F.A.Q. The sort of questions your average Joe or Joginder would ask, but was afraid to ask! Answered by Dr Kadam. (More Q&A to follow) Egg related questions - Green Surrogacy and Medical questions - Blue Money and Legal questions - Red Where do you plan to deliver babies? Currently, Hiranandani Hospital is the best option. I am trying at the other multispeciality hospitals. Will let you know. Is your new premises cheaper to lease than Bandra and is this one main reason of your lower charges? No. I have taken a reduction in all my profits. What is the proportion of oversea clients in your clinic? to follow The ever helpful Bobby and his oneinsix.com website is bringing you clients. How are you able to cope with the influx. Are you expanding your search for surrogates and donors? Will new patients have off-the-shelf surrogates ready and willing or will there be a waiting period? to follow Is your male specimen room in fully working order? Will male patients be given 'materials' to work with including a working dvd player and instructed how to operate? to follow It's best to bring along a magazine or newspaper as patients keep pinching the 'glossy' mags! I left some Playboy magazines and xxx VCD with the clinic, inform us if it's not available. What pretests and checkups does the intended parent need to perform in the west before sanctioning treatment? Baseline Profile (To be done on day 2/3 of your menstrual cycle if using your own eggs) [] Serum FSH [] Serum LH [] Serum TSH [] Serum Prolactin Fertility Screen [] Complete Blood Count [] Fasting & PP Sugar [] Blood Grouping & Rh typing [] Bleeding Time & Clotting Time [] Routine Urine [] Test for HbsAg [] Test for HCV [] Test for VDRL [] HIV (1+2) Antibody [] Test for Chlamydial Antibodies (IgM + IgG) [] Endometrium for TMA-TB & TB Culture [] Test for Antiphospholipid Antibodies (IgG + IgM) Male Tests [] Routine Semen Analysis [] Antisperm Antibodies (Husband/Wife) [] Semen Culture ABST [] Test for HbsAg [] HIV (1+2) Antibody [] Blood Grouping Rh typing [] Detailed Sperm Morphological Profile(Modified Kruger's Criteria) These tests can be done in India. To do these tests just prior to commencing surrogacy is possible. The outcome does have a bearing on the surrogacy program. You will need to arrive a week earlier. Best to confirm all this with the clinic. What scans/tests do you do during the course of the pregancy? Scans are done approx. every monthly for the surrogates. In addition, Nuchal scan is done at 13 weeks, anomaly scan at 20 weeks and 3D/4D scan at approx. 28-30 weeks. HIV tests are done monthly. Complete screening of all infectious diseases is done at the time of recruitment, again at three months and seven months of pregnancy. Triple Marker tests are done in the first and second trimester. Monthly updates for the surrogates is given to the indented parents every monthly till seventh month followed by fortnightly in the eighth month and weekly in the ninth month. Can you provide information on your new laboratory and equipment? We have a state of the ART laboratory equipped with the most advanced instruments and equipments keeping in mind the delicate work that needs to be done here. Our K-System, which is the main work station for any lab. is specially imported from Germany and technically best suited to handle the delicate oocytes. There are two incubators, both large ones for culturing our embryos and which act as a back up for each other. The ICSI machine is from Research Instruments, UK and is the most stable micro manipulator to work on. We also have facility for Assisted Hatching and doing blastocyst cultures. There are also the large Nitrogen tanks for storage of the embryos and facilities are there for vitrification method of freezing. Is there a chance that you might mix up the eggs – have you ever had this before? I have heard stories of this happening. Please note that such a thing does not happen as we follow very strict quality norms wherein patient labeling begins from semen jars to even syringes and needles as wells a all plates with the embryos. The delicate dishes are handled only by a well trained embryologist and we all know the ISO norms and follow the same and our clinic will also obtain certificate for the same. Can you tell me in regards to Indian egg donors the difference between wheatish and fair. Which is lighter skin colour? Fair is a lighter skin colour. What checks and criteria do you make on any surrogate entering your program? She must have her own children and be under 35/36 years of age. The surrogates we recruit undergo a thorough and strict screening process which includes a hormonal screen as well as an infectious disease screen along with a psychological screen and an IQ test done by a qualified psychologist. They are also counseled at the clinic along with their husbands regards the entire process prior to taking them up into the program. We have social workers allocated for each surrogate who take care of them. Their nutrition and diet is controlled by us and we have a staff nurse visiting them daily. I'm thinking whether to use the eggs of my wife whose age is 42 or an egg donor. In light of your wife's advanced age, we will recommend her to get her S.FSH level done on day 1/2/3 of her next menses. An FSH level of more than 10 mIU/ml but less than 14 mIU/ml is suggestive of Incipient Ovarian Failure and that above 14 mIU/ml suggests Established Ovarian Failure. In such a case Donor Egg IVF will be the best option for you. (the less the number the better) Can I see and choose an Egg Donor from her picture before flying to India? Yes, of course Prompt them every month for the newest batch of donors for viewing The bill for the procedure of using our own found egg donor over the clinic's donor should be less as there's no donor expenses involved. Is that true? i.e. remove the donor's wage from our bill! Yes, this is true, provided your egg donor does not require a very high doses of Gonadotropin injections to form multiple eggs. Will we meet the clinic's egg donors before treatment? No. I'm sorry, as this is an anonymous egg donation programme this would not be possible. Can I be there at the exact time as the Egg Donor on egg collection day so that I can clearly see who the donor looks like (discreetly) just to alay fears? Being that I have to be there for my sperm sample which happens on same day. to follow The screening test on our own found Egg Donor will take how long before results? The entire profile could be done on one day ie. ( Day 1 or 2 or 3 ) of the donor's menses and we would get the reports within 3 days. My friend got a Donor and a Surrogate about 5 years ago and later on (after doing a dna test) he discovered that the baby is NOT HIS! How do I ensure that after all has been done that: A)The donor is the same that was first presented to me. B)My sperm was the one that was actually used and not some random guy . You can be present in the clinic at the time of the Ovum (egg) Pick-up of the donor. You can do a DNA test later to confirm. Are surrogacy contracts signed in clinics? Do you provide the agreement forms? Yes we do. Do some surrogates of yours donate their own eggs to the cause? Either seperately or with surrogacy they give their own eggs. Our egg donor and surrogates are separate. However, our surrogate could be an egg donor separately. How many embryos can be implanted in the surrogate? to follow The male giving his semen sample. This assumes he only needs to arrive for a day to give his sample. Do you not need to check his semen/blood for HIV/AIDS etc and if so hows that done in one day? Please note that we will recommend the male patient to get his screening test for HIV done in his own country. However, we will get an HIV-PCR done upon his arrival here before we inseminate the eggs with his sperms. I am white. We don't seek a donor. All I want is my eggs implanted on your surrogate. How long will I need to be in india? You will need to be here for two weeks starting from day 1/2 of your menses so that we can start your stimulation here. However, you can also begin your injections in your hometown and reach the clinic by day 7/8 so that your stay in Mumbai is for a week only. (cost of drugs in the west is higher) I am white. We don't seek a surrogate or donor. All I want is IVF done on myself. We will just need you to undergo the screening tests prior to starting the cycle. Kindly courier us a copy of all the reports. We will then begin the cycle at the earliest. Your maximum stay in Mumbai will be for two weeks. Using my frozen embryo, it should take less than 2 weeks to complete the whole surrogacy process. Exactly how long? In case of a Frozen Embryo Transfer, you will need to be in Mumbai for a maximum of five days. We will begin the preparation of the surrogate here from day 1 of her menses and begin her Luteal support once the embryos have reached our clinic. The Embryo Transfer is done on the fourth day after we begin the luteal support. The surrogate will then continue all her medication for fifteen days at the end of which a pregnancy test will be done. You can however, leave the day of the Embryo Transfer and we will inform you the report by email. What is the best day of my cycle to book my first appointment. As I don't wish to stay any longer than necessary. Is this the same for donor surrogacy as well as standard surrogacy? The best day for the initial appointment with a short stay will be day 1/2 of menses in case of a self cycle and 1-2 days prior to the donor's Ovum Pick-up in case of a donor egg cycle. (If you can understand this you're a better person than I am! Both instances use a surrogate, first instance is if you use your own egg and the other instance is when a donor is used. Unless ... oh forget it!) Can we send our own found surrogate to your clinic to perform the blood tests etc alone. Can we prepay the fees for this? Yes. Sure you can. Kindly ask the surrogate to reach the clinic on day 1/2 of her menses on an empty stomach for the same. The accuracy of period is never known in advance so can our own found surrogate go to the clinic when she's on the first day or does an appointment have to be made? Can she turn up unannounced and still perform tests? Kindly note that she is required to be on an empty stomach for the Fertility Screen. We would therefore recommend her to go fasting on Day 2 of her menses and get all the tests done together(Baseline Profile and Fertility Screen) at one time. So using our own frozen embryo that we brought along can we expect a reduction in price of surrogacy since we won't be needing any large scale medication. The total cost of surrogacy in this case will be ....? to follow Should I bring along or fax over to you anything regarding our past medical history? Yes, preferably courier us copy of all the previous reports so that we can guide you better. I know you don't do sex selection, but there are instances like genetic health reasons. Otherwise an abortion will have to take place. Is there any way you can help in this? to follow How much for freezing semen? to follow How much for freezing eggs/embryos? to follow Can we pay by card? to follow A male Gay couple (or single gay bloke) wishes to be a father. He seeks a surrogate and egg donor. Do you cater for single gay male or a male gay couple? Please note that we cater for two men and even one man :) Are you fed up with answering our questions? No, not at all :) drkadam@indiansurrogacy.com ---------------------------------------------------------------------------------------------------------------------------------------------------- Some old questions we put to the doctor several years ago which applied to our strange surrogacy case of when we had our own surrogate who also donated her own eggs. The doctor was most perplexed to say the least! Biological parents will be entered in the birth certificate made out at hospital. What in our case? Bobby is father and Miss X (surro) is bio mother? Whose name shall be entered in the certificate then? In this case since surro is the biological mother, her name Miss X will be written on the birth certificate with your name as the genetic father. Thus, Nikki will need to adopt the child after birth in order to legally become the child's parent. Ok, if the Egg Donor gave the eggs and Miss X (surro) delivers the baby, whose name will be on the certificate? Assuming no DNA testing is done given the hospital thinks its Miss X and Bobby. Is the Egg Donor (or sperm donor) out of the picture as far as the Hospital is concerned? No. The birth certificate will be in the name of Bobby and the Egg Donor. (not the surrogate) Okay, so if we had used your anonymous Egg Donors (u don't reveal details i assume of donors) then whose name is on the birth certificate along with mine if the Donor is not revealed? Or if the Donor gave a false name then what? Put it this way, the hospital where we to deliver the baby will not know it was a surrogacy or know it was a Donor. They will assume its Miss X (surro's). So whose to say any different? We will keep mum and not say a word to the maternity people keeping the whole process simple and uncomplicated. Miss X (surro's) name will be on the certificate whether you like it or not! (phew!) Please note that we are checking up with the ICMR on how to deal with such an issue. I will write to you as soon as I hear from them... Bobby and Nikki certainly put it to them! |