Do you really need a surrogate ? – Dr.Malpani

As an IVF specialist, I receive a lot of queries from infertile couples from all over the world. Many of these are older couples who have been infertile for many years; and since they cannot get medical treatment in their own countries ( either because it’s too expensive or because their government does not allow it), they want to come to India for treatment. Many of them think that because they are too old, their best option would be surrogacy; and since they have read many articles about how easy surrogacy is in India, they often email me asking for gestational surrogacy services.

The tragedy is that so many infertile couples are still so poorly informed about surrogacy treatment and who it is useful for. Many couples naively believe that a surrogate is the final answer to all infertility problems; and that surrogacy has a 100 % pregnancy rate ! Sadly, this is just not true !

Surrogacy is an expensive and complex treatment option, which is best reserved for women without a uterus, or whose uterus is damaged. Older women who are infertile rarely need a surrogate. As they get older, their fertility declines, not because their uterus ages, but because their eggs get old – a condition called the oopause. Since their own uterus is usually completely normal, using a surrogate makes no sense for them at all ! After all, how can replacing a normal uterus (their own) with a surrogate’s uterus improve pregnancy rates just because the surrogate is fertile and has had babies in the past ? These couples would be much better off considering the options of donor eggs or donor embryos.

Unfortunately, they are often so desperate to have a baby, hat they do not bother to learn that as their biological clock ticks away, it’s the ovaries which get depleted of eggs – not their uterus. Since surrogacy is a lucrative treatment option to offer ( it’s the most expensive of all the IVF treatments offered today) , many IVF clinics are happy to offer surrogacy, without bothering to explain to couples why it may not be the right treatment option for them.

It’s exactly the same situation with couples who have failed multiple IVF cycles; or who have had repeated miscarriages. They are emotionally very vulnerable and are willing to clutch at straws. They have low self-esteem, since their bodies have failed them, and are very happy to explore surrogacy. However, research shows that the reason for failed implantation is much more likely to be genetically abnormal embryos ( because of poor quality eggs), rather than a uterine problem. Even though surrogacy may not be their right treatment option for them, it continues to be overused and misused. This sort of medical abuse it likely to give all IVF clinics a bad reputation.

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