In October 2012, Mr K and I went to see our old IVF specialist.   For anyone who has ever read much of this blog, you probably know already that the ten microscopic frozen embryos that I have in storage represent a huge weight hanging over my head.  So we went to see Glenn to discuss the idea of using them via a surrogate, in what would be a last ditch attempt to try and have another child.  Glenn seemed happy to see us as per usual, remembered every detail of every other patient I had sent to him, enquired after my family – my mother, my father, both of my sisters and even two friends I had sent him, and told us that our embryos statistically have an 80% chance of ‘taking’ if put back in a normally fertile and healthy woman… as compared the <30%ish chance they always had when being put back in me.  It all sounded very positive and doable even (though the cost was going to be prohibitive with a rough figure of approximately $30,000 being bandied about).  But then again… Glenn always was very optimistic for us, largely due to my youth, which in fertility terms at the time I was seeking treatments was on my side.  He told us that from when we decided to go ahead, it would take about three months in legals and counselling before an implantation to a surrogate could take place.  And I remember thinking… ‘That soon, huh?’

Anyway, we talked about it for a while and eventually Mr K decided we would ask his sister if she would act as a surrogate for us.  Such a huge… HUGE… thing to ask anyone, and while we have had offers from two other women in our lives, who said they would help us out in this way if they could – it was his sister whom we felt we could most trust with the most precious possession we have in this life… our potential unborn child.  It’s a very delicate subject all round and so highly charged with emotions.  Mr K’s sister has two absolutely delightful children of her own, so understands the enormous impact of what we would be asking her, as well as fully comprehending the import that accompanies agreeing to enter into such an arrangement.  So, Mr K said he would talk to her and see what she said, and eventually in July 2014 (with me hovering in the wings for months waiting for him to find an ‘opportune moment’, trying so desperately every day not to push for things to move more quickly… patience has never been one of my strong suits and I was worried he would change his mind), he spoke with her about it.  He decided it would be best to ask her ‘brother to sister’, and I could talk with her later if she wanted any more information about artificial reproductive technologies or the emotional side of complicated fertility or indeed, what this would mean to us.

July he broached the subject with her.  A week or so later, I visited and thanked her for considering the situation and told her that I felt she was the person we most trusted to help us with this endeavour.  I could not describe how this undertaking felt for me, nor could I adequately put into words my thoughts about how absolutely impossible it would be for us to thank her should she choose to go through with this, and give us the gift of another little person to add to our small family… and then we backed off and gave her space to think.  July came and went.  And then August… I mentioned to her once in passing that if she needed more detailed information, that I could make an appointment with the IVF specialist for her and he could offer her independent advice on what being a surrogate entails.  August behind us, September flew past, all the time… every single day… I fretted.  I worried about what would happen if she said ‘no’.  I worried about what would happen if she said ‘yes’.

I was scared shitless by the enormity of what we were considering entering into – giving our precious embryos into someone else’s safekeeping in a legal environment that gives all rights to any child born to the birth mother, and not the biological parents.  I worried away at it every single day, to the point where I have found it difficult to think cohesively on other things.  October came and went and I could feel myself starting to get sick to the stomach every time I thought about it.  Convinced that this wasn’t important to her.  Convinced that we aren’t important to her.  Convinced that our happiness doesn’t matter to others at all. Worried that she had forgotten all about it, or that she felt we shouldn’t have more children or, even worse, when my imagination ran away with me, felt that we didn’t deserve more children.

Then November rolls around and on a weekend while I am out of town, Mr K’s sister tells us that she can’t help us.  She doesn’t want to be a surrogate for us and immediately I felt like the very air around me was being sucked out of my lungs.  I could not breathe.  I was at an event surrounded by friends and strangers… some of them very dear and very close friends, but whom I didn’t feel I could confide in about something so personal or so explosively emotional, without completely breaking down in front of 140 people.  There was no where to go, no where to hide, no where to let my pain out.  I didn’t have (and still don’t) any details as to why she has decided she can’t undertake this for us or doesn’t want to.  In part, I am not sure it really matters what the reasons are behind it – the outcome is the same regardless, but I’d like to know all the same.  I am thankful that she even considered doing this for us and by all accounts she seems to have considered it long and hard… but I can’t find the words to describe how unbelievably devastated I feel.  Like I have been waiting for the last four years for things to come together for us to be able to consider surrogacy as an option only to find that it’s not an option after all.

I was surrounded by people and yet I’ve never felt so alone in my entire life.  I am not sure how I held it together in the hours that followed – I wanted to scream, I wanted to cry, I wanted to run away, I wanted to hurl myself into freezing water, I wanted to tear at my flesh with my fingernails and wail about how unfair my whole fucking life has been… I wanted to feel something, anything other than the deep and unrelenting sadness and crushing disappointment that gripped my heart and my mind.  Instead, I smiled and carried on with my day… pretending to enjoy the company of my friends and hoping that no one noticed anything was amiss because I certainly didn’t want to explain this to anyone.

And now I feel like a huge bottle of angst waiting to explode.  What am I to do now?

Commercial surrogacy is estimated to be worth more than $1bn a year in India. While pregnant, some surrogate mothers live in dormitories – which critics call baby factories. They give childless couples the family they have longed for, but what is it like for the women who carry someone else’s child for money?

“In India families are close. You are ready to do anything for your children,” says 28-year-old Vasanti.  “To see my children get everything I ever dreamt of, that’s why I have become a surrogate.”  Vasanti is pregnant, but not with her own child – she is carrying a Japanese couple’s baby. For this she will be paid $8,000 (£4,967), enough to build a new house and send her own two children, aged five and seven, to an English-speaking school – something she never thought was possible.  “I’m happy from the bottom of my heart,” says Vasanti.  She was implanted with their embryo in the small city of Anand in Gujarat and will spend the next nine months living in a nearby dormitory with about 100 other surrogate mothers, all patients of Dr Nayna Patel.

There are up to 10 surrogate mothers in each room. The women have their meals and vitamins delivered to them and are encouraged to rest. Vasanti, however, cannot help feeling restless.  “At night I wander around because I can’t sleep. As my tummy is getting bigger and the baby is growing I am getting really bored,” says Vasanti.  “Now I want to go home really soon to be with my children and my husband.”  The rules of the house forbid the women from having sex during the pregnancy, and emphasise that neither the doctor nor the hospital, nor the couple whose baby it is, are responsible for any complications.  If the mother is bearing twins she receives a higher fee – $10,000. If she miscarries within three months, she receives $600. The couples are charged around $28,000 for a pregnancy that leads to a successful birth.

Dr Nayna Patel (front centre) has delivered hundreds of babies in the last decade

Dr Patel, who runs the IVF clinic and the dormitory and delivers the babies, acknowledges that many people find her work offensive.  “I have faced criticism. I am facing it and I will be facing it, because this, according to many, is a controversial subject,” she says.  “There are a lot of allegations that this is just a business, this is just baby-selling, a baby-making factory, and all these phrases used to hurt.”  Some say that the surrogates are being exploited, but Patel argues that the worlds of big business, glamour and politics are harsher.  “I feel that each and every person in this society is using one or the other person,” Patel says.

In her opinion, the mothers are getting a fair deal.  “These surrogates are doing the physical work, agreed, and they are being compensated for that. They know that there is no gain without pain,” she says.  While they stay in the surrogate house, Patel says the women are taught new skills such as embroidery so that they can earn a living after they leave.

The women are taught new skills such as how to become beauticians

And the money they earn is huge by local standards. Vasanti’s payment, which she receives in instalments, dwarfs her husband Ashok’s monthly income of about $40 a month.  Some mothers come back again after giving birth once. Three times is the maximum Patel allows.  There are a number of reasons why India is “the surrogacy hub of the world”, she says. Good medical technology is available and the cost is comparatively low. But the legal situation is also favourable, Patel argues.

“The surrogate has no right over the baby or no duties towards the baby, so that makes it easier. Whereas in the Western world… the birth mother is considered as the mother and the birth certificate will have her name.”  Not having the surrogate’s name on the birth certificate can make it harder for the children to find out about the surrogate mother who gave birth to them if one day they want to gain an understanding of their past.

India has one third of the world’s poorest people and critics argue that poverty is a major factor in the women’s decision to become a surrogate.  “There are… many needy females in India,” says Patel. “The food, shelter, clothing and medicine, healthcare is not free for all in India. People have to fend for themselves.”  Patel says she encourages the women to use their earnings wisely. Vasanti and her husband are building a new home.

“The house I live in at the moment is a rented house, this one will be much better,” says Ashok.  “My parents will be pleased that their son and his wife have managed to build a house. Our status in society will go up, which will be a good thing.”   But the new house comes at a price. It will not be built in the same area as their old one, because of hostility from neighbours.  “If you are at home then everyone knows that we are doing surrogacy, that this is a test tube baby, and they use bad language. So then we can’t stay there safely,” says Vasanti.

Vasanti and Ashok with their daughter

As she nears her due date, Vasanti becomes more anxious about the birth.  “I don’t know anything about whether my couple will come and take my baby straight away, or if it will stay with me for 10, 15 days, 20 days. I might not even get to see it,” she says.  Vasanti is moved to hospital and after a protracted labour, Patel decides to give her a caesarean section.

It’s a boy – usually a cause for celebration in India, but Vasanti is concerned that the Japanese couple had originally wanted a girl.  The baby is taken directly to a neonatal hospital where his parents will be able to collect him and take him to Japan.  Vasanti is tearful as she remembers the moment she caught a glimpse of him.  “I saw him when I had my caesarean. I saw my son, but then they took him straight away. I must have seen him for five seconds, so I saw that he was living.  “The couple wanted a girl and it’s a boy. It’s good whether it’s a boy or a girl. She’s got a child at least.”  As the tiny baby boy she has carried for the past nine months starts his new life, Vasanti is beginning hers. She lives in her new house with her family and her children attend an English-speaking school.  “My children are growing day by day and we want a good future,” says Vasanti.  “That’s why we [did] this, and not in my entire life do I want my daughter to be a surrogate mother.”

House of Surrogates will be broadcast on Tuesday 1 October at 21:00 BST on BBC Four. Or catch up later on BBC iPlayer

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I managed to find and watch the documentary, and have to admit, I was quite surprised by it.  I expected to be confronted by extremely desperate self serving western couples who were completely taking advantage of the poverty of these Indian women – because I know what that particular desperation looks like, and it’s not pretty, so I could understand entirely how and why this could end up being the case. However, these women who choose to be surrogates were not exactly lacking in agency.  Yes, they come from poverty stricken backgrounds and are generally not very educated, but they making a conscious decision to enter into surrogacy to improve their personal family situations, knowing what they are doing and, very importantly, why they want to do it.  Most of them are doing it for the money, though some of them mention they want to help the childless couples too. The surrogates receive health monitoring, financial counselling, room and board, vocational training, and while I personally think that they could benefit by a less ‘hard love’ and more Western approach to counselling about the emotional side of giving up a child, I’m not so sure you could definitively say they are being exploited.

The surrogates have all had their own families and understand the import of what having children means in someone’s life. These women want to better their own lot in life and decide to carry a baby for a childless couple in order to gain a huge increase in quality of life for herself, her husband, her children and frequently for her extended family also.

I haven’t actually made enquiries… but it makes me want to contact Dr Patel’s clinic and find out how to transfer my embryos to India.   Scary and risky prospect that that is.