STUDENTS across the country were last night toasting the nation’s best ever A-level results.
Brushing off concerns that the exams have become too easy, teenagers celebrated after recording an unprecedented 97 per cent pass rate.And one in four sixth-formers were awarded at least one A grade (25.9 per cent, up from 25.3 per cent last year).Teachers and ministers denied A levels have been dumbed down, despite the national pass rate rising to a record level for the 26th year in a row.Results received by some 300,000 teenagers in England, Wales and Northern Ireland, showed only 2.8 per cent of them failed the exams.But for the first time the exam board released a regional breakdown, examining pass rates and the proportion of students getting A grades in various areas of the country.It showed the greatest improvements in the last six years have been in the south-east with the north-east appears to be lagging behind.While the south-east has seen A grades rise 6.1 per cent – to 29.1 per cent since 2002 – the north- east has seen an improvement of just 2.1 per cent – to 19.8 per cent in the same period.Shadow Children’s Secretary Michael Gove said the divide was “worrying”.He said: “It underlines yet again the need for reform to create new good school places so that children in the less well-off areas get the same opportunities as others."
But there remained fierce argument over whether the tests had become too easy.While critics said the pass rate meant A levels were becoming meaningless, supporters argued that the results were simply a testament to students’ hard work and better teaching.Chris Keates, leader of the Nasuwt teachers’ union said: “These are Olympian achievements and represent years of hard work and sustained effort by students and teachers alike.”Dr John Dunford, of the Association of School and College Leaders, said: “If you continue to get nearer to 100 per cent it would suggest schools and colleges’ guidance programmes are improving. That’s got to be in the best interests of students.”There was a whole gamut of success stories yesterday, including a set of 18-year-old quadruplets who scored stunning results. Tolu, Tayo, Tobi and Tosin, all members of the Oke family, were born just a few minutes apart.They all achieved A, B or C grades at the St Francis Xavier Sixth Form College in Clapham, south-west London.Sisters Tayo and Tolu and brothers Tobi and Tosin will now go to their first-choice universities.Tolu was awarded a grade A in history, an A in sociology and a B in English language and literature. Tobi achieved a B in English language and literature, a B in sociology and a C in history. Tayo got an A in business, an A in sociology and a C in biology. Tosin kept up the high standard with an A in sociology, a B in business and a C in IT.But the quads were not the only tale of success among families with multiple births.A set of triplets was also celebrating after a clean sweep in their A-level results – notching up a stunning 13 grade As between them.Tim, Rachel, and Clare Heard, all 18, are now looking forward to going to university.Tim, who gained the top grade in geography, chemistry, biology and general studies said: “We are all absolutely delighted with our results. Rachel and Clare worked really hard but I preferred to socialise with my friends.”The trio all attended King Edward Camp Hill School in Birmingham, but will now go their separate ways to different universities. Other successes saw identical twins Anika and Nicola Ueckermann scoring impressive results.The 18-year-olds, from Colchester County High School for Girls, were delighted with their A and B grades and will both go to the University of East Anglia. They rejected criticism that exams are becoming easier. “They are definitely not,” said Anika. “This year was really hard.”
Friday, 15 August 2008
Thursday, 7 August 2008
warwick courier - Twins club turns 25 years
Members of Leamington's twins group have celebrated its 25th anniversary with a summer picnic.
Children and their parents met in Jephson Gardens last week to remember the opening of Leam-ington Spa and District Twins Club in 1983.More than two decades since it was started, the group is still offering the parents of twins a chance to meet others in the same situation.The club is appealing for any of the founding parents or children from 25 years ago to come forward so they can attend a summer party on Sunday.Organiser Lucinda Thornton joined the group when she found out she was pregnant with twins Annabelle and Jamie who are now two-and-a-half.She found the club while looking for advice on the internet.Describing the group, she said: "The twins club offers mothers a chance to speak with people who understand the issues of having twins. Normally people just say; 'I don't know how you cope which isn't very helpful. We offer the chance for mothers to discuss problems with people who have been through the same thing and it is a great help."Membership entitles parents to discounts on toys, equipment, holidays and many other things needed to raise twins.Second hand sales, parents' nights out and children's outings such as trips to Cotswold Wildlife Park are also offered.The club meets on Tuesdays between 10am and noon. Visit: www.warkcom.net/leamingtontwins
The full article contains 244 words and appears in Leamington Courier newspaper.
Children and their parents met in Jephson Gardens last week to remember the opening of Leam-ington Spa and District Twins Club in 1983.More than two decades since it was started, the group is still offering the parents of twins a chance to meet others in the same situation.The club is appealing for any of the founding parents or children from 25 years ago to come forward so they can attend a summer party on Sunday.Organiser Lucinda Thornton joined the group when she found out she was pregnant with twins Annabelle and Jamie who are now two-and-a-half.She found the club while looking for advice on the internet.Describing the group, she said: "The twins club offers mothers a chance to speak with people who understand the issues of having twins. Normally people just say; 'I don't know how you cope which isn't very helpful. We offer the chance for mothers to discuss problems with people who have been through the same thing and it is a great help."Membership entitles parents to discounts on toys, equipment, holidays and many other things needed to raise twins.Second hand sales, parents' nights out and children's outings such as trips to Cotswold Wildlife Park are also offered.The club meets on Tuesdays between 10am and noon. Visit: www.warkcom.net/leamingtontwins
The full article contains 244 words and appears in Leamington Courier newspaper.
daily express - Lisa Marie Presley expecting twins
Lisa Marie Presley is expecting twins, her spokeswoman has said.
The babies are expected in the autumn. Presley, daughter of Elvis Presley and actress Priscilla Presley, announced her pregnancy on her MySpace page in March, saying she was forced to go public with the news after photos of her looking heavier were ridiculed in the media. The 40-year-old singer has two children from her marriage to musician Danny Keough, which ended in 1994. She was briefly married to Michael Jackson and Nicolas Cage. Presley married music producer Michael Lockwood in January 2006."It's her time to celebrate with her husband," Priscilla Presley said in an interview. "My daughter is a very family girl. She loves children, and I know that she and Michael have been hoping for this for a long time." She said twins run in the family "on Elvis' side and on my side too. I have twin brothers, and then, of course, Elvis had a twin brother" who died at birth.
The babies are expected in the autumn. Presley, daughter of Elvis Presley and actress Priscilla Presley, announced her pregnancy on her MySpace page in March, saying she was forced to go public with the news after photos of her looking heavier were ridiculed in the media. The 40-year-old singer has two children from her marriage to musician Danny Keough, which ended in 1994. She was briefly married to Michael Jackson and Nicolas Cage. Presley married music producer Michael Lockwood in January 2006."It's her time to celebrate with her husband," Priscilla Presley said in an interview. "My daughter is a very family girl. She loves children, and I know that she and Michael have been hoping for this for a long time." She said twins run in the family "on Elvis' side and on my side too. I have twin brothers, and then, of course, Elvis had a twin brother" who died at birth.
Thursday, 31 July 2008
nhs news - Complications of IVF
“Fears of complications with IVF babies dismissed in new study” is the headline in The Guardian. Research based on 1.2 million births in Norway looked at the babies of women who had conceived once by IVF and once spontaneously. It found little difference between the siblings, and concludes that the risks associated with IVF are likely to be related to existing fertility problems in the parents and not a result of techniques used during assisted fertilisation, the newspaper explains.
The Daily Telegraph also reported some of the results of this study, saying “babies conceived through IVF are much more likely to die at birth”. These results are consistent with many other studies looking at the outcome of assisted fertilisation pregnancies. The newspaper did not directly discuss the implications found in the comparison of IVF and non-IVF siblings.
This large study used complex statistical methods to try to tease out the risks related to the various factors. It is reliable and should be reassuring to women undergoing IVF. However, it is important to note that the risks of complications in an individual birth are in fact quite low (around 1% perinatal deaths in this study).
Where did the story come from? Dr Liv Bente Romundstad from the Department of Obstetrics and Gynaecology at St Olavs University Hospital in Trondheim, and other colleagues from around Norway, UK and France, carried out the research. The study was funded by the Trondheim Hospital and the Norwegian Research Council. It was published in the peer-reviewed medical journal The Lancet.
What kind of scientific study was this? This was a cohort study in which the researchers used data from the Medical Birth Registry of Norway. This has records of more than 2.2 million births, which occurred in Norway between 1967 and 2006. The researchers had information about pregnancy across the population as it had been recorded on standard forms by midwives or doctors within one week of delivery for all deliveries after 16 weeks gestation. This information included details about the mother’s health, antenatal and birth history, and it was linked to the “Statistics Norway” database. The researchers were able to identify outcomes for all the babies, because in Norway each baby is given a unique identification number.
From the data on 1,305,228 births from January 1984 to the end of June 2006, the researchers excluded records where there was missing data on the number of children, or if the mother was less than 20 years old or had had more than six children. Only single babies (not twins or other multiple births) who were born at 22 weeks or later, and weighed 500g or more, were assessed. After this process, they found 1,200,922 births following normal conception and 8,229 after assisted fertilisation.
First, the researchers assessed differences in birthweight, gestational age, and the chances that babies were born small for their gestational age, were born prematurely or died in the period around birth (perinatal death). They analysed the relationships between all these variables, using a model that looked at all mothers as a whole (the whole study population analysis). They also divided the mothers into groups for their year of birth, maternal age, and number of children, and assessed them separately.
"The adverse outcomes of assisted fertilisation ... could therefore be attributable to the factors leading to infertility, rather than to factors related to the reproductive technology." Liv Bente Romundstad, lead author
After this whole study population analysis, the researchers then looked at whether the risks associated with IVF were due to the IVF technique itself or whether they were due to other factors linked to the fertility of the parents. In order to do this, they compared the health of babies born to mothers who had experienced both an assisted fertilisation (IVF) conception and a normalone. There was information for 2,546 Norwegian women available for analysis. These “sibling-relationship comparisons” looked at whether there were differences between the brothers or sisters born to women after both assisted fertilisation and normal conception. The researchers also took into account the order of conception (if IVF occurred before spontaneous conception or the other way around). They adjusted the results for maternal age, number of previous babies, sex of the baby, time between pregnancies and year of delivery.
What were the results of the study? In the whole study population analysis, assisted-fertilisation conceptions were associated with lower average birthweight (a difference of about 25g), shorter duration of gestation (about two days), and an increased risk of babies being too small for their gestational age, or dying in the period around birth.
In the sibling-relationship comparisons, where spontaneously conceived babies were compared with their assisted-fertilisation conceived sibling, there was an average difference of only 9g in birthweight and 0.6 days in gestational age, and these differences were not statistically significant.
There was also no statistically significant difference in the rates of small-for-gestational age births and perinatal mortality when the assisted fertilisation babies were compared with the spontaneous conception babies in the sibling-relationship comparisons.
What interpretations did the researchers draw from these results? The whole study population results, which showed that the risk of adverse events is higher with IVF, are consistent with many other studies looking at the outcome of assisted fertilisation pregnancies compared with spontaneous pregnancies.
However, looking at the babies born to women who had conceived both spontaneously and after assisted fertilisation, there was no difference in birthweight, gestational age, risk of small-for-gestational-age babies, and preterm delivery between siblings.
The researchers conclude that adverse outcomes of assisted fertilisation seen in the general population could therefore be attributable to the factors leading to infertility, rather than to factors related to the IVF technique itself.
What does the NHS Knowledge Service make of this study? This study has successfully compared the outcomes in the babies of individual women who had become pregnant following both assisted (IVF) conception and a normal (spontaneous) conception.
This is a novel approach made possible by the large population-based database. As a large study, it has provided reliable results. Even so, the researchers say that the study was not large enough (powered enough) to study births that occurred before 32 weeks of gestation, or to study the perinatal mortality among women who had conceived both spontaneously and after assisted fertilisation.
It is possible that some of the conceptions were misclassified, i.e. recorded incorrectly, particularly for those women where conception occurred outside of Norway.
Overall, the study confirms that birthweight, gestational age, and risks of small-for-gestational-age infants and preterm delivery did not differ among brothers and sisters born to women who had conceived both spontaneously and after assisted fertilisation. This should provide reassurance to mothers that any adverse effects following assisted fertilisation are more likely to be due to underlying infertility
The Daily Telegraph also reported some of the results of this study, saying “babies conceived through IVF are much more likely to die at birth”. These results are consistent with many other studies looking at the outcome of assisted fertilisation pregnancies. The newspaper did not directly discuss the implications found in the comparison of IVF and non-IVF siblings.
This large study used complex statistical methods to try to tease out the risks related to the various factors. It is reliable and should be reassuring to women undergoing IVF. However, it is important to note that the risks of complications in an individual birth are in fact quite low (around 1% perinatal deaths in this study).
Where did the story come from? Dr Liv Bente Romundstad from the Department of Obstetrics and Gynaecology at St Olavs University Hospital in Trondheim, and other colleagues from around Norway, UK and France, carried out the research. The study was funded by the Trondheim Hospital and the Norwegian Research Council. It was published in the peer-reviewed medical journal The Lancet.
What kind of scientific study was this? This was a cohort study in which the researchers used data from the Medical Birth Registry of Norway. This has records of more than 2.2 million births, which occurred in Norway between 1967 and 2006. The researchers had information about pregnancy across the population as it had been recorded on standard forms by midwives or doctors within one week of delivery for all deliveries after 16 weeks gestation. This information included details about the mother’s health, antenatal and birth history, and it was linked to the “Statistics Norway” database. The researchers were able to identify outcomes for all the babies, because in Norway each baby is given a unique identification number.
From the data on 1,305,228 births from January 1984 to the end of June 2006, the researchers excluded records where there was missing data on the number of children, or if the mother was less than 20 years old or had had more than six children. Only single babies (not twins or other multiple births) who were born at 22 weeks or later, and weighed 500g or more, were assessed. After this process, they found 1,200,922 births following normal conception and 8,229 after assisted fertilisation.
First, the researchers assessed differences in birthweight, gestational age, and the chances that babies were born small for their gestational age, were born prematurely or died in the period around birth (perinatal death). They analysed the relationships between all these variables, using a model that looked at all mothers as a whole (the whole study population analysis). They also divided the mothers into groups for their year of birth, maternal age, and number of children, and assessed them separately.
"The adverse outcomes of assisted fertilisation ... could therefore be attributable to the factors leading to infertility, rather than to factors related to the reproductive technology." Liv Bente Romundstad, lead author
After this whole study population analysis, the researchers then looked at whether the risks associated with IVF were due to the IVF technique itself or whether they were due to other factors linked to the fertility of the parents. In order to do this, they compared the health of babies born to mothers who had experienced both an assisted fertilisation (IVF) conception and a normalone. There was information for 2,546 Norwegian women available for analysis. These “sibling-relationship comparisons” looked at whether there were differences between the brothers or sisters born to women after both assisted fertilisation and normal conception. The researchers also took into account the order of conception (if IVF occurred before spontaneous conception or the other way around). They adjusted the results for maternal age, number of previous babies, sex of the baby, time between pregnancies and year of delivery.
What were the results of the study? In the whole study population analysis, assisted-fertilisation conceptions were associated with lower average birthweight (a difference of about 25g), shorter duration of gestation (about two days), and an increased risk of babies being too small for their gestational age, or dying in the period around birth.
In the sibling-relationship comparisons, where spontaneously conceived babies were compared with their assisted-fertilisation conceived sibling, there was an average difference of only 9g in birthweight and 0.6 days in gestational age, and these differences were not statistically significant.
There was also no statistically significant difference in the rates of small-for-gestational age births and perinatal mortality when the assisted fertilisation babies were compared with the spontaneous conception babies in the sibling-relationship comparisons.
What interpretations did the researchers draw from these results? The whole study population results, which showed that the risk of adverse events is higher with IVF, are consistent with many other studies looking at the outcome of assisted fertilisation pregnancies compared with spontaneous pregnancies.
However, looking at the babies born to women who had conceived both spontaneously and after assisted fertilisation, there was no difference in birthweight, gestational age, risk of small-for-gestational-age babies, and preterm delivery between siblings.
The researchers conclude that adverse outcomes of assisted fertilisation seen in the general population could therefore be attributable to the factors leading to infertility, rather than to factors related to the IVF technique itself.
What does the NHS Knowledge Service make of this study? This study has successfully compared the outcomes in the babies of individual women who had become pregnant following both assisted (IVF) conception and a normal (spontaneous) conception.
This is a novel approach made possible by the large population-based database. As a large study, it has provided reliable results. Even so, the researchers say that the study was not large enough (powered enough) to study births that occurred before 32 weeks of gestation, or to study the perinatal mortality among women who had conceived both spontaneously and after assisted fertilisation.
It is possible that some of the conceptions were misclassified, i.e. recorded incorrectly, particularly for those women where conception occurred outside of Norway.
Overall, the study confirms that birthweight, gestational age, and risks of small-for-gestational-age infants and preterm delivery did not differ among brothers and sisters born to women who had conceived both spontaneously and after assisted fertilisation. This should provide reassurance to mothers that any adverse effects following assisted fertilisation are more likely to be due to underlying infertility
Wednesday, 30 July 2008
The new Mountain Buggy Urban Double is due August
The New Mountain Buggy Urban Double 2008 buggy has just get even better, the buggy has always been a favorite with mums and dads of twins, it's a roomy yet narrow double buggy at just 74cm wide fits through most doors yet has plenty of space for your growing children.
The new MBUD 2008 is suitable from birth with the multi reclining seats adjusting to near flat and the new model now has an aduster bulit into the harnesh for smaller babies - great from twins! or as with all the range can be used with Mountain Buggy Carry Cots to make a twin pram.
Comes complete with a free Mountain Buggy Twin Storm cover, with it's front opening zip which can be rolled open, large shopping basket with pockets for bottles and keys and phone, a bottle carrier and a Mountain Buggy pump is included in our price.
The short wheelbase makes maneuvering easy, and as its so narrow helps when exiting doorways. The front swivel wheels option is excellent on busy streets & indoors and offers true 'turn the buggy with just one finger' .
By locking the front wheel to the fixed position, the Mountain Buggy Urban Double can handle the park, light jogging & off-road conditions with ease making this an all terrain buggy, and now with rear suspension to give even more comfort. The four large wheels give market leading stability in all conditions for safety, and with an adjustable handlebar to ensure optimum comfort for the parents while pushing.
Turn this buggy into a twin pram with optional carrycots available to suit one or two babies or two toddlers, details of carry cots can be found in our Buggy Accessories.
Mountain Buggy Urban Double 2008 offers -
All purpose High tensile aluminium frame
Upright to fully reclined seat positions
Rear wheel suspension for a smoother ride on any surface
Large storage basket with smaller storage pockets
Suitable from newborn
Quick release wheels
5-point safety harness
Foot operated brake
Easy one-step fold
Sunhood with viewing window
Water resistant, easy cleaning Hardwearing fabric
Full range of accessories
Free air pump and drink bottle holder
Made in New Zealand
Dimensions
Width 74 cms
Fold Size With Wheels 104 x 39.5 x 74 cms
Weight 16 kgs
Mountain Buggy reviews
Should you require further assistance, or wish to place a pre order for the new 2008 Mountain Buggy, please email customerservice@twins-store.co.uk delivery due in August
The new MBUD 2008 is suitable from birth with the multi reclining seats adjusting to near flat and the new model now has an aduster bulit into the harnesh for smaller babies - great from twins! or as with all the range can be used with Mountain Buggy Carry Cots to make a twin pram.
Comes complete with a free Mountain Buggy Twin Storm cover, with it's front opening zip which can be rolled open, large shopping basket with pockets for bottles and keys and phone, a bottle carrier and a Mountain Buggy pump is included in our price.
The short wheelbase makes maneuvering easy, and as its so narrow helps when exiting doorways. The front swivel wheels option is excellent on busy streets & indoors and offers true 'turn the buggy with just one finger' .
By locking the front wheel to the fixed position, the Mountain Buggy Urban Double can handle the park, light jogging & off-road conditions with ease making this an all terrain buggy, and now with rear suspension to give even more comfort. The four large wheels give market leading stability in all conditions for safety, and with an adjustable handlebar to ensure optimum comfort for the parents while pushing.
Turn this buggy into a twin pram with optional carrycots available to suit one or two babies or two toddlers, details of carry cots can be found in our Buggy Accessories.
Mountain Buggy Urban Double 2008 offers -
All purpose High tensile aluminium frame
Upright to fully reclined seat positions
Rear wheel suspension for a smoother ride on any surface
Large storage basket with smaller storage pockets
Suitable from newborn
Quick release wheels
5-point safety harness
Foot operated brake
Easy one-step fold
Sunhood with viewing window
Water resistant, easy cleaning Hardwearing fabric
Full range of accessories
Free air pump and drink bottle holder
Made in New Zealand
Dimensions
Width 74 cms
Fold Size With Wheels 104 x 39.5 x 74 cms
Weight 16 kgs
Mountain Buggy reviews
Should you require further assistance, or wish to place a pre order for the new 2008 Mountain Buggy, please email customerservice@twins-store.co.uk delivery due in August
guardian - The fertility tourists
The fertility tourists
The ads are brazen: 'healthy young women - superovulated exclusively for you!'. The fees are half those of UK clinics ('flights and hotel included!'). And the industry is unregulated, leaving doctors free of legal and ethical constraints. No wonder more and more Europeans are going to India for fertility treatment. Raekha Prasad reports
Raekha Prasad
Wednesday July 30 2008
At the end of last year, Ekaterina Aleksandrova boarded a plane in London and flew to Mumbai. It wasn't her first trip there - she is a management consultant and often goes abroad on business. But this time she went to have five embryos implanted in her womb. A couple of days later she flew back to Europe. While on business in Hong Kong in January, she discovered she was pregnant with just one embryo.
For Aleksandrova, 42, this was the culmination of a six-year struggle to become a mother. She divorced at 29, and hadn't been in a serious relationship since she was 34. "I always wanted to have a child but the men kept saying, 'Why don't we travel?'" she says. "It wasn't that I was obsessed with my career, I just couldn't get men to be a father."
First, she tried to adopt in Germany, where she holds citizenship, but that didn't work out. Then, in 2004, she moved to the UK to take advantage of this country's more liberal attitude to single women who need IVF. She spent £18,000 in less than three years, trying and failing to conceive at a private Harley Street clinic. When she finally conceived in India, Aleksandrova was in a state of "shock and disbelief".
The baby she is due to give birth to in September has no genetic link with Aleksandrova. The colour of its eyes, length of its legs and slope of its nose will be determined by a man and a woman who are strangers not only to her, but also to each other. Her baby's biological parents live 7,000km apart, and are separated by language, culture and currency. All they share is their decision to ply their gametes in the global fertility bazaar where Aleksandrova shopped for the ingredients of life, perusing and eventually paying for eggs and sperm. Aleksandrova bought the sperm online from a Danish sperm bank retailing in New York. The $1,600 (£800) price-tag included shipping to Mumbai, where her Indian doctor helped get the tiny frozen container through customs unscathed. There, the Danish sperm was used to fertilise the fresh eggs of an Indian woman who was paid 40,000 rupees (£500).
Alexsandrova first began surfing foreign fertility clinics' websites in the winter of 2006/7. Impressed with the Indian doctor's responses to her email inquiries, she flew out to Mumbai for a couple of days the following April to investigate further. She then visited the Taj Mahal.
She brought home a Punjabi-style pyjama suit for the baby to wear if it was a boy, and bangles if it was a girl. India has a fascinating culture, she says, and she plans to bring the child to India to expose him or her to "50% of their background". The prospect of raising a mixed-race child doesn't faze her. The daughter of a diplomat, she was born in Pakistan and says she has fond memories of her childhood Pakistani friends. "I'm curious to know how the baby's going to look being Danish-Indian. I like coloured kids. I find them cute. I find mixed blood gives a bit of a boost."
She plans to tell the child the truth about the way he or she was conceived. "You can't lie to your child all your life," she says. But she hasn't yet thought about the fallout if the child wants to know more about its genetic parents. "It's preferable that they're kept anonymous. What's the meaning of finding out?"
Aleksandrova herself knows very little about the donors. Her baby's father, she learned from the bank's online catalogue, is 6ft 4in, an architectural student from a family of doctors and "musical". She knows even less about the baby's biological mother, the egg donor. They have never met and donor anonymity prevails in India. "The doctor asked me what I wanted. I said I wanted a young, healthy woman with a child. Because I'm Caucasian, I wanted a fair-skinned person. The doctor said 'she is good-looking with some education'. I'd love to know more. But I trust him. I don't think he picks someone off the street," she says.
In Britain, there is an acute shortage of women donors. Had she stayed here, Alexsandrova would have faced a long wait for eggs, a bill of £7,000, and a cap on the number of embryos planted in her womb - a restriction aimed to prevent high-risk multiple pregnancies but, in her eyes, a curb on her chances to have a baby.
It is different in India; there, the market rules. Clinics' websites offer "many healthy young fertile Indian women" who are "superovulated exclusively for you" in dollar rates payable online by credit card. Moreover, Aleksandrova's Indian clinic put more than double the number of embryos allowed in the UK into her body. "I understand multiple-births are not a good thing," she says. "But for women like me whose bodies reject embryos, the higher the number, the greater my chance."
Alexsandrova is part of a growing number of global fertility tourists from rich countries such as Britain who fish for cut-price genetic material from India's pool of highly trained, English-speaking doctors.
It is a phenomenon wholly distinct from medical tourism, where patients needing a hip replacement or heart bypass receive identical treatment minus the waiting list and the large bills. Reproductive holidays in India are a real getaway from conditions back home. Fertility tourists are often people desperate to break free from not only financial, but also legal and ethical constraints, in a bid to create life. And Indian clinics woo patients with the language of free choice and a can-do attitude.
Age, for example, rarely poses a barrier in India. Earlier this year, twin girls conceived by IVF in India were born in the Midlands to a British Indian couple with a combined age of 131. Their mother, thought to be 59, is one of the oldest women in Britain to give birth.
Ethnicity is no problem either. Those making the trip to India are not just people of Indian descent who want a baby who resembles them. Increasingly, they are white couples that have no problem with the idea of having brown babies.
India was the second country in the world after the UK to produce a "test-tube baby" - the Indian girl was born just 67 days after Louise Brown in 1978 - but it has yet to create a single law regarding infertility treatment. Instead, Indian IVF doctors are self-regulating and only have to refer to a set of guidelines, not work within them.
Meanwhile, Britain has spent the past 30 years reforming infertility laws through public debates. These began with the Warnock Committee in the early 80s, which examined the moral, scientific and religious issues raised by IVF and led to the establishment of the world's first statutory body of its kind - the Human Fertilisation and Embryo Authority - to license and monitor clinics.
Three decades of scrutiny of IVF techniques in Britain has resulted in a recognition of the emotional maelstrom inherent in the creation of life. The result is that not only do British doctors consider the scientific possibilities of having a child, but also the impact of assisted reproduction on a child's emotional wellbeing, human rights and racial identity. Just because you can do something does not mean you should, is the maxim in Britain. The opposite appears to be the case in India.
There, the growing number of white westerners turning up for fertility treatment is reported in the press not as an ethical dilemma, but simply as another example of how the country is "booming": it is a source of national pride that India is getting foreigners pregnant where their own countries have failed. "Move over yoga, Ayurveda, there's a new Asian hip trend starting up ..." begins a story in the Indian Express on a British couple at a Mumbai clinic.
Similarly, while Diane Blood faced years of legal challenge and moral handwringing in her quest to use her dead husband's sperm for IVF, her Indian counterpart, "Puja", became India's first woman earlier this year to conceive with her dead husband's sperm. There was no fanfare, legal wrangling or public debate; her pregnancy was simply reported as a happy ending to a sad story.
One of India's most vocal proponents of patient choice is Dr Aniruddha Malpani, a favourite among British fertility tourists. To get to his clinic, on the edge of Mumbai's upmarket shoreline, his foreign patients must travel from the shiny new airport, past glass towerblocks in the shadow of which ragged children play in fetid pools beside pavements where they sleep, before arriving in a street lined with palm trees. A lift carries them several floors up into the compact, white-walled clinic where nurses scuttle between clean, sparse private bedrooms.
More than half the clinic's patients are from abroad. Hundreds like Alexsandrova, who have had no success in their own country, come to the man who says "yes". Sitting behind his desk in a small office, Malpani is a fast-talking defender of patients' rights, and sees the people he treats as consumers of a technology that needs only the lightest of regulation. As long as people can pay, let them decide, he says. He rails against the "sociologists" who question whether science can act without ethical restraint. "In whose interests are we doing this stuff? Should there be someone sitting in judgment? It's best for the mother to decide what's best."
Malpani turns out to be master of medical propaganda. He calls his patients "reproductive exiles" from medical establishments that are hostile to their desire to have children. The people who come are not desperate, he says, they have been disempowered - and his team is intervening to allow them to "build families".
Malpani taps on the keyboard in front of him while we talk. When challenged on a point, he types rapidly and spins round the screen on which flashes the relevant web page to back up his argument. The impression is of a man in a hurry to prove the world wrong, with all the arguments at his fingertips.
In Britain, people conceived since 2005 by a donor have the right to information about their genetic parent once they reach the age of 18. Children conceived using donor eggs, sperm or embryos in India have no such right; there, donors remain anonymous. That's as it should be, insists Malpani: receiving an embryo from a stranger is no different from getting pregnant after a one-night stand, he says. "If someone just slept with someone and decided to have the baby, no one would ask her to reveal his identity. Just because it's a clinic, why do these questions get asked?"
Malpani also sees no problem with his clinic giving white patients the eggs and embryos of Indian donors, saying, "They've thought about it", before enthusing about how "alike" donor-conceived children's mannerisms are to their birth parents.
British medical thinking, he says, is not designed with the patient in mind. In Britain doctors and patients are encouraged to transfer a maximum of two embryos into the uterus. Any more and the risks of premature birth, smaller babies and children with language and behavourial disorders increases substantially.Malpani transfers up to five embryos. "We have the flexibility to give a woman the best chance," he says. "If they don't get pregnant at all, they are the ones to suffer."
By his own admission, Malpani is a libertarian. He is also a respected fertility expert - his IVF clinic has been named among India's best - with a CV boasting a string of awards and scholarships for his clinical skills.
His greatest advocates, however, are those patients he has enabled to have a child. Sitting on the sofa in their living room more than 6,500km away from Mumbai in Market Rasen, Lincolnshire, are Brian and Wendy Duncan. Wendy, 42, pulls her three-year-old daughter, Freya, on to her lap: the little girl was conceived with Malpani's treatment.
"Freya is just like me. I delivered her and experienced every moment of her growing," says Duncan.
What is striking on first meeting mother and daughter, however, is their difference: Duncan is the palest of redheads while Freya has the dark skin, black hair and brown eyes of an Indian. She looks nothing like her father, either, who is also white. To conceive Freya, Duncan had five fertilised embryos from an Indian couple implanted into her womb.
Duncan was denied IVF treatment on the NHS because she already had a daughter, now 22, and was both overweight and a smoker. So the Duncans went private, borrowing £8,000 for one IVF cycle, which failed. For their second attempt, in India, they spent half that amount, including flights and hotels. "I wanted a child. The system in Britain didn't allow me to have one, so I had to look for an honest alternative," Duncan says.
While ethical decisions in India are left in the hands of individual doctors, in Britain each proposed embryo or gamete donation is considered by a clinic's mandatory ethics committee made up of lay people, clinicians, nurses and counsellors. There is no blanket ban on interracial donation, says Pip Morris of The National Gamete Donation Trust, "but the donor would be matched as closely as possible to the recipient".
"For example, if you had two black recipients and a white donor then that would be questioned and refused. If there's any doubt about the welfare of the child, then a donation would not go ahead."
Duncan says Freya's racial difference is irrelevant to her. "I wasn't bothered when she was born and I'm not concerned now. What matters is that she gets all the love and care she needs growing up." But what if it's relevant to Freya? "Of course I'll tell her if she asks about it. But if she doesn't, I won't stick my neck out to tell her."
Duncan argues Freya's looming questions about the fact her genetic parents are from a different continent, culture and race will be little different from those of her eldest daughter, from a previous relationship, who is mixed race. "When I told my older daughter about her origin there was no problem and it shouldn't be too difficult for Freya to understand the dynamics of it."
In the global market of commercial fertility, India remains one of the cheapest places to buy gametes. In America the going rate for an egg from an Ivy League student is around $60,000 (£30,000). An Indian egg never fetches more than 40,000 rupees (£500), and in the country's small towns a woman is paid as little as 5,500 rupees (£70).
It is almost impossible to get an accurate picture of exactly who India's donors are. The issue is shrouded in secrecy. Part of the reason appears to be the social stigma of being a donor in a conservative society. When asked about the backgrounds of their donors, IVF doctors give a standard response: they are from lower middle-class families, and are all married, with at least one child. One says they might work as a secretary or in a shop and generally have "a little education". But all the doctors claim donors refuse to be interviewed.
Perhaps one unspoken reason for the secrecy is the ugly reality that some donors in a country as poor as India trade their eggs simply to stay afloat financially.
In a dusty rural hamlet near the city of Anand, in the western state of Gujarat, Pushpa clutches her seven-year-old daughter's hand and stares at the cement floor of her house. The 25-year-old sold one of her eggs to pay off crippling debts after the family was reduced to eating just one meal a day. Her husband earns 2,800 rupees (£35) a month labouring on a construction site. "A moneylender would have stripped us of whatever little gold we had. I could not let my last bit of security go," she says.
The emphasis placed on informed consent, rights and counselling for egg donors in rich countries are absent in Anand. Moreover, the medical risks associated with farming eggs, such as pelvic infection or ovarian hyperstimulation syndrome - which in severe cases can be life-threatening - are often hidden from donors."The doctor told me there were no risks; that donating was just selling something that will be wasted away from my body anyway," Pushpa says.
Of even more concern, say critics of India's unregulated IVF industry, is the way that some doctors try to maximise profits by overdosing donors with hormones to stimulate them. "The amount of drugs pushed into them is way above the recommended dose," says Dr Puneet Bedi, a Delhi-based consultant obstetrician and gynaecologist specialising in foetal medicine. "If guidelines say to give 10 shots, they'll give 20 to increase the harvest rate and optimise their conception rates. Because IVF is a completely commercialised industry in India, it's all about delivering to whoever's paying."
The result is that the risk to a donor's health is amplified, says Bedi. While in Britain there is officially a 1% to 2% chance of egg donors getting hyperstimulation syndrome, Indian donors face "a many, many fold risk" in comparison. "We don't really know what happens to these women. Who pays for her life-threatening treatment? Nobody cares. Nobody's answerable."
Pushpa is matter-of-fact about her decision. "You wouldn't ask me why I did it if you'd ever lived on one meal a day," she says bitterly. "Selling the egg was quite easy. I was given some medicine; they took it out. I got the money."
So lucrative was the 5,600 rupees (£70) she received for donating, she did it twice more. "I wanted to send my children to a good school. They will have a better future. This was only possible because of me - a woman. After all, men can't produce eggs," she says.
She doesn't know who bought her eggs. "I don't feel exploited; here, in the villages, every aspect of life is exploitative - where you can work, what you can eat, when you have sex. This is the best option available to me," Pushpa says.
Not all Indian egg donors come as cheap as Pushpa. At the top of the country's social ladder are urban college students, who sell their eggs to bankroll their penchant for new clothes and gadgets. Sipping a cappuccino on the terrace of a cafe in a bustling Mumbai business district, one 20-year-old physics student - who agrees to speak anonymously - explains why she sold her eggs to one of the city's infertility clinics for 20,000 rupees (£250).
Some of her friends had sold their eggs and so she began searching clinics' websites. "If I can earn more money than getting a part-time job, then why not?" she says. "I needed to buy a new mobile and wanted to go abroad on vacation with my friends. I have always had what I wanted in life. But for my own enjoyment, I can't ask my parents for money all the time."
Although she is dressed in jeans, a T-shirt and designer shades, like any other affluent student in India's financial capital, she is acutely aware of the stigma surrounding donation in India. "My parents must never find out. They wouldn't understand why I did it," she says. "They'll think I'll never be able to be a mother myself. It's in the best interests of the family to keep it a secret."
Time is up. She waves down a taxi and hops inside. "I couldn't afford this ride earlier and now I can," she says as the car pulls away. "What's wrong with that?"
The ads are brazen: 'healthy young women - superovulated exclusively for you!'. The fees are half those of UK clinics ('flights and hotel included!'). And the industry is unregulated, leaving doctors free of legal and ethical constraints. No wonder more and more Europeans are going to India for fertility treatment. Raekha Prasad reports
Raekha Prasad
Wednesday July 30 2008
At the end of last year, Ekaterina Aleksandrova boarded a plane in London and flew to Mumbai. It wasn't her first trip there - she is a management consultant and often goes abroad on business. But this time she went to have five embryos implanted in her womb. A couple of days later she flew back to Europe. While on business in Hong Kong in January, she discovered she was pregnant with just one embryo.
For Aleksandrova, 42, this was the culmination of a six-year struggle to become a mother. She divorced at 29, and hadn't been in a serious relationship since she was 34. "I always wanted to have a child but the men kept saying, 'Why don't we travel?'" she says. "It wasn't that I was obsessed with my career, I just couldn't get men to be a father."
First, she tried to adopt in Germany, where she holds citizenship, but that didn't work out. Then, in 2004, she moved to the UK to take advantage of this country's more liberal attitude to single women who need IVF. She spent £18,000 in less than three years, trying and failing to conceive at a private Harley Street clinic. When she finally conceived in India, Aleksandrova was in a state of "shock and disbelief".
The baby she is due to give birth to in September has no genetic link with Aleksandrova. The colour of its eyes, length of its legs and slope of its nose will be determined by a man and a woman who are strangers not only to her, but also to each other. Her baby's biological parents live 7,000km apart, and are separated by language, culture and currency. All they share is their decision to ply their gametes in the global fertility bazaar where Aleksandrova shopped for the ingredients of life, perusing and eventually paying for eggs and sperm. Aleksandrova bought the sperm online from a Danish sperm bank retailing in New York. The $1,600 (£800) price-tag included shipping to Mumbai, where her Indian doctor helped get the tiny frozen container through customs unscathed. There, the Danish sperm was used to fertilise the fresh eggs of an Indian woman who was paid 40,000 rupees (£500).
Alexsandrova first began surfing foreign fertility clinics' websites in the winter of 2006/7. Impressed with the Indian doctor's responses to her email inquiries, she flew out to Mumbai for a couple of days the following April to investigate further. She then visited the Taj Mahal.
She brought home a Punjabi-style pyjama suit for the baby to wear if it was a boy, and bangles if it was a girl. India has a fascinating culture, she says, and she plans to bring the child to India to expose him or her to "50% of their background". The prospect of raising a mixed-race child doesn't faze her. The daughter of a diplomat, she was born in Pakistan and says she has fond memories of her childhood Pakistani friends. "I'm curious to know how the baby's going to look being Danish-Indian. I like coloured kids. I find them cute. I find mixed blood gives a bit of a boost."
She plans to tell the child the truth about the way he or she was conceived. "You can't lie to your child all your life," she says. But she hasn't yet thought about the fallout if the child wants to know more about its genetic parents. "It's preferable that they're kept anonymous. What's the meaning of finding out?"
Aleksandrova herself knows very little about the donors. Her baby's father, she learned from the bank's online catalogue, is 6ft 4in, an architectural student from a family of doctors and "musical". She knows even less about the baby's biological mother, the egg donor. They have never met and donor anonymity prevails in India. "The doctor asked me what I wanted. I said I wanted a young, healthy woman with a child. Because I'm Caucasian, I wanted a fair-skinned person. The doctor said 'she is good-looking with some education'. I'd love to know more. But I trust him. I don't think he picks someone off the street," she says.
In Britain, there is an acute shortage of women donors. Had she stayed here, Alexsandrova would have faced a long wait for eggs, a bill of £7,000, and a cap on the number of embryos planted in her womb - a restriction aimed to prevent high-risk multiple pregnancies but, in her eyes, a curb on her chances to have a baby.
It is different in India; there, the market rules. Clinics' websites offer "many healthy young fertile Indian women" who are "superovulated exclusively for you" in dollar rates payable online by credit card. Moreover, Aleksandrova's Indian clinic put more than double the number of embryos allowed in the UK into her body. "I understand multiple-births are not a good thing," she says. "But for women like me whose bodies reject embryos, the higher the number, the greater my chance."
Alexsandrova is part of a growing number of global fertility tourists from rich countries such as Britain who fish for cut-price genetic material from India's pool of highly trained, English-speaking doctors.
It is a phenomenon wholly distinct from medical tourism, where patients needing a hip replacement or heart bypass receive identical treatment minus the waiting list and the large bills. Reproductive holidays in India are a real getaway from conditions back home. Fertility tourists are often people desperate to break free from not only financial, but also legal and ethical constraints, in a bid to create life. And Indian clinics woo patients with the language of free choice and a can-do attitude.
Age, for example, rarely poses a barrier in India. Earlier this year, twin girls conceived by IVF in India were born in the Midlands to a British Indian couple with a combined age of 131. Their mother, thought to be 59, is one of the oldest women in Britain to give birth.
Ethnicity is no problem either. Those making the trip to India are not just people of Indian descent who want a baby who resembles them. Increasingly, they are white couples that have no problem with the idea of having brown babies.
India was the second country in the world after the UK to produce a "test-tube baby" - the Indian girl was born just 67 days after Louise Brown in 1978 - but it has yet to create a single law regarding infertility treatment. Instead, Indian IVF doctors are self-regulating and only have to refer to a set of guidelines, not work within them.
Meanwhile, Britain has spent the past 30 years reforming infertility laws through public debates. These began with the Warnock Committee in the early 80s, which examined the moral, scientific and religious issues raised by IVF and led to the establishment of the world's first statutory body of its kind - the Human Fertilisation and Embryo Authority - to license and monitor clinics.
Three decades of scrutiny of IVF techniques in Britain has resulted in a recognition of the emotional maelstrom inherent in the creation of life. The result is that not only do British doctors consider the scientific possibilities of having a child, but also the impact of assisted reproduction on a child's emotional wellbeing, human rights and racial identity. Just because you can do something does not mean you should, is the maxim in Britain. The opposite appears to be the case in India.
There, the growing number of white westerners turning up for fertility treatment is reported in the press not as an ethical dilemma, but simply as another example of how the country is "booming": it is a source of national pride that India is getting foreigners pregnant where their own countries have failed. "Move over yoga, Ayurveda, there's a new Asian hip trend starting up ..." begins a story in the Indian Express on a British couple at a Mumbai clinic.
Similarly, while Diane Blood faced years of legal challenge and moral handwringing in her quest to use her dead husband's sperm for IVF, her Indian counterpart, "Puja", became India's first woman earlier this year to conceive with her dead husband's sperm. There was no fanfare, legal wrangling or public debate; her pregnancy was simply reported as a happy ending to a sad story.
One of India's most vocal proponents of patient choice is Dr Aniruddha Malpani, a favourite among British fertility tourists. To get to his clinic, on the edge of Mumbai's upmarket shoreline, his foreign patients must travel from the shiny new airport, past glass towerblocks in the shadow of which ragged children play in fetid pools beside pavements where they sleep, before arriving in a street lined with palm trees. A lift carries them several floors up into the compact, white-walled clinic where nurses scuttle between clean, sparse private bedrooms.
More than half the clinic's patients are from abroad. Hundreds like Alexsandrova, who have had no success in their own country, come to the man who says "yes". Sitting behind his desk in a small office, Malpani is a fast-talking defender of patients' rights, and sees the people he treats as consumers of a technology that needs only the lightest of regulation. As long as people can pay, let them decide, he says. He rails against the "sociologists" who question whether science can act without ethical restraint. "In whose interests are we doing this stuff? Should there be someone sitting in judgment? It's best for the mother to decide what's best."
Malpani turns out to be master of medical propaganda. He calls his patients "reproductive exiles" from medical establishments that are hostile to their desire to have children. The people who come are not desperate, he says, they have been disempowered - and his team is intervening to allow them to "build families".
Malpani taps on the keyboard in front of him while we talk. When challenged on a point, he types rapidly and spins round the screen on which flashes the relevant web page to back up his argument. The impression is of a man in a hurry to prove the world wrong, with all the arguments at his fingertips.
In Britain, people conceived since 2005 by a donor have the right to information about their genetic parent once they reach the age of 18. Children conceived using donor eggs, sperm or embryos in India have no such right; there, donors remain anonymous. That's as it should be, insists Malpani: receiving an embryo from a stranger is no different from getting pregnant after a one-night stand, he says. "If someone just slept with someone and decided to have the baby, no one would ask her to reveal his identity. Just because it's a clinic, why do these questions get asked?"
Malpani also sees no problem with his clinic giving white patients the eggs and embryos of Indian donors, saying, "They've thought about it", before enthusing about how "alike" donor-conceived children's mannerisms are to their birth parents.
British medical thinking, he says, is not designed with the patient in mind. In Britain doctors and patients are encouraged to transfer a maximum of two embryos into the uterus. Any more and the risks of premature birth, smaller babies and children with language and behavourial disorders increases substantially.Malpani transfers up to five embryos. "We have the flexibility to give a woman the best chance," he says. "If they don't get pregnant at all, they are the ones to suffer."
By his own admission, Malpani is a libertarian. He is also a respected fertility expert - his IVF clinic has been named among India's best - with a CV boasting a string of awards and scholarships for his clinical skills.
His greatest advocates, however, are those patients he has enabled to have a child. Sitting on the sofa in their living room more than 6,500km away from Mumbai in Market Rasen, Lincolnshire, are Brian and Wendy Duncan. Wendy, 42, pulls her three-year-old daughter, Freya, on to her lap: the little girl was conceived with Malpani's treatment.
"Freya is just like me. I delivered her and experienced every moment of her growing," says Duncan.
What is striking on first meeting mother and daughter, however, is their difference: Duncan is the palest of redheads while Freya has the dark skin, black hair and brown eyes of an Indian. She looks nothing like her father, either, who is also white. To conceive Freya, Duncan had five fertilised embryos from an Indian couple implanted into her womb.
Duncan was denied IVF treatment on the NHS because she already had a daughter, now 22, and was both overweight and a smoker. So the Duncans went private, borrowing £8,000 for one IVF cycle, which failed. For their second attempt, in India, they spent half that amount, including flights and hotels. "I wanted a child. The system in Britain didn't allow me to have one, so I had to look for an honest alternative," Duncan says.
While ethical decisions in India are left in the hands of individual doctors, in Britain each proposed embryo or gamete donation is considered by a clinic's mandatory ethics committee made up of lay people, clinicians, nurses and counsellors. There is no blanket ban on interracial donation, says Pip Morris of The National Gamete Donation Trust, "but the donor would be matched as closely as possible to the recipient".
"For example, if you had two black recipients and a white donor then that would be questioned and refused. If there's any doubt about the welfare of the child, then a donation would not go ahead."
Duncan says Freya's racial difference is irrelevant to her. "I wasn't bothered when she was born and I'm not concerned now. What matters is that she gets all the love and care she needs growing up." But what if it's relevant to Freya? "Of course I'll tell her if she asks about it. But if she doesn't, I won't stick my neck out to tell her."
Duncan argues Freya's looming questions about the fact her genetic parents are from a different continent, culture and race will be little different from those of her eldest daughter, from a previous relationship, who is mixed race. "When I told my older daughter about her origin there was no problem and it shouldn't be too difficult for Freya to understand the dynamics of it."
In the global market of commercial fertility, India remains one of the cheapest places to buy gametes. In America the going rate for an egg from an Ivy League student is around $60,000 (£30,000). An Indian egg never fetches more than 40,000 rupees (£500), and in the country's small towns a woman is paid as little as 5,500 rupees (£70).
It is almost impossible to get an accurate picture of exactly who India's donors are. The issue is shrouded in secrecy. Part of the reason appears to be the social stigma of being a donor in a conservative society. When asked about the backgrounds of their donors, IVF doctors give a standard response: they are from lower middle-class families, and are all married, with at least one child. One says they might work as a secretary or in a shop and generally have "a little education". But all the doctors claim donors refuse to be interviewed.
Perhaps one unspoken reason for the secrecy is the ugly reality that some donors in a country as poor as India trade their eggs simply to stay afloat financially.
In a dusty rural hamlet near the city of Anand, in the western state of Gujarat, Pushpa clutches her seven-year-old daughter's hand and stares at the cement floor of her house. The 25-year-old sold one of her eggs to pay off crippling debts after the family was reduced to eating just one meal a day. Her husband earns 2,800 rupees (£35) a month labouring on a construction site. "A moneylender would have stripped us of whatever little gold we had. I could not let my last bit of security go," she says.
The emphasis placed on informed consent, rights and counselling for egg donors in rich countries are absent in Anand. Moreover, the medical risks associated with farming eggs, such as pelvic infection or ovarian hyperstimulation syndrome - which in severe cases can be life-threatening - are often hidden from donors."The doctor told me there were no risks; that donating was just selling something that will be wasted away from my body anyway," Pushpa says.
Of even more concern, say critics of India's unregulated IVF industry, is the way that some doctors try to maximise profits by overdosing donors with hormones to stimulate them. "The amount of drugs pushed into them is way above the recommended dose," says Dr Puneet Bedi, a Delhi-based consultant obstetrician and gynaecologist specialising in foetal medicine. "If guidelines say to give 10 shots, they'll give 20 to increase the harvest rate and optimise their conception rates. Because IVF is a completely commercialised industry in India, it's all about delivering to whoever's paying."
The result is that the risk to a donor's health is amplified, says Bedi. While in Britain there is officially a 1% to 2% chance of egg donors getting hyperstimulation syndrome, Indian donors face "a many, many fold risk" in comparison. "We don't really know what happens to these women. Who pays for her life-threatening treatment? Nobody cares. Nobody's answerable."
Pushpa is matter-of-fact about her decision. "You wouldn't ask me why I did it if you'd ever lived on one meal a day," she says bitterly. "Selling the egg was quite easy. I was given some medicine; they took it out. I got the money."
So lucrative was the 5,600 rupees (£70) she received for donating, she did it twice more. "I wanted to send my children to a good school. They will have a better future. This was only possible because of me - a woman. After all, men can't produce eggs," she says.
She doesn't know who bought her eggs. "I don't feel exploited; here, in the villages, every aspect of life is exploitative - where you can work, what you can eat, when you have sex. This is the best option available to me," Pushpa says.
Not all Indian egg donors come as cheap as Pushpa. At the top of the country's social ladder are urban college students, who sell their eggs to bankroll their penchant for new clothes and gadgets. Sipping a cappuccino on the terrace of a cafe in a bustling Mumbai business district, one 20-year-old physics student - who agrees to speak anonymously - explains why she sold her eggs to one of the city's infertility clinics for 20,000 rupees (£250).
Some of her friends had sold their eggs and so she began searching clinics' websites. "If I can earn more money than getting a part-time job, then why not?" she says. "I needed to buy a new mobile and wanted to go abroad on vacation with my friends. I have always had what I wanted in life. But for my own enjoyment, I can't ask my parents for money all the time."
Although she is dressed in jeans, a T-shirt and designer shades, like any other affluent student in India's financial capital, she is acutely aware of the stigma surrounding donation in India. "My parents must never find out. They wouldn't understand why I did it," she says. "They'll think I'll never be able to be a mother myself. It's in the best interests of the family to keep it a secret."
Time is up. She waves down a taxi and hops inside. "I couldn't afford this ride earlier and now I can," she says as the car pulls away. "What's wrong with that?"
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