Saturday, May 30, 2009

Mumbai for a Jiffy - Literally 72 hours, but who's counting?

Well, after more than 11,000 miles, I am finally in Mumbai. I cannot believe this journey started only 2 1/2 months ago and here I am in this far-away place - filled with much anticipation, but really just feeling blessed to be taking this amazing ride - whatever the outcome.

I have learned so much from the Americans and other non-Indian couples who have journeyed down this path before me - through their blogs and emails, I found the reassurance and confidence to do this and Steve easily jumped on board. I will back track and write about the steps thus far, but first want to share my initial reflection on Mumbai.

I traveled for the better part of 24 hours to get here - 5 hours LAX to ATL and then 17.5 hours from ATL to BOM. Yes, I cashed in some of those Delta Skymiles and sat up front - I have flown close to two million miles over the years and can honestly say it was the best long-haul first class experience I've had - better than the Asian carriers. I flew on the Delta 777 configured Business Elite cabin with lie flat seats (not the old version seats on the 767, these are very different and much better). The layout is a little crazy like something out of a sci fi flick, but the service, the food and the comfort factor were all A+. The seat itself was not particularly comfortable in the lie flat position, but there were so many adjustments on the seat that all you had to do was play with it to get it into your own personal 'sleep # setting'.
Two movies, 1/2 a Chelsea Handler book, 7 hours sleep and many trips to the lavatory later and I arrived in Mumbai - albeit 2 hours late - just before midnight on Saturday, May 30. Yes we were an hour late leaving Atlanta and another hour in a holding pattern over the Arabian Sea so the flight was 2 hours longer than planned - scheduled flight time 15.5 hours - actual 17.5 hours.

The customs arrivals process was simple and pretty quick - the airport was humid and musty, but surprisingly modern and clean. The first stop was a somewhat chaotic counter with no lines, huge floor fans moving around hot air (and all sorts of interesting odors) and six or seven plain clothed Indian personnel wearing medical masks. This first stop was to have our 'Swine Flu Declaration' stamped. This was ridiculous. First of all, these 'Swine Flu' forms were the reason for a late departure in Atlanta. Someone at the gate had forgotten about the Indian government requirement (apparently) and we had to wait for them to be printed off a laser printer at the gate...300 of them approximately. The flight was full - not one empty seat. So, after being pushed and shoved into a position at the counter, a woman looks at my form, glances at me, says nothing and stamps it. What did the form declare? I checked boxes saying I had no fever and did not believe I had been around anyone with flu symptons. Huh? Yes, a highly effective deterrent to boarding someone with flu exposure. Not.

Once past this station, there was fairly quick movement through to customs/passport control - there must have been 50 or so agents and I was through there in 5 minutes - tops.

Then onto customs declaration which was the point past baggage claim. There was one small baggage screening section and a line that was 10 people wide narrowing to this one little machine with two workers. I stood there for 10 minutes without moving and then decided to walk around the other side of the screening area to an agent who looked at me and let me walk right through...past 100 or more people. I have no idea. Then a long corridor past aggressive currency exchange agents all trying to pull your attention so they can trade your currency at an inflated rate. Keep walking. Finally, you exit the airport and there are literally thousands of people behind ropes holding signs for car pick up. Saturday night I am told is particularly busy. Luckily, my guy was right up front holding my name on a card front and center. I exhaled for the first time in 20 minutes. It took only about 5 minutes for his co-worker to bring around the car and only another 20 minute ride to arrive at the JW Marriott on Juhu Beach. My concierge is Parashar with He was referred by Mike A and Mike B in Boston who used him and he is the kindest, most patient man - and immediately put me at ease. The cost for his services is approximately $30 per day + approximately $30 per day for transportation (unlimited from 10am - 6pm) - well worth it. You don't want to do this alone! Today there are no charges as I am on my own.

I wasn't really too sure what to expect upon arriving here. I had heard so much about the mounds of people and chaos, but, to be honest, I find it no less stressful than any other large, developing city. Parts of Athens looked like much of Mumbai prior to be awarded the Olympics as I recall and the traffic and sanitation are not unlike parts of Bangkok. Yes, the driving is mayhem and there are no lanes and rickshaws EVERYWHERE coming at you from all sides - it is amazing more people aren't hit, but nothing terribly out of the ordinary.

Now, Parashar and I agreed that I would hang out at the hotel today, Sunday - maybe get some sun at the pool, get some work done, rest. He is to pick me up tomorrow, Monday, June 1 and drive me to Rotunda (the Center for Human Reproduction) for the Egg Pick Up and IVF. My appointment to provide my semen sample is at 10am - the exact time of the scheduled Egg Donor's 'Egg Pick Up'. I bid good bye to Parashar and he agreed to pick me up on Monday morning at 9am for the 30 minute ride to Rotunda from the hotel. He plans to take me sightseeing in the afternoon and says he will provide a local cell phone so I do not incur roaming charges on my US mobile phone.

One last word on the hotel: security is tight, which is good, but at first alarming. When you pull into the gates, there are many security personnel along with bomb sniffing dogs. The hood is raised along with the trunk and mirrors hanging from sticks are run under the car as part of the inspection. At the entrance to the hotel there is a metal detector and baggage screening belt - not unlike any federal building in the US, but certainly not something you generally see at a hotel. This hotel, I am told, was targeted for the November 2008 attacks, but were foiled in their attempts at this particular property - so, security is high.
The service industry here is unlike anything in the West - they walk you to the room and expect no tip - there is little expectation of being compensated for common courtesy and general assistance - they see it as their job. Unlike the US where we place tip jars at the counters in Starbucks! It is refreshing and it makes you want to offer cash gratuity.

I am a long time Marriott Frequent Guest so I was given access to the Executive Lounge. Unlike many of the US properties, the lounge is open 7 days a week and there are not just snacks but full buffet spreads at various times throughout the day. Breakfast was amazing and I had two different people serving me at any given time. All is complimentary.

View From the Hotel Lobby Looking Out Toward the Arabian Sea

View Out the Front of the Hotel Toward Street Entrance (Security Checkpoint)

After breakfast I decided to take a walk. Parashar had advised against strolling on the beach today as he said it was 'Sunday which is a holiday for locals and the beach is not safe for tourists'. This sounded a bit paranoid to me and of course I was curious so I headed out for a little exploration. Attached are some pictures of what I found...a little scary. Note the live cow. I did get accosted by some young Indian boys who began to throw rocks and laugh - I couldn't understand a word they were saying, but I don't think it was good and I heard some variation of 'American', so I headed back to the hotel.

Google: 'Gay Surrogate India'. What you will find are various links to a laundry list of news articles and You Tube videos with one recurring story about an Israeli same sex, male couple who had a baby through surrogacy in India. This is how it all started for us. The clinic the couple used - Rotunda, The Center for Human Reproduction in Mumbai, India.

Simply put, we couldn't afford the $100,000+ USD it requires to go through the Egg Donor/IVF/Surrogacy process in California. Yes, California is one of the premier locations for such services in the world and there are a host of facilities that cater to same sex couples, but at prices that only a select few can actually afford. So, I went on an informal 'google' search for options in other countries. I figured if you could adopt internationally then perhaps you could do other things internationally too. Low and behold, the unfolding world of Medical Tourism in India and the evolving reproductive therapy business in India. I had no idea what I was about to learn.

The reality for gay men seeking to build a family is as follows:
  1. Adoption in the US is filled with uncertainty - the birth mother can change her mind even though she has assured you otherwise. We had a straight couple - close friends of ours - enter an open adoption in California recently. The baby was born and handed over to our friends - the following day the birth mother called and asked for the baby back. Heartbreak. The length of the 'window' for birth mothers to reassert parental rights is different by state. Bottom line - too risky for us.
  2. Adoption outside the US is not allowable for single men (much less coupled men) - single women yes, single men no. Sure there are ways around it if you know the right people, but there are no guarantees and the costs are not insignificant - the costs are in fact very significant.
  3. Surrogacy in the US - as I mentioned - expensive. The contracts are also risky and there have been instances of surrogates asserting parental rights. We have also had friends who experienced nightmares with unsophisticated surrogates who ate poorly, smoked, drank or worse. You limit some of this risk by selecting a well established agency, but you pay dearly - thousands upon thousands in agency fees.
  4. Surrogacy in India - legal, gay friendly, affordable, less risky. Lots of people have written about this before me, but here are the key points. There is legislation set to go before the Indian Parliament to provide more specific legal support for the process - it is somewhat unregulated at present - there are guidelines in place but no real oversight to ensure compliance. There are three main clinics in Mumbai - yes, there are countless others, but the three main ones are Rotunda, Surrogacy India and Dr Patel (in Anand). The two former are open and willing to working with gay couples - the latter is not. The estimated costs for egg donor + surrogacy (excluding travel expenses and unforseen medical complications) is approximately $28,000 USD. These costs are ever changing and have gone up significantly in the past few years. You can read more about Rotunda on their web page There has been no recorded incidence of an Indian surrogate asserting parental rights over the child she has carried and birthed - not one. There are a host of reasons not the least of which is cultural acceptance.
We only contacted Rotunda - we started there and ultimately signed on with them.

The Process:
  1. Wait for forms to arrive via email. Visit a local notary public and have them signed - send via UPS or similar carrier so you have tracking. It takes things about 4 or so days to arrive and costs around $50 for the air courier fees.
  2. Deposit Rs 60,000 via wire transfer to register in the program. Note on this: because all rates for Rotunda are quoted in Rupees, I did the first wire transfer in Rupees. I got killed on the exchange rate with Bank of America, my bank. The rate was roughly 7% more than anywhere else I looked on line. On subsequent wire transfers, I sent the amount in USD and the clinic's bank in India did the exchange which saved me big time on the currency swap.
  3. The doctors at Rotunda will ask you to send them six separate lab reports. Visit your local physician and request the following blood screening: (1) HIV antibody test, (2) Hepatitis B antibody test, (3) Hepatitis C antibody test, (4) Blood Typing and RH. You will also be asked for a (5) Semen Culture as part of this lab work. Now, my primary care doctor at Cedars had no clue what this was, but he requested it. When I got to the lab for the blood to be drawn, they were equally as confused. After several phone calls, it was determined that all I need to do is provide a semen sample and off I went to the men's room with a specimen cup and my laptop. The confusion on this point was that a semen culture does not require immediate testing of the sample - meaning that you can provide the semen sample and they can culture it later - they are checking for STD's and bacteria. You will also be asked to have a (6) Semen Analysis - this one MUST be fresh - they must test it within 30 minutes or so. I went to a local, male fertility clinic for #6 and paid $150 for this report which covers a whole bunch of details as it relates to your swimmers. They look at # of sperm per milliliter, volume in the ejaculate, motility (what % are moving), morphology (what % are normally shaped) and a handful of other things. Anyway, given that the process is done via IVF (in a lab dish) you only have to be slightly fertile to make it work. So, the fact that I had a low sperm count became irrelevant - they are just checking to make sure you are not completely infertile. If you have even one sperm - they have a process by which they inject it directly into the egg to feritilize it - pretty amazing. For those who are wondering - normal count is anything over 20 million per milliliter - YES - 20,000,000!! I had 18 million. What causes low sperm count? Drinking, smoking and everything else I did in my 20's and 30's. Ugh.
  4. Scan reports into email and forward to Rotunda.
  5. Deposit Rs 200,000 for Egg Donor Fees and IVF + Rs 45,000 if you wish to have any supernumerary embryos (those that aren't implanted in the first cycle) frozen for future use + Rs 150,000 for Surrogate Preparation. This is it for fees until you determine if you are pregnant. For reference - $1 USD = approximately Rs 49.00.
  6. Wait.
  7. Wait.
  8. Wait.
  9. I had a couple of panic attacks from not hearing back from Rotunda. The longest gap was 3 weeks. I was reassured by several of their clients - whom I met on line - that this happens and that the clinic is very busy and somewhat short staffed. I can tell you that it was approximately one month from first contact until they emailed us 5 egg donor profiles to select from.
  10. Pick your egg donor. You will get a handfull of PDF files emailed to you by the clinic. You have a small headshot, age, weight, height, Caste (Muslim, Hindu) and basic medical and fertility history (previous pregnancies including any abortions) and education/occupation. Our first donor selection ended up being unavailable because she ended up pregnant by her husband - not meant to be. So, we asked for additional profiles (we didn't prefer any others from the first lot). They were emailed over and we re-selected. They are all named with initials as the entire process is anonymous and we will never meet either the egg donor or the surrogate. The surrogate was selected for us - with no input from us - but they did send us her profile so we could see all the same information as was on the egg donnor profiles.
  11. Wait for the egg donor to begin her medications/stimulation - which begins upon commencement of her menstrual cycle.
  12. Wait for date from Rotunda to fly to India - generally a 3 day window.
  13. Fly to Mumbai.
  14. Pray, be open minded and know that everything happens for a reason and whatever the outcome will be, will be.
  15. To Be Continued...

1 comment:

Rhonda and Gerry W said...

Awesome post guys! Great for those starting out and wanting to know the process.

Go whoop those little boys butts for rock throwing! Very odd.

India is wonderful...enjoy every minute and take it all in!

Very best of luck to you both, we will be following along.