The entertainment industry is abuzz with news of filmmaker Karan Johar becoming a father of twins via surrogacy. He joins a celeb club that includes Aamir Khan and Kiran Desai; Farah Khan and Shirish Kunder; and single dad Tusshar Kapoor. Advances in reproductive technology as well as relaxed rules on commercial surrogacy (at least till the draft bill is passed) has meant that many more couples and singletons are becoming parents through surrogacy or assisted reproductive technology (ART), which includes in-vitro fertilisation (IVF). According to research by a healthcare private equity firm Quadria Capital, the total demand for IVF cycles in India was 1 lakh in 2015 and is expected to touch 2.6 lakh by 2020. Surrogacy too has become a multi-million dollar business.
In contrast, the rate of adoption in India has been gradually declining since 2010. According to the Central Adoption Resource Authority (CARA), the designated agency which co-ordinates adoptions in India, in-country adoptions have dropped from 5,693 in 2010 to 3,011 in 2015-16.
Are legal adoption numbers going down because of technology that allows couples to have a biological child even if age and fertility are not on their side? The answer is partly yes, admits Avinash Kumar, member, CARA steering committee, as well as an adoptive parent. “New technologies like IVF and surrogacy offer a quick-fix to childless couples and also a chance to have a biological child. So instead of considering adoption as the first option, it becomes the last,” says Kumar, who also runs Families of Joy Foundation, an NGO that works to create awareness around adoption. He adds that about 40% of couples who come forward for adoption have experienced failed IVF.
To compare timelines, IVF, though more expensive (Rs 1.5 to 2 lakh, per cycle), is faster. An IVF cycle can be carried out each month. Most couples opt for three cycles at the most. The success rate of each cycle is around 40%. This means at least some couples will conceive within three months. Surrogacy is even more expensive (Rs 5 lakh to Rs 12 lakh) but those who can afford it prefer it because it promises a biological child. It also has a high success rate of around 80%.
In comparison, adoption takes way longer. Even the ideal timeline is a year. After registering for adoption, the process of home study takes one month. Next, referral of child takes 9 to 14 months. However, delays are common and adoption can even take two to three years. There is also a lot of paperwork, including submission of various documents at government offices, involved. Dr Shobha Gupta, an IVF specialist based in Delhi, says that many couples who come to her are disheartened by the adoption procedure. “In India, the procedure is lengthy and comes with many requirements, like you should own your home, have a certain bank balance and be of a certain age. People feel IVF is faster,” says Gupta.
Dr Rita Bakshi, an IVF and surrogacy expert based in Delhi, adds that the reason why more infertile couples prefer to undergo assisted reproduction is because now the number of children available for legal adoption India is far less than the number of infertile couples seeking children.
Biological vs adopted child
Richa and Mohit, a couple based in Delhi kept both options open. In their late 30s, the couple decided to start IVF as well as adoption. “After my first cycle failed I signed up for a counselling session at CARA’s office. However, just a week before the session, my second cycle succeeded and I got pregnant,” says Richa, whose son is now a year old.
Dr Duru Shah, a senior IVF expert based in Mumbai, says infertile couples who reach out to her rarely want to adopt. “We suggest adoption if the woman is 37-38 years or older. But most couples balk at the idea,” says Dr Shah.
Kumar of CARA says that the desire to be parents, whether through adoption or IVF, should be unconditional. “But couples want children who resemble them, are healthy and preferably in the 0-2 years age bracket. Most children legally available for adoption don’t fulfill these criteria,” says Kumar.
The child matters
Even science finds that it’s just the presence of children rather their being biological or not that makes couples happy. A 2013 study done in Sweden compared quality of life among couples who had adopted a child with couples who conceived naturally, as well as with couples who had successful or unsuccessful IVF. The findings revealed a high quality of life in the adoption group while couples with unsuccessful IVF and living without children had low quality of life scores. Hence, quality of life appears to be independent of the outcome of IVF as long as there are children in the family.
Courtesy: Shobita Dhar, The Times of India