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Tuesday, July 22, 2014

Embryo transfer to Rita and the plight of surrogates in India

The day of embryo transfer came. My two frozen-refrozen embies were thawed.  I was not a bit nervous about the thawing process. I know Dr.Sai is competent enough to do it in a good way. I was just waiting for the photos of the embryos.  Actually, I felt a lot more relaxed than if I have to accept those little embies in my uterus. In other words, nothing appeared real. We were in Tirupathi on the day of ET, praying to Lord Venkateswara ( ridiculous right, you outsource your duty to someone and pray to God ;). I was wondering about Rita! How will she be feeling? Does she really know what it means by embryo transfer? I mailed Dr. Malpani requesting him to  show her the embryos. What will she think seeing those minute blasts? I had no way of talking to her. I don’t know to speak Hindi, Rajender could speak (this is a very big disadvantage!).  Inspite of Dr. Malpani’s insistence that I must meet Rita, I was very reluctant to do so. At those times my thinking was like this: I must never get involved in any way in my surrogate’s pregnancy. I shouldn’t develop a bond with the baby or the surrogate. Once upon a time I even told Dr, I don’t even want to see the ultrasound photos. I thought naively, I will see my surrogate when I have my baby in hand. The pain I have gone through and the pain I saw in Rajender when we lost our babies wanted me so badly to protect myself and my husband against any further pain brought about by any untoward happening. My thinking is - if we are in no way involved in this pregnancy (other than giving our gametes) our pain will be less if something unfortunate happens!  I didn’t realize at that time that my thoughts were too childish and it can never be like that in reality.

Dr. Sai promptly sent me the photos of my embryos after the transfer. They looked perfect; I would say Dr. Sai managed to thaw them perfectly, close to 100%. Dr. Malpani sent me a mail saying that everything went well. I entered into a 2ww which is completely new to me. I was so relieved that I will not have any restriction in my activities from my loved ones (actually in every restriction they put for me I feel their insecurity and pain, it is very difficult to face it); I was relieved that I don’t have to obsess all the time about my uterus area; I was extremely relieved that I don’t have to perform that evil urine pregnancy test at the end of 2ww and nervously wait for a tiny pink line which will decide our future. I was also so relieved that I am in no way involved in the outcome of this FET cycle (although this thought is a kind of delusion) - may it be a positive or negative! What a pleasant 2ww! I was wondering what kind of instructions were given to Rita after embryo transfer. I wanted Rita to go on with her daily life and not lying down even for a day after the transfer.  I hope she didn’t!

During the 2ww, I thought more about Rita than my embies. What it means for her to carry my baby? How will she feel when the pregnancy test comes back positive? Being a first time surrogate, will she be happy or scared if the test comes back positive? I thought, perhaps only when she gets a positive pregnancy test, she will start to realize the real impact of the job that she will be doing for me. I must admit that Rita will get only a meager 2 lakh rupees (less than 4000 dollars!) for the tough and altruistic job she will be doing for us.  But I and Rajender have always thought, when she gives us our baby, her children’s education will be our responsibility (she has two lovely children-a boy and a girl). Rita will be a member of our family, she will be there with us during all the important happenings in our family and we will be there for her through thick and thin (if she wants it that way!) I wanted her to be one among us and my child will grow up knowing that he/she has two mom’s – the one who carried in her womb and the one who unfortunately couldn’t carry him/her in her uterus but who will always carry them in her heart ! After all Rita is doing something for me which my sister wouldn’t or couldn’t do. Treating her the right way is the best compensation I could give her for what she will be doing for us. Loving her and not using her is the way to go!

Surrogay in India is 10 times cheaper than in USA. If an US surrogate receives 40,000 dollars for her altruistic act, Indian surrogate gets only 4000-8000 dollars! This has turned India into a surrogacy hub. This is what attracts lots of foreign couples towards India for reproductive tourism. Such reproductive tourism benefits India as it earns lots of foreign exchange; it benefits doctors as they do see a good amount of profit; it benefits the tourists as they have a chance to get the baby they yearn for in just 1/10th of the price when compared to surrogacy in their own country; but does it benefit the surrogate? I would say yes, that is why they are ready to undergo the whole process. In a poor surrogate’s point of view 2 lakhs is a big money. It helps to alleviate their poverty at least a bit.  Of course those few thousand dollars will not be enough to buy even a piece of land or a flat. It will not be enough to give their children the best education possible. Maximum they can do with that money is to live well for a year or pay their children’s school fees for two years (for a decent education)! Or they could pay the debt they have got from someone at a huge interest which is handicapping their normal life. This is all they could do! On the other hand, a rich person in Mumbai will easily spend more than 2 lakhs in a night for a party! If it is so, then is the compensation an Indian surrogate gets is unfair? Is it financial exploitation of poor women? I would say, yes and no. If surrogates are able to do some other job which could give them this amount of money, many wouldn’t prefer to carry someone’s baby due to the social stigma involved in it, especially in a society like India. Just because they have no source to earn that little money, is it OK to pay just 2 lakhs - 4 lakhs for Indian surrogates? I don’t know what others think about this but for me it does appear unfair and I think instead of discussing what is wrong, who is wrong and getting on with my own life, it is wise to do what is just in my eyes to my surrogate! Will I be able to keep my word?! :)

Other then the meager compensation an Indian surrogate gets, there is one more danger Indian surrogates are always exposed to: lack of freedom of choice! Indian surrogates are not highly educated women. Many are illiterate and even if they know to read and write, it doesn’t mean they could understand the medical terms or medical details that are shared with them.  Many lack basic medical knowledge; like many of us, they suffer from health illiteracy too. Many find it difficult to grasp the medical information provided to them and make use of it aptly. This makes them highly vulnerable to exploitation in many ways.  For example, consider this situation: there comes a couple to an IVF doctor with a demand that they need twins via surrogacy. They promise to offer him more money for that. Remember, doctors work for the commissioning parents as they are the one who is paying him. So naturally many doctor’s aim will be to take into consideration the best interest of the commissioning parents. In order to achieve a twin pregnancy or in order to achieve a pregnancy, the doctor transfers multiple embryos to the surrogate. The decision how many embryos to transfer to surrogate’s uterus is not left to Indian surrogate’s hand. Only the doctor and the commissioning parents decide that, but the risk of multiple pregnancy has to be borne by the surrogate and her body! There is no one for an Indian surrogate who will act on her best interest, someone who could talk on behalf of her and help her to take decisions which benefit her the most. I read in a blog where the prospective parent wants her surrogate to take a particular vitamin. She writes, 'I am not sure whether my surrogate is taking what I give her. So I asked her to take the vitamin in front of my eyes'! This might appear as a trivial issue but this clearly shows how helpless and vulnerable Indian surrogates are! If it is in USA, no surrogate will heed to your orders. If they think that particular vitamin is not going to do any good or if they find it uncomfortable to take it, they can politely refuse your request. They have the freedom to choose! Another example: a surrogate’s early first trimester TSH level is 2.63. The biological parent reads in a scientific journal that the TSH must be within 2.5 during the first trimester and that gives the baby the best possible environment to grow. She gets very nervous and asks the IVF doctor to put her surrogate on thyroxine therapy. A TSH of 2.62 will not harm the baby or hinder its development in any way. As the pregnancy progresses the surrogate’s body will start producing more thyroxine to meet the growing needs.  There is no rationale to give the surrogate thyroxine therapy as it is a hormone which in excess can create lots of problem for the surrogate as well as the baby. But the commissioning parent is adamant that the surrogate’s TSH level must be corrected. Obviously most doctors who work on the best interest of their patient will put the surrogate on thyroxine therapy in order to satisfy his patient. An Indian surrogate will obviously not know what thyroxine is and what effects it will have on her body! If I could give one more example, a surrogate is in her 37th week of pregnancy, the commissioning parent want the baby to be removed from the surrogate via c-section as she was paranoid for many different reasons about vaginal delivey’s effect on her baby. Or, one of the commissioning parents has his/her birthday on a particular date and they want their baby to be born on that particular date. Or, the commissioning parent’s family believes that if the baby comes into the world on a particular day and in a particular time (auspicious day and time fixed by the astrologer!), it will do the family good (yes such people still exist!). The commissioning parent demands a c-section on a particular day. They ask the surrogate whether she would like to have a c-section and the surrogate was too tired to carry the pregnancy for many different reasons (she is eager to get back to her family and children instead of lying in the hospital for 3 more weeks). She says that she will agree to c-section and she desires that too! It is a well-known scientific fact that c-section posses additional risks to the mother. Should the surrogate’s wish be considered and a c-section ordered? Is she wise enough to take her own medical decision by weighing the pros and cons? I hope these examples will make you understand how easily an Indian surrogate could be exploited. I wish every Indian surrogate has a patient advocate with her who works on her best interests! 

There is another view about Indian surrogates too. An Indian surrogate is poor and illiterate. She will do anything for money. Since she works as a surrogate in want of money she doesn’t deserve to be treated well. She has no moral values whatsoever. If you give her more space, she will demand from you more money (yeah, she will build a palace by looting you!). If you get increased vaginal discharge it is overgrowth of your vaginal flora, but if your surrogate gets increased vaginal discharge, it is STD! And even more, there are people who shout at their surrogate instead of thanking her when she was lying in pain after the c-section!  No more a poor woman, who is risking her health and life to carry your baby, for the beggarly compensation you provide could be insulted! Actually, the reality is, Indian surrogates are highly desired because they live in a family setting, don’t use intoxicants, they are humane, friendly and humble than women elsewhere.

Please remember, your relationship with your surrogate is a two way street. Loving your surrogate instead of using her as a baby-making machine will makes a lot of difference in the way she cares for your baby! 

So what happened at the end of 2ww? Did Rita conceive?


  1. I have been following your blog for the past one year. I am so happy that you have been able to overcome the loss and share the story of such a beautiful jouney to surrogacy. May God bless you and your family in every way.

  2. Good luck. Assuming you are successful, will you attempt to breastfeed?

  3. Thanks for sharing this informative post about surrogacy in India. It's sad that they receive a small sum, as well as lose ownership of their own body.


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