TIMECODE

DIALOGUE

00:00

(101 EAST)

00:08

STEVE CHAO: They may be in their 70s, but these couples are not “grandparents”. In India, the pressure to have children is so great that elderly childless women are turning to the country’s booming in vitro fertilization industry to help them conceive. And doctors are happy to help.

00:31

I’m Steve Chao. On this episode of 101 East we explore the ethics of giving birth at any age and ask is this IVF industry out of control?

00:44

SUPER

INDIA’S MIRACLE BABIES

A FILM BY MARY ANN JOLLEY

00:48

MARY ANN JOLLEY: So sweet. How old is he?

MOHINDER SINGH GILL: Two months

00:53

MARY ANN JOLLEY: Daljinder Kaur and her husband, Mohinder Singh Gill, are the proud parents of a baby boy.

1:01

MARY ANN JOLLEY: Who do you think he looks most like?

DALJINDER KAUR: Pappa.

MARY ANN JOLLEY: Pappa.

1:09

MARY ANN JOLLEY: After 46 years of marriage, the 72 and 79 year old finally have the child they’ve always wanted.

1:21

SUPER

DALJINDER KAUR

ARMAAN’S MOTHER

1:21

ACTOR’S VOICE

DALJINDER KAUR: A lot of people used to tell me, adopt a child, but I never felt the urge to adopt or have someone else’s baby.

1:30

MARY ANN JOLLEY: They’ve named him, Armaan, meaning, hope, and in their eyes, their little son is nothing short of a miracle from God.

1:40

ACTOR’S VOICE

DALJINDER KAUR: The Almighty only has made this possible for us, it is his gift and we haven't done anything. It is his wish and he granted him to us, otherwise we wouldn't have got him.

1:55

MARY ANN JOLLEY: In reality though, baby Armaan is a product of India’s in vitro fertilisation industry – conceived with a donor egg, possibly donor sperm and born by caesarean in April this year.

His mother is reportedly to be the oldest woman in the world to give birth.

2:17

ACTOR’S VOICE

DALJINDER KAUR: I want everything for him, that he should become a big man and bring me fame. He has already brought me fame.

2:26

MARY ANN JOLLEY: But with fame has come condemnation and calls to put an age limit on IVF treatment.

2:32

DR NARENDRA MALHOTRA: 72 is not the right age to have a baby.

2:35

SUPER

DR NARENDRA MALHOTRA

INDIAN SOCIETY OF ASSISTED REPRODUCTION

2:35

DR NARENDRA MALHOTRA: It was shocking in the way that, yes, science can do it, science can do a lot of things, but it is for the society to decide whether we are going to let scientists do which are things which are not in favour of the society or which are unethical or are which put the patient and the child to great harm and that is what has happened here.

2:58

MARY ANN JOLLEY: And it’s the Indian government who many hold responsible for allowing lives to be put at risk.

3:06

SUPER:

MARY ANN JOLLEY
NEW DELHI, INDIA

3:06

IMARY ANN JOLLEY: t’s almost 40 years since the first IVF baby was born in India and since then there’s been an explosion in the number of IVF clinics. Yet, there’s still no laws governing the industry. Legislation has been pending in parliament for the past six years, leading many to suggest that the industry has become too big and too powerful to regulate.

3:32

MARY ANN JOLLEY: The northern Indian town of Hisar isn’t a place you’d expect to find cutting edge medical technology, but this backstreet is home to the National Fertility and Test Tube Baby Centre where Armaan was created. The mastermind behind the clinic’s success is Dr Anurag Bishnoi.

3:52

DR ANURAG BISHNOI: Hello

MARY ANN JOLLEY: Dr Bishnoi?

DR ANURAG BISHOI: Welcome.

MARY ANN JOLLEY: Mary Ann Jolley, nice to meet you.

DR ANURAG BISHNOI: Have a seat, please.

MARY ANN JOLLEY: You’re very famous in this part of the world.

DR ANURAG BISHNOI: So nice of you that you have come to this clinic from so far off.

4:06

MARY ANN JOLLEY: The embryologist claims to have treated thousands of post-menopausal women over the age of 50 and says more than 100 of them have become pregnant.

14:16

SUBTITLES

Taking older patients was a necessity and is still a necessity because when they were middle-aged say 40,45, the technology was not there… so they’re coming at it now after hearing about it from so many people that an older woman can become pregnant.

14:16

DR ANURAG BISHNOI: Taking older patients was a necessity and is still a necessity because when they were middle-aged say 40, 45, the technology was not there. So they’re coming at it now, now, after hearing about it from so many people, that an older woman can become pregnant.

4:37

SUBTITLES

This I the uterus where the baby stays for nine months…

4:37

DR ANURAG BISHNOI: This is the uterus where the baby stays for nine months.

4:41

MARY ANN JOLLEY: Dr Bishnoi insists his older patients have to pass rigorous health checks before beginning IVF treatment.

4:48

SUBTITLES

We don’t see much of a risk as far as middle-aged and older ones are concerned. We don’t see that.

4:48

DR ANURAG BISHNOI: We don’t see much of a risk as far as the middle aged and the older ones are concerned, we don’t see that.

4:57

MARY ANN JOLLEY: But not everyone agrees the risks are low.

5:01

DR NARENDRA MALHOTRA: Getting a 72 year old pregnant is putting her life in jeopardy.

5:05

MARY ANN JOLLEY: Dr Malhotra is President of India’s Society for Assisted Reproduction and runs his own high tech IVF clinic.

5:15

DR NARENDRA MALHOTRA: I talked to him on the telephone, we met him personally once and we told him this is not right. He says, they’re coming, they’re demanding so I’m giving. So that doesn’t mean if someone demands I’ll call you, give him, I’ll call, someone demands drugs, you’ll give them drugs or someone is doing suicide, you won’t stop him.

He feels he’s a God or the King Maker or the only child maker in the world.

5:43

MARY ANN JOLLEY: For a family in this village that’s precisely what he is. Baby Armaan isn’t the first child Dr Bishnoi delivered to a couple in their 70s. Rajo Devi Lohan previously held the world record for the oldest first time mother. She was 70 when she had her daughter, Naveen, in 2008.

6:09

MARY ANN JOLLEY: What was this occasion? When was that?

6:16

SUBTITLE FOR RAJO DEVI LOHAN

This was her birthday.

6:17

SUBTITLE FOR NAVEEN LOHAN

My Birthday.

6:18

MARY ANN JOLLEY: Your birthday? Your first birthday?

6:24

MARY ANN JOLLEY: In this family portrait, taken when Naveen was just one, she’s surrounded by her many older nephews.

6:32

NAVEEN LOHAN: … Naveen!

MARY ANN JOLLEY: And so you’re the aunty to all of those boys? You’re a very lucky aunty aren’t you? That’s amazing.

6:53

MARY ANN JOLLEY: And that’s not the only complicated relationship in the family. Rajo Devi married Bala Ram when she was twelve and he was fourteen. Fifteen years later they had no children so her husband took a second wife, her younger sister, OmnI. But, still no children came.

7:17

SUPER:

RAJO DEVI LOHAN

NAVEEN’S MOTHER

7:17

ACTOR’S VOICE

RAJO DEVI LOHAN: When people used to tease us, I’d get angry with them. Those who were on our side would say, it’s God’s wish, this is your fate and nothing can be done about it. We would just close our gate and lie low or sleep. If we had work to do, we’d do it.

7:36

MARY ANN JOLLEY: Decades later the family was still childless, but then they heard from a neighbour about Dr Bishnoi.

7:46

ACTOR’S VOICE

RAJO DEVI LOHAN: All three of us went to the doctor. He checked us and said your younger sister has high blood pressure, so I will give you treatment.

7:59

ACTOR’S VOICE

OMNI DEVI: I told her you try for a child, produce a child. It’s the same thing whether it’s your child or mine, she’ll come to our family ultimately.

8:10

ACTOR’S VOICE

OMNI DEVI: It’s important to have a baby, be it a boy or a girl, to take the family’s name forward.

8:17

MARY ANN JOLLEY: So Naveen, who’s now 8, was born.

8:25

ACTOR’S VOICE

BALA RAM: When she was born she was only1 kg now she has grown so tall. I love her a lot, I find her very sweet.

8:40

ACTOR’S VOICE

RAJO DEVI LOHAN: She’s sweet. I still find her good looking. She is very dear to me. She loves me a lot, she is the only one for us. Whatever is there, it’s just for her. Everything is for her.

8:58

MARY ANN JOLLEY: But the IVF treatment and pregnancy seems to have taken its toll on Rajo Devi’s body. Today her family doctor is giving her intravenous medication to ease stomach pain.

9:13

SUPER:

DR PRAVEEN SHARMA

FAMILY DOCTOR

9:13

ACTOR’S VOICE

DR PRAVEEN SHARMA: Earlier she was healthy and strong, but after she had a baby, she turned weak, then after a year or two she got cancer.

9:24

ACTOR’S VOICE

RAJO DEVI LOHAN: The doctor didn’t tell me anything about the dangers and I never felt that there was any danger. I just thought I have to go for this. Whatever happens, I will face it.

9:40

MARY ANN JOLLEY: Since Naveen was born, Rajo Devi has had three operations to repair a ruptured uterus and remove cancerous tumours, as well as, many rounds of chemotherapy.

9:54

ACTOR’S VOICE

DR PRAVEEN SHARMA: I feel the treatment she underwent at this age, may have caused all these problem because having baby at this age means there is some fiddling with the hormones.

10:04

DR NARENDRA MALHOTRA: See for the womb to grow back and the patient to start menstruating and the lining to form, you have to give her very high doses of oestrogen. If you give high doses of oestrogen to older women then they’re more likely to have cancer. So that could have been easily happen. I also cannot say for sure that that is the reason, but that’s one of the reasons, yes.

10:25

MARY ANN JOLLEY: But Dr Bishnoi insists his treatment’s not to blame and claims Rajo Devi’s now cancer free.

10:33

SUBTITLES FOR DR ANURAG BISHNOI

Presently, she has no problem. She is fine, she’s out of the problem.

10:33

DR ANURAG BISHNOI: Presently, she has no problem. She is fine, she’s out of the problem.

10:46

MARY ANN JOLLEY: In another village three hours drive away, fertile farming land may have brought a level of prosperity, but nothing like the richness Dr Bishnoi’s brought to the lives of another aging couple. Their six year-old twins, a boy and a girl, are having fun and the elderly parents couldn’t be more overjoyed.

11:13

ACTOR’S VOICE

DEVA SINGH: Earlier people used to tease me.

11:15

SUPER:

DEVA SINGH

FATHER OF TWINS

11:15

ACTOR’S VOICE

DEVA SINGH: What will you do, where will you take all your wealth. I did go for a second marriage, but that didn’t help. With the grace of the almighty, now things are great. Children mean the world to us, we are very happy, it’s a good thing.

11:33

ACTOR’S VOICE

BHATERI DEVI: My house has changed, there was darkness earlier but now it's a happy environment.

11:38

SUPER:

BHATERI DEVI

MOTHER OF TWINS

11:39

ACTOR’S VOICE

BHATERI DEVI: Now I spend the whole day with children and I am very happy.

11:46

MARY ANN JOLLEY: Bhateri Devi is another of Dr Bishnoi’s famous mothers. In 2010, at the age of 66 she became the oldest woman in the world to deliver triplets. The babies were in intensive care for months.

12:05

ACTOR’S VOICE

BHATERI DEVI: When I saw them I was overjoyed. I looked at their limbs and their faces to see if they were alright. They were very thin.

12:15

MARY ANN JOLLEY: One of them, a little girl, didn’t make it. And Bhateri Devi almost lost her own life.

12:24

ACTOR’S VOICE

DEVA SINGH: Once she delivered the babies, she was hospitalised, she was in a very bad condition, she was almost on her death bed, she spoke only after 10 to 12 days.

12:39

MARY ANN JOLLEY: She had a condition that caused her to haemorrhage during childbirth, but according to Dr Bishnoi, it was of little concern.

12:48

SUBTITLE FOR DR ANURAG BISHNOI

Now that can occur in a younger female also, that is not related to  old age. It was not cardiac failure, it was not renal failure.

12:48

DR ANURAG BISHNOI: Now that can occur in a younger female also, that is not relative to the old age. It was not cardiac failure, it was not renal failure.

12:57

SUPER:

DR NARENDRA MALHOTRA

INDIAN SOCIETY OF ASSISTED REPRODUCTION

12:57

DR NARNEDRA MALHOTRA: If it happens in someone who is over 55, then it is very dangerous, it is very very dangerous and you know it is going to happen. Triplets would carry triple the risk. If he had detected triplets at first, second month he should have gone ahead and reduced them to single one so to reduce the risk.

13:17

MARY ANN JOLLEY: But Bharteri Devi says she refused to let that happen.

13:24

ACTOR’S VOICE

BHATERI DEVI: Even the doctor said that there was a risk to the children, three of them, but I told him I want all three. It was very important for me to have a child of my own to have a full family even if it was at the cost of my life.

13:46

MARY ANN JOLLEY: Back at Dr Bishnoi’s IVF clinic, the waiting room is packed. But not all his patients leave with good news.

This older couple lost two sons, one as a child and the other at 21, just two years ago.

14:04

ACTOR’S VOICE

RANBIR SINGH: Everyone wants a child so that generations go on. Sadness will prevail until we are blessed with a child.

14:14

MARY ANN JOLLEY: Today they’re devastated to hear the IVF cycle has failed.

14:19

ACTOR’S VOICE

RANBIR SINGH: The doctor said that whatever treatment we gave you didn’t succeed, so try once again, take a second chance.

14:28

ACTOR’S VOICE

ANITA SINGH: I am ready, but don’t have the money.

14:31

ACTOR’S VOICE

RANBIR SINGH: I sold a plot of land to pay for the treatment. We will take one more chance and will take out a bank loan for the sake of having a child.

14:41

SUBTITLES FOR DR ANURAG BISHNOI

We have a lot of stress on our shoulders that we should get results in a positive manner and our credibility should continue. So let the faith continue and we’ll try to fulfil their dreams.

14:41

DR ANURAG BISHNOI: We have a lot of stress on our shoulders that we should get results in a positive manner and our credibility should continue. So let the faith continue and we’ll try to fulfil their dreams.

15:02

MARY ANN JOLLEY: To fulfil the baby dreams of aging parents – an egg from a fertile donor is essential. This 20 year-old woman is recovering after having her eggs harvested. Her husband and son are at her bedside. This is the first time she’s donated eggs.

15:24

ACTOR’S VOICE

ZEENAT PRAVEEN: I was told that all this is not complicated but I’m having pain here since yesterday. I didn’t realise that I will also suffer pain.

15:35

MARY ANN JOLLEY: Out in the cafeteria, an agent has brought three potential donors from Delhi. He’s clearly in demand. His phone never stops ringing.

15:46

ACTOR’S VOICE

SUBHAS CHANDRA: There are so many IVF centres running in or outside Delhi. Wherever they are, they have demand for egg donors. Without donors, IVF centres just can’t operate.

15:58

MARY ANN JOLLEY: He says he has six other agents working for him, some of them, former egg donors, who recruit up to 15 new donors a day.

16:09

ACTOR’S VOICE

SUBHAS CHANDRA: There are no complications in this procedure at all, so my agent tells other ladies that we pay a handsome amount for egg donations. If someone works in a factory they earn less more than 75 dollars a month, but here we can pay 525 dollars for the ten day process.

16:27

MARY ANN JOLLEY: But with no legal regulation of the IVF industry,  egg donors may end up paying with their lives. At least two are known to have died in recent years.

16:40

MARY ANN JOLLEY: In 2010 Sushma Pandey died in Mumbai. She was only 17. Despite IVF guidelines that egg donors should be at least 18, no action has been taken against the clinic.

16:57

MARY ANN JOLLEY: Then in 2014, 24 year-old Yuma Sherpa died in Delhi. She and her husband had left their young daughter with family at home in West Bengal - and came to the Indian capital to earn money. Yuma was working at this garment shop when she was recruited as an egg donor.

17:19

SAPTNA MIHRA: She was the main earner in the family. She did all this just for 30,000 rupees to raise money to travel home on a trip.

17:27

ESTHER LAL THANG: She was a nice friendly, very bubbly person.

17:30

MARY ANN JOLLEY: She shared not only her hopes – but also her fears with her work colleague.

17:36

ESTHER LAL THANG: We started checking on the internet what are the side effects, you know, what it can possibly spoil in a woman. So when we started reading, she started getting really scared. So she finally said, I’ll stop doing it. So she went to the doctor and I think the doctor told her that she cannot back out in the middle because it’s already in the process.

18:01

SUPER

RE-ENACTMENT

18:02

MARY ANN JOLLEY: So in January 2014, Yuma left work early and went to the IVF clinic to have her eggs extracted. Around 6.30 that night she called her husband, very distressed. He rushed to her bedside. He says, by the time he arrived, she was unconscious and there were no doctors present.

18:24

SUBTITLE

SANJAY RANA: When I tried to wake her up I realised something was wrong. I started screaming and asked for the doctor. They called the doctor and the doctor came half an hour later.

18:40

SUPER

SANJAY RANA

HUSBAND

18:40

SUBTITLES FOR SANJAY RANA: I felt, I check her hand and check her nose also.

18:40

SANJAY RANA: I felt, I check her hand and check her nose also, there was nothing actually. I felt she died at that time only.

18:47

SUBTITLES FOR SANJAY RANA: There was nothing actually. I felt she died at that time only.

18:47

SANJAY RANA: There was nothing actually. I felt she died that time only.

18:52

MARY ANN JOLLEY: It was another three and a half hours before she was taken to a hospital where she was pronounced dead.

18:59

VIKRAM PRADEEP: They should have got her there as soon as possible.

19:02

SUPER:
VIKRAM PRADEEP
LAWYER

19:03

VIKRAM PRADEEP: You’re running such an institute, you’re supposed to be prepared for an emergency and the fact is, it’s a known fact that procedures like this involve an element of risk and fatality so when there is such a known risk, why would you not be prepared for it. That would amount to negligence on their part I’d say.

19:19

MARY ANN JOLLEY: Lawyer, Vikram Pradeep, is acting for Yuma Sherpa’s husband. He’s taken on the case pro bono after being contacted by the garment shop where Yuma worked.

19:30

VIKRAM PRADEEP: Our entire case talks about the likeliness of an overdoses taking place, yes.

MARY ANN JOLLEY: Overdose of hormones?

VIKRAM PRADEEP: Of the hormones which are injected into the woman. And in the end they just made the conclusion.

19:41

MARY ANN JOLLEY: The autopsy showed Yuma Sherpa suffered Ovarian Hyper Stimulation syndrome. This can occur when high doses of hormones are used to produce higher numbers of eggs and is potentially fatal.

19:55

VIKRAM PRADEEP: In an average woman if they’re supposed to undergo the procedure as per guideline, maybe 12 to 18 eggs depending on the woman’s BMI, is what is supposed to harvested, but right now there is no law on it, there is no one regulating them, there’s no one supervising it, so what usually these clinics do they harvest about 50 eggs. So that ends up putting the woman’s life in danger.

20:14

MARY ANN JOLLEY: Is that your daughter?

SANJAY RANA: Yes

20:16

MARY ANN JOLLEY: The clinic director and doctor refused to talk to us. For them it’s business as usual, but for Yuma Sherpa’s husband the tragedy plays out every day.

20:27

SUBTITLES

SANJAY RANA: It’s too difficult actually to explain to a two-years-old child that your mother was no more, no more, that she must never come to you again. My wife, whatever happened to her, I know that… I don’t want it happening to any others again.

20:27

SANJAY RANA: It’s too difficult actually to explain a two-year-old child that your mother was not more, no more, that she must never come to you again. My wife, whatever is happening to her, I know that I don’t want it happening to any others again.

20:58

MARY ANN JOLLEY: Dr Bishnoi’s laboratory is where conception begins for his elderly patients. It’s here, donor eggs are fertilised and embryos are created. But the genetic makeup of the embryos is not discussed.

21:13

SUBTITLES

DR ANURAG BISHNOI: We never tell them the details that we’re taking, not taking his sperm, we’re not taking her eggs. Let these things have a curtain on them. When these curtains are raised they have a bad social impact on both the parents as well as the child. Let these curtains remain there.

21:13

DR ANURAG BISHNOI: We never tell them the details that we’re taking, not taking his sperm, we’re not taking her eggs. Let these things have a curtain on them. When these curtains are raised they have a bad social impact on both the parents as well as the child. Let these curtains remain there.

21:33

MARY ANN JOLLEY: And that seems to be precisely how Rajo Devi and her husband have come to terms with Naveen’s DNA.

21:44

SUPER

RAJO DEVI LOHAN

NAVEEN’S MOTHER

21:44

ACTOR’S VOICE

RAJO DEVI LOHAN: What do people know about where the egg comes from? No one can say whose it is. Everyone knows that she is my child.

21:54

ACTOR’S VOICE

BABA RAM: Whatever it is, it’s all written by God.

21:59

MARY ANN JOLLEY: God is a constant comfort for these elderly parents. With life expectancy in India at 67 for men and 71 for women, they’re already living on borrowed time.

22:14

ACTOR’S VOICE

RAJO DEVI LOHAN: My nephew assures me that he will be around to look after her, Naveen is also very sharp, if someone challenges her, she turns back and gives them back, that this is my house. When she is so independent, she will manage herself, we don’t fear, she is sensible, and rest assured God is there to look after her.

22:41

MARY ANN JOLLEY: Deva Singh also hopes God will provide. His health is failing and he struggles to keep up with his six year old twins. He says it’s something that worries the little ones.

22:55

ACTOR’S VOICE

DEVA SINGH: They say to us that you have grown old, who will look after us, I tell them, all will be taken care by the Almighty.

23:04

MARY ANN JOLLEY: He clearly loves his children, but he now thinks that no one over 55 should have IVF.

23:15

ACTOR’S VOICE

DEVA SINGH: 70% of the children borne by aged women suffer a lot, even if there are a lot of resources at home, parents die, then who takes care of them?

23:32

MARY ANN JOLLEY: Despite nearly dying in childbirth, his wife doesn’t agree.

23:39

ACTOR’S VOICE

BHATERI DEVI: There is no guarantee of life. Someone can die at 30 years of age, 50, 80 years or even older. What's the harm, what do children have to do with age? Children will be nurtured. What’s the problem? There will be uncles and aunties in the family who can nurture the family. The family will keep running, it won’t stop.

24:07

MARY ANN JOLLEY: At only two months old little Armaan has a long way to go before he’s out of nappies, let alone able to fend for himself.

24:18

ACTOR’S VOICE

DALJINDER KAUR: He doesn't gain weight. I keep wishing he grows plump.

24:21

SUPER

DALJINDER KAUR

ARMAAN’S MOTHER

24:21

ACTOR’S VOICE

DALJINDER KAUR: His arms become thick so that we can get a good grip.

24:25

MARY ANN JOLLEY: Looking after a newborn is exhausting at any age, but clearly for 72 year-old, Daljinder Kaur, it’s overwhelming.

24:39

ACTOR’S VOICE

DALJINDER KAUR: I have been feeling very weak, I had a really tough time. At times he keeps on crying and doesn't get pacified then I get very nervous. I am nurturing him alone, people have someone to help, Grandmothers and all, I do everything on my own.

25:01

MARY ANN JOLLEY: With no close friends or extended family, who will look after Armaan when she and her husband are gone?

25:15

ACTOR’S VOICE

DALJINDER KAUR: Don't talk to me about this. I don't like this. I don't want to talk about it, I haven’t talked to anyone. God is his guardian, I cannot trust anyone.

25:28

MARY ANN JOLLEY: India’s IVF industry may have made history delivering miracle babies to these elderly couples, but the big question is at what cost to the mother, egg donor and, ultimately, to the child?

25:57

AL JAZEERA

26:00

END