The fact that Tusshar Kapoor has become a single father through donor egg surrogacy has got a lot of media attention. Many celebrities have used IVF and surrogacy to complete their families and they are willing to be vocal about this. This has helped to remove the stigma associated with infertility, and has accelerated the acceptance of these assisted reproductive techniques in India, which is all for the best, as we can now provide many more medical treatment options to infertile couples.
However, if we probe a little deeper, this pregnancy raises more questions than it answers. While it is great that we allow single parents to have a baby (and I personally feel that's fine), what bothers me is the fact that this baby was born as a result of flouting the Indian Council of Medical Research guidelines.
Here's some background to put this in context: IVF clinics which offer assisted reproductive technology treatments to infertile couples (such as IVF and surrogacy) are regulated by the ICMR guidelines. These have been published online at the ICMR website, and they tell IVF clinics what they are allowed to do, and what is not acceptable.
We expect that all good IVF clinics will follow these guidelines, and one of the guidelines says that surrogacy should be restricted only to married Indian couples. Now whether an IVF doctor agrees with these guidelines personally or not, it still behooves him (or her) to follow them. However, if these guidelines get flouted simply because you are treating a celebrity, this is unfair for other patients. It sets a bad precedent and it suggests that we have different standards , depending on the patient's status in society.
The justification provided for doing the treatment is that because no law has yet been passed which regulates surrogacy treatment in India , this means that no laws were broken by doing surrogacy for him.
However, in that case, what's the point of having guidelines for IVF clinics ? These were passed in order to regulate IVF clinics, many of whom had behaved irresponsibly in the past. For example, they would transfer multiple embryos, in order to jack up their success rates. This led to an epidemic of multiple births (many of these babies were premature and died), and it was because good IVF doctors were worried that IVF treatment had started becoming completely unregulated, that it was decided to pass these guidelines. This was done in order to safeguard patients, and multiple discussions have been held over many years, to formulate these guidelines.
However, if doctors who are registered with the ICMR flout these guidelines, that means they are treating the ICMR as a toothless tiger, just because they can get away with this. Since there is a legal vacuum, they conveniently conclude that everything which is not prohibited by the law explicitly can be considered to be legal.
My worry is that if we ignore the guidelines simply because the legislature is taking so long to actually pass the law, we are making a mockery of the entire process. This means that an IVF clinic can continue do whatever they like, simply because there is no law! However, it was exactly because there was no law, and we knew that it would take a long time for the law to be passed, that the guidelines were laid down, and it was expected that IVF clinics would voluntarily abide by these. However, if doctors are allowed to pick and choose which guidelines they want to follow, this will encourage a backlash where activists will say that this proves that IVF clinics can't be trusted, and that doctors are not able to police themselves. They will use this as a justification to pass a law which will be much harsher and stringent than it would have been otherwise. This will be very sad for infertile couples, as doctors will end up losing their autonomy, because of a few irresponsible IVF clinics who are taking advantage of a "loophole".
This smacks of double standards. A few weeks ago, when a doctor in Punjab got a 72-year-old woman pregnant, all the IVF specialists and medical societies blasted him for being unethical and irresponsible because he was flouting the guidelines. Now, when the same guidelines are being broken for doing single parent surrogacy, no one is objecting.
Since all IVF children are deeply loved, let us be consistent, and stop discriminating based either on age, gender, sex or citizenship. We should allow everyone who wants to have a baby to do IVF and surrogacy, if this is medically appropriate for them. Yes, we do need to make sure that the surrogate is not exploited, and this can be done by making sure that she is paid 20 percent of the total fee charged by the IVF clinic for her services. This would be fair and ethical, so that people can complete their family with the medical assistance they need.
Dr Aniruddha Malpani is a leading IVF specialist.