The putrid mix of money and medical malpractice

Three years ago, Laxmi (name changed to protect identity), 28, decided to sell her eggs. She worked part-time as a waiter in Mumbai, about 60 km from her home in Badlapur, but wasn’t able to make ends meet. “I was desperate for work and money,” she says. Each job offered just between ₹250 and ₹300 per day.

Laxmi says she left her husband to start a new life after he began living with another woman with whom he had a child. “We were married for eight years. It was an inter-caste marriage. My husband’s family was pressuring him to marry someone from their caste,” she adds.

While her husband was from the Agri community, a subcaste of fisherfolk, Laxmi was a Mahar, listed as a Scheduled Caste.

“I was unable to make enough money to rent a house and live on my own,” she says, adding that she was forced to stay with friends for a year.

During that year, on a train to Mumbai for work, she met Sulochana Gadekar, 44. She told Laxmi that she could make some “quick money” through egg donation. “She told me to look at it as a social service for women who couldn’t bear their own children. She said it was a common practice at IVF (in-vitro fertilization) centres.”

Laxmi, like many women, had seen boards of IVF centres and did not think it was illegal. In India, the Assisted Reproductive Technology (Regulation) Act, 2021 permits egg donation only once in a lifetime by a woman who has borne a child. It prohibits commercialisation and stipulates medical insurance for the donor.

Gadekar offered Laxmi accommodation at her house in Vangani, about 25 km from Badlapur. She was relieved to have a rent-free place to live in and at the prospect of cash. For the first cycle, which took place in Gadekar’s house, she was paid ₹15,000.

After a month, Laxmi moved out and found her own rented accommodation in Vangani, a 1RK (room and kitchen) unit, and decided to undergo the egg donation process again.

“I underwent the cycle eight times. Each cycle took about a month,” she says. For these, she remembers going to Nashik and Thane and being paid between ₹12,000 and ₹25,000.

She says she finally had to stop donating eggs when she was diagnosed with a thyroid problem. Six months ago, she had a problem in her pelvis. “I feel my health complications are linked to multiple egg donations,” she says.

Laxmi has gone back to her job as a gig worker in the catering industry. In her sparse home, she sits on an ageing wooden sofa, its sponge exposed, and says, “I would donate eggs again if I could. I still need money.” The only time she cries is when she speaks about her husband.

On February 18 this year, Gadekar was arrested. According to the Maharashtra police, she is part of an inter-State network of clinics, pharmacies, and egg-harvesting agents, all operating illegally. Since then, the police have made six more arrests. The two other main accused are also agents: Ashwini Rupesh Chabukswar, 29, and Manjusha Wankhede, 46.

The others named as accused in the First Information Report registered at the Badlapur (East) police station are Sonal Gurudev Garewal, 24, who allegedly operated a sonography machine without formal training at Bhagwan Hospital in Ulhasnagar; Dr. Amol Patil, director of Malti IVF Centre in Nashik; and Sumit Bhagwan Sonkamble, 38, a pharmacist allegedly involved in arranging logistics and documentation. Satish Dilip Choudhary, an electrician who allegedly worked with Patil, was also arrested.

The flat belonging to accused Sulochana Gadekar where the police conducted a raid and recovered multiple vials of hormonal injections.
| Photo Credit:
Emmanual Yogini

The police are investigating the role of Rajesh Jammu Nehlani, 47, owner of Bhagwan Hospital, and examining documents and medical records seized during searches conducted at several hospitals. According to the police, Malti IVF Centre was licensed to operate in Nashik, but its branch in Thane was functioning without authorisation.

The IVF market, a subset of the healthcare industry, was valued at $883.50 million in 2022, as per Allied Market Research, a market research, consulting, and advisory firm. It is estimated to surpass $4667.80 million by 2032.

Laxmi is one of 10 women identified as victims of the alleged IVF scam.

The modus operandi

Three days before Gadekar’s arrest, a woman walked into a government health centre in Badlapur East. She told the physician on duty that she was not paid for the eggs she had donated. The woman assumed that the government was paying for egg donation because Gadekar had told them that this was part of a social contribution.

The doctor noted her complaint and Gadekar’s name and alerted the police.

Investigators conducted a raid on Gadekar’s residence on the 13th floor of a gated housing society in Joveli Gaon on the outskirts of Badlapur and recovered multiple vials of hormonal injections, valued at approximately ₹8 lakh.

According to the police, agents would approach women facing financial hardship. They would offer potential donors amounts between ₹18,000 and ₹30,000. Women producing more than five eggs were promised more money. Gadekar would shelter them at her residence for 10 to 12 days and administer daily hormonal injections.

These injections are intended to stimulate the ovaries to produce multiple eggs in a single cycle, say doctors. Egg extraction was conducted without medical consultation, say the police.

Multiple teams are probing the case, said Deputy Commissioner of Police Sachin Gore, Ulhasnagar Police, at a recent press conference. “The preliminary investigation has revealed that the three main arrested accused were in direct contact with IVF centres. The inter-State links, financial trail, and involvement of medical professionals are being probed,” he said.

Digital evidence retrieved from mobile phones seized from the accused indicates that donors were transported to various locations. Investigators say data show that after being administered hormonal injections at transit points, the women were taken to medical facilities in Karnataka’s capital Bengaluru, parts of Telangana, and within Maharashtra, including Nagpur, Pune, and Nashik, where the eggs were extracted.

The police say forged Aadhaar cards were used to make it difficult to track down victims. Fake Aadhaar cards were found at the residences of Gadekar and Choudhary.

“We are tracking 30 to 35 agents and trying to find the recipients of the harvested eggs,” says a police officer.

Building and bringing down lives

With Gadekar in jail, her second husband lives alone in the 500-600-square-foot home they had moved into this January in Joveli Gaon, which is nearly denuded of trees. The 16-floor apartment block sits next to a highway and close to an industrial area. A home here costs about ₹50 lakh.

He says he has liver cirrhosis and that Gadekar was the “main earner”. He adds that he lost his job as a watch repairer in Mumbai after his employers got to know about his wife’s arrest.

“Twenty years ago, after we got married, I realised that she had been an egg donor and a surrogate mother. Soon, she became an agent. Offers came in from doctors to find other women to donate eggs,” he says.

When the police raided the house, they did not produce a search or an arrest warrant, he says. “It all happened after 9.30 in the night. The search went on until 11. They took her to the police station and only then produced the arrest warrant,” he says.

He points to a wooden cupboard and says they just had it made, but the police broke it. Hormonal injections were recovered from here, he adds. “I don’t have money now, so I am not sure how I will survive. The only person who earned was Sulochana. I now have to try and get bail for her.”

Medical professionals have highlighted the health risks associated with repeated and unsupervised egg donation. “The donors are receiving injections of menotropins [the hormonal injections that were recovered from Gadekar’s house]. If high dosage is administered multiple times in a lifetime to induce repeated ovulation, it increases the risk of ovarian cancer,” says Dr. Sainath Bairagi, an obstetrician-gynaecologist based in Kalyan, explaining the complications posed by drugs used in such procedures.

He adds that the immediate side effects can be life-threatening. “It causes Ovarian Hyperstimulation Syndrome. This can lead to fluid accumulation in the body. It is a life-threatening situation. No one should donate eggs repeatedly.”

Far away from Badlapur

Bharatiya Janata Party MLC Chitra Wagh, who raised the matter in the Legislative Council, claimed some women were made to donate eggs up to 10 times. Deputy Chairperson of the House Neelam Gorhe then directed Minister of State for Home (Urban) Yogesh Kadam to cancel the licences of doctors allegedly involved in the scam.

Health Minister Prakash Abitkar assured the Legislative Assembly that an investigation will be conducted and warned that action will be taken against the guilty.

Maharashtra has 860 IVF centres, as per government data. The Health Minister said these centres will be linked to a centralised monitoring system, but did not specify a timeline. Joint inspections by the Home and Health departments will be carried out through committees comprising the Superintendent of Police and the Civil Surgeon, he added.

The State government indicated that it may invoke the Maharashtra Control of Organised Crime Act, 1999 if the investigation reveals a larger criminal conspiracy. This law stipulates that a person, if convicted, can get punishment up to life imprisonment.

Rupali Chakankar, who stepped down as chairperson of the State Women’s Commission on March 20, had visited Badlapur on March 5 to review the case. She met police officials, the doctor at the government health centre who alerted the police to the illegal network, and the mayor of the local municipal council.

Addressing reporters, she said, “Although the illegal extraction of eggs has taken place in Badlapur, its roots have spread across the State. A crackdown will begin on illegal IVF and sonography centres in and around Badlapur from today. We will dig up the roots of this network.”

Chakankar resigned from her position over her alleged association with a self-styled godman who was arrested for allegedly exploiting hundreds of women in Nashik district.

Meanwhile, the woman who first approached the doctor in Badlapur East over money she was allegedly owed for repeated egg harvesting has not spoken again, even to investigators. The police say she has left her home, and possibly fled.<extra_leading>

chinmay.r@thehindu.co.in

Edited by Sunalini Mathew