India may be the most populous country in the world, but the number of Indian couples turning to assisted reproduction technology (ART) has seen a steep increase in the recent years. As per the National Guidelines and Regulation of ART Clinics in India, the incidence rate of infertility is between 10 and 15 per cent. In Vitro Fertilisation (IVF) and surrogacy methods have become a boon for couples to conceive babies through a natural process of pregnancy.
Dr Padmaja Divakar, Medical Director, Dr Padmaja Fertility Centre, Hyderabad, explains that a woman opts for IVF procedure when she is not able to conceive for more than a year without the use of any birth control methods. Hormonal, ovulation issues and tubal blocks are few reasons contributing to the problem.
Surrogacy is no more a taboo as the number of people choosing this option is on the rise. “Women with absent uterus, uterine cavity adhesions, multiple large fibroids, high blood pressure and diabetes and heart conditions could all benefit from IVF and surrogacy,” says Dr Firuza R. Parikh, Director, Department of Assisted Reproduction and Genetics, Jaslok Hospital, Mumbai.
“Couples around the age of 39-40 also opt for surrogacy after several failed attempts of IVF knowing that only a surrogate could help,” says Dr Nayana Patel, Akanksha Hospital & Research Institute, Anand.
“Awareness, better acceptance by society and family, independent living, financial stability is encouraging people to opt for this technology,” says Firuza. “The surrogate knows that there is no harm in helping another woman and is more open to becoming a surrogate,” says Nayana.
India has become one of the growing hubs for commercial surrogacy, with many people coming to the country in the hope of having a child. However, the Indian government has sought a ban on commercial surrogacy, which allows only Indian married couples to use the service.
On the contrary, infertility specialists feel the ban could lead to illegal surrogacy industry. Dr Nayana feels that government should consider stringent regulation than seeking a complete ban.
IVF is a process where the egg is fertilised outside the body and embedded into the womb after few days of fertilisation. “The eggs are retrieved from the ovary, while the sample is also collected from the husband and is processed by the lab. The sperms are then injected into the eggs and kept in the incubator. After few days of fertilisation, the eggs are then implanted into the uterus of the woman. The pregnancy is considered viable after 15-18 days when the beta HCG level in the woman’s blood is more than 300. A woman can carry the baby to full term when the foetal heart rate is normal,” explains Padmaja.
Surrogacy involves the use of a surrogate’s uterus to implant and carry the embryo and deliver the baby for another couple. “The surrogate lady undergoes vigorous medical, physical and psychological checkups before the concerned parties sign the agreement forms. The genetic parents undergo IVF. The surrogate undergoes stimulation of the uterine lining, either with hormone replacement therapy or with injections. The centre prepares the embryos, and when the uterine lining is ready, two good quality embryos are transferred. Then the surrogate moves into the surrogate house where she receives adequate medical treatment,” says Firuza.
Experts quote that the results of IVF are better in the younger age group of 28-33 as the quality of the eggs are good. Similarly, in surrogacy, success rate is high in younger couples and quite low in the older age.
“The IVF costs up to Rs 1.5 lakh, inclusive of everything for each attempt. Multiple attempts are required since the procedure may not be successful in the first attempt,” says Divakar Reddy, Managing Director, Dr Padmaja Fertility Centre, Hyderabad. “Cost of surrogacy would range from Rs 12-15 lakh, without the cost of IVF,” says Nayana.
Side effects of IVF include dizziness, discomfort, headache or bloating sensation. Few patients experience Ovarian HyperStimulation Syndrome (OHSS), a condition where there is enlargement of ovaries and fluid builds up in the abdominal cavity. “This may occur several days after egg retrieval or early stages of pregnancy. Emotional stress is one of the main side effects, which one could avoid if your expectations are realistic,” says Padmaja. “Surrogacy treatment is legal, secure and not dangerous if done by reputed IVF clinics,” says Firuza.
Tips for Successful IVF/Surrogacy
“Surrogacy should not be demeaned or given a bad name. It is one of the practical arrangements to deliver a baby,” says Nayana. “The nutrition of the surrogate mother and her dental hygiene are crucial along with regular antenatal check-ups and delivery in a safe environment,” says Firuza. “It is important to go to a specialised centre, where you get expert diagnosis, and not get depressed if the first IVF attempt is unsuccessful,” says Padmaja.