Following severe criticism and after rounds of deliberation over the Surrogacy Regulation Bill, the Union cabinet has approved it after accepting the recommendations of a Rajya Sabha Select Committee. The long pending Assisted Reproductive Technology Bill that covers a larger gamut of aspects under the assisted reproduction has also received the cabinet’s nod. As the Indian government is in the process of bringing in legislation for assisted reproduction, this series delves into on-the-ground realities.
For twenty-six-year-old Dhanam*, a native of Komarapalayam in Namakkal district, it has become an ordinary affair to sell her oocyte (eggs) to manage her financial needs. She has donated on ten occasions in the last three years and her friend Seetha*, 33, has donated seven times between 2015 and 2018.
While Seetha hasn’t donated in the last one year due to deteriorating health and irregular menses, Ramya*, 35, from Pallipalayam who was a surrogate before turning to egg donation claims that she is “frequently falling ill and hasn’t donated in the last few months”.
Welcome to the prominent twin powerloom centres of Komarapalayam and Pallipalayam in Tamil Nadu, which is in the midst of a distressing economic situation. It has witnessed massive job cuts and as the equal workforce women face job crunch, many have turned to oocyte sale, as reported in the second part of the series.
Frequent egg donation has led to a stage where many women consider it as an option to earn money, to compensate for their regular income. A sum anywhere between Rs 15,000 and Rs 25,000 per donation would help in taking care of their families for three to four months or in repaying a portion of debt, overlooking their health.
‘Unbearable after-effects’
All donors who were interviewed complained of frequent fevers, anaemia, weight loss, fatigue and excessive bleeding along with extreme abdominal pain during their menstrual cycle.
“… can’t explain the amount of pain and bleeding during the three days, sometimes it (menstrual cycle) lasts more than five days. If injections during the medical procedure are painful, the after-effects are unbearable,” says Dhanam.
According to Dr Parikshit Tank, repeated ovarian stimulation which is needed for oocyte retrieval, “increases the chance of benign and cancerous problems in the ovary.”
“At our hospital we’ve an arbitrary cutoff of three donations per donor in her lifetime. While it is possible to maintain a record of donors who visit our hospital, currently with no centralised system, it’s impossible to track the total number of times a woman donates,” he says.
The Assisted Reproductive Technology (ART) Bill that has been long pending and approved by the Union cabinet in February, an oocyte donor shall be allowed to donate oocytes only once in her life and not more than seven oocytes shall be retrieved.
National registry for regulation
According to donors, following initial tests and scans, they’d be given hormonal injections for about a week. A test would be followed by oocyte retrieval procedure. While “new donors” are made to stay in the hospital to finish the entire process, “experienced donors” are given injections for self-use and they visit hospital after the stipulated period to complete the procedure.
When travelling to hospitals in other states, often a group of women are taken together by agents during which the food and travel costs are borne by the donor.
“There is no fixed amount that we’d receive; it all depends on our ovulation, the hospital, and the city or town we are taken to. We’d get anywhere between Rs 15,000 to Rs 25,000,” admits Dhanam who has gone to hospitals in Karnataka and Kerala, apart from all the main cities in Tamil Nadu.
“A portion of the money would obviously be deducted as commission by agents,” she says.
While the ART Bill has provisions for a national registry for regulation, supervision and prevention of misuse, experts have raised concerns over its feasibility considering that the infertility services market has already grown out of proportion, estimated at nearly half a billion dollars in India.
“Even though its (national registry) enactment is still indefinite, we only hope that activities like sperm and egg donation are not too severe because their donation is not like organ donation. The industry undeniably needs regulation but only to the extent that the services are not misused,” says New Delhi based Dr Rita Bakshi, senior gynaecologist and IVF expert.
In Komarapalayam, Dhanam is unaware of all the regulations. But she very well knows the toll regular egg donation has on her health and, claims that sometimes doctors and nurses at hospitals warn about the perils of frequent egg donation.
“But, what else can I do to feed my children.”
*Names changed to protect identity.
This reportage was supported by the Thakur Foundation. Dharani Thangavelu, an independent journalist from Tamil Nadu is a recipient of a grant for investigative reporting in public health, 2019, awarded by the foundation.