Ajay Kiran Hooda’s world came crashing down when she lost her only son aged 25 in a car accident two years ago. At 55, the physical education teacher from an upscale Gurugram neighbourhood had no expectations to live the joys of being a mother again. She was past her natural age of conception. Then doctors suggested In-Vitro Fertilisation (IVF) an assisted reproductive technology (ART) that involves fertilising an ovum outside the body, in a laboratory dish, and then implanting it in a woman’s uterus. She got an ovum donor, and later underwent embryo implantation at a Delhi hospital.
She came to us as a rare case of postmenopausal pregnancy. Today, she is a proud mother of twins, said Amita Shah, Chief of Obstetrics and Gynaecology at Columbia Asia Hospital in Gurugram. But behind such happy endings are thousands of ovum donors in southwest Delhi’s Kapashera and Samalkha, besides villages in and around Gurugram’s Maneser industrial areas where a large number of young women and men work as labourers and helps.
A willing egg donor must first take drugs for nearly three weeks to suppress her natural cycle. She is then injected with hormones to stimulate her ovaries. This is followed by ultrasound tests to confirm if the eggs are ready and another round of hormone injection to induce ovulation. Finally, on the donation day, surgery is performed on the donor under anaesthesia. A needle is used to retrieve the eggs.
Many of these women suffer from health complications, including varying degrees of ovarian hyperstimulation syndrome (OHS), a medical condition which in extreme cases can lead to death, a Mail Today investigation found. Some of the other related symptoms include bloating, weight gain, nausea and, in severe cases, blood clots and kidney failure. Women say they are doing it for money. Kapashera’s Sharmila Verma (27) said, My husband works in a garment factory. His monthly income was just Rs 12,000 two years ago. A group of nurses from a local hospital contacted me and offered good money for eggs. I initially hesitated but said yes for a respectable life and a better future for both our kids. Vinita Thakur (24) learnt about egg donation in a hospital where she had admitted her son for dengue treatment three years ago. I badly needed money. A nurse offered a good sum and I said yes. I do it five times a year. I suffer from nausea. But it’s still easy money, she said.
The IVF boom is because pregnancies happening at an advanced age are increasing because of late marriages, single parenthood and women opting to have children at a later age. The social stigma of being childless and lengthy adoption processes have increased the demand for ART procedures such as IVF, sperm donation and surrogacy. Dr Shivani Mathur, a prominent gynaecologist in Gurugram, said: Egg donation sounds immoral but is not illegal. In the last three years, IVF market has almost doubled. Delhi-NCR has over 300 IVF centres and they handle over 1,500 such cases a month.
While in the West, egg donors sign a contract with the client or a hospital, here it’s mostly the middle man who calls the shots and acts as a bridge between the donors and hospitals. This leads to monetary exploitation as well. Guidelines ask hospitals to arrange egg donors through certified banks, but the ground reality is different. Sources say that in several cases the hospitals with IVF facilities themselves contact middlemen for eggs. Tarun Mehta, a tout in Samalkha village, admitted he was in touch with over 30 IVF centres in Delhi and Gurugram. For each order, I charge Rs 55,000 to Rs 70,000 to a hospital. I pay 40-50% to the donor, he said.
Recipients of eggs are not entitled to get information about the donors as per IVF guidelines but there is a huge demand for young women from states such as Jammu and Kashmir, Himachal Pradesh, Punjab and Haryana in the age group of 20 to 30 years due to their desirable fair complexion. The rate depends on the woman. It’s high for donors from Kashmir, Punjab or Haryana and low for those from Bihar, Uttar Pradesh and West Bengal, Mehta admitted. Women said they go for egg donation because surrogacy is time-consuming and it costs customers much more. A surrogacy consultant in Gurugram’s sector 38, Satish Kumar, said We have 20 surrogate mothers. The cost is Rs 12 to 13 lakh. Gurugram Police PRO Subhash Bokan said We are aware of the nexus of hospitals and touts. If we receive complaints from donors, we will inform the health department and book offenders.
No legislation currently regulates assisted reproduction in India. In 2002, the Indian Council of Medical Research (ICMR) laid out guidelines for surrogacy. Further, in 2005, the ICMR issued guidelines for ART clinics. The Assisted Reproductive Technology Bill was first proposed in 2008. The latest version came in 2017. The Surrogacy (Regulation) Bill-2016 is pending in Parliament. (Some names have been changed to protect identity)