Is Low Cost Surrogacy in India Ethical?

A Chawla

Anurag Chawla, Advocate

Low Cost Surrogacy in India

The drive back to our hotel in Delhi was just like all the other car rides we”ve had in Delhi 🙂 cars ignoring the lines for 3 lanes of traffic and creating five lanes instead, motorcycles with sometimes 3 or 4 people on them weaving in and out, lots people standing on the sides of the road waiting for buses, smog, and the ever present horn-honking. By now, we barely hear the horns.. they”ve become almost like background noise to us. I guess that means we”ve adapted to life here in Delhi!

Back at our hotel, we planned to meet Anurag Chawla and his associate Pooja Yadav – a very enthusiastic young lady, recent graduate of law school, whose warm smile and beaming energy immediately endeared us to her. Anurag has been doing surrogacy in India since the very beginning.. in fact, that is his claim to fame, and just about everyone knows him or knows of him. He is soft spoken, gentle and one gets the sense that he truly cares about what he does and that he has high ethical standards. There”s that word again.. ethics. I must admit, it gets tossed around as the new “buzz word” of low cost Indian surrogacy and egg donation and the fact that it is tossed around so much means that any potential Intended Parents need to always keep their ears and eyes open and not take everything at face value. It”s easy to say your practices are “ethical” — that goes for clinics, doctors, lawyers — and of course that”s true for surrogacy and egg donation services around the globe. There is good and bad everywhere. But clearly Indian surrogacy and egg donation has been getting a bad rap lately and that”s why suddenly the buzzword “ethical” is popping up in just about every conversation we”ve had here.

That being said, we did get a very strong sense that Anurag believes strongly in doing the “right” thing – for both the Intended Parents as well as the surrogates. He started out with the first international surrogacy case in association with one of the most well known fertility doctors in Delhi. They did many cases together and all seemed to be going well and the business was growing. However per Anurag, as business grew, he decided that the doctor was not acting in accordance with what he felt were ethical guidelines and in one particular incident, he said that she had forged documents in regards to the surrogate”s marital state to help get the paperwork through the British Embassy. After this, the two broke ties.

Since then, Anarug has been working as an advocate (lawyer) in assisting many different clinics and India surrogacy agencies (remember in India, the clinic cannot own the surrogacy agency, it has to be an outside company or a separate business). He has seen the good and the bad. He knows the stories all too well about the Intended Parents who pay thousands of dollars up front, only to get repeated negative cycles, who then are “forced” to pay additional fees for more IVF cycles and new surrogates if they want to continue. At this point, it”s quite hard for an Intended Parent to pull out because they”ve already invested so much – financially and emotionally – that it would be very difficult to start over with a new Indian clinic or associated surrogacy agency. Anarug also confirmed the stories we had heard about Intended Parents who were called when their surrogate was six months pregnant and told that she was bleeding and being rushed to the hospital and that if they didn”t pay more money right then and there (immediate wiring of funds) the pregnancy would be terminated. He told us about the stories where four sets of IPs are shown the same profile of a surrogate, all four sign up and only one person gets that surrogate. The others get other surrogates… which may be fine, but is misleading and unethical, when you believe you”ve chosen a particular surrogate. These are the horror stories that we”ve heard about in regards to travelling for treatment in India… and to be quite frank, it was scary to hear him confirm that they were true. Again, it puts the Intended Parents in a “hostage” position – where if they don”t act immediately and pay more – they will lose their baby. It makes Global IVF”s trip to India that much more important and worthwhile, because with our backgrounds in the fertilty world and our knowledge of how surrogacy and egg donation should work, we are able to discern between the reputable companies and those that tend to shine you on. Of course, it”s hard to tell anything about a potential clinic or doctor from back home.. websites all look great, everyone has positive references to offer up (in fact, we encourage IPs to ask potential clinics, doctors and advocates what are some of the problems that they”ve personally encountered with international clients and how have they dealt with them? You can often tell more about a company in the way they handle problems as opposed to how they handle success stories. If an Indian fertility clinic, doctor or surrogacy agency says they have never had any problems, take that as a warning…it”s nearly impossible to have a picture perfect records in anything, let alone surrogacy and egg donation).

So back to Anarug… he was very knowledgeable and eager to share his wealth of information. He is very involved in the new issues surrounding the guidelines that have suspended same sex IPs and couples who have been married less than 2 years from pursuing India surrogacy. Even during our stay, he emailed us a document (which has been posted on Global IVF) telling that an upcoming meeting was going to be held to discuss this very big issue. Anarug felt that ultimately the tables would be turned and that same sex IPs, single IPs, and couples married less than two years would be able to again pursue low cost surrogacy and egg donation in India, but he wasn”t sure when that would happen. Could be a few months, could be longer… but he was very confident about it. Hopefully he is right, because we know this will significantly impact those IPs pursuing fertility treatments abroad as a way of becoming parents.

So Anarug”s law firm works in several different ways… International IPs can contact him directly and use him in conjunction with another clinic/surrogacy agency. Often times, particular clinics and agencies who have relationship with Anarug will refer their clients to him for the legal portion of the surrogacy. Or, and this was the new and interesting thing to us, Anarug was starting his own surrogacy division.

Now, in the United States there are many surrogacy attorneys who run surrogacy agencies as well – it is fairly common. Personally I feel this can be a conflict of interest in a sense, because what”s casino online to keep a lawyer who wants to match his agency”s surrogate with an IP to remain unbiased in terms of fully screening the surrogate. But there are many attorneys who manage to maintain professional standards, so it”s not that it can”t be done.

This is a new venture for Anarug and his associate Pooja will be overseeing it. The main reason they started this division is that Anarug was tired of seeing International IPs being held hostage by doctors and surrogacy agencies. He saw how the money was adding up and how when Intended Parents ventured into an Indian surrogacy contract, they potentially had no idea just how much they would really end up spending. Low cost surrogacy could ultimately turn into high cost surrogacy. Anarug wanted to present a program that was transparent, that would take out the middleman (namely the surrogacy agency) and in doing so would truly keep costs down for international IPs. He wanted to be able to quote one price to the Intended Parents and the start and stick to that price.. with no additional surprise items popping up throughout the surrogacy journey.

The way the new program will work is that IPs will contact Anarug directly. He will act as the liaison between the clinic/egg donor and the IP. He will find the surrogates directly (they already have several ready to go) and Pooja will act as the case manager overseeing the entire IVF and subsequent pregnancy. He will send profiles of potential surrogates to the IPs, and they can choose whom they would like to work with.. and then they can skype with the surrogate (with the help of Pooja or Anarug). The surrogates will not be housed in communal surrogate housing, but instead will remain in their own homes, with Pooja checking in on them personally a lot… They stress that the surrogates they work with are treated ethically and respectfully and that in their opinion, that makes for a healthier and happier pregnancy. They say that their surrogates are treated like family – that they form personal relationships with several women from single areas who choose to become surrogates. We liked their approach but wondered about how international IPs would feel about their surrogates living and home without knowing their living conditions and assurance that they were doing their medications properly. Pooja assured us that she would be visiting each surrogate independently, as well as constantly calling, skyping … and that when they choose their surrogates to work with they make several visits to the home unannounced so that they are getting a real sense of the cleanliness and overall environment. Pooja was so energetic and enthusiastic that we have no doubt she will keep her word in doing a great job of case management, however we chuckled and told her that in a year”s time our guess is she will have hired a few other case managers to help oversee the surrogates. There”s simply no way one coordinator can do justice if there are more than 10-15 or so surrogacies going at a given time.

To be honest, the most compelling thing about Anarug”s program is the cost. He is quoting overall 13k or approx 15/16k (with an egg donor). What???? How is that possible? Seriously, we couldn”t understand how he could possible offer such a low cost surrogacy package. That truly is low cost surrogacy and low cost egg donation! Here”s the rough breakdown:

(1) Surrogate Mother (including two attempts): 7520 US $

(2) Doctor for IVF (Including/exclusive of retrieval): 1880 US $

(3) Doctor for monitoring the gestation period (including C-sec and twin fee): 1880 US $

(4) Legal attorney & Guardian fees: 1880 US $

Total: 13, 160 US $

Additional Expenses

(5) Selection of Egg Donor/Sperm Donor: __________ INR (Can”t comment as this is usually arranged by the Commissioning Parents)

(6) Accommodation for surrogate mother, if I.P”s want: 2256 US$

As noted above this includes 2 IVF attempts and subsequent OB/delivery costs. Any neonatal health care is paid for by the IPs (this is standard across the board. No agency pays for neonatal care.. so IPs need to be aware of this because if they have twins and they are born premature, the babies could be in NICU for several weeks. The big difference between in regards to baby care in India and the US is the cost… in India NICU care will probably run about $200/day.. in the US, it can easily be several thousand a day – if you don”t have insurance. So in the grand scheme of things it”s not a lot of money, but one that IPs generally don”t factor into their overall cost projection.)

Anarug”s surrogacy program is relatively new.. they”ve only had about 3 clients so far. But keep your eye out for Global IVF”s JOURNEY section – because potentially two of Anarug”s clients (both from Australia) will be sharing their low cost Indian surrogacy experiences with us.

If indeed Anarug”s low cost surrogacy in India program ends up being all that they plan for it to be, it will definitely be an option worth investigating. This is the lowest price tag we”ve seen in India.. without feeling that there was compromise in any real area.


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