Their blood wounds and ovarian eggs: just some of what Sumati convinces neighborhood women to exchange for cash. It's an open secret that she is the fertility agent in the shadows of Chai's vibrant cityscape. Countless women face the harsh reality of having few ways to make a

living, with loneliness circling her doorstep. Forty-year-old Suti has only known a life of poverty. Years ago, Suti donated her eggs and later worked as a surrogate before becoming a broker, connecting other women with fertility clinics and taking a

roughly 10% cut from the donor. Her role is crucial in shaping India's fertility market, a rapidly expanding part of a $35 billion global industry. But this trade is rarely an arrangement between two equals. Impoverished women with few job opportunities are donating their eggs to

survive, while clinics are making significant profits. As these women supply the product underpinning India's booming fertility industry, we ask: What is the true price of an egg? Sumati was born into what's considered to be the lowest-ranked caste

in India's social hierarchy. Now she recruits local women to serve as egg donors. With no running water, residents rely on communal taps – a fixture in this area that Sumati uses as a place to find her clients. She requested we only use her

first name for her safety. The egg donors we spoke to also asked that we keep their identities hidden for safety reasons.

Young girls and women are approached by hospital workers, cleaning ladies, relatives, and friends. Sourcing egg donors is a big challenge; there is not much awareness, and you cannot pay money legally. So how do you source egg donors? There are some intermediaries who help in

getting egg donors. You cannot see any upper-class, very rich people, or millionaires donating. Raw material is being supplied by the marginalized people. The Dalits are among the most marginalized groups within the Indian caste system, often deprived of quality education and jobs. But these women carry something

more valuable than anything among their family's modest possessions: their fertility. For Sumati, this is the way she can turn that possession into cash. She's a cog in a sprawling network of agents and go-betweens across the country, profiting from the sale of human

eggs. Every 15 seconds or so, human eggs are taken from a woman somewhere on the planet to satisfy the global demand for assisted reproduction. India is now home to the world's biggest population, and it's seeing a huge demand for IVF, or in-vitro

fertilization. As the number of IVF cycles continues to climb, more eggs than ever are needed to power the industry. Ten years back, the number of clinics was very low, whereas now the clinics are mushrooming; every street has

three or four clinics. Now the problem with the fertility industry is too much competition and too much greed. Indian women face cultural demands to have children, fueling the market. Couples are also getting married later and have higher disposable income, plus there's greater awareness about

Infertility treatments. Infertility is considered a social stigma in India. If Indian people have infertility, they are ready to spend a lot, as the demand for eggs only increases. India passed a law in 2021 to protect donors who put their

health at risk during the donation process. It established a National Registry of clinics and banks and outlined requirements like age and the maximum number of eggs that can be extracted. On paper, egg donation has to be altruistic in India, but practically speaking, 10 days of injections, undergoing

anesthesia to donate eggs—nobody wants to give them free of cost. So, what happens? These ART banks and these couples pay some consideration for the egg donor. As per the ART Act, the notification says that you cannot pay anything to the egg donor, but some amount can be paid for

example, travel and food expenses; all those things can be paid. So, clinics and ART banks are utilizing this particular loophole to pay the egg donor. Egg retrieval is not without pain or risk. First, egg donors are pumped with drugs for 10 days to trigger super

ovulation, which is when the female body releases more eggs than usual. This offers a better chance of a live birth and greater profit, but can sometimes pose health risks. There have been reports of rare cases where donors face complications after their ovaries were overstimulated,

and even death. Fertility doctors also say the new rules made it nearly impossible to source eggs legally, essentially driving egg donation underground and putting egg donors at even more risk. Many people in the industry are also not very clearly aware of the nuances of the act and

Then rules and so the industry is going unchecked. Even now, it takes time to regularize the industry; more and more exploitation will be happening. The government has restricted third-party reproduction: egg donors, sperm donors—everything. And they want it to be realistic: only one donor per couple, but...

considering that the majority of the population in India is below the poverty line and they cannot afford IVF treatment, if you're going to restrict so much, how will they become pregnant? So, treatment has to be equitable; treatment has to be affordable for everybody. I...

hope that the Supreme Court at some point changes the rule. Legally, egg donors are required to sign consent forms ahead of becoming an egg donor, in the event there are complications with the procedure. But the majority of these women are illiterate, uneducated; most of the time, they will not...

read; they will sign without reading it. Dr. Shanti confirms that, at times, this could be the case. Unfortunately, these people are not coming to the clinic after egg donation for their own follow-up; they will just come for their monetary need and then they will just go away...

with the money. Even if they are interested, even if they are aware that they need to come for a check-up, they cannot come because of their pressuring need to earn. It is inhuman to treat such donors...

[Music] Donors. Advocates warn that India's poorest women are at the mercy of an industry that preys on the most vulnerable. For Sumati and the other women in her village, the people who make the laws feel worlds away. [Music]

India’s Fertility Dilemma: Inside the Rush for Human Eggs

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Bloomberg Originals

인도의 숨겨진 불임 시장과 빈곤층 여성에 대한 착취.

불임 시술 업체인 수마티는 여성들의 경제적 취약성을 악용해 현금을 받고 난자를 기증하도록 유도합니다.

난자 기증자이자 대리모였던 수티는 현재 거래를 중개하며 착취의 조직적 특성을 강조하고 있습니다.

빈곤층 여성은 기회가 부족해 난자를 기증하는 반면, 클리닉은 상당한 이익을 얻게 되어 불평등한 교환이 이루어지고 있습니다.

수마티의 낮은 카스트 배경은 이 시장에서 소외된 커뮤니티를 타겟팅하는 것을 강조합니다.

수마티와 기부자들은 안전 문제로 인해 익명을 요청했으며, 이는 관련된 위험을 설명합니다.

난자 기증자 확보의 어려움과 중개자의 역할.

기부자에 대한 인식 부족과 지불에 대한 법적 제한으로 인해 합법적으로 기부자를 확보하는 데 어려움이 있습니다.

특히 달릿과 같은 소외 계층은 제한된 기회로 인해 난자 기증자의 주요 공급원이기도 합니다.

달걀 판매로 이익을 얻는 대규모 네트워크의 톱니바퀴 역할을 하는 수마티의 역할은 착취의 조직적 성격을 강조합니다.

인도의 급성장하는 IVF 시장과 이것이 난자 기증에 미치는 영향.

인도의 많은 인구와 시험관 아기 수요 증가로 인해 더 많은 난자가 필요합니다.

불임 클리닉의 급격한 증가는 경쟁의 심화와 착취 가능성으로 이어집니다.

문화적 압력, 결혼 지연, 가처분 소득 증가, 불임 치료에 대한 인식 증가가 시장을 촉진하고 있습니다.

인도의 불임에 대한 사회적 낙인은 난자에 대한 높은 수요에 기여합니다.

인도 난자 기증 제도의 법적 규제와 허점.

2021년 법은 기부자를 보호하는 것을 목표로 하지만 시행에 어려움을 겪고 있습니다.

법의 허점으로 인해 직접 보상이 금지되어 있음에도 불구하고 기부자에게 간접 보상을 지급할 수 있습니다.

난자 채취 과정에는 난소 과자극 증후군, 심지어 사망과 같은 위험이 수반됩니다.

새로운 규정으로 인해 합법적인 난자 조달이 어려워지면서 난자 제공이 음성화되고 기증자의 위험도 커지고 있습니다.

제한적인 규제로 인한 결과와 불임 치료에 대한 공평한 접근의 필요성.

제3자 생식에 대한 정부의 제한으로 인해 많은 사람들이 시험관 아기 시술에 대한 접근이 제한되고 있습니다.

특히 빈곤층을 위한 저렴하고 공평한 불임 치료의 필요성이 강조되고 있습니다.

기부자들의 문맹은 정보에 기반하지 않은 동의로 이어져 윤리적 문제를 더욱 악화시킵니다.

경제적 압박으로 인한 기부 후 후속 조치의 부족은 기부자의 취약성을 부각시킵니다.

기증자에 대한 비인간적인 처우에 대한 비판이 제기되면서 더 나은 보호가 필요하다는 목소리가 높아지고 있습니다.

India’s Fertility Dilemma: Inside the Rush for Human Eggs

India’s Fertility Dilemma: Inside the Rush for Human Eggs

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