Surrogacy Laws Inconsistent?? Are They?
According to Dr. Samit Sekhar “the ICMR draft bill 2010 runs into hundreds of pages pretty much covering all the aspects of the Assisted Reproductive Technology”, still the reporter feels that the laws are inconsistent/inadequate
Below Dr. Sekhar focuses on few points the reporter raises and tries to answer them.
Question 1: There is no stipulation on the number of times an intending couple or individual can make use of surrogacy.
Answer: Schedule 1 part 7 of the ICMR draft bill states clearly the “information and counselling to be given to patients” and states that Doctors at their discretion should advise how many times a couple can undergo the process, pregnancy rates/cycle etc.”
Question 2: Further there is no maximum age limit prescribed under the Bill for the couples or individual in order to be eligible to make use of ART though the minimum age limit is prescribed as 21 years.
Answer: Yes whilst its true that there is no maximum age limit, a study done at our clinic has shown that only 1% of couples who seek ivf/Surrogacy are beyond 60 years in age, only 3% are between 55 to 60 years of age and only 6 % are between 50 to 55 years of age.
So a great majority of these patients are below 50 years of age, it is pertinent to understand that with modern medical science life expectancy is improving tremendously and folks are able to live a healthy life well into their eighties and nineties. So if a couple who is paying from their own pockets wants to have a baby in their fifties the Government has no right or business trying to stop them.
“I can understand that in the UK they prevent women from undergoing IVF in their late forties but that is because the NHS pays for their treatment. This does not stop women in their forties from coming to India for IVF/Surrogacy because this treatment they avail on their own expense.”
So how do we screen women with advanced age(beyond 45)? Well first of all if a woman wants an IVF done then obviously she needs to undergo a detailed health check and see if she is fit enough to carry a pregnancy to term. It is important that the lady in question is not at risk of developing pregnancy related Diabetes, Hypertension, Heart or Kidney diseases.
Obviously at 45 years or more she will require an egg donation and it is pertinent to understand that in such scenarios, we do not transfer more than 1 Blastocyst to prevent a twin pregnancy (high risk in a woman in her forties) unless the patient consciously wants twins in which case we will transfer two Blastocyts after detailed counseling and consents.
Question 3: There is no screening of the socio-economic/family background of the couples. Neither are there any eligibility criteria for an individual to be a fit parent to have child via surrogacy. There is no appointed government body to monitor the issue.
Answer: There is no way one can run a check on socio economic/family background of any patient whether they approach for IVF/Surrogacy or any other medical procedure.
The oath we take as Doctors prevents us from discriminating against patients on the basis of their socio economic or family background. What we can do and what we do at the Kiran Infertility Centre is to ask as many questions as legally and practically possible from the intended parents and screen patients who we feel might not be able to take responsibility of a future child.
If we try to legitimize the reporter’s argument should we then prevent all financially backward people from having a child on the pretext that they cant care for their child/children? If according to the reporter she is worried that the surrogate will not be paid then the clinics do have insurance in place for the surrogate mother to cover such scenarios and that is also one of the reasons clinics take an advance from the patients.
Question 4: The ART bill prohibits sex-selective surrogacy in consonance with the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) act. But during the pendency of the bill there is no means to check if the clinics are complying with the same; further there is no effective body to oversee the conduct and operation of clinics.
Answer: The PNDT act is very strictly monitored at every state and district level to prevent such a scenario and the PNDT act is independent of the ART bill. The PNDT act has been in place since 1994 all over India to prevent such a scenario. A district medical and health authority(DMHO) is in place to keep a watch on the functioning of all private hospitals and nursing homes and all hospital and clinics have to obtain a license to function. https://kiranivfgenetic.com/achievements/
About the Author:
Dr. Samit Sekhar
IVF and Surrogacy Program Director.
Kiran Infertility Centre, Hyderabad.