logistics and costs of surrogacy in india

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Logistics Costs of Surrogacy in India
By Dr. Samit Sekhar Kiran Infertility
Centre Pvt. Ltd. Hyderabad/ Gurgaon/ Nepal
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Planning a Child With help of Surrogacy
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Why India for americans

• World Class Medical Expertise Medical
  Facilities
• Clearly Defined Laws and Guidelines and Minimal
  Legal Complications
• Abundance of English Speaking Population
• Good Connectivity from Across the Globe
• Good Infrastructure
• Cost Advantage, much much affordable.
• Safe and Friendly Country and people

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Costs

• Surrogacy Self cycle 32,000 US
• Surrogacy Indian Donor 32,000 US
• Surrogacy Caucasian Donor 45,000 US

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Who are eligible

• Married Couples (Heterosexual) married for more
  than 2 Years
• Citizens of countries which recognize Surrogacy
  such as USA,Canada,UK,Brasil,Singapore Etc..

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Initial enquiry

• Enquire through Internet, known successful
  parents, Forums about the hospitals providing
  services.
• Ensuring that the Hospital is registered with
  I.C.M.R. (Indian Council of Medical Research) for
  providing Surrogacy Services.
• Contacting Hospital in India through e-mail /
  phone/ Skype
• Negotiate the terms and conditions
• Sign Contract, can be done over email

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Initial enquiry

• Enquire through Internet, known successful
  parents, Forums about the hospitals providing
  services.

It is always better to be double sure best way
is word of mouth by other successful parents in
past and visiting the facility personally
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Initial enquiry

• Ensuring that the Hospital is registered with
  I.C.M.R. (Indian Council of Medical Research) for
  providing Surrogacy Services.

Only hospitals registered with I.C.M.R. are
allowed to treat patients of foreign origin.
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Initial enquiry
Mostly costs range around 32 K US to 45kUS
depending on the Services being offered.
Services offered include 1) No of IVF and
Embryo Transfer Attempts 2) Donor
Type-Indian/Caucasian 3) Food Accommodation
4) Concierge 5) Travel 6) Legal
Assistance 7) Singleton or Twin Birth
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Initial enquiry

• Move Ahead

Ready to Go Discuss with clinic appropriate
timelines according to medical conditions and
plan your itinerary accordingly at-least a month
in advance to proceed further.
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Logistics During Initial Visit Surrogacy/ ART
Visa
It is granted only if following conditions are met

• To a Foreign Man Woman duly married to each
  other for more than 2 Years
• A letter from Embassy of country of origin of
  Intended Parents in India or from their Foreign
  Office stating that they recognize Surrogacy and
  will accept the child/ Children born as the
  biological child of Intended Parents
• Affidavit by Parents assuring to take care of
  Child Born
• Surrogacy should be commissioned only in
  registered clinics in I.C.M.R.
• Duly Notarized Tri Party Agreement involving the
  Intended Parent, Surrogate Mother, and Clinic
• Agreement can be done over email or post

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http//hyderabad.usconsulate.gov/surrogacyinfo.htm
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Treatment cycle
Initial Stay Logistics

• Your Initial Stay Duration depends on the genetic
  material you are intending to use.
• in case of donor eggs the male partner is
  generally required to stay for not more than 4
  days for Semen Extraction
• In case you are using self eggs then you require
  to stay anywhere around 12-16 days per Egg
  Retrieval cycle depending upon the medical
  protocol prescribed by our doctor.
• In case of Egg Donor, Intended Parents need only
  4-5 days of initial stay

• There is abundance of hotels providing world
  class stay and dining facilities around in major
  cities, charges per day for a couple on an
  average will not be more than 100 US.
• You need too register with FRRO, Foreigners
  regional registration officer which will require
  1 day
• stay and FRRO Process is also a part of the
  package offered to you by KIC
• There are very rare indications of emergency
  situations in an IVF process, Almost all
  hospitals registered with ICMR are fully capable
  of handling such situations

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Antagonist Protocol for In Vitro
Fertilisation/ICSI

• 1.Tablet Yasmin(or any other similar Oral
  Contraceptive pill) twice a day for 15 days
• You will stop the pill 4 days before your
  departure for India and hence this way when you
  arrive here it will be day 1/2/3 of your
  menstrual cycle and we can begin treatment
  immediately
• 2.Injection Recombinant FSH(300 units/day) or
  Highly Purified HMG from day 2 of the Menstrual
  cycle to be injected Sub Cutaneous/Intra muscular
• 3.On day 4 of Gonal F,the female partner will
  undergo Ultrasound to check for size and number
  of follicles
• 4.if 2 or more follicles are 10 mm or more in
  size then Injection Cetrorelix(0.25 mg/day) will
  be added to the Gonal F on a daily basis
• 5.Ultrasound will be repeated on day 6/8/10/12 to
  check for follicle growth

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Antagonist Protocol for In Vitro
Fertilisation/ICSI

• 6.When 3 or more follicles reach a size of 18 mm
  or more ,Injection HCG(Human Chorionic
  Gonadotropin) will be given to trigger ovulation
• 7.Egg retrieval under general Anaesthesia or
  Sedation is performed 36 hours after HCG
  injection
• 8.Sperm from Male partner is used to fertilise
  the eggs from the female partner and embryos are
  cultured in the incubator for transfer on day
  2/day3 or day 5
• 9. Egg donor stimulation is also similar to the
  steps mentioned above, she will also take the
  ovarian stimulation and Pills on the same dates
  as the Genetic parent
• 10.if Embryo transfer needs to be done for the
  Surrogate mother then the Surrogate mother will
  also take medications on the same days as the egg
  donor or Genetic Parent but she will take
  medications to improve her Endometrial
  receptivity rather than medication to produce eggs

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Time Lines
A gist of timelines applicable in Surrogacy

• Surrogacy Visa To be applied at-least 4 weeks
  before you plan your travel
• Duration of Stay with regards to Semen
  Collection 4 Days
• Duration of Stay with regards to Egg Retrieval
  12-15 Days
• Time between Egg Retrieval and Embryo Transfer 6
  Days
• Result Post Embryo Transfer 10 to 15 Days
• Interval between 2 Transfers Approx. 15-21 Days

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precautions at Birth
Medical Aspects

• In case of Singleton pregnancy the child may be
  required to be in Hospital for an average period
  of 3-4 Days
• In case of Premature Delivery (Mostly applicable
  for Twin Births) the child is required to be
  Hospitalized for an average period of 7-14 Days

Legal Aspects

• Application for Citizenship and Passport for the
  child in US Consulate/ Embassy ( takes approx.
  7-10 working days),our most recent case this
  weeek were issued passport without the DNA test
  in 3 days post birth.
• US Consulate/ Embassy is available in all major
  cities across India including Hyderabad
• Application in FRRO for Exit permit for Child
  -normally takes 3 days .
• Costs involved in entire Legal Post Birth process
  included in package.

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To-do list

• Do not wait for the last week, be ready to fly
  anytime after 34 weeks
• Pre-order and ship DNA kits in advance to nearest
  US Consulate/ Embassy
• Pre-book your hotel in advance near the Pediatric
  Facility provided by your clinic to ensure easy
  access . in case the stay post birth is not
  included in your package)
• Pediatric Hospitalization costs are not covered
  in the packages offered by Hospitals and is
  Approx. 60-100 US per day per child
• Look out for a nanny for handling child
  (Important for 1st time to be parents).
• Keep a timeline of approx 15-20 days of stay in
  India
• All baby related items are available in India,
  you do not need to get it from abroad

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Costs Not Covered in Package

• Paediatric / NICU Approx 100 to
  200 US
• Stay If gt 15 days
• Eating Out
• Sight seeing
• AirFare
• FRRO Exit for baby 100 US

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Thank you
Dr. Samit Sekhar Kiran Infertility Centre Pvt.
Ltd. Hyderabad/ Gurgaon/ Nepal