Dr. Gupta said 10 per cent of his clients are foreign; most are like Ms. Hayer, people of Indian origin now living abroad. His clinic has policies, as all are supposed to, under a non-binding directive from the Medical Council of India: he said his cut-off age for women bearing children is 50.
But minutes later he happily reported on the case of a 59-year-old woman in whom he implanted embryos the day before; he made her walk 10 kilometres a day for a month to prove she was fit enough. "You could not say she is 59 from looking at her, her system is immaculate."
Does he have qualms about creating a mother that old - who may not even live to see her child into adulthood? "These days, children want to leave their parents by the time they are 15 anyway," he chirped.
"I considered turning that couple away but I thought it would be giving them stress rather than happiness, so that's why I did it."
Dr. Gupta, who works with his wife, Alka Gupta, the clinic's "chief embryologist," is particularly excited about the chance to offer donor egg embryos or surrogacy to women whose first-born children have some sort of congenital problem. "All these people with abnormal babies - thalassemia [a blood disorder] juvenile diabetes, a Mongol child [Down syndrome]" he enthused. "We can help them."
Surrogacy for foreign parents attracts the most attention in India; the practice was pioneered by a Gujarat doctor named Nayna Patel in 2003. Her clinic in the small town of Anand has an adjacent hostel where dozens of village women, many seeking a way to pay to educate their own children, wait out their pregnancies, hot and bored, before they deliver babies for North Americans and Europeans. The total cost is about $10,000, compared with $50,000 to $70,000 in the United States. (Commercial surrogacy is illegal in Canada).
"These surrogate mothers are just being kept there like baby factories," said Nandita Rao, a lawyer pushing for regulation of the fertility industry. "The women are just sitting there producing that child with no rights on that child and no rights on their health - the contract says if you don't produce the child, you don't get the money - so they go on with a pregnancy no matter what [the risk]and there is no maximum number on the times they can do this. In India, which is so fiercely patriarchal, many families are using their daughters-in-law as baby-churning factories."
Many of the best-known Indian fertility clinics offer a roster of surrogate profiles from which to choose. Better educated women command a higher price - perhaps a $7,000 fee, compared to $3,000 for a village woman in Gujarat. The buyer also pays medical and living costs.
One of Dr. Gupta's clients, Anita, a Delhi private-school teacher who didn't want her surname published, found her surrogate through an ad in a women's magazine. At 38, she had failed at IVF herself and sought a young woman to carry a baby made with donor eggs and her husband's sperm. The ad was placed by the surrogate's husband; the woman, Puja, 21, said quietly that she didn't like the idea and it took her three months to agree, that she gave in because her father-in-law has left the family with debts that they must pay. She has two small children of her own. Anita comes to hover over her ultrasounds; asked how Puja felt about carrying the twins developing in her womb, Anita replied blithely, "Oh, we haven't told her yet."
A year ago, Anita had another surrogate pregnancy under way with a woman she brought to stay at her home, but six months in, Anita began to suspect the surrogate was stealing. "We lost confidence in her, so we terminated that pregnancy," she said calmly.
It is part of the standard Gupta clinic surrogacy contract that a surrogate must terminate a pregnancy if the doctor directs her to do so. "We were more careful choosing someone this time," Anita added.