# Article on 'fertility tourism' in India



## olivia m (Jun 24, 2004)

Enormous ethical questions raised in this article - exploitation of donors, putting back four or five embryos...let alone what brown skinned children are going to think of being born to white parents and with no access to info about genetic background.
http://www.guardian.co.uk/lifeandstyle/2008/jul/30/familyandrelationships.healthandwellbeing
Olivia

/links


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## Lorna (Apr 8, 2004)

If this article reads correctly, I do think there are ethical issues with the way donors are treated in India.  From reading BB's, I do find the rules in the UK, are unhelpful, for both donors, and recipients.  

On the other hand in the USA, there was no way any of the women I chose to help me become a mum, didn't know what they were getting into.  My donor had donated before, so she definitely knew what was going on.

I would like to see a loosening of the rules in the UK, and allowing US style donation to take place.  Even without money, IMO, it is very good way of way of doing things.  At least let donors, and recipients chose, whether to donate completely openly or anonymously.

As to money, well if members of the HFEA committee who attend a meeting to discuss infertility issues, receive around 200 pounds a day, for  generously giving up their time to "help" us, then why doesn't a woman who has to starve hereself, go through an operation, and rest for 3 days, a woman who puts her life on the line, why doesn't she at least get 200 pounds.

And during the time Suzi Leather was chair, the HFEA committee set a limit of 250 pounds worth of expenses for donation.  Suzi Leather, one year, got over 12,000 pounds of expenses.  Why doesn't she have to pay back 11.750 pounds of expense.

When it comes to money, there seems to be one type of altruism for the HFEA committee and another for donors!

Give us a more sensible set of rules, and then no one would need to go abroad.

Lorna


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## olivia m (Jun 24, 2004)

Hi Lorna
I really don't think HFEA members expenses or fees have anything whatsoever to do with what donors might or might not receive, and Suzi Leather's expenses were in reimbursement of money paid by her for travel from the West Country where she lives and the inevitable stay in a (not hugely smart) hotel in London whilst she carried out her duties at the HFEA.  Lisa Jardine lives round the corner from the office so her expenses will be considerably lower.
The decision to pay 'expenses only' to donors was taken on the best ethical grounds - that human gametes (the means to make life) should not be traded commercially.  Donors need to understand the meaning of what they are doing, particularly now that anonymity has ended in the UK.  They should never be out of pocket but neither should they be able to profit by or be tempted to lie about their characteristics, when donating.  It is of course only a 'donation' if someone is not paid.  Otherwise it is a commercial transaction.  Many DC adults have said they dislike the idea of having been conceived as a result of money being paid to the person who gave an important ingredient for their creation.  These rules were not made to try and put barriers in the way of couples and individuals making families, they were made to protect the people created as a result of donated gamete treatment...they don't get a say in the choices their parents make.
Olivia


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## Lorna (Apr 8, 2004)

olivia m said:


> Hi Lorna
> I really don't think HFEA members expenses or fees have anything whatsoever to do with what donors might or might not receive, and Suzi Leather's expenses were in reimbursement of money paid by her for travel from the West Country where she lives and the inevitable stay in a (not hugely smart) hotel in London whilst she carried out her duties at the HFEA. Lisa Jardine lives round the corner from the office so her expenses will be considerably lower.
> The decision to pay 'expenses only' to donors was taken on the best ethical grounds - that human gametes (the means to make life) should not be traded commercially.
> Olivia


As to HFEA committee member's attendance allowance, and expenses, it is entirely relevant to this discussion. While Suzi Leather was chair, the HFEA committee set a limit of 250 pounds worth of expenses for donation. If a donor incurs 300 pounds of expenses, tough luck they are out of pocket. So, IMO, the person who made this pronouncement, Suzi Leather, should also be out of pocket, and she should be made to repay 11,750 pounds of expenses.

Also HFEA committee members receive an attendance allowance. If this bunch of altruistic people, who sacrifice their valuable time to "help" us, get an attendance allowance, why doesn't a donor get an attendance allowance. That is how it is described in the US, and that is how surrogates are compensated. Notice the word compensated, not paid, which IMO, is a derogatory term. That is how the HFEA committee describe their attendance allowance compensation, but they describe any money a donor gets as payment. Why?

HFEA committee members are compensated for their time, why aren't donors?

And HFEA committee members are well compensated. If you look at the amount of time an egg donor spends doing a single donation, if an HFEA committee attended that many meetings, they would get all their expenses, plus about 6000 pounds in attendance allowance! And once you join a Quango, like the HFEA, if you behave yourself, you get to serve on all sorts of other, better rewarded committees. It is financially very rewarding to join the HFEA!

It does feel like the people preaching self sacrifice are doing precious little of it themselves.

So yes Suzi Leather's are completely relevant to this discussion.



olivia m said:


> It is of course only a 'donation' if someone is not paid. Otherwise it is a commercial transaction. Many DC adults have said they dislike the idea of having been conceived as a result of money being paid to the person who gave an important ingredient for their creation. These rules were not made to try and put barriers in the way of couples and individuals making families, they were made to protect the people created as a result of donated gamete treatment...they don't get a say in the choices their parents make.
> Olivia


Donors in the US, are compensated for their time, and IMO, poorly compensated.

So having been to the USA, and seen how donation is done there, money *does* make a difference to the whole process. What I experienced in the USA, was thoroughly professional. The screening of everyone involved was intense, and yes as prospective parents we could have been rejected.

Few, if any, can do donation or surrogacy unless they are committed to helping people. The money may get people interested, but only a deep personal commitment to wanting to make someone else's lives better can make you go through with it. And if people actually went over to the US, and talked to people who had signed up for donation, and then didn't donate, you would understand money is *not* what makes people donate. It is caring about other people that makes the difference. And I find it deeply insulting that anyone could possibly imply that my donor or surrogate did either for money.

And if you had read something like A Matter of Trust: The Guide to Gestational Surrogacy by Gail Dutton, you would know how wonderful surrogacy, done US style, is for the surrogate. Have you read this book?.

Your reply is deeply deeply insulting to the people who helped me. And I am hurt and upset that you think my donor and surrogate did it for money.

Lorna


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## olivia m (Jun 24, 2004)

You are taking this much too personally Lorna.  I am talking principles, not about your particular treatment.
Olivia


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## Lorna (Apr 8, 2004)

You are dammed right I am taking your comments personally.  You called taking money for egg donation a commercial transaction.  And for my donor and surrogate, it wasn't.  I actually think for the women in India it isn't either, despite what this article implies.

Why do we percieve an HFEA committee member as someone, who willing gives up their time, and so should of course be compensated around 200 pounds a day for that sacrifice?  Why do we consider an HFEA committee member an altruistic person, for doing what they do?  

But if an donor starves themselves, goes through an operation, has to rest for 3 days, essentially puts their life on the line,  we say, that they are selling their eggs, if they were to receive the same 200 pounds.  Why don't they get the same compensation as an HFEA committee member 200 pounds a day, or 600 pounds for the actual act of donation!

Well if HFEA committee members can be compensated on principle for their time, then I think donors should be too.  If HFEA committee members get all their expenses, then donors should be too.  No limit!

Lorna

PS why is it OK for a clinic to charge a 400 pound finders fee, to find a woman an egg donor, but an agency that only specialises in finding egg donors, can't charge a thing?

Surely, if it is illegal for an agency to a charge a finders fee, then shouldn't the directors of clinics who charge finders fees, be prosecuted and jailed for doing so?


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## Jane D (Apr 16, 2007)

Just noticed there is an article in marie claire magazine this month about western couples using Indian surrogate mothers.  They are using own sperm and eggs but using Indian woman to carry child. Women being compensated around £3k for the procedure which apparently equates to 10 years annual salary over there.


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## Lorna (Apr 8, 2004)

I bet after a story in Marie Claire there are quite a few people tapping away on the internet, trying to do find out how to surrogacy in India.

Whether you like it or not people are taking their hard earned cash, and spending it, the way they want to.  How many people on Fertility Friends have said “if the HFEA introduces eSET, I am going abroad for treatment.”  Or “After the changes to the donor rules, I am going to Spain”

Whether you like it or not, deregulation exists.  Might not exist in this country, but in a global economy, with bags of info available on the internet, lots and lots of people, are voting against, what they see as the excessive regulation in the UK, and going to places where things are easier to do.

The attitudes displayed by the media about infertility, are reminiscent of Poggenpohl kitchens.  Maybe you are all to young to remember, the “Buy British” Campaigns.  As unemployment rose in the UK, the media ran extensive campaigns on how “The Great British Public” should buy British, and so save British jobs.  But lots of British kitchens, were poorly designed, didn’t look good, and didn’t last.  Quite frankly, it didn’t matter how much the media poured scorn on people, consumers opted for Poggenpohl kitchens, as they were so much better quality.

Now we would laugh at being told to buy a sub standard product, just because it is British.  Nowadays, we accept, that the best product wins.

And infertility treatment is no different.  It is just like any other market.  It isn’t “special”.  It obeys exactly the same rules.  If the home market does not supply the end users needs, then people will shop abroad.  And this story and all the other stories clearly demonstrate that.

You will have people going to Spain, so they can have an anonymous donor.  Or a 42 year old woman will go  to the Ukraine, so she can transfer the recommended 5 embryos.  Or a 32 year old woman will go to Russia, so they can transfer 2 embryos.  Or couples will go to India for surrogacy.  You can’t stop ‘em.

Well, maybe with oppressive laws you can, but all that will happen is people will lie, and, IMO, lies are bad for children.  The best thing for any children created, is complete openness, and if the USA is anything to go by, that seems to be encouraged by a deregulated market.

As far as I am concerned the only way to go is to deregulate here.  Introduce an updated version of California style laws, and let people chose what they want to do.  They are doing it anyway.

You want to stop donors and surrogates in other countries, being abused by clinics, that cater to British couples seeking treatment abroad.  Well bring infertility back to the UK.  Deregulate. 

Lorna


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## daisyg (Jan 7, 2004)

Lorna,

Ref your quote - "The best thing for any children created, is complete openness, and if the USA is anything to go by, that seems to be encouraged by a deregulated market."

I wonder if like me, you are a frequent visitor to the US DE boards?  I don't believe, from the several years I have frequented these boards and from DE contacts in the USA, that the above is true at all.  If anything it feels to me that more of the US DE recipients are in the no tell camp very strongly.

In my experience, there appears to be more openness and more people in the tell camp in the UK than in the US?  What do you think?  Certainly, I am not aware of an organisation like the DCN in the US for example?  

I do believe however, that those wishing to be open have a far greater chance due to the extensive information and access to open donors in the US which I believe is vastly superior to what is available to us in the UK and Europe. This is where I agree with you - that those wishing to be open are helped greatly by the market in the US.

Just something that struck me from my own experience.

Best,

Daisy
x


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## Lorna (Apr 8, 2004)

Hi Daisy,

Sorry, I took a while to reply. Long weekend away. Had a wedding to attend. Might take a long time to respond, if you reply. Lots of other things going on at the moment.

The openness I was referring to was the fact that we could discuss what we were doing with anyone, and they congratulated us on our the upcoming birth /arrival of our children. I was encouraged by heath care professionals to breast feed. The health care professionals were just fantastic. Most had never met a surrogacy / DE child, and they just wanted to know more. The support we got from everyone was amazing. And it does contrast with some of the stories, I have read on this and other BBs

In the UK, yes I have told close friends and family, and got some negative reactions. No one outside this close circle knows the truth, and I don't feel comfortable discussing what we did with strangers. In the US, I did.

Daisy, you say 
> In my experience, there appears to be more openness and more people in the tell 
> camp in the UK than in the US?
Where are your experiences taking place? On the bus, at a railway station, at work, on BBs, or at DCN meetings?

In the US, I would not be concerned, if one of my twins blurted out the truth at school. I know my local school is superb, but I still worry, what will happen, if one of then talks about their origins. In the UK, I worry it will rebound on my kids, particularly with all the negative press around.

So I feel that in the states I was in, people thought having children was fantastic. How they came about was mostly irrelevant. Not all states/counties are as open as the ones I was in.

You mention that lots of people in the US, prefer to do anonymous donation. Could that be, because people go to their clinic, they ask the clinic to find them a donor, and the clinic will *only* supply an anonymous donor. Doctors love anonymous donors. It is less work for them. More profit. And just makes their lives easier. We got rejected, by quite a lot of clinics, as we insisted on brining a known donor!

Having said "anonymous donation is common", you have to define, what sort of donation you mean.

Do you mean the UK version, where a woman/couple go to a clinic, and request a donor. They are then given drugs, monitored, and told to turn up on the day for embryo transfer. Or do you the anonymous donation that we were offered in the US?

There were offered information a 10 page dossier on the donor, starts with a picture, general information about location, whether married/single, details about her children, employment history, educational achievements, hobbies, criminal record checks, full medical history, medical history for siblings, parents, aunts/uncles, grandparents, and if known great grandparents, what donor thought about donation, what she wanted for any child/children conceived, message to the child, and so on. I have forgotten what else. And we could ask any questions we like about the donor, as well?

The difference, in the US, between anonymous/open donation, appears to be whether you got to meet the donor, and whether, the donor was willing to meet the child, when that child was older.

So anonymous donation equals don't meet, and open donation equals do meet!

The only couple I knew who did "anonymous" donation, certainly had photo, educational/employment history, and full medical history. I don't think the current group of recipients, using known donors in the UK, get as much info as that!

So please define how the donation is done in the US. Please describe it, so I can understand, what you mean by anonymous donation!

You comment that in the US, there seems to be no equivalent organisation to the DCN. Back in 1993, a group of concerned parents got together to find ways to tell their donor conceived children, abut their origins. Why was there some problem? In the US, you tell or don't tell? No big deal.

If you get stuck you go and find a counsellor who has a PhD in gamete donation, and get them to help. In case you can't tell, I strongly believe that in the UK, we should have independent counsellors. The independent counsellor, we used in the US, specialised in this field. It was hard going to see her. She asked such searching questions, and really made you think about what you were doing.

I find it suspect that counsellors can only be attached to clinics. Isn't it he who pays the piper gets to call the tune?

As to the DCN, it is very much pro tell. Parents who chose not to tell, didn't join. Parents, who were undecided, but leaning towards not telling, wouldn't have joined. And people like me who can't fathom what benefits they would get by joining, also don't join. There are a huge number of families, some tellers, many non tellers who haven't joined.

The research says that only 10% of parents tell their children. So even if everyone who told joined the DCN, it would still only represent 10% of families with donor conceived children. We know not everyone joins, so the DCN is an organisation that represents, a very small minority of families with donor conceived children!

And what sort of views does it represent. Well periodically, I have a look at the DCN web site. There appears to be a death of research. OK, just recently DCN added some research on telling the child young, and I did find one book, which looked as though it was done by someone with s strong academic background, but it appeared to me that the rest of the web site was "stories", tales about people's experiences. I am struggling to find any other article that describes the findings of a paper published in a peer reviewed journal. Maybe it is there and I am just being thick, because I can't find it.

Yes the DCN does reference conferences, Walter Merrick's views, a parent's experiences, a donor conceived child's experiences....... Ok apart from the paper on telling children young, I am having trouble finding an article, about a paper published by Dr. XXX from an internationally acclaimed university, who has done research independently of the DCN. What I am talking about is research published in the American Medical Association journals, The New England Journal of Medicine, the American Psychiatry journals, top journals for counsellors, papers published by people with a PhD, who work in this field, and who haven't worked in anything else, and so on.

Love to see the long list of titles of papers, that the DCN uses, and in which journals those papers were published. That would shut me up wouldn't it?

Carrying on., when people go to the DCN's meeting they talk about ways of telling a donor conceived children about their origins. They are not talking, about why it is better not to tell. At your meetings, you may well have adults, who found out they were donor conceived, at a late age, and who feel angry about that. But do you have adults, who found out they were donor conceived, at a late age, and went "So what?"

When you get a group of people together who all hold the same views, it is very easy to get into "Group Think" mode. I knew my Masters in Business would come in useful! In Business, "Group Think" is considered one of the most dangerous things a business can do. See the end of my post for how damaging Group think is.

It appears to me from what little I have read, that the DCN is for those who believe that telling is right.

And we know how destructive beliefs can. How many believe that Megan's / Sarah's law will keep their children safe from paedophiles?

There is hard solid evidence, published in peer reviewed Scientific Journals, that says, not only does Megan's / Sarah's Law increase the chance of my child being killed by a paedophile, but it also increases the chance of my child being the victim of other violence, whether that is being run over by a car or mugged in the street. And as there are a lot more road incidents, and muggings than paedophile murders, it means, that more children are dying violent deaths today, than pre Megan's/ Sarah's Law.

And for 60 years doctors "knew", that burns victims recovered faster, if treated with Albumen. Just until the research showed that it killed more people than it saved. Over 100,000 people may well have a died, as a result of this belief.

So without hard solid research, how does the DCN know that what they are suggesting is right?

And what is worse is the DCN has in the past, rather forcefully put its views to government. http://www.publications.parliament.uk/pa/cm200405/cmselect/cmsctech/7/7i.pdf paragraph 151

In the US, in states that allow, what you might consider, a very relaxed attitude to Assisted Reproduction, then why would anyone want to join an organisation, that insists people do things their way? And on top of that, in the US, it appears to me, that if X gets compensation for their time, then Y should too? How many arguments have I had with Olivia M, about compensation and expenses? HFEA Committee members, are considered to be self sacrificing people, who generously give up their time to help with thorny issues like infertility, so it is right to award them, an attendance allowance, and full expenses. But that same group of self sacrificing people, who generously give up their time to help with thorny issues, deny donors any kind of attendance allowance, and set a limit on expenses! That attitude is the antithesis of attitudes in the USA!

I'll ask a question, was it DCN members who gatecrashed the HFEA committee, and forced through the changes on donation. http://www.publications.parliament.uk/pa/cm200405/cmselect/cmsctech/7/7i.pdf paragraph 215

Whoever it was, they didn't try to make donation better, more accessible, easier, or whatever, they forced their beliefs on the rest of us. They didn't believe, that we should be allowed to make the best choice, considering our personal circumstances. They believed, the only choice we should be allowed to make, is the one they implemented. And that, IMO, is wrong.

We are back to, I want policy based on 5 things,
1) papers published in peer reviewed internationally acclaimed journals. Based on hard fact, not on anecdotal evidence.
2) What users really need, not what people think we need,
3) what works,
4) ruled that don't discriminate
5) and rules that allow users to make up their own minds o what to do.

I am also protell, but I do recognise, that when you look a individual families, that sometimes, it might be better to keep quiet. And in that respect the DCN , and I seem to differ.

Lorna

What is Group Think?
Group Think in business, happens when the board of Directors / senior mangers spend all day, everyday, in the same environment as each other, and with their employees. They all get together, and discuss a problem, and come to a solution. They make decisions based on their world view, but as every single one of those directors, has exactly the same world view, the directors are unable to conceive, of an alternative reality.

Example. The US car market. All the big car companies in the USA, GM, Ford, etc, were based in the same area. The big chiefs went to the same conventions. Employees of the car firms, bought their cars from their employers. So the directors of Ford, etc., decided big gas guzzling, chucky cars were the thing, and made more of the same.
The bigwigs of the top American car makers, all, inhabited the same world. They would not employ, or would listen to others who tried to tell them; or would not look at research that said, that after the 1970's oil crisis, the world had changed and they needed to change too. But the Japanese recognised, that small, well built, fuel efficient cars were the way to go, and cleaned up the market.

We all used to buy, American Electronic products. Now who buys them? Well Group Think got the American Electronic companies too.

And Group Think, nearly wiped out all life on earth. You are jolly lucky to be here, it could have gone, so differently, and none of us would have been here to debate stuff on Fertility Friends. What am I talking about? The "Bay of Pigs Fiasco", that led to the "Cuban Missile Crisis", that nearly resulted in an all out nuclear war. This all happened in the early 1960's, long before many people on this board were born. And it happened because, Kennedy and all his advisors, had grown up in the same sort of environments, been educated together, etc. They all thought the same way, and no one saw the flaws in a mission, that was doomed from the start.

If you want another bizarre form of Group Think, that caused a bit of an outcry, a few years ago. A group of paedophiles got together and discussed things. They came to the conclusion, based on their view of the world, their beliefs, that sex with children was OK, and they were going to lobby parliament, to make it legal for a grownup to have sex with a child. They wanted the statutory rape law abolished!

Maybe they should take a leaf out of the group that gatecrashed the HFEA committee, and get one of their own on a Quango, and get the laws changed that way. The gate crashers certainly let the evil genie out of the bottle!

Without solid research, or contradictory views, it is very easy to come to a conclusion that is perfectly logical to you, but completely outrageous to everyone else.


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## roze (Mar 20, 2004)

Lorna,

Well said, particularly the bits about compensation and how there are different rules for different people.

I have come across your posts accidentally and found it highly informative and well argued.  Unfortunately I also have the same view about the DCN position and have commented previously too on so many strong statements with so little properly peer reviewed research to back it up.  I find their approach quite dangerous and frankly reminiscent of the bible bashing of fundamental US organisations and even more concerning when you discover that they are presenting a false picture to governments who probably don't probe much beyond the covers.
DCN members join because they agree with the philosophy already, not because they want a balanced discussion. I have always been concerned about the prominence of and free rein given to this organisation on this website and how people going through donor conception seem to be ' targeted' and pummelled with DCN views.  Its judgement, judgement all the way.

I have had two sets of treatment in the Ukraine from a team of very profressional people who were so clearly committed to the success of the treatment, and to the very best care of patients , donors, and future children. Despite which they were , thankfully , light on the moral judgements. 
My donor received compensation however not so much that she could go on a cruise or not work. It was a fair price - a fair exchange.  It would have bought her a long weekend in the Crimea.
Whether a monetary exchange is always a commercial one is in the eye of the beholder. In some circumstances it may be, particularly in the US where huge sums can be charged for particular donor characteristics. The issue however is surely one of degree and extent, not absolute.
There are risks and discomforts in the treatment which warranted adequate and fair compensation. Money is the currency that most people will understand and appreciate therefore it is surely the best one however having personally gone through several IVF treatments with my own eggs I have to say that there are better ways of earning a fast buck that having to go through pain, discomfort, and a drug  regime with many side effects.  There are also more lucrative ways of earning money than being  a donor, so our apparently immoral donors could do better. 
After a great deal of research I have concluded that there must be more motivation for being a donor than fast cash and I have absolutely no discomfort at all at how my baby was made. 


I wish you all the best,

roze  xx


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