After leaving Lilivati, the bustling large hospital with the fertility department nestled amidst several other medical departments, it was a nice change of pace to head to a more residential area and a building devoted to one fertility clinic. We had heard about Corion clinic from a Global IVF visitor prior to our trip. She had asked if we would check it out and we assured her we would. At the entrance to Corion, we were asked to remove our shoes. We are becoming quite accustomed to this and generally it is for cleanliness reasons, the roads in India are so dirty, that it only makes sense to remove your shoes at the door and leave the outside dirt there as well. Perhaps it’s a practice the US clinics should start using! The clinic itself was nice, the reception area inviting and nicely decorated, warm colors and lots of wood.
Dr. Kadam is a very warm, friendly woman (which goes well with the overall feeling of her clinic). She took us into her office and we immediately felt at ease chatting with her. We got into the issues of surrogacy pretty quickly. Dr. Kadam allows the IPs to choose their own surrogate…but during a cycle, she will have a few surrogates being additionally prepared, so that if the surrogate that was chosen by the IPs is not having a good response, the cycle does not have to be cancelled. This was an interesting concept to us. Basically, if the surrogate chosen by the IPs was not responding well, then Dr. Kadam would let the IPs know what other surrogates were currently available (and ready for transfer – meaning their uterine linings were well prepared) and then she would allow the IPs to choose one. She would not transfer an embryo into a surrogate until she had approval from the IPs regarding that particular surrogate.
Like many of the other fertility centres, Corion has a separate but in-house division that handles surrogacy and Indian egg donation. They house their surrogates in surrogate housing , which was approximately 5 minutes from the clinic. Unfortunately we were not able to see the housing for ourselves. Dr. Kadam explained the reason why. Apparently in Mumbai, the television networks are more powerful and much like the American version, they like to play up the ‘seedy’ side of things. In the past, the Indian media got inside the surrogate housing and played up the entire thing with a very negative angle, so since then she has said no to any filming inside her housing accommodations. Dr. Kadam was happy to send us pictures of her surrogate housing (which was quite sparse and more ‘indian- like’ them some of the more western housing accommodations we have seen) but it certainly would have been better if we had been able to see it for ourselves. That being said, the surrogates stay in the housing from the time of embryo transfer all the way through delivery. Their children can stay with them – up to the age of 5. The housing can accommodate 20 -25 surrogates at any given time, with 4-5 staying in one room. This sounds a bit ‘cramped’ to us… but of course it is based on how full the house is at any given time. The house has guards (visitors are allowed until 8pm), a maid, cooks and a staff nurse who visits every day to administer medications.
Dr. Kadam does two infectious screening labs on the surrogates, one at the initial evaluation and another right before transfer. Additionally she does HIV screening every month and a complete STD screening at the end of each trimester. She’s obviously careful and precise about this aspect of the surrogate’s health and it should help to put IPs at ease.
In India Fertility Center, the approximate cost for a surrogacy/Indian egg donor cycle with Dr. Kadam is about $24,000… more if you want a Caucasian egg donor, and Dr. Kadam works with a few top notch agencies who provide Caucasian donors from various countries around the world. Her self-reported success rates for egg donor/surrogacy are 60-70% and her twin rate is 20%. She generally does 3 day transfers, but will go to blast if there have been multiple failed cycles. If the first cycle with a surrogate does not work, she will give you a new surrogate free of agency charge, however you will need to pay for the FET and screening costs.
Dr Kadam was initially with Rotunda Clinic – but 3 years ago decided to open her own place. We’re glad she did, because she really does come across as ethical and compassionate. She currently has about 30 – 35 surrogates pregnant (at various stages) and she watches the surrogates throughout the entire pregnancy. She makes sure that every month the natal checkup is sent to the IPs so that they can know the progress of their pregnancy. The surrogates generally do not speak English, and they deliver at hospitals in Mumbai where the IPs are not allowed in the delivery room. (to me this is just so strange… I can’t imagine not being allowed in the delivery room for my own baby, but it is a compromise and as we tell IPs all the time, the delivery is just one moment in time, you will have your baby forever).
One main difference that we noticed with Dr. Kadam’s program is that all medical payments regarding the hospital are paid directly to the hospital and not through the surrogacy agency. Typically a normal delivery will cost about $1800 US dollars. A c-section will cost more, and if the IPs want to take a room at the hospital for themselves that will cost more as well. If the baby is in NICU, the costs will be directly dealt with between the IPs and the hospital – the agency will not act as an intermediary.
We talked a little more about what type of Indian women become surrogates. As we’ve driven around various parts of India, we can’t help but notice all of the shacks and shantys. We have to ask the question… is this where her surrogates are coming from? Is that what they call home? Dr. Kadam said absolutely not. The shacks and shantys are for the really poor… the people who are impoverished and possibly malnourished. Her surrogates (and most Indian surrogates for that matter) come from a lower socio economic class and they certainly do not have a lot of money, but they tend to live in apartment buildings and their homes are neat and clean. They are not malnourished, they are not beggars, they are not selling things in the street. The main reason the Indian women become surrogates according to Dr. Kadam is to better the lives of their children, and that’s easy for us to believe, because that is one of the main components of why American women become surrogates as well.
We toured around Dr. Kadam’s clinic and were impressed with how nice it was. Clean rooms, modern equipment – everything to indicate that any IVF procedures would be top notch. In fact, another nice note… Dr. Kadam provides daily updates to IPs after egg retrieval/fertilization. She will let you know how the embryos are progressing and what her opinions are about them. She will let you know what they look like on day 2 and what her suggestions are for day 3 transfers. This type of information exchange was refreshing. (of course, we’re information hounds.. and with our own multiple IVF cycles, were desperate to know how the embryos were developing. Most clinics will only give you a report on fertilization rates and then again on your day of embryo transfer).
As we were moving from room to room and floor to floor, we did pass by a waiting room of several surrogates and egg donors… they seemed happy, healthy and nicely dressed. Definitely no sense of major poverty there. Of course they were putting on their best ‘face’ but it’s unlikely if the were really impoverished that they would be able to get themselves together this much. Just seeing them made us feel better about the Indian women who opt to help Intended Parents like ourselves.
Overall, we got a very pleasant feeling from Dr. Kadam’s clinic – the only thing we wish is that we had been able to see her surrogate housing for ourselves. We understand her reasons for not allowing us, but in all honesty, it’s much better to see things firsthand when deciding upon such an important journey.