Albert Tochilovsky, the owner of Biotexcom center for human reproduction, told Delo.ua about designer babies, body rejuvenation, bearing children in an “artificial uterus”, moral and ethical issues of reproductive medicine, and harassment by authorities.
Please tell us about the ways of searching for surrogate mothers and egg donors.
There are special intermediary companies working in Ukraine. Often, the same companies are engaged in the selection of personnel. They deal with advertising in the field of surrogacy and egg donation. Now this is, in fact, the most serious issue. Biotexcom has no problems with customers, 99% of people standing in line for treatments are foreigners, it is extremely difficult to include Ukrainian people in the customer’ list. All of this was done thanks to our good reputation that was achieved due to the efficiency of our work, as previously we were occupying about 90% of the market. Of course, now reproductology is a trendy sector, thus, about 50-70 clinics have already appeared in the country, but we are still leading and setting trends.
There is a great competition in the egg donation market. Ukraine is only taking the first steps, but we are already leaders in Italy and I think that the majority of customers from other countries will also come to us. But there is an industry competition between Ukraine and such countries as Spain, the Czech Republic, Cyprus and Slovakia. Especially, regarding to the last ones – there are more donation clinics in Brno than in Kiev. It’s very difficult to compete with the experts who have 30 years of history, but we are capable to do that. And the world recognizes that Ukraine is showing good results in reproductology. It’s a pity that other industries, for example, oncology, are dying out. The quality of medical services is not improving. Even our people of higher rank like parliamentarians and officials do not trust the Ukrainian medical sector, so, you can imagine how difficult it is to convince foreigners to trust it.
It is necessary to develop medical tourism. Reproductology reached a higher level in Ukraine, meanwhile Turkey and Belarus are very good in transplantology.
Biotexcom has built up a good reputation, maybe you can become a driving force in other medical sectors and open up Ukraine for medical tourism?
Once the prosecutor’s office on the occupied territories decided to take away my business, we started distributing our developments territorially. Now we work with stem cells and we will open a European biotechnological center in Leipzig. A building has been already bought, and this is going to be a big company.
You see, working here may be scaring for people, especially after seven tries of putting me in a detention center. I was accused of trafficking thousands of Ukrainian babies abroad, authorities have made inquiries to other countries, but the answers were that the children have a genetic kinship with their foreign parents. Such hype is often raised to justify authorities’ greed, they just want to take away this business, but this only worsened the image of Ukrainian medicine among European countries. Then they realized that we have representative offices in all European countries, and if they take away the business, this sector will disappear. There will be nothing but the companies’ buildings and people without their working places. Then they decided to designate me as manager and receive a half of the profit. For this purpose, they wanted to put me into jail. Usually, the prosecutor’s office succeeds in this with others, but they faced serious resistance, many public organizations stood up for us, so the courts asked for a deposit instead of putting me in prison. We wrote a statement about the persecution to the State Bureau of Investigation, sent the attached documents there, but the cases are returning in order to shut the case down.
Thank God, a new Government took office and things got better, the pressure decreased. So, we took a chance and started construction of a stem cell stroke center in Kiev. It’s difficult to predict what happens next, political situation influences 90% of country’s events. If the new Government’s promises are fulfilled, we’ll have a chance for development. Otherwise, we will die from globalization along with the other countries.
Globalization is like an escalator. If it moves down, you have to run up. If you stop, you will be carried away
By the way, the world is developing so fast that even I am scared. Something new is produced every day. And everyone is working hard. Yet, Ukraine, like Russia, has stopped its progress. Our northern neighbors think that they will survive at the expense of hydrocarbons, and we, in our turn, consider the survival at the expense of agriculture. However, we will die without modernization, parasitizing on Earth is wrong.
You know Ahmed Zaki Yamani, a former Minister of Petroleum and Mineral Resources in Saudi Arabia, said that the age of oil will end not because of a lack of oil, like the Stone Age ended not because of the lack of stones. Therefore, we must move forward, yes, we make mistakes, but we should not be afraid of them. If there are some moral issues, we must deal with them.
Actually, they have already arisen – remember the Chinese genetically modified children Lulu and Nana, who were created by He Jiangkui.
Therefore, it is necessary to gather at a round table for discussing these issues without any fear of society’s censure. 90% of society’s decisions are wrong. People realize the essence of the events in 30 years when there’s no way to change anything. Talkative deputies, for example, boast of the Ukrainian own car industry while such world concerns like Rolls-Royce, Bentley, Volvo fail. Japanese tycoons are in panic, European concerns like BMW or Mercedes do not understand which way to go further as new advanced companies supported by countries with trillion turnover appear. Who needs Slavuta* in this world? [*Ukrainian car company].
New spheres are emerging, and it’s a chance to compete for them. Unfortunately, every new thing causes fear. Well, we could compete in biology.
To reinforce your words – what is the percentage of in vitro children in Europe?
In 70s, when the process had just started, it was assumed that the number of such children would be small. It’s like with mobile phone – all the major forecasters said that mobile phones were too expensive and only 100,000 people could afford them. But what is the situation nowadays? Everyone has a pocket computer.
The same goes for IVF. According to the present statistics, there is every tenth child is in vitro in Europe. And some experts say that every third child will be in vitro by 30s-40s. Why? Because of the low male sperm quality, this is the official statistics of the World Health Organization. In the past, people considered normal to give birth to 3 babies at the age of 18. Now women begin to think about having a baby only after 40 years old, and it turns to be difficult without IVF. I mean, in Europe a person attends a gymnasium within 13 years, then the university follows, then he or she spends certain time for the career, finally, the end of the reproductive age comes.
Lifetime is growing along with this. Pushkin described one of his main characters as “an old man of 30”. Juliet’s mother was 28 years old. Now girls stop going to night clubs only at the age of 28. An average lifetime is 70 years. Therefore, the significance of reproductive medicine will grow, the number of programs will increase, and medical tourism will also develop.
Let’s return to the donors and surrogates search. There are egg purchase advertisements in local buses. Do you think this situation normal?
I’ve got my special attitude towards this. Ads are placed by our resellers. They want to earn money. I have nothing against them. When a small business starts, it has not much funds to invest, to build a factory. These people are recruiters, start-up businessmen who create initial capital. It’s a nonsense to limit them. We cannot force clients to go directly to the clinic, saying that an intermediary is useless, let’s remove this layer – it’s wrong. It would be better to let small business appear and let it earn money. I understand that the advertisements may be too provoking …
Surrogates are offered half a million, this is a huge amount of money for rural residents.
Prices have already risen. All clinics pay more than half a million. The cost of egg donation reaches 40 thousand because of a certain shortage of donors. Surrogate mothers participate in our programs several times. There is a record holder surrogate in our company who has given a birth to 4 surrogate children. And this is not the limit, the British Carol Horlock gave birth to 15 children, the last baby was born at her age of 48, she still is going to continue. And this is normal, because biologically she can carry a baby both at her 60 and 70. The main thing is a good quality of the eggs.
Regarding women from villages … They live in a small village, they have their own children, sometimes 3-4 children. In most cases they have no husband, because there are very few men to rely on in those regions. Many men in small villages do not have work, because of the lack of working places, that is why most of them cannot support their families, drink alcohol. The situation is different in Kiev where men try to move fast.
Such women from small villages without husbands have got a very low salary which is twice less than the official salary (4000 hryvnas). These women are exploited for 2000 hryvnas. It’s impossible to support a family for such earnings even having a subsidiary farm. Even if she will knit, spin, do something else – machines do it faster and cheaper. Surrogate mother and egg donor are highly paid jobs besides the fact a new life is coming to this world, it’s a holy thing.
Legalization, in general, is an extremely useful tool. I am liberal in my points of view and I even support the legalization of prostitution. There are less sexually transmitted diseases, lower level of AIDS in countries where it exists, because this sphere is controlled by the state, not by bandits.
And when everything is illegal, it turns out that the state itself builds corruption, explaining this with moral positions.
Of course, the worst thing that scares everyone in this sphere is infant mortality. Pardon me, a child may die either being born by a surrogate mother or a baby’s mother, it depends on many factors. Moreover, according to the statistics of WHO, the birth mortality rate in Ukraine is the lowest among all the popular surrogacy areas (Georgia, Kenya, Nigeria).
How to avoid this?
Errors will exist anyway. Doctors make mistakes, but it’s impossible to impose the death penalty, otherwise problems will increase, any specialist will be nervous with shaking hands while removing appendix. I admit that the price of these mistakes is life. Therefore, responsibility is higher. But, believe me, the punishment should not be prohibitions, it should be money.
I would introduce excise tax in surrogacy so that each surrogacy clinic would pay 100,000 hryvnas for every genetic affiliation form used. The clinic buys 50 forms, and if something happens, they will be canceled.
And the person understands: it is necessary to follow medical and legal protocols, you can’t move on a short path, because the pledge is 5 million UAH. You may save 5000 here but you are going to lose 5,000,000 there. The economic expediency of reducing the cost is disappearing.
Surrogate mothers shouldn’t pay, for sure. Egg donors shouldn’t pay, they are poor women. As representatives of commerce, we are to pay a certain amount of money for each certificate. Let this money be used for medical purposes, for the treatment of our women’s infertility, for partial payment of IVF.
Another plus of this decision is that these forms are strictly registered. The form is registered in a clinic, no one can fake anything, the clinic manager puts a stamp on it, he calls up to the registry office. This is a guarantee that nobody can assign genetic kinship to a Ukrainian child.
If this proposal meets the interest of our elite, we need to gather at a round table to discuss the issue. Thus, a question of benefits of reproductive clinics will not be raised: here it the benefit, the state earns millions.
What countries do your clients come from? You mentioned Italy, Germany, France, who else?
You will be surprised, but now even people from India come here, which is the Mecca of surrogacy. They are allowed to do this for themselves, but not for foreigners. Several centers were closed. I think, we will get about a third part of Indian clients by 2030.
How much do surrogacy programs cost?
Prices in Ukraine range from 30 to 70 thousand dollars, depending on the package, which includes accommodation, programs, payment for a surrogate mother, meetings, and flights. Couples can stay here for 2-3 months. It happens that paying for a surrogate mother is a small part of the package. Medical services are very expensive, we give a guarantee, set the trend – up to five attempts of fertilization. The surrogacy programs, of course, are more expensive than IVF, because the eggs of the biological mother are stimulated separately from the recipient who will carry a baby. Therefore, the programs are expensive, but it is not possible to reduce prices, if only to remove additional services. At the same time, in the USA the cost of such programs reaches 300 thousand dollars.
Why do people choose surrogacy rather than IVF?
The matter is in medical indications. Having the Mayer–Rokitansky–Küster–Hauser syndrome, a woman is born without an uterus. Sometimes the uterus is removed. It happens – and this happens more often – that antibodies interfere with the ability to carry the fetus. If you cannot carry a baby by yourself, you need another carrier. It is clear, if there is an opportunity to have IVF treatment, it is better to use it.
Tell us, how does the surrogacy process take place?
First of all, one parent must be genetically related to a child. A woman’s eggs are stimulated and she takes birth control pills so that periods get started after their cancellation. A surrogate mother also takes birth control pills to synchronize cycles. Then comes the stimulation, eggs retrieval, semen collection and after that, fertilization. The surrogate mother takes medicines that will help her body accept embryos and then fertilized eggs are transferred to her uterus. As the baby wasn’t naturally conceived, a surrogate mother has to continue taking medicines for 3 months after the transfer to support the pregnancy and avoid a miscarriage.
When a child is born, a certificate from the maternity hospital is taken, then comes DNA testing in an independent laboratory, the surrogate mother signs a notarized relinquishment of parental rights, the registry civil office reissues all the documents to intended parents. Then the embassy process starts. All embassies send the DNA tests to their native countries, where they are checked. Clients from many countries are forced to stay in Ukraine for 2-3 months after the birth of the child, since embassies issue documents only after a thorough check of each particular case.
What do you, as a person with great experience, advise expectant mothers?
You know, the experience is so different … First – do not be afraid. Choose a good hospital, search through the internet information about specialists who will take the labor process. There are many professional and talented obstetrician-gynecologists in Ukraine.
The main thing, perhaps, to remember is that it is better not to delay the birth of a child. You can still wait up to 30 years, but after, girls, I advise everyone: do not indulge! I understand that modern life makes you carve out a career, but after 35, having a baby can cost you tens or even hundreds of times more. In the civilized world a person receives $ 70 thousand a year, that it makes sense at least and it’s understandable why. Our salaries are not worth it, so it is better to not drag your feet on this matter.
Further. Before you have an abortion, think a hundred times. Of course, the state support is important here, as even the current package for mothers is already a huge step forward, and if you manage to introduce an excise tax for clinics, this money can be sent to women who are in a difficult situation.
Interviewed by Dmitry Bunetskiy, specially for Delo.ua