Women head east for wombs to rent

No drinking, no smoking, no taking drugs and eat healthily." As she lists the rules she wants her future surrogate mother to abide by, the voice of Rumyana  Nencheva, 34, a dentist from Varna, Bulgaria, gets thinner and quieter.

Nencheva has come to Ukraine, seeking a surrogate mother. Diagnosed with uterine cancer in June 2008, she cannot bear a child of her own.

The 'Infertility Epidemic'

According to the European Society of Human Reproduction and Embryology, ESHRE, in 2013, one in seven couples in the world suffers from infertility.

In up to 35 per cent of cases, ESHRE says, this is down to physiological reasons in the woman. An average of ten out of 100 women aged 20 to 44 cannot have a child.

"Infertility is turning into an epidemic whose peak we have yet to see," says the clinic’s head.

She is a part of a growing phenomenon of women who are unable to get pregnant - and facing a ban on surrogate pregnancy at home - travel thousands of miles to Ukraine to rent another woman's womb.

Victims of society's stigma against childless women, especially in the Balkans, they also confront the hostility of the law in most countries to paid-for surrogacy.

They are drawn to Ukraine by the former Soviet republic's relaxed laws on commercial surrogacy, its relatively developed medical infrastructure - and the price.

Most women heading for Ukraine come from Western Europe and the Americas - only they can usually afford the fees. But a growing number, like Nencheva, are middle-class professionals from the Balkans for whom the cost is still a huge sacrifice.

The staff at the International Surrogate Motherhood Center, in Ukraine, tell Nencheva that she is not the only woman with that name from Bulgaria to have travelled hundreds km.

"We have many patients from the Balkans," the woman at the center confides. While there, Nencheva spots another Balkan traveler, Snezhana, a rotund Macedonian in her forties.

Ethical dilemma

For women who want to escape the taboo on childlessness, and who do not want to adopt, the only solution is to find a surrogate mother who will carry their egg to maturity.

For most governments, however, surrogacy raises serious ethical dilemmas, mainly concerning women being paid to carry children for someone else.

That is why no European Union country allows commercial surrogacy, and why women seeking to rent a womb have to head east to Ukraine, Russia, Georgia, Kazakhstan, or even further afield to India.

In the EU, Austria, Germany, Sweden, France, Hungary and Italy prohibit all forms of surrogacy, paid-for or not. Britain, the Netherlands, Belgium, Denmark and Greece allow surrogacy, as long as no commercial element is involved.

Ukrainian law, by contrast, is the most surrogacy-friendly in Europe. Article 123.2 of Ukraine's Family Code stipulates that women may receive financial compensation to carry someone else's child, and the law places no limits on the amount that can be paid.

The law also guarantees the biological mother's legal rights to the child or children born in the surrogate mother's womb. No adoption process or court order of any kind is required. The entire process is regulated by a contract signed between the agency or clinic, the biological mother and the surrogate mother.

By this, the surrogate mother surrenders all rights to the child carried in her womb. Only the names of the biological parents are entered on the birth certificate.

The vice-president of the Ukrainian Association of Reproductive Medicine says 150 to 200 paid-for surrogate motherhood cycles take place in the country each year.

About half of the women renting these Ukrainian women's wombs are foreigners, usually from the US, Britain, France, Sweden and Italy, but also from Balkan countries.

Cheaper in Kiev

In Balkan societies the taboo against childlessness is especially strong. Here "the inability to conceive a child, and carry it to maturity, is regarded as abnormal," says Bulgarian psychologist Yana Pacholova.

"If people learn about it, the woman experiences shame, reproachful glances, negative attitudes, whispers behind her back, isolation and being pointed out by society," she adds.

Fear of barren women in Bulgaria is handed down the generations. Folklore teaches that childlessness is a curse and a disease.

In some parts of the Balkans, the families of a childless woman give her the child of a relative to bring up as her own, according to Violeta Stan, a child psychiatrist in Timisoara, western Romania.

But, among the Roma, the inability of a woman to conceive can lead to the annulment of the marriage. Among the Kardash community in Bulgaria, meanwhile, a mother-in-law can even chase away an infertile daughter-in-law.

The law is not the only reason why women seeking wombs to rent come to Ukraine.

"The main reason ... is the price," patients' coordinator at one of the Kiev clinics.

Price for the surrogacy program in Kiev is only about one-third of the price charged in those US states, such as Florida, Nevada, New Hampshire, Virginia and California that permit commercial surrogacy.

Too pricey for the Balkans

While prices in Ukraine are far lower than in the US, they are well above what most people in Balkan countries can afford. It is far too costly for Ani Dimova, a frail-looking young woman from Asenovgrad in Bulgaria.

She still remembers her deep shock on discovering in her teens that she would never conceive. "At first, my parents tried to hide it from me," she says.

"I was 14 and had just had my first check-up in hospital. I went outside and waited for them in the car. When my mum came out, she was crying."

Though naturally smiley, Dimova says few days go by when she is not reminded that she cannot have her own child. "I've thought about going somewhere where surrogacy is possible but the prices are very high," she says.

((http://www.aljazeera.com/))

Happy Childhood :)

Fairy childhood

This 3-year-old girl is the happiest kid in the world! She regularly visits Disneyland and has already become the unofficial star of the most famous entertainment park in the world. Her talented mother creates a wonderful costumes inspired by the Disney cartoons. Every wee little girl, her mother and father visit Disneyland. In such a way mother wants to help her little daughter to overcome excessive shyness.

The shared journey of IVF

“Don’t think of IVF as a treatment,” says Dr David Walsh of SIMS clinic. “It’s really more of a test. It examines how well a man’s cell – the sperm – and the woman’s cell – the egg – can work together.

It’s really an incidental by-product that when you put those embryos into a uterus it results in a pregnancy.” IVF is the process where a woman’s eggs are fertilised outside of her body in the laboratory. The resulting embryos are then transferred back into the uterus a few days later.

According to Walsh, IVF is recommended for women with absent, blocked or damaged fallopian tubes. It is also often used in cases of unexplained infertility, in some cases of male factor infertility and can be used in combination with ICSI (intracytoplasmic sperm injection).

Timeframe

Walsh says that, while every patient is different, there is a time frame to follow before considering the IVF route. “Couples generally turn to IVF after two years of trying.

Usually, in the first six months the couple will be trying themselves and then they may turn to their doctor for some advice. He/she may offer some options or advise taking supplements for the next six months.

“After that it is normal for the couple to look for some fertility treatment options.

IUI (intrauterine insemination) is one example. This involves taking the sperm and planting them high up in the womb to double the couple’s chances of getting pregnant. If this is unsuccessful IVF is usually the next option.”

There is an exception to this time frame– the woman’s age. “If the woman is coming close to her 40th birthday it may be important to consider IVF at an earlier stage.

Remember, often couples will want to have more than one child. They can sometimes focus too much on the first and, by unnecessarily delaying the process, they push back the second baby – this can create a problem.

It’s often about creating a family and not just one child.”

Two months

Walsh says that the IVF process takes, on average, two months.

“If I see somebody in mid November, generally speaking you would be looking at treatment in mid January,” he says.

“You need time to check the egg count and get them prepared for the cycle.”

The chances of success from IVF vary between patients, particularly according to the age of the woman. However, on average, about 28 per cent of patients will have a baby after one attempt at standard IVF.

“We are simulating what Mother Nature does. Mother Nature gives you a one in five chance of getting pregnant every time you try. We are doing something similar.

“With each failed cycle however the chances of success do decrease. Interestingly, if the man has a fertility problem, it’s not necessarily a bad thing. You can do something about it. Often men can be sensitive if their sperm count is low. But I tell them it is also a good thing because it means the treatment is more likely to work - because we know where some of the problems are arising from – and how to eradicate those problems.”

According to Walsh, it is crucial that couples lean on each other for support.

Eager to not sugar-coat the process, he admits IVF is a hard route to take.

“There will always be challenges along the way. How you cope with those challenges together is very important. Failing to get pregnant is just one of the problems that couples can face, there is also the possibility of not staying pregnant or having an ectopic pregnancy. The couple must be there for each other through the whole process. If they do that then I believe they have a great chance to succeed.

It’s a shared journey. And that’s the critical thing. In fact, I find that most couples are brought closer together by the process.”

What does IVF entail?

There are four general steps involved in an IVF cycle:

Stimulation

Under the care of a consultant gynaecologist, the woman is given fertility medications to stimulate her ovaries to produce many follicles. Follicles are the small fluid filled structures which develop on the ovaries, each of which will hopefully contain an egg.

The number and size of the developing follicles are measured by trans-vaginal ultrasound scans. The exact number of follicles, which develop varies between patients, but the average is about 10. The final preparation for egg retrieval involves a hormone injection, which mimics the natural trigger for ovulation. Egg retrieval will take place 36-38 hours after this injection.

Retrieval

Egg retrieval is a minor operating theatre procedure which is carried out on an outpatient basis under local anaesthesia. The trans-vaginal ultrasound probe is used to visualise the ovaries and a needle attached to the probe is passed through the vaginal wall into the follicles. The fluid within each follicle is aspirated and then examined in the IVF laboratory for the presence of an egg.

After identification, the eggs are washed and transferred into a special culture medium in Petri dishes in an incubator.

Fertilisation

While the egg retrieval is proceeding, the sperm is also prepared. A semen sample is provided by the male partner and, in the laboratory, a concentrated preparation of the best motile sperm is extracted from the semen sample. This sperm preparation (containing approximately 150,000 sperm) is added to the dishes containing the eggs, and they are incubated together overnight.

Transfer

Embryo transfer is a simple theatre procedure that does not routinely require anaesthesia. The embryos are placed into the uterine cavity by the doctor/IVF nurse by means of a fine catheter inserted through the cervix. The correct positioning of the embryos is confirmed by abdominal ultrasound, so the woman is required to have a full bladder for the procedure.

((http://www.independent.ie/))

Surrogacy and EU

Our question this time in U-talk is: “European countries have very different positions concerning surrogacy. Where is it allowed and where is it prohibited? And do you think harmonisation of the different legislations is possible? “

The answer to this question comes from a legal expert with the Research Centre on Fundamental Rights, (CREDOF), at the University Paris Ouest, Nicolas Hervieu.

“The current situation concerning the issue of surrogacy is very diverse in Europe. Some countries expressly prohibit it, such as France of course, where recently there has been much debate about surrogacy. It’s also prohibited in Germany, Spain, Switzerland and Italy.

“Other countries, though far fewer, expressly authorise surrogacy on their soil, such as the UK, Greece, Russia or Ukraine. And there are countries which have not yet clearly decided in their legislations.

“Do we have to stick to this European diversity? Or, on the contrary, should we try to harmonise these different laws?

“For European institutions and European courts, the point is not about choosing between diversity or harmonisation.

“For the European Court of Human Rights for instance, such diversity is not a problem at all.

“This court is part of the international organisation called the Council of Europe which is made up of 47 European countries, (including the EU’s 28 member states). This court is different from the European Court of Justice based in Luxembourg and which is part of the EU.

“In two very important rulings, issued on 26/06/2014, (concerning the cases ‘Mennesson versus France’ and ‘Labassée versus France’), the European Court of Human Rights explicitly recognised that a state is entitled to prohibit surrogacy on its own soil.

“But the court also recognised that the prohibition of surrogacy could not be made at the expense of children legally born to surrogate mothers in a foreign country. It is for this reason alone that the court ruled against France.

“So in the short term all European states, including those prohibiting surrogacy on their soils, must formally recognise the filiation between the intended parents and those children born through surrogacy abroad.

“This is because otherwise this would violate the children’s right to an identity. Even so, these rulings are not going to entail a harmonisation of European legislations towards the acceptance of surrogacy.

“Some EU institutions differ from the European Court of Human Rights, but they have limited powers in family policy. They can have some influence on the issue but this does not imply harmonisation.

“In the medium- and the long-term, if harmonisation towards acceptance of surrogacy gets momentum in the European Union, it would be due to member states. In any case, the EU’s institutions and courts would only acknowledge it and legislate after this evolution.”

Facebook, Apple pay for egg freezing, sperm donors

Free lunches, dry cleaning, massages — frozen eggs?
Silicon Valley's biggest companies have long offered cushy perks to attract top talent and keep workers happy logging scores of hours on the job. But beyond day-to-day luxuries, Facebook and Apple will now give up to $20,000 in benefits to help employees pay for infertility treatments, sperm donors and even to freeze their eggs. The move comes amid stiff competition for skilled engineers, and as many of the biggest firms try to diversify their male-dominated ranks to include and appeal to more women.

"Anything that gives women more control over the timing of fertility is going to be helpful to professional women," said Shelley Correll, a sociology professor and director of the Clayman Institute for Gender Research at Stanford University. "It potentially addresses the conflicts between the biological clock and the clockwork of women's careers: The time that's most important in work, for getting your career established, often coincides with normal fertility time for women. This can potentially help resolve that by pushing women's fertility into the future."

Facebook this year started offering to reimburse workers for up to $20,000 worth of reproductive-related costs, over the course of employment. Apple's similar perks will start next year. The companies' egg-freezing benefits were first reported by NBCNews.com on Tuesday.

Freezing eggs involves removing a woman's eggs and cooling them to subzero temperatures to preserve them for future use and stop the egg from changing and developing. Generally speaking, the viability of a woman's eggs can decline a bit at age 27 before taking a steeper drop around age 34 or 35. The rate of women who had their first child between 40 and 44 has more than doubled in the past 20 years, according to the Centers for Disease Control and Prevention. As more women wait longer to have their first child, the number of women choosing to freeze their eggs has grown "exponentially," said Dr. Alan Copperman, a fertility specialist at Mount Sinai Hospital. They are also doing it at a younger age, which means healthier and more viable eggs.

Freezing their eggs gives women an option to focus on their career or education first, the "leaning in" that Facebook Chief Operating Officer Sheryl Sandberg champions. But the procedure can cost upward of $10,000, plus storage costs of several hundred dollars a year. Later it costs another several thousand to thaw and fertilize the eggs and implant them in the womb.

The number of egg freezing patients at the New York University Fertility Center rose to about 400 this year from just five in 2005, said Dr. Nicole Noyes, a fertility specialist at the center. She said some big banks also are covering the procedure, and expects law firms to do the same if they want to keep good female employees.

Copperman thinks Apple and Facebook are ahead of the game in offering to cover the procedure, both as a recruitment and retention tool and from a public health perspective. He expects other companies to follow suit, "because it's the right thing to do and it's going to send a signal that women's health should be a priority."

"It's telling women they have the opportunity to put off child bearing and focus on their careers," he said. "(And) not make decisions based on certain reproductive limits women have."

Apple's and Facebook's reproductive benefits policies could also appeal to gay and lesbian couples who want to use a surrogate or a sperm donor to have a baby, or heterosexual couples who incur in vitro fertilization costs not covered by insurance. Apple also reimburses adoption costs.

Coverage of infertility treatments is becoming more common among big employers, according to the benefits consultant Mercer. Sixty-five percent of companies with 500 or more workers covered the beginning step of an evaluation by a fertility specialist last year, according to Mercer's annual benefits survey. That's up from 54 percent in 2008. IVF coverage rose too. Slightly less than a third of companies offered no infertility treatment benefits, down from 41 percent.


But coverage of egg freezing is rare. Corey Whelan, of the American Fertility Association, said she's never heard of an insurer or employer covering the procedure for women who want to delay pregnancy for non-medical reasons like school or a career.

"Insurers will sometimes cover egg freezing for cancer patients, but it's by no means guaranteed," said Whelan, the nonprofit's program director.

While the technology is growing more popular, experts stress that egg freezing is not foolproof.

"It's really, really important for women to know it's not a guarantee of motherhood," Whelan said. "Some women consider it an iron-clad insurance policy. It's not."

((http://www.denverpost.com/))

Surrogacy boom: Graduates rent wombs for a secure future

Number of educated women willing to rent outtheir wombs is on the rise; many use the money to start a business, educate their children orinvest in property, say infertility experts

Mona Mahta a-28-year-old woman with a BCom degree, earned lakhs of rupees in eight months.

She is using the money to not only educate her two daug-hters but also prepare for exa-mination to get a bank job. But Mehta she is not just another working mother. She is a surrogate mom.
With Ahmedabad ranking only second to Anand in hand-ling surrogacy cases in India, several young and educated women like Mona are renting their wombs to earn money. With the money they earn, some start their own business, educate children or invest it in property.
Despite her Bachelor's deg-ree, Mona - who hails from Madhya Pradesh - could not land a job of her choice as she did not know Gujarati. Her hu-sband drives an autorickshaw and has to spend part of his income on paying the rental for the vehicle which leaves the family with limited cash. That is, till Mona opted for rent her womb to a foreign co-uple as a quick and legal alternative to make money.
"I have more than 150 surr-ogate mothers at my centre, of which 10 are graduates. They let out the wombs with their family's permission. More and more young educated women are opting for this method to improve their socioeconomic status," said Dr Kamini Mehta, infertility expert at Vani Hospital. Sushma Prajapati, 20, is BEd qualified and has already given birth to two surr-ogate children. "Her husband's income is inadequate to run the family and she cannot aff-ord to leave her only child alone at home so she opted for surrogacy," said the doctor. She also gave the example of Preeti Desai, a double graduate, whose husband is a computer trainer. She recently registered herself at an IVF clinic for surrogacy.
"As surrogate mothers are provided with medical insurance worth lakhs, which they can claim during any medical emergency even after del-ivery, women are willing to rent their wombs," experts said.

INVESTING IN FUTURE
This has opened a wide range of opportunities for educated women. Geeta Solanki, 23, started a catering business with the money she received after renting her womb twice. "She has hired 50 girls to help her with the business. She also extended monetary assistance to the family during the marriage of her sister-in-law," revealed Mehta.
She added that even women who dropped out of school are learning English to communicate with biological parents, usually foreigners. Surrogate mother Neha Jalla has studied till Class 8. "She is now learning English so that she can speak to the couple without the help of a mediator," said Mehta.

BABY FACTORY
India first opened its gate to surrogacy in 2002 along countries like Georgia, Russia, Thail-and and Ukraine, and a few US states where women could be paid to carry others' biological children. Currently, surrogacy brings millions of rupees to the country and according to medical experts. Around 80 percent of this money comes to Guja-rat. For every delivery, couples give the mothers anything between Rs 4 lakh and Rs 5 lakh. According to their agreement, the couple also pays for the daily expenses of the surrogate mother until the baby is born.

((http://www.bangaloremirror.com/))