Nigerian Surrogacy Contracts

MOTHER OF ALL CONTRACTS- Girl hired to carry pregnancy for another woman• Earns N.2m compensation By AGAPTUS ANAELE

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With a little over N1million, a couple’s five-year search for the fruit of the womb has become history. Late last year, the couple smiled home with a bouncing baby boy delivered normally at the OMNI Advanced Medical Centre in Lagos. A single lady in her 30s (names withheld) graciously carried the pregnancy at the cost of N200, 000, thus ending the couple’s nightmare. The N200, 000, Sunday Sun, learnt was compensation for the lady that carried the pregnancy, while the balance was paid the medical bills and cost of In vitro Fertilization.Interestingly, the lady that carried the pregnancy on behalf of the couple hails from the South Western part of the country and lives in Lagos, while the couple from the South Eastern part of the country, resides in the east. But the hospital ensured anonymity between both parties.The couple who were referred from the east had indicated their interest to own a baby through the procedure, following medical indication that the surrogate mother was unfit to carry a pregnancy to term. Sunday Sun learnt that it took the hospital one year from the time the couple showed interest to secure a match for the contract.Another interesting thing is that the couple is not alone in the search for the fruit of the womb. In the last two years, over 20 couples have approached the hospital for the same purpose including three Nigerians resident abroad. However, only two have had their dreams actualized. Many were unable to continue because of the cost.Leader of the medical team that performed the process, Professor Osato Giwa-Osagie tells the story:“We have successfully performed a surrogate pregnancy. We have had two experiences during the last five years. One was through IVF while the other was through artificial insemination. The most recent was through IVF.”
How it was doneThe carrying mother was referred to us. Somebody had discussed it when they met and were talking socially about modern fertility. The person told her that people were doing it, and any one who accepted the offer would be paid for it, so the lady took up the offer, but the person telling her about it thought it was a joke. She asked seriously where such things were being done, and she worked into this clinic and said that’s what she wanted to do and that was it.“First, we ensured that the carrying mother was a healthy person to avoid complications. She was screened for Hepatitis and HIV. We also ensured that she was not hypertensive, nor diabetic. Secondly, we enlightened her about the terms of the contract. We followed her up to make sure that she did not develop psychological sequelli. We ensured that the couple that sought the pregnancy was psychologically ready to accept the child. This was to ensure that they do not make a change of mind half way into the arrangement, when somebody is already pregnant. We also ensured that both parties do not know themselves,” Giwa-Osagie said.Baby’s sexThe baby was a boy. It was a normal baby in everyway.Surrogate parentsThe problem was that the woman was badly hypertensive but controlled on drugs. Again, she was already in her late forties, so she was advised that it was dangerous for her to carry pregnancy. So there were two reasons, medical indication and her age. The husband was okay, but because the marriage was five years old and they had no childThe surrogate parents don’t live in Lagos. They were referred to us from the South eastern part of the country. They are both graduates, self-employed. They are over 45 years of age. They signed a consent form, which explained what the contract was all about. The receiving parents also signed that they have agreed that surrogate pregnancy should be arranged for them and that they were going to be responsible for the cost and that they would look after the child to the best of their knowledge. The lady that carried the pregnancy lives in Lagos and is in her mid 30s. She is also educated.CostIt is not cheap. For instance, a circle of IVF in Nigeria at the moment costs between N400, 000 and N800, 000. So, if you are going to do surrogacy through IVF, that is the cost you have to bear. In addition, they paid money to the surrogate mother because that is why she is doing it. From our own experience, the carrying mother expects to be paid at least N200, 000. So, when you add all the costs, you will be talking about N1million plus.CoordinationThe couple was responsible for the medical costs of the person that carried the pregnancy. They maintained the person for one year that is during nine months pregnancy and six weeks after. Some couple brings their wife’s elder sister, who volunteers to carry the pregnancy, but as a policy, we usually turn down such person because of the closeness. It may lead to problems in later years. That is why we insist on anonymity between the two. What we did was that, when the surrogate parents have undergone our screening, they were asked to go and, when we found a surrogate mother, we contacted them detailing the costs. They came to Lagos and presented the sample of the husband’s sperm.ChallengesOne is the issue of ensuring that the people are properly counseled and that they know what they are doing, and they are stable to go ahead with it. The second is the logistics, getting people to come over all the way from across the Niger. How baby was transferredThat part was handled by the social worker, because she was used to both parties in the preceding months. The procedure is that the carrying mother is not allowed to carry the baby for more than 24 hours after delivery, otherwise the problem of bonding may arise, so the baby was transferred within 24 hours.BreastfeedingWe suppressed the breastfeeding. We gave the carrying mother some medicines to suppress the breast secretion, while we gave the receiving mother drugs to produce breast milk, which she used in breastfeeding the baby.EthicsThe fundamental issues here are those of informed consent. We must not do anything to anybody without letting him or her know and agreeing to it. That is why the clinician, who is organizing it, having selected the people involved, withdraws and allows the social worker to do the remaining part of the job. The social worker sees people from the behaviour point of view, and then offers advice. We also ensure that there is no influence.UniqueIt is unusual, and it requires a lot of organization to get it right.SurrogacySurrogacy is when a woman carries a pregnancy on behalf of another. This occurs when you have patient ‘A’ who has infertility and after assessment, it is decided that what is required is surrogacy and then another person agrees to carry the pregnancy. There are two approaches to this. One is for the surrogate mother to agree to be inseminated with the sperm of the patient’s husband. So you have Mr. and Mrs. ‘A’ and Miss ‘B’. The former are the couple that wants a pregnancy by surrogacy for whatever reason. Miss/Mrs. ‘B’ is the surrogate mother, that is the person that carries the pregnancy. MethodsYou can impregnate Miss. B with the sperm of Mr. A by injecting her with the sperm directly. That is what we call artificial insemination. So you prepare her, you inseminate her and then she becomes pregnant. At the end of the pregnancy, she hands over the baby to Mr. and Mrs. A, that’s one arrangement.The second route is to use Mr. A’s sperm to fertilize Miss. B’s eggs. So you stimulate Miss. B, collect her eggs physically and then do In vitro Fertilisation using Mr. A’s sperm. The resulting embryo is then put back into Miss B, who is the surrogate mother.PreferenceSome people prefer the first route to do straight forward insemination, while some insist that you must do IVF, and then put the embryo back. The important thing is to make sure that Mr. and Mrs. A are mentally stable and also in their relationship, because the last thing you want to achieve is to go through the process and the relationship breaks down. You must also ensure that the person, who is going to carry the pregnancy, understands very well that she has decided to carry the pregnancy and surrender the child after birth. With good counseling, there shouldn’t be any complication at all since both parties understand what they are doing.