Tuesday, 30 July 2013

kiran infertility centre newsletter

No guidelines for surrogacy for applying passports!!


each country where surrogacy is legal does have an application process for applying for a passport for a newborn post birth.
we at the Kiran infertility centre have helped couples from more than 21 different nationalities have babies through our surrogacy program.
during the past four years our legal team have learnt the process involved in applying for these passports and now they can safely say that they are well versed with the process.
there are different laws for each country and it is clearly spelt out on the websites of these countries.
for example the Process for the USA which is the most common is clear and more information can be gathered by writing to them on HydACS@state.gov
similarly there are different application process for different countries like canada,Uk,Spain,Brazil etc.for countries where the process is not outlined clearly our lawyers or the intended parents themselves write to the respective consulates before entering into a surrogacy agreement.
some consulates take less time to issue passports for the newborns(usa-2 weeks)some take an abnormally long time-Uk-(2 to 6 months) since they have different process if the Surrogate mother is single and a different process if she is married.
obviously if a foreign couple does have a baby through surrogacy in India then they atleast one of the parent has to prove a genetic link to the child via DNA test.only in such a scenario will the Designated country issue a passport for the newborn.
the problem arises when the intended parents dont do a background check and approach clinics or surrogacy centres in india who are not well versed with the legal process.they do not realise that the newborn will be subjected to a DNA test post birth in a majority of the cases and often do a complete embryo donation when they are not able to get the desired results using gametes from the parents themselves.this leads to a legal imbroglio because the Country of intended parents will refuse to give a passport and the Indian Govt can only issue a passport if the parents can legally adopt the child which can be done only on Humanitarian grounds maybe only after  a court directive/order is obtained.
so its important for Intended parents who wish to pursue surrogacy in India to perform a proper background check of the place they have selected for having their baby through surrogacy.
Dr.samit sekhar

Monday, 29 July 2013

Surrogacy laws inconsistent??

are they?
 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
let us see a few points she raises and lets see if we can answer them to her satisfaction.
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 http://www.kiranivfgenetic.com/resource.html
 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 buisness 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 obviosuly we will do 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 disease.
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 counselling 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 legitimise the reporter's arguement 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 clincs take an advance from the patients.
3>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
Dr.Samit Sekhar

Wednesday, 24 July 2013

Sudan national moves HC against surrogacy norms

A Sudan national Monday moved Punjab and Haryana High Court challenging the guidelines of the Ministry of Home Affairs (MHA) restricting single foreign nationals and unmarried couples from coming to India for purposes of surrogacy on medical visas.
well the matter is subjudice now,so i cannot somment much but hopefully things go back to the way they were before the order came into affect albeit with regulations and monitoring or all Surrogacy clinics.
Dr.Samit sekhar

Wednesday, 17 July 2013

Surrogate children in India deprived of mother's milk ????

Goes the headline in a major Indian news paper!!the reporter states that "The Health Ministry guidelines on the regulation of ART clinics fail to address the issue of breast feeding for surrogate children".according to the journo"in their haste to hold their babies in their arms, commissioning parents tend to overlook the infant’s need for mother’s milk, despite the fact that is has been scientifically established that mother’s milk is a critical source of nutrition for the infant".

whilst the headline is true it is misleading as  babies born to surrgate mothers do get adequate nutrition through formula feeds.
well a lot of folks have written to me asking here i stand on this.whilst one can never deny the importance of Breast milk as a source of nutrition for the infant there are cases in which formula milk needs to be used.
Breastfeeding is the natural way to feed a baby. Nature has created a unique way of having the right amount of milk in the right place, right temperature and at the right composition.
However, not all women are able to breastfeed. For instance, some women who have had breast surgery can have difficulty breastfeeding. and of course Single/gay men for obvious reasons cannot breast feed.
So is using Formula a good idea?
 a lot of scientific Studies show that there's no great difference in the nutritional or food value of the Breast milk or Formula feeds. If a mother either can't or doesn't want to breastfeed her baby then formula is more than sufficient to feed the new born
however It's vital to buy the correct milk powder to suit the age of the baby. It is also extremely important when mixing up a formula to use the correct amount of powder for the weight of the baby.
while using formula, it's important to be clean and hygienic. Always wash  hands before making a bottle.
Powdered formulas are sterile but may contain bacteria that could give your baby a stomach upset if they are not prepared correctly. Powders must be mixed with water that has been boiled and then left to cool to around 70°C.


Monday, 15 July 2013

How music gives IVF eggs good vibrations by making them more likely to get fertilised

Some of the colleagues of mine are attending the European Society of Human Reproduction and Embryology’s annual conference in London and told me about an interesting presentation by a group of spanish researchers that Playing music to an egg in a dish in an IVF lab increased the chances of it being fertilised by 5 per cent.
The Spanish researchers believe that the tiny vibrations produced by music give fertilisation a helping hand,They think the vibrations may ease the passage of nutrients into the egg and speed the removal of toxic waste, so increasing the odds of fertilisation taking place and the embryo surviving.
apparently Pop, classical and heavy metal were equally good,apparently these group of music lovers placed iPods in half the incubators and left them playing music including pop songs by Michael Jackson and Madonna, heavier tracks from Nirvana and Metallica and classical works by Bach, Mozart and Vivaldi.
When they checked the dishes, they found that fertilisation rates were higher in the incubators in which music had been played.
Embryos don’t develop the ability to hear for at least 14 weeks, so the Doctors think that the vibrations produced by the music are key.
at first the idea seemed bizarre to me but it could have some scientific basis.
after ICSI we keep the Embryos in a petri dish filled with culture media but after natural intercourse the embryos move down the fallopian tubes and then pass all the way to the uterus so maybe the vibrations from the music maybe mimicking this affect! well seriously i dont know! maybe more studies are needed but who would have thought!!


Surrogacy abroad: updated information for intended parents from the united Kingdom.

Latest news is that the Britain’s Foreign and Commonwealth Office (FCO) recently updated its guidance for couples commissioning surrogacy in India apparently to make it more accessible to commissioning parents planning on traveling to India and provides clearer information about the various immigration requirements that intended parents must master in order to navigate a safe journey home to the UK with their surrogate born child.
whilst this seems to be true on paper in reality the British consulate is the most difficult to navigate for intended parents who want to have a child by surrogacy in India.
the usual process  for getting a passport for the newborn is between 2 to 3 months and according to the several British parents who have had a baby through surrogacy at my clinic they never respond to emails,in comparison the American process is fairly simple and patient friendly and they always respond to phone calls and emails..the average processing time is also very short at 2 weeks.
British  surrogacy law applies to British parents all over the world no matter where they get the process done. The rules can seem confusing and daunting for British parents, since  a foreign birth certificate or foreign court order is not the only document enough to entitle their child to a British passport. British nationality law treats the surrogate mother (and if married her husband) as the legal parents regardless of the genetic link to the new born.
The FCO guidelines state-
  • Requirements for a medical visa for foreign nationals intending to visit India for surrogacy.
  • DNA test reports from UK organisations accredited by her Majesty’s Court.however till now none of our patients from the Uk have been subjected to a DNA test.
  • Identity documents from a surrogate mother-Birth certificate/school certificate/pass port/drvier's license/pan card etc.
  • Evidence pertaining to the marital status of the surrogate.if she is single the process is much easier post birth.

Friday, 12 July 2013

Globo tv chatshow on surrogacy in INDIA,

Below is the link of a tv Chat show featured on Brasilian Globo tv.
it features our patients Ivonete,Pedro and their Daughter Estella who was born via the KIC surrogacy Program.its in portugese so i cannot understand much!



Tuesday, 9 July 2013

Relationships formed as a result of surrogacy are valued and enjoyed by surrogates and sustained over time!!

Preliminary results from a pioneering study at Cambridge University paint a positive picture of the relationships formed between surrogates and the families they help to create.
“Our research shows that in the majority of cases, relationships formed as a result of surrogacy are valued and enjoyed by surrogates and sustained over time,” said Dr Jadva,who headed the report.
we ourselves at the Kiran Infertility centre have done research on similar lines and the study is ready to be published in numerous international journals.

Monday, 8 July 2013

Why Surrogacy in India is not a cold commercial transaction.

 on surrogacy again.it seems to me that the Daily mail has special vested interest in Indian Surrogacy.it also seems the Journo has not done a detailed study but seems to have based his article on numerous other articles written on similar lines by vested foreign journalists who are being paid by Clinics and agencies abroad who are afraid of loosing their patients to Indian clinics.
By saying that India has reduced surrogacy to a cold commercial transaction is doing a great disservice to the Indian Doctors,their staff,the infertile patients,their babies and the hundreds of surrogate mothers who offer their wombs to carry a baby for 4 lac rupees.an amount which they will probably never earn in their lifetime.the Journo is also not aware that the Govt. Of India is allowing only married Heterosexual couples to have babies through surrogacy in INDIA since the beginning of this year another reason to believe it is a paid story.

the journalist advocates adoption as a alternative,well he wouldn't if he had applied for adopting a child in one of the numerous adoption centres in INDIA.one has to wait for atleast 2 to 5 years to adopt a baby subject to the numerous illogical checks and balances in the adoption law.
by using word like "cheap",he shows that Some Indians have not gotten over deriding their own people in front of the entire world.American clinics perform the most number of ivf surrogacy cases worldwide yet one never hears a story like this about the American surrogacy clinics and Agencies.
What Indian ART clinics and Doctors  offers is unique and nothing short of a miracle and what the Surrogate's offer is an absolutely selfless act of Altruism and no article or journalist can take this away from them.
Dr.Samit sekhar.
ivf and Surrogacy program Director.


Thursday, 4 July 2013

got a very sweet message from a couple of Spanish parents.

Here is the letter of appreciation we recieved froma spanish couple Carlos and Christopher who had their gorgeous little baby Alba Citali through our surrogacy program.
it is much appreciated by everyone at the clinic.



It has been more than 5 years since we wanted to achieve a dream: become fathers. Life had decided that we had to go through different experiences until make the step to write to different clinic and get rapidly in touch with Kiran Infertility Center (KIC)... Their disposition, their clarity and all those small details made the difference to choose them… But the biggest difference came in April 2012, last year, when we both stared at the picture of Miquel and Daniela, two recent baby twin born, of a Spanish gay couple with which KIC put us in touch to share their experience months ago. KIC made their dream come true, why not for us?


So, by the end of July 2012 we flew to Hyderabad full of hope, illusion and emotion. 5 unforgettable days... How could we forget our first meeting with Dr. Samit and Anjani full of respect and shyness? What about the city: full of history, contrast, a melt of religions, noise, colors and people smiling all day long no matter what…


Days after we were back home. Then, we received a mail from Anjani explaining that the implantation of our first embryos had been done after fertilization. Days seemed years, until one Wednesday afternoon of October, Anjani prudently wrote us that our beta value was high enough to be possibly pregnant… At this moment, everything changed... We couldn´t wait to project ourselves in our new life and wondering: are they two? Just one? A boy? A girl? Luckily, Anjani confirmed us soon that we were pregnant of one.  The countdown just began… Days after days, weeks after weeks Anjani kept in touch with us through pictures and video where we could see our future baby growing and ensure that the surrogate was well…


When on Thursday May 2nd Anjani told us that 24 to 48 hours were remaining for the baby to be born we just cried. The baby we had been waiting for years was just about to come. We flew to Hyderabad for the second time and discovered the same city: from sunrise to sunset, people in the street, cars, noise, colors and smiles… a lot of smiles…  One of those was the one of our baby: Alba Citlali was sleeping so peacefully waiting for us with a smile on her mouth. But how could you be so grateful to Dr. Samit and Anjani for all this work accomplished? Dr. Samit has the ability and humility to give life and Anjani to be the frame of all this magic managing all the steps of the process. Together they just had made our dream come true. So are those two words enough? THANK YOU?


But more than a dream, we also wanted to thank them for so many lessons they have been giving us and that we would be proud to teach to Alba Citlali. Anjani, we learnt from you the respect of others´ work, as each person has its way to work: you were so effective, you never stopped to be here even if we didn’t saw you, we knew you were acting.  Dr. Samit, we would love Alba to have your humility: you treat each case with hope and do your best to make family dreams come true. But our stay would not have been so unforgettable without the hospitality of each person we met there. In the Hotel, we were received every day with so much distinction, always with a smile and asking for Alba. Finally, we would love to see Alba surrounded by so much colors and be smiling all day long as all the people we met no matter who they were...


In the end… It is said that the beauty of a place is not made by the landscape but by the people that give life to it. For this adventure, the beauty of this dream is full of color and people smiling.


To Dharani U., Dr. Samit, Anjani, M. Singh, Saji and all the Park Hotel team THANKS for making our live a colorful smiley DREAM.


Shah Rukh khan's surrogacy secret is out !!

well so it has finally been reported in the papers today that Bollywood actor Shah Rukh khan has become a father of a boy through surrogacy,apparently the baby was born pre term and needed to stay in the NICU for nearly two months.
the TImes of India carried an article http://timesofindia.indiatimes.com/life-style/relationships/parenting/Surrogacy-is-an-alternative-to-adoption/articleshow/20892864.cms
trying to demystify surrogacy.
now the same press was Anti surrogacy and screaming Exploitation just a few days back but now all of a sudden Surrogacy is this boon to mankind and infertile couples! i cant understand one thing though,if a regular person/couple has a baby through surrogacy they are exploiting poor illitrate women!! and if a bollywood superstar has a baby through surrogacy there is no mention of exploitation?
the media has now declared truce with actor and are now forgiving him for having allegedly had the surrogate mother undergo a Gender detection test in early pregnancy because he wanted a male child!! Gender selection during pregnancy is a crime in India and attracts a jail term of 2 years for all parties involved!so Khan being Mr.Money bags has gotten away with breaking a major law of the land and will get away scot free because of who he is!!
one other glaring error i found in the article where the lawyer is quoted as answering a query-Till when can a surrogate agreement be terminated? answer-"The intending couple can terminate the agreement within the first three months, as that is the biological period by when you can actually terminate the pregnancy"!! i was shocked to read this because this is absolutely untrue because under the The Medical Termination of Pregnancy (MTP) Act 1971/Amended 1975,clearly states the conditions under which a pregnancy can be ended or aborted, the persons who are qualified to conduct the abortion and the place of implementation.
Some of these qualifications are as follows:
  • Women whose physical and/or mental health were endangered by the pregnancy
  • Women facing the birth of a potentially handicapped or malformed child
  • Rape
  • Pregnancies in unmarried girls under the age of eighteen with the consent of a guardian
  • Pregnancies in "lunatics" with the consent of a guardian
  • Pregnancies that result are a result of failure in sterilisation

the Times is a national newspaper and hence it is pertinent that they state facts and not glaring errors like the ones commited in this column!!
Dr.Samit Sekhar

Wednesday, 3 July 2013

Court Order: Couple Who Hired An Illiterate Indian Woman As Surrogate Must Prove She Was Not Exploited

According to Media reports in a bizzarre turn of events an Australian gay couple who hired an  Indian woman to be the surrogate mother of their twins was ordered by a judge to return to India to prove she had not been exploited!!!
apparently the surrogate mother had used a thumb print to sign a 29-page contract written in English.
She gave birth to twins and handed them over to the same-sex couple in 2011.
But in the Aussie Family Court earlier this month, Justice Ryan said she was concerned the woman had no idea what was in the contract.
“There is nothing in the document which suggests that before the birth mother signed that it was read and translated to her,” Justice Ryan said.
now whilst i understand that the Judge maybe worried about exploitation i simply dont understand why this is deemed necessary now?
the same agreement would have been shown to the Australian consulate and other Authorities who would have done their investigation and given an Australian passport to the twins in 2011,taking this passport the couple would have gone to the Indian FRRO and gotten Exit visas for their twins.if at all any doubts were there,it should have been dealt with at that very moment!!
conservative figures show that alteast a hundred babies would have been born to Aussie parents with the help of Indian surrogate mothers,so have the judges asked all of them to return to india to prove that their surrogate has not been exploited?why this Bias against one particular couple?has it got anything to do with their Orientation?
Dr.Samit Sekhar
ivf and Surrogacy program Director.

Monday, 1 July 2013

How three parent babies will be born through surrogacy in the future!!

How three parent babies will be born through surrogacy in the future!!

India and its Doctors has always been at the forefront of ground breaking medical procedures and research especially in the field of Assisted reproduction and Surrogacy.
"Genetic diseases are a group of hereditary abnormalities due to a mutation in the mother's mitochondria,these diseases can affect one part of the body or multiple parts including the brain, kidneys, muscles, heart, eyes, and ears”.
according to conservative estimates thousands of children across the world are born each year with a mitochondrial disorder including mental retardation, epilepsy, cardiovascular disease and muscular dystrophy etc,many unable to go past the first few months of infancy and succumbing to the genetic condition”.
what this relatively simple technique will do is to take only the healthy genetic material from the embryo of a woman with defective mitochondria and a second embryo is then stripped of its key DNA but still retains its healthy mitochondria. Finally, the fertilized embryo is placed in the womb of the mother. This is excellent news for families with mitochondrial disease. This will give women who carry these diseased genes more reproductive choices!earlier they had no choice but to opt for an egg donor.
 the notion that a child will be born with DNA matching three parents is incorrect as the donor egg that is left stripped of its DNA contains no genetic material that will influence the child's physical Traits”

of course this procedure needs to be Legislated in parliament and should be allowed to be practiced however  some orthodox groups have already called the practice unethical and risky and say it will lead to the birth of “designer babies” and With the growing popularity of IVF and surrogacy this debate is here to stay!!

Dr.Samit Sekhar

ivf and surrogacy program Director

Kiran infertility centre pvt.ltd.