Dr Jatin Shah oversaw the birth of actor Shah Rukh Khan's surrogate child. Dr Jatin Shah, director of Mumbai fertility clinic and IVF Centre, joined IBNLive readers for an interaction on surrogacy in India and how it can help people.
Q. How much of privacy and confidentiality is available and needed for this? Asked by: sundar1950in
A. Confidentiality is of utmost importance, the Indian council of medical research has laid down guidelines about confidentiality which are covered on the legal documents to protect both parties. As per the legal clauses, the surrogate mother has no rights on the child born and agrees to relinquish the child on delivery. Also, it is mandatory for the In Vitro Fertilisation (IVF) center to maintain confidentiality as with all other IVF procedures as far as surrogacy is concerned
Q. Excepting a monetary incentive there is nothing else for the surrogate. She runs the risk of problems associated with pregnancy. Is there any advantage for person agreeing to be a surrogate mother? Asked by: sundar1950in
A. The surrogate goes through intensive counseling about the procedure, all the risks involved, the risk to her life, of pregnancy and its complications, possible long term sequelae, etc. They are explained the entire legal contract in their own mother tongue and have to consent of their own free will without any pressure from any quarters (husband, in-laws or friends). Also, only women who have had safe and mishap-free previous deliveries are normally selected as this greatly reduces the chances of pregnancy related complications. Monetary compensation is decided by the mother and the couple through a special bank which provides the services of surrogate mothers. Generally, the clinic or doctor is not involved in such agreements.
Q. How is the intended mother's egg taken? Is a surgery required? Asked by: Urmi
A. The eggs are retrieved through the vagina under transvaginal ultrasound guidance with a needle that is about the thickness of an ordinary blood test needle (no surgery/cutting/stitching), procedure takes about 5 minutes, generally safe and quick.
Q. "Vicky donor" popularised sperm donation. good cause. How about a movie on the surrogacy receptor. Movies with such a theme can popularise the Surrogacy and it's benefits? Asked by: sundar1950in
A. To the best of my knowledge, there are several documentaries on the subject and lots more in the making, would surely have a lot of benefits.
Q. What is the cost involved in having a surrogate mother arrangement? Asked by: sundar1950in
A. Total cost would vary as per bank charges, surrogate fees, IVF costs, medical expenses for 9 months, delivery costs, neonatal intensive care unit (NICU) cost in case of premature delivery, legal costs, etc. Difficult to give a fixed figure as there are too many variables involved.
Q. Is it necessary that the women who cant get pregnant naturally only can go for surrogacy? Asked by: kirti
A. Not really as there are many causes of infertility all of which are not womb related. Women who need surrogacy include women who are born without a uterus (womb), uterus is damaged by diseases such as tuberculosis, uterus has been removed for some reason or has had multiple IVF failures with a reasonably certain medical opinion that failure was because of failed implantation of otherwise healthy embryos. Not every infertile patient needs surrogacy. It would be fair to say that maybe 5 percent of infertile couples would finally need surrogacy when all else fails.
Q. Will the child have DNA of surrogate mother in addition to the couple? Asked by: leena
A. Absolutely not. The DNA of the child will only match that of the biological or genetic parents (the couple from whom the egg and sperm were taken).
Q. Does surrogate mother has to stay with the couple? How will couple see the progress and monitor? Asked by: Urmi
A. She can be looked after in a surrogacy home, nursing home, can stay at her own house or stay with the couple, all options are open.
Q. Please explain the surrogacy process. Asked by: gaurav
A. The uterus of the surrogate mother is prepared with estrogen tablets. Her egg production for that month is suppressed for that month so that she can not get pregnant with her own egg in that month. The eggs are retrieved from the female partner of the infertile couple, fertilized in vitro (in a petri dish in the laboratory) and the resulting embryos are then transferred to the uterus of the surrogate mother. The surrogate mother carries the baby to full term, delivers the child who is then handed over to the biological parents.
Q. How safe is surrogacy? Can there be complications for child? Asked by: gaurav
A. Surrogacy is about as safe for the mother as a normal pregnancy is. To elaborate, all complications of a normal pregnancy can occur with the same frequency in a surrogate mother too. The child can also have all the same complications such as growth retardation, preterm birth and so on. There is no added risk to a pregnancy as compared to a normal pregnancy (with surrogate).
Q. I think a rich couple can opt for surrogacy it is not for a poor one. Is it so? Asked by: Lopa
A. That would be sorted out once the Assisted reproductive technology (ART) guidelines from the central government become law and payment terms and conditions are laid down clearly.
Q. Who will nurse the new born? Is mother's milk not essential for immunity of the child? Asked by: sundar1950in
A. That is the downside of surrogacy that the child cannot have breast feeds and has to be kept on top feeds.
Q. What is the legal position if the Surrogate mother decided to terminate arrangement midway. Can an alternate one take over? Asked by: sundar1950in
A. She would not receive any payments if she does so. The legal documents offer protection to both parties. Neither the surrogate nor the biological parents can back off midway. Another surrogate cannot take over this pregnancy as you cannot transfer the baby into another uterus once pregnancy is established. Just as the surrogate would have to forfeit her payments, so also the biological parents would, by law, have to take home a handicapped child (if such a catastrophe occurs)
Q. So not getting to have breast feed can lead to ill health of the surrogate child? Asked by: kirti
A. Not really, there are enough substitutes and nutritional supplements available which can be monitored by a good pediatrician without any major adverse effects on the baby
Q. Concept of mother dies with this surrogacy? Is it not like putting the sperm and ovum in an incubator to get a child, then who can be the mother of the child? Asked by: Prathap
A. Absolutely not. There are many aspects to motherhood such as he genetic mother (who gives the egg and genes), the surrogate mother (who nurtures and nourishes the child), the mother who raises the child and so on. Except for carrying the pregnancy, the mother retains all the other aspects of good motherhood. Also, we are talking about a lady who otherwise would never be a mother (and not about normal people going in for surrogacy) so the question of concept dying should not arise. Vis a vis adoption, the couple still has the pleasure of having their own genetic / biological child which is psychologically very important for both the mother and the baby when he/she grows up.
Q. Some people are saying that what was the need for Shah Rukh Khan to go go for surrogacy when he already had two children, does this thing has any relevance? Asked by: kirti
A. In a democracy there is no limit to the number of children you may desire or have. The onus to have one, two or ten children lies wholly with the couple. It was common for out forefathers to have more than 5 children. Even in the USA, it is common for families to have three or more children. The reasons are endless. It would suffice to say "to each his own". Yes, the more valid question would be about the surrogate mothers - as per the law they can undergo the procedure only twice in their lifetimes.
Q. How much a surrogate child cost normally? Asked by: Lopa
A. Have already answered that question some time ago.