Fertility trade: Rented wombs, sperms and eggs

The number of men and women selling sperms and eggs and those renting wombs to couples that need children is on the rise as financially able couples have taken to that option of reproduction.

The growing fertility trade in Kampala, has seen eggs and sperms become commodities like any other, to be bought and sold.

Along with rented wombs now easily available from young women across the country, the once loathed option is being accepted and growing fast, benefitting the growing trend for working women who start reproducing later, when they might have more problems conceiving and HIV/Aids positive couples.

The clinics, also growing in numbers, offer services for women who cannot carry the pregnancy to full term and have a medical condition that affect fertility.

“The demand is growing fast,” says Carol Oaikhene, a gynecology nurse at Paragon fertility centre in Bugolobi.

According to medical workers we spoke to, the fact that couples can still have biological children through another person is encouraging many couples to try the method.

Also, the lucrative nature of the business has seen a number of young girls willingly offer their wombs for rent while a growing number of men are offering sperms for single women and men who cannot produce them.
At Paragon, between two to seven men report to the fertility centres daily to donate sperms at a fee.

According to Arnold Ssali, the director Invitro fertilisation and pharmacy at Kampala Women Fertility and Gynecology Centre, the hospital receives several requests and inquiries about opportunities for surrogacy and sperm donation.

“On average, we get about 70 requests on a monthly basis and these are the official figures but we do not count those who come and inquire quietly and go away,” says Dr Ssali.

The clinics also receive several requests from single women who say they want to have children without men and raise them as single mothers.
According to Oaikhene, Paragon also receives several requests about similar services sometimes up to 10 a day.

“Women have a lot of problems. Some of them do not have a uterus because they were removed during an abortion but they still produce eggs. It is just lack of awareness. People can have children through surrogate mothers and still have biological children,” says Oaikhene.

Dr Jamal says just one year after the Bugolobi-based facility was opened, surrogacy is becoming such a popular service among women in the age bracket of 20-45 despite the service not being advertised.
“We have a sperm bank to keep as many varieties as possible because sometimes patients come with specific characteristics which we should be able to provide,” he says.

Hope for HIV positive couples
According to the hospitals, though many couples unable to have babies on their own are going for this, the method is very popular among discordant and HIV-positive couples who want to have babies.

“We harvest the eggs and sperms and wash off the HIV virus from them. Thereafter, conception is ready and the babies are born HIV-free,” says Dr Jamal Andrew, the director Paragon Fertility Centre.

He adds though that the method does not give a 100 per cent guarantee of a HIV free baby.

Women offering
The caliber of women offering their wombs range from educated to illiterate and the amount paid depends on one’s bargaining power.
According to Onyait Denis, a laboratory technician at Paragon, a big number of girls, especially the illiterate and semi-literate are flocking the facility and the hospital prefers to work with them because they are not as complicated as educated women.

“Sometimes the doctors here are too busy that they leave the hospital at 2am. There are single women who say they are fed up of men and they want to raise children as single mothers. They come here and they order for sperms of their specifications,” he says.

Administrators at both centres, however, stress that they only treat and help heterosexual couples.

“Here we strictly deal with women and men with gynecological problems like low sperm count among men, weak eggs among women and other gynecological disorders like raptured uterus, as well as women whose uterus cannot hold babies,” says Dr Jamal.

He adds: “We deal with patients who have conception problems. You may find a woman has weak eggs because of advanced age, or because of using contraceptives and in such cases we use reproductive technologies like Invitro fertilisation or intra uterine insemination,” he says.

“When couples present themselves as husband and wife and they want to have children, we have to ascertain that they genuinely want the children on medical grounds and we have to prove it,” says Dr Ssali.

At the Kampala Fertility Centre and Paragon, more than 20 women who were seen in the past one year did not have a uterus; some as a result of abortion, while others were born without it.

While for other women, a dysfunctional uterus caused by fibroids which are difficult to treat or other diseases, makes it difficult for them to carry a pregnancy.

A woman with a heart disease which might be complicated by the pregnancy leading to death, also qualifies for surrogacy.
The medical workers warn that surrogacy is not a procedure of convenience, especially for those women who might opt for it because they fear carrying a pregnancy.

Contractual terms
“You know this is a highly secretive business. The kind of people we get must know how to read and write because there is some consent they have to sign,” says Dr Ssali.

The couple and the surrogate mother have to agree on the terms of payment and any other benefits.

“Of course, when the time to give birth comes, we carry out the C-section because we want to avoid the surrogate host from creating a bond with the baby,” he says.
Several of the surrogate hosts we interview said the business is so secretive that they never get to meet let alone know the name of the couples whose child they are carrying.

Obstacles
There is, however, several obstacles to this method as it is still very expensive and way above what even middle income earners can pay.
Commissioning parents require a minimum of $10,000 (Shs30 million) to manage a surrogacy arrangement.

To ease cost, the doctors encourage the women to speak with their sisters who can offer to carry the pregnancy for free.

Besides the fee, the commissioning couple also meets the daily living costs of the surrogate host.

At both Paragon and the fertility centre in Bukoto, married women and single mothers are the main surrogate hosts.

Problems, however, sometimes arise where the woman is married. Her husband has to be involved from the onset.

In addition to finances, there are other obstacles the commissioning couples have to overcome. For increased chances of success, the surrogate host has to have had children before.

Some of the conditions include giving up the baby immediately it is born, avoiding sex for the first two to three months from the time the surrogate host gets the embryo, and not engaging in anything that may endanger the baby’s life and health.

The surrogate host is not allowed to make any future claims on the baby. To ensure the surrogate host abides by these conditions, a legal contract is prepared and signed by the surrogate host and the commissioning parents.

Despite the prohibitive cost of the surrogacy method, the number of couples who need the service is rising.

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A surrogate mother speaks

Sometime in 2009, Sharon* received an invitation to meet a doctor at a fertility clinic in Bukoto, a Kampala suburb.

The doctor put a proposal forward. She was being requested to help a couple carry their baby.

Sharon says this was an extraordinary meeting. Although she had been at the centre before, it was to donate her ovary but not carry another woman’s baby to term.

Would she agree to carry a pregnancy on their behalf since the wife had failed to carry a pregnancy to the end?

“It took me about a month to think about it before I signed the papers,” says Sharon. “I asked myself several questions but because I was a single mother, I told myself I was doing it for my child.”

When she finally made up her mind to do it, a fee of at least Shs7 million was agreed upon and the 26-year-old joined a growing list of young women between the age of 18 and 30 years who are renting out their wombs to carry other people’s pregnancies.

An agreement was drawn up stipulating the fee and that she would hand over the baby to the couple in the delivery room. Shs600, 000 would be paid monthly and the fee of Shs7 million would be paid after delivery and hand-over of the baby.

The trend which is seen as a solution in developed countries for infertile women seeking to have their own children, is increasingly gaining acceptance in Uganda.

In the past five years, more than 30 couples have commissioned other women to carry their pregnancy for them at several fertility centers and hospitals that offer the service in Kampala.

Also growing is the number of men engaging in an emerging business of donating sperms.

According to Sharon, she was introduced to the business by a friend who told her about the programme at Kampala Women’s Fertility Hospital in Bukoto.

At the centre, she was informed of a programme to help woman who could not conceive or carry pregnancy to term due to medical complication but are ready to part with some money to have someone perform the task.
“When I heard about it, I said it’s okay. If it is just coming to carry for someone a baby, I can do that,” she narrates.

The tall slender, woman recollects that when she first enrolled as an egg donor in 2009, she donated eggs twice that year and she was asked to graduate into a surrogate mother.

“The doctors said they would help me and I decided that if it was just about helping somebody carry a baby, there was no harm,” she says.
To date, the sweetness of the money from the business has made Sharon be a surrogate twice.

According to Arnold Ssali, a doctor at the fertility centre, they carry out scanning and screening to ascertain the candidate surrogate mother’s medical history.

“We evaluate their general health, mentally and their medical history because it is not easy for somebody to carry another person’s pregnancy,” he says.

“They are also counselled to help them understand the task ahead so they have to be mentally competent so as not to harm the baby.”

The pregnancy
Surrogacy is an agreement in which a woman carries and delivers a child for another person or couple.
The procedure involves the retrieval of eggs from the woman who is unable to carry the baby. The eggs are then fertilised in a laboratory using the husband’s or partner’s sperm.

The resulting embryo is then transferred into the surrogate host’s womb to conceive and carry the pregnancy to term.

Once the child is delivered, the surrogate host hands it over to the commissioning couple guided by terms of a contract signed between the two parties.

Sharon narrates that after the implant was successful, she shifted from her place in Kawala to Kasubi for fear of what the neighbours and other relatives would say. She stayed at her sister’s place for the nine months but only revealed to her sister about the surrogacy at eight months of pregnancy.
Luckily for her, the sister kept the secret.
At nine months, she was induced and underwent a caesarean-section. “By the time I woke up, the baby and the couple were gone.”

The hospital then handed her the fee and she went back home.
“I was paid Shs600,000 monthly and when I gave birth; I was given Shs7 million immediately. I have no regrets because my life has improved. My child is in a good school, and my shop generates at least, between Shs50,000 and Shs100, 000 per day,” she says.

Compiled by Stephen Otage

*Name changed for legal and privacy reasons.