Infertile Couples in Iran Find New Hope in Surrogacy

One of life’s greatest joys is having children but some couples have to go to great lengths to become parents due to problems of infertility and conception.

Most infertile couples can conceive with ‘first level’ infertility treatments like medications or lifestyle changes; however others may require more advanced technologies.

Surrogacy is an approach for treating infertility in couples whose female partner lacks a functional uterus for conceiving or delivering a neonate congenitally or as a result of medical or surgical complications. In 2002, the Majlis (parliament) passed a law that permitted surrogacy for infertile married couples and it was approved by the powerful Guardian Council.

Currently, there are around 70 infertility clinics across the country performing gestational surrogacy. Among them Avicenna Infertility Treatment and Research Center and the Royan Institute, both in Tehran, are two of the best which offer quality services besides only implanting a couple’s IVF embryo into a surrogate or birth mother. The other services include legal counseling and medical and psychological screening in surrogacy.

“Gestational surrogates are interviewed and screened by our psychiatrists to determine whether or not they are qualified in all ways for the surrogacy arrangement,” Dr Behzad Qorbani, head of the Avicenna Infertility Treatment Center told the Financial Tribune.  

In response to a question on how infertile couples find surrogate mothers, he said, “The center does not introduce gestational surrogates. Birth mothers are proposed to us by the infertile couples themselves.

We provide genetic parents with detailed information on whether the applicants are suitable for embryo transfer. But the final decision rests with the couples as they should make the contract with the birth mother.”

In other words, there is no law to prevent them from signing a contract with the birth mother even with those who may be identified unsuitable as birth mothers by the center’s experts. “But as the baby’s biological parents are often sensitive on this matter they usually accept our recommendations,” he added.

“We know this is a sensitive journey that includes countless uncertainties and concerns. The best way to prepare for it is to recognize the potential bumps on the road and offer expert guidance.”

Elaborating the screening process, he says, “We believe that surrogates should be mothers themselves, so as to ensure that they do not become emotionally attached to the baby they carry for nine months.”

They also are checked for addiction and severe psychological disorders through interviews and medical tests.

Women who are on drugs or those who take medications that are harmful to the fetus are rejected, Qorbani said, giving an example of an applicant who was taking lithium to treat her bipolar affective disorder (manic depression) and therefore was rejected after the genetic parents were told that she is not suitable to carry their baby.

It is also necessary for those who are married and want to become surrogates to take part in the selection tests with their spouses. This is due to the fact that an applicant may be healthy, but her husband could be on drugs. “In one instance, we found that an applicant’s husband was an addict and had forced her to become a birth mother for monetary gain. Both spouses should be healthy physically and psychologically.”

“From among every 100 applicants introduced to the center, 10-15 are rejected after scrutiny,” he said.

Annually, around 2,000 babies are born through surrogacy in Tehran alone.

In response to a query whether there is any ceiling on the money paid to surrogate mothers he said, “There is no limitation, it can be anything from a visit to a holy city to owning a house. We just help the parties to set their contracts in which it should be clearly stated how much money will change hands at the beginning, how much mid-way or at the end.”

Stating that the center has an international section, he said there is no ban on providing infertility services to foreign couples. Iranian expatriates can also have surrogacy arrangement in the country.

 High Demand

According to Qorbani, demand for different infertility treatment including surrogacy is very high. “Although there are several centers which provide services to infertile couples, some don’t adhere to the rigorous standards. There are always many applicants in the queue in Tehran while the number of top-quality centers is few.”

The number of doctors in the field is also limited and this has caused some problems in scheduling appointments. But “we are seeking ways to address the problem and meet the growing demand for infertility treatment services.”

He asserted that quality and diversity of services provided to infertile couples are on par with European countries.

The only treatment method not used at the center is ‘Sperm Donation’ which is banned due to religious reasons. “Using a donor’s embryo is a suitable option for couples whose male partner is diagnosed with low sperm count, low motility…”  

Avicenna Infertility Treatment and Research Center is affiliated to the Academic Center for Education, Culture and Research (ACECR) which is a public non-governmental higher education institution established in 1980. ACECR is involved in innovative research and development projects in different fields of science and technology.

At present, there are 3 to 5 million infertile couples in the country and the figure is increasing by 15% each year. Ovulation induction, in vitro fertilization (IVF), intrauterine insemination (IUI), embryo donation and finally surrogacy are methods currently performed in the country to help infertile couples.