India has scored a number of medical firsts, and these firsts are nothing to be proud of. For instance, our country is the diabetes capital of the world and it now seems that we are also the surrogacy capital of the world. Today, patients from across the globe come here for surrogacy treatment, which is a welcome sign. It is indicative of the fact that we provide world class medical treatment and that is what infertile couples who really need this treatment, are looking for.

Unforeseen problems

Unfortunately, having this spotlight shine on us is creating certain unforeseen problems; specifically for infertile Indian couples whore doing IVF treatment. We now see a number of patients who are being advised to opt for surrogacy after a couple of failed IVF cycles. When an IVF cycle fails, the first thing the doctor will say is that it’s a failed implantation and that surrogacy is the best option for the couple.

What they are implying here is that in case the embryo doesn’t implant, the problem lies with the patient’s uterus; that her body is rejecting the embryos that have been so carefully treated by the doctor in the lab. Therefore surrogacy becomes her best option to have a baby. I reality, this thinking is completely flawed and this option benefits no one but the doctor the most. The main thing is that it gets the blame of IVF failure off the doctor’s shoulders.

The tests

Most doctors will also take this opportunity to run a slew of tests, most of which are very complex and expensive, to confirm their so-called diagnosis. The different tests the patient will be asked to do are for:

  • Tumor necrotic factor (TNF)-alpha
  • Interferon (IFN)-gamma levels
  • Natural killer ( NK ) cells

Since these are considered to be very sophisticated tests and the samples have to be sent to a certain center (which could be in a different city/country).  Very simply, this adds to the cost as well as all the glamour. In most instances, these tests come back abnormal and these results will then become the basis of the doctor suggesting that the patient opt for surrogacy.

The fact to keep in view here is that surrogacy becomes a highly lucrative option for doctors. They also find it very easy to manipulate the surrogate’s medical records; it’s also why many of these surrogates do get pregnant, but they also almost always “miscarry” within a matter of weeks.

Why patients agree to do IVF

There are a number of reasons why patients fall in line with this advice:

  • Very few patients bother to do any homework on their own
  • They trust their doctor, and are happy to blindly obey whatever their doctor advises
  • Many infertile women have low self esteem. They believe their bodies are flawed and are quite willing to accept the blame for the failure
  • Many infertile women feel their uterus is defective. They often mistake the PMS they get every cycle for early signs of pregnancy, which is why they believe that they must be getting pregnant every month, but that their body is expelling the embryo , because of excessive body heat or immunological incompatibility ( depending upon their level of medical sophistication)
  • Some are quite fed up of doing IVF, and are happy to find a surrogate who can carry the baby for them, so that they do not need to go through the emotional ups and down of an IVF cycle themselves

A genetic problem

And so, for various reasons, surrogacy becomes the ideal treatment for many couples. In most cases, their IVF failure is caused by genetically abnormal embryos; eggs of older women have more genetic abnormalities and these eggs cannot be screened for these abnormalities. Using donor eggs is a much better option for these women.  

Another major reason why IVF cycles fail is that the embryos aren’t of a good quality as the labs don’t have the competency to make good quality embryos. Many clinics don’t even bother to provide their patients photos of their embryos. It would be much better for these patients to find another doctor, rather than start looking for a surrogate.

Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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