1 March 2014

Tanzania: Surrogacy Gains Ground in Dar

TANZANIAN women with obstetric problems which have stopped them from having children can thank their lucky stars because using an In Vitro Fertilisation (IVF) procedure of surrogacy is now available in the country.

Fertility Specialist and Medical Director of Dar IVF and Fertility Clinic, Dr Edward Tamale Ssali exclusively told the 'Daily News on Saturday' that at least 20 procedures have successfully been conducted in the country and the demand is increasing.

"Surrogacy is now on the increase not only here in Tanzania but throughout the world. We have treated more than 100 cases in Uganda and 20 in Tanzania.

We do this for women with no uterus, for women with scarred uterus due to fibroids and those with chronic medical conditions like renal failure, heart disease and for recurrent miscarriages," he explained.

Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person.

This woman may be the child's genetic mother (called traditional surrogacy), or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship, transferred to her uterus (called gestational surrogacy).

According to the World Health Organisation, global estimates of infertility range between 8 and 12 per cent of couples with women of childbearing age, affecting between 50 and 80 million people.

Assisted reproductive technologies (ARTs) include in vitro fertilization (IVF) and embryo transfer (ET), intracytoplasmic sperm injection (ICSI), ovarian stimulation with exogenous gonadotropins, surgical laparoscopy, and surrogate motherhood.

Explaining about the costs involved, Dr Ssali said that for traditional surrogacy, a friend or a relative may agree to do this for free or for a fee which is agreed between the biological parents and that surrogate.

Relatives usually can do it free or demand certain benefits like a gift of land, cars etc. This arrangement, he said, the clinic has no participation in it apart from paper work and legal cover to ensure that the relative or friend does not claim that child and that in their experience, only 1 per cent of surrogates claim.

For unknown women, this person has no contacts with the biological parents at all. She does not even see the child after delivery.

The cost for this ranges from 10,000-25,000 US Dollars inclusive of her contracted fees (a lumpsum), her monthly maintenance, pregnancy care for nine months, her rented home (if applicable), maternity dresses, feeding and hospital fees depending upon the number of babies she carries.

"Immediately after the baby is born, it is taken to the 'real mother' for breastfeeding and the milk flows automatically.

This is a God given miracle. God made a link between the breast nipple and the brain," he said.

Dr Ssali explained that once the nipple gets irritated or sucked on, a message is sent to the brain centre, and a gland called Prolactin producing gland, starts secreting prolactin hormone which then stimulates the breast glands to produce milk.

You do not need to be pregnant for the milk to be produced, he said, adding that it is the initiation of this reflex arc between breast and brain which does this trick.

It is God given miracle which happens in all breast feeding animals including man. He said that for patients with recurrent miscarriages, they have many treatment options for them where surrogacy is the last resort.

"I have treated only one patient (non-Tanzanian) in my practice of 10 years who used a surrogate because she had lost so many babies before.

A total of seven patients who had lost more than four pregnancies, were treated with medications and later conceived," he lamented.

Fertility expert, Dr Sifat Baharoon said that surrogacy as well as IVF issues are new to Tanzanians and that as talking about issues pertaining to infertility to many African cultures was a near taboo, it is no different to this country.

Dr Baharoon said that in his experience, society plays a huge role and it is for this reason that many seekers of this procedure usually go for unknown persons to avoid future complications.

"As far as I know, surrogacy is new in Tanzania; we are still trying to educate the masses on these issues particularly about surrogacy and infertility," he said.

Highlighting on the complications, the specialist said that when the issue becomes public knowledge to the person who is carrying that child or children for you, there can be extra demands.

Also in the case of using someone you know, that child or children will be in close contact with the surrogate and their relationship could become difficult or strained.

Dr Baharoon said overall having a family is a confidential issue which involves the two main candidates namely the mother and father and that once one involves a third party whom you know or are close it will strain that relationship both ways.

The Ministry of Health and Social Welfare Chief Medical Officer, Dr Donan Mmbando was recently quoted to have said that infertility in the country was a big problem and that the government was aware of it.

"We appreciate the difference IVF can make. At the moment we have no plans of having a centre of our own but we appreciate the differences being made by our partners," he said.

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