‘Those who used surrogacy should lab-check their child’s genes’

About the new laws governing surrogacy and artificial assisted reproduction, the author of Politics of the Womb: The Perils of IVF & Surrogacy says India could’ve done better but our rules still stack up well against global laws

National award-winning writer Pinki Virani has been a trenchant observer of the ‘commodification of babies, the ruthlessness of the fertility-industry on women’s bodies and its resultant reduction of motherhood’ in India. Last week, the central government notified the Surrogacy (Regulation) Act 2021 and the Assisted Reproductive Technology (Regulation) Act 2021. These hope to regulate in-vitro fertilisation (IVF) clinics and prohibit commercial surrogacy or ‘wombs-on-hire’. It does allow altruistic surrogacy where the birth-mother, a relative of the couple, is to be covered on all medical and insurance expenditure. Since the patriarchal pressure continues to be very real, especially upon women, of ensuring a child, critics fear that commercial surrogacy is likely to go underground. 

Excerpts from the interview. 

The new Surrogacy Act bans commercial surrogacy and the ART Act bans sperm [male] and ovum [ova, oocyte, female egg] sales. How do you view this?
I’ve been a part of some of the processes on both laws since 2016. My own prior research for the book had proved that if the Parliamentdidn’t put its foot down, our young girls were increasingly at risk of being sucked into money-making monster-machine. 

Equally at risk were middle-class women. Those who read both Acts will also realise that once money is removed from the surrogacy equation, these laws put back the power of choice where it truly belongs—in the hands of women. In the absence of any regulation earlier, women’s bodies and emotions had been exploited mercilessly— by their own greedy families too—and all of it was allowed in the name of yet-to-be-born babies. It had become both, a body and baby bazaar.

What is your response to the critics who say that commercial surrogacy will now be carried out surreptitiously?  
May I point out that the ART Act makes it less complicated for patients to go to licensed, registered clinics? Couples have the choice of going to these clinics if they have been unable to conceive naturally. It’s misleading when surrogacy is promoted by some as the automatic go-to.

I must add here that once laws are made, it’s up to the government, as also the police, to ensure that swift punishment is meted out to those who break it, beginning with the “fertility-industry”.  

Would you agree that adoption delay is one of the key reasons why couples turn to questionable means to acquire a child? 
Should we be equating adoption with desperation?  It’s a well-thought out decision by the adopter, who is prepared to go through the sort of screening that, really, every want-to-be biological parent should be put through to understand that children are not a right but a responsibility. The adoption of a child, or children, is a noble act by adults, be they married or single. Those who adopt children are to be admired, and supported because raising an adopted child has its own set of complexities. As for those who are buying babies—in effect, becoming human-traffickers themselves—they need to stop to consider why exactly they are becoming criminals.
 
How do the ART Act and the Surrogacy Act, which lets a woman choose if she wants to be an altruistic surrogate, make it better for every party involved?
Surrogacy is a part of third-party reproduction [3pr]. Another part of 3pr is the sale-purchase of sperm and egg. There have been no ‘donors’, only buyers and sellers. A film like Vicky Donor paints the wrong picture because on-screen, he sold sperm without any medical checks and balances. 

The ART Act expects appropriate screening of what would amount to genuine donors whose sperm-egg usage will not be hyper-repeated thereby reducing the risk of genetic-siblings growing to have sex with each other as adults. Yes, this has been known to happen and it’s revolting.

 All of 3pr is part of IVF [in-vitro fertilisation]. In 3pr, any number of combinations can be brought into play between male sperm, female egg and female uterus. To understand this, let’s look at our own parents. Sperm-providers are our biological fathers. Our mothers are both, our genetic [ovum] mothers and our birth [pregnancy-delivery] mothers. This combination makes our mothers our biological mothers.

Infertile couples who feel pressured to immediately go to IVF clinics should know that the failure rate is 75 per cent. Tonnes of money is to be made per IVF cycle, which also accounts for the shady “IVF clinics” that have sprouted in every Indian town. The ART Act now puts a stop to such charlatans posing as fertility-doctors.

After repeated cycles with the couple’s egg-sperm-uterus, if there is no pregnancy leading to a ‘take-home baby’ (so termed, because the mother-child hospitalisation and complication-rates are high, more so in surrogacy), brought into play is 3pr. A stranger’s sperm, a stranger’s egg, a stranger’s uterus, sometimes the same stranger’s egg and uterus (which would make the woman the child’s biological mother)—all combinations are made possible but not necessarily conveyed to the couple. Is it the intending-father’s sperm being paired with the intending-mother’s egg? Or is it another couple’s left-over sperm or egg? Or has it been purchased from the market, where a ‘donor’ is claimed to be of a certain age, height, colour, education and is perhaps only one of the above? What about that ‘donor’s’ mental-health history—mental illnesses can be genetic too; or her/his family’s cancer history? All of this can have consequences for the intended-child but by that time the baby-making factory’s conveyor-belt is on a roll.  The sperm and egg are fused in the lab to make embryos. In the natural baby-making process, one embryo self-forms inside the womb. 

(In rare cases there are more, leading to the birth of twins or more.) The lab-grown embryos can only be inserted into the woman after her body is chemically-tricked into thinking she’s undergoing menopause, otherwise she would get her period and the embryo won’t ‘catch’. 

When this temporary, mini-menopause is in play, the embryos are inserted and then gummed into place with a series of chemicals and hormones through injections into the tummy and vaginal pessaries. And yet, they don’t always stick. Then it’s onto the next round of the same process. Purely as recent examples, if one embryo sticks, actor Priyanka Chopra-Jonas gets a surrogate-mother’s birth-child. If more than one embryo sticks, director Karan Johar takes home twins but not their birth-mother nor their genetic-mother. Do they share the same birth-mother? This would be known only to the “fertility specialist”; both Acts stop this.

By mentioning ‘limitation of their own bodies’, you are saying that there are short and long-term effects of ART and surrogacy too?
Unfortunately, Bollywood insists on making it look simplistic. No ill should ever be wished upon a baby, but international research shows that there can be long-lasting negative effects of these procedures on the child as also the mother, whether she is the birth-mother, the egg-mother or both.

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