She was only 12 years old, when her mother took her to a private fertility clinic in Erode. There, she was forced to undergo a procedure where her eggs were retrieved and in exchange, her mother received a considerable amount of money for it. Over the last four years, this girl was forced by her mother and her mother’s partner, to have her ovum/eggs retrieved, a staggering eight times, to fertility centres located in Erode and neighbouring districts. According to Erode police, the fertility centres provided Rs 20,000 to the victim's mother and Rs 5,000 to an agent who is a friend of the victim's mother, for each forced retrieval.
The now 16-year-old girl’s mother, her partner and her friend from Erode district, Tamil Nadu were all arrested by Erode South police for forcing the girl to give up her ovum to private fertility clinics in the district, by furnishing a fake Aadhaar card.
The victim's mother lived with her partner, a painter in Erode, from the time the girl was three years old. Later, the teen was sexually assaulted multiple times by the partner. After experiencing emotional trauma and sexual abuse, the victim left her house last week and disclosed her trauma to her relatives in Salem.
The relatives immediately lodged a complaint against the trio with the police on June 1. The heinous behaviour of the victim's mother shocked the state and also raised alarm over the gamete (sperm/ovum) racketeering in the state. TNM spoke with gynaecologists, fertility specialists, legal advisors and investigators to know more about the issue and the norms that every fertility centre should follow and the details that every gamete donor should know.
A six-member team from the Directorate of Medical and Rural Health Services (DMS) visited the government home where the girl is staying and recorded her statement. Based on her statement, the team visited and conducted enquiries in several hospitals in Erode and neighbouring districts.
Joint Director of DMS Dr A Viswanathan, who led the team, told TNM that inquiries were conducted in two hospitals in Erode, one hospital each in Salem and Hosur on Tuesday. “The minor victim was taken to these hospitals and was forced to give up her eggs. We also have reports that she was taken outside Tamil Nadu. This is the first time we have come to know about selling eggs by coercion. Our investigation will be expanded to cover this angle and examine claims from hospitals who say they retrieved the egg from the minor donor, based on the Aadhaar details she furnished in the hospital. But, hospitals should have conducted better verification,” he said. The team will be submitting a report to the government, after the investigation is complete. They are also looking at hospital records to check for discrepancies. “We will take legal action against the hospitals and doctors if any violations are established,” he added.
Speaking about the prevailing situation at the fertility centres, Dr Hitesh Bhatt, a Mumbai-based gynaecologist said, "There was no law or Act to regulate such donations or to avoid such illegal procedures until this January. Before that, we followed Indian Council of Medical Research (ICMR) guidelines, which would be updated once in a while and new regulations would come into force. The age of the donor was 18 years before 2010. After 2010, it was increased to 21 years and now, the legal age for donating eggs is 23 years. Doctors are not investigators. If the donors have proper documents, then we start the ovum retrieval procedure with her consent.”
Along with the age requirements, changes were also made to ICMR guidelines about the number of eggs that could be donated. Doctors say, there was a time when a woman could donate up to six eggs in a lifetime. Then ICMR reduced the numbers to three and now it is just one, but ICMR always recommended that the donor should be a major. Now as per ART Act 2021 (The Assisted Reproductive Technology Act), the donor can give only one ovum in her lifetime. But, doctors say they cannot know how many times a donor has given eggs, unless she volunteers the information. “Before the Act, the guidelines did not make it mandatory to bring an Aadhaar card, but now hospitals are following it. To avoid such allegations, doctors in some parts of the country ask donors to sign an affidavit, stating her age and that the medical history furnished is true, in front of the notary," Dr Hitesh added further. As per the ART Act 2021, the ART banks shall obtain oocytes from females between 23 and 35 years of age. An oocyte donor shall donate oocytes only once in her life and not more than seven oocytes shall be retrieved from the donor.
On the risk of frequent ovum retrieving treatment, Dr Hitesh said, "In the initial stage, donors can increase the risk of having Ovarian Hyperstimulation Syndrome (OHSS), a common reproductive disorder that causes irregular periods and a large number of follicles. There is no health risk condition up to six times of egg donation. The ovaries would start to function very normally from the following month after the donation. But more than six times may lead to the donors getting ovarian cancer in the future. This is the case not only with donors but also the women who are getting frequent treatment to have babies."
A Chennai-based fertility specialist called this incident a violation that happened against the minor victim and a violation of government guidelines. Dr Priya Kannan, embryologist and Scientific Director at Garbba Rakshambigai Fertility Centre said that the girl would have had a severe traumatic experience being subjected to ovum retrieval procedure at the age of 12. She also said that the girl may have been subjected to frequent sexual assault, so that she might not experience any discomfort during the egg retrieval procedure. Such discomfort in turn, would have raised the suspicion of the doctors.
"We accept eggs from women who are below 30 years of age, married and have kids, with the consent of their husbands. We require Aadhaar card details of the donor and her husband along with the marriage certificate, ration card, and photo identity proof to ensure that the donor is married. If the donor is divorced, we don’t need a consent letter from the husband. But we need proper documents to declare that she is divorced. We also collect the birth certificate of the children birthed to donors, delivery related discharge summary. Besides these documents, we ask the donor to give written assurance that this is the first time she is donating her egg,” she explained.
Despite these precautions, there is no way to establish whether the donor has already donated her eggs at another hospital. “We don't have any mechanism to monitor such illegal donations. On January 25, the ART Act 2021 was enacted and ICMR was asked to complete all the pending procedures with already collected gametes within six months. After six months, all the fertility centres will get the donors from the registered ART banks only. This may reduce such incidents in the future," Dr Priya Kannan said.
She also said that women might get paid anything from Rs 20,000 to Rs 40,000 for donating eggs – tempting many to see it as a way to resolve their financial difficulties. “But, strict regulations should be followed to check the veracity of the donor,” she said.
More hospitals are expected to come under monitoring as this case becomes bigger every day. The investigating team also found the eggs taken from the 16-year-old girl in Tamil Nadu were sold to hospitals and clinics in Kerala and Andhra Pradesh. The investigation team is likely to conduct inquiries in other states in the coming weeks.