The Maharashtra police last month conducted a crackdown on a multi-crore egg donation racket, where women were allegedly exploited into repeatedly donating eggs at in vitro fertilisation (IVF) centres.

The police first arrested three women allegedly involved in the forced procedures and operating out of a residential apartment and a sonography centre in Badlapur, Thane district. The seventh accused in the case was arrested last week.

The issue was also raised in the ongoing Legislative Assembly proceedings, with concerns of violations of the Assisted Reproductive Technology (Regulation) Act, 2021, and the Surrogacy (Regulation) Act, 2021.

What was the case?

The police claim that a woman approached doctors at a Primary Health Centre in Badlapur, telling them that she had been promised money in lieu of a fertility procedure of egg stimulation and extraction, but was not paid. The doctors alerted the police, and the probe led them to the residential apartment.

The police claimed that financially distressed women were offered money and were administered ovulation-stimulating injections, without proper consultation and in violation of the law. The women were then sent to IVF centres for the extraction of the eggs to be used in fertility procedures for other couples.

The police alleged that the racket involved collusion with individuals linked with sonography and IVF centres, those assisting the accused with forging documents of the women to have them undergo the procedure multiple times against the law, and the supply of medical equipment for the process.

They further claimed that the women were offered Rs 25,000 to Rs 30,000. The police last week also arrested a doctor, a director of an IVF centre in Nashik, linked to the case. The police are still probing whether other centres and doctors were involved.

In 2005, the Indian Council of Medical Research (ICMR) and the National Academy of Medical Sciences devised guidelines for the accreditation, supervision and regulation of Assisted Reproductive Technologies (ART) clinics in India.

The need was felt with an increased demand for ART, which refers to a range of fertility treatments. At the time, it was estimated that approximately 13 to 19 million couples were likely to be infertile in the country at any given time.

The research bodies of experts said that this had led to the mushrooming of infertility clinics in India, but many did not have adequately trained manpower and infrastructure. They suspected that couples were being cheated in the guise of being offered complex and expensive procedures.

The guidelines mentioned the need for a state-level authority through the Department of Health or Family Welfare, tasked with the accreditation, supervision and regulation of ART clinics. This would help ensure proper registration and adherence to ethical guidelines and suspensions for violations.

An authority for addressing complaints was also recommended. The 133-page document stated the possible misuse of ART through the sale of embryos and sought a ban on commercial transactions, and said that ART clinics must not be a party to any commercial element in donor programmes or in surrogacy. In 2008, the ICMR released a draft Assisted Reproductive Technology (Regulation) Bill and Rules.

In 2009, the 228th Law Commission Report was submitted on the need for legislation to regulate ART clinics. Highlighting how India had become a favourable destination for foreign couples in seeking surrogate mothers, it noted the legal and moral issues involved in ‘renting wombs’.

Subsequently, in July 2019, the Surrogacy (Regulation) Act, and in 2021, the Assisted Reproductive Technology (Regulation) Act, were enacted. The two laws have key provisions on the commercial exploitation of women for surrogacy and embryo sale.

The Surrogacy Act prohibits commercial surrogacy, including the selling or buying of human embryos or trading in their sale, or trading the services of surrogate motherhood by giving any kind of benefit, payment to the surrogate mother or her dependents or representatives, only allowing ‘altruistic’ surrogacy under specific conditions.

Similarly, the ART (Regulation) Act defines ART as “all techniques that attempt to obtain a pregnancy by handling the sperm or the oocyte outside the human body and transferring the gamete or the embryo into the reproductive system of a woman”.

The Act has specific provisions for women donors, including that they must be between 23 and 35 years of age; they shall donate oocytes (the immature egg cell) only once in their life, and that no more than seven oocytes shall be retrieved.

The Act also requires that the woman be given insurance coverage for 12 months, and all necessary donor information should be maintained, including Aadhar card registration, to avoid duplication. Any clinic or bank responsible for collection must be registered and faces cancellation of registration in case of violation.

In the Badlapur case, the police suspect that the women donors were induced to donate eggs multiple times by forging their documents. The Act criminalises selling human embryos or gametes, running an agency, a racket or an organisation for selling, purchasing or trading in human embryos or gametes, with a fine of Rs 5 to 10 lakh rupees, and for subsequent offences, imprisonment of 3 to 8 years. The accused in the case have been booked under both Acts.

A discussion in the Maharashtra Legislative Council termed the case “extremely serious”. Medically, the donors also face the risk of Ovarian Hyperstimulation Syndrome (OHSS) if precautions are not taken.

A similar incident, dating back to 2010, had caused uproar in the state when a 17-year-old girl died three days after she had donated eggs. Her documents were forged to make her seem 19 years old. The trial in that case is yet to begin, with many gynaecologists who were initially booked getting discharged due to a lack of evidence.