this particular centre is the first in the world which has done a blastocyst transfer within three months of its set-up.

Providing an explanation, Dr Tandulwadkar states, “Inspite of the many advances in the field of Assisted Reproductive Technology (ART) and the mushrooming of the new In-Vitro Fertilisation (IVF) centres around the world, the takehome baby rates have been stubbornly low, mainly because of broken down cells, slow cleavage rates and limited length of survival which pose serious problems. What happens, therefore, is that couples may invest a huge amount in the process, but the guarantee factor is limited to a mere 25 to 30 per cent. This can result in a financial and psychological blow to those who have found the courage to undergo the operation. The blastocyst transfer process is one that pushes up the success rate to above 65 per cent.”

Based on guidelines provided by the Sydney IVF Centre (said to be the best in the world), Dr Tandulwadkar undertook a year-long study process, visiting centres around the world. In simple terms, a blastocyst culture allows genetically defective embryos to cease development and allows only the toughest to survive for longer periods in vitro, thereby producing a select population of embryos for transfer in the uterus.

What’s more interesting is that Ruby Hall’s IVF Centre is now equipped with state-of-the-art incubators which implies that embryos can be frozen and stored for a period of 10 to 15 years. “We can have couples coming back to us for another child and the embryo would be ready for use.Where incubators are not available, healthy embryos are thrown away,” explains Dr Tandulwadkar.