Understanding Surrogacy: A Comprehensive Guide

Surrogacy offers hope to individuals and couples facing infertility by enabling them to experience parenthood. This process involves various medical, emotional, and legal aspects. In India, surrogacy is regulated under specific laws to ensure ethical practices and prevent exploitation. This article covers everything about surrogacy: what it is, alternative options, eligibility criteria, dos and don’ts, contraindications, and insights into legal regulations and trends.

Surrogacy is a form of assisted reproduction in which a woman, known as a surrogate, carries a pregnancy on behalf of another person or couple, known as the intended parents. After birth, the surrogate hands the child over to the intended parents, who then assume legal responsibility for the child.

1. Traditional Surrogacy: In this form, the surrogate’s egg is fertilized with the sperm from the intended father or a donor. The surrogate is the biological mother of the child, making traditional surrogacy more complex from a legal and emotional standpoint.

2. Gestational Surrogacy: The embryo is created via in vitro fertilization (IVF) using the intended parents’ or donors’ sperm and egg. The embryo is then implanted into the surrogate’s uterus. Since the surrogate has no genetic link to the child, gestational surrogacy is the preferred method and is legally simpler.

Besides surrogacy, other options may suit couples facing fertility issues:

• In Vitro Fertilization (IVF): An egg is fertilized by sperm outside the body, and the resulting embryo is placed into the uterus of the intended mother or a surrogate.

• Intrauterine Insemination (IUI): Sperm is placed directly in the uterus, enhancing the chances of fertilization.

• Egg or Sperm Donation: Donor eggs or sperm may be used when one partner cannot contribute viable reproductive cells.

• Adoption: Adoption provides a path to parenthood without a biological link, allowing couples or individuals to raise a child as their own.

Consulting a fertility specialist helps intended parents explore these options and determine the most suitable path.

The Surrogacy (Regulation) Act, 2021 in India has established clear eligibility guidelines:

• Marital Status: Only married Indian heterosexual couples are eligible for surrogacy. Single individuals, same-sex couples, and foreign nationals are currently excluded.

• Age Limit: The female partner should be between 23-50 years, and the male partner between 26-55 years.

• Medical Necessity: A couple must prove medical reasons that prevent the intended mother from carrying a pregnancy, such as a medical condition or reproductive health issue.

The Act’s strict requirements ensure surrogacy is used responsibly and ethically, focusing on genuine medical need.

• Consult Medical and Legal Experts: Always consult with medical and legal professionals who specialize in assisted reproduction to understand the process and requirements.

• Choose Licensed ART Clinics: Seek services only from clinics registered and certified under India’s Assisted Reproductive Technology (ART) Act.

• Prepare a Legal Agreement: A clear contract between the intended parents and the surrogate ensures transparency and mutual understanding of responsibilities.

• Avoid Commercial Surrogacy: Under Indian law, commercial surrogacy (offering payment beyond medical expenses) is illegal.

• Don’t Overlook Emotional Preparation: Surrogacy is emotionally challenging for all parties. Psychological counseling is recommended for both the surrogate and intended parents.

• Don’t Pursue Cross-Border Arrangements: International surrogacy can present legal challenges, including citizenship issues and complex laws.

Surrogacy isn’t suitable for everyone. Here are some reasons it may not be advised:

• Health Risks for the Intended Mother: Conditions like severe cardiovascular or autoimmune diseases that make pregnancy risky.

• Unsuitable Surrogate Health: A surrogate must be physically healthy, without a history of high-risk pregnancies or underlying health issues.

• Lack of Emotional Readiness: Both intended parents and the surrogate should be emotionally prepared for the surrogacy process. Psychological screening is essential.

Surrogacy involves advanced reproductive techniques like IVF, which allow two main approaches:

1. Traditional Surrogacy: The surrogate’s own egg is used, fertilized with the intended father’s or donor’s sperm. Due to its legal and emotional complexity, this method is uncommon in India.

2. Gestational Surrogacy: An embryo created from the intended parents’ or donors’ egg and sperm is implanted into the surrogate. Gestational surrogacy is preferred as it carries no genetic link between the surrogate and child.

The Surrogacy (Regulation) Act, 2021 and Assisted Reproductive Technology (ART) Act, 2021 govern surrogacy in India:

• Altruistic Surrogacy Only: Only altruistic surrogacy is allowed, where surrogates are compensated for medical expenses but not financially rewarded otherwise.

• Surrogacy for Close Relatives Only: The surrogate must be a close relative of the intended parents and already have her own biological child.

• Verification Process: Couples must seek approval from a state-appointed medical board to confirm eligibility and the medical need for surrogacy.

These laws aim to safeguard ethical surrogacy practices and prevent misuse or exploitation of surrogates.

India’s infertility rate stands at around 10-15% among couples, according to estimates. Surrogacy has become an option for many facing challenges with natural conception, especially for those who have experienced failed IVF cycles. However, stricter eligibility and legal requirements have reduced the number of surrogacies, limiting the procedure primarily to medically eligible Indian couples. The law’s restrictions aim to protect surrogates from commercial exploitation while providing a clear framework for eligible couples.

Surrogacy presents an opportunity for individuals and couples who face difficulties with natural conception. However, the journey requires careful planning, legal support, and a clear understanding of eligibility and ethical requirements. The legal framework in India aims to ensure surrogacy is conducted ethically and responsibly, providing a safer path to parenthood for those who truly need it. Consulting medical, legal, and psychological professionals can guide intended parents in making informed choices on their journey to building a family.