Surrogacy

Surrogacy is a third-party reproduction where a surrogate mother bears and delivers a child for another couple after a legal agreement.

There are two methods of surrogacy -

1. Traditional surrogacy (Partial, natural, or straight surrogacy) – In this method, the surrogate's egg is fertilized by the intended father's or a donor's sperm and baby is genetically or biologically relate to the surrogate. It is not allowed in India.
2. Gestational surrogacy (Host, or full surrogacy) – In this method, an embryo formed by in vitro fertilization, is implanted into the uterus of the surrogate mother who carries and delivers the baby. The resultant baby is not genetically related to the surrogate.

The resultant embryo can be created by

• Using the intended father's sperm and the intended mother's eggs, or
• Using the intended father's sperm and a donor egg
• Using the intended mother's egg and donor sperm
• Using a donor egg and a donor sperm i.e donor embryo (in surrogate) not allowed in India

Type of surrogacy (depending upon whether the surrogate receives financial reward for her pregnancy) -

1. Commercial - If surrogate receives money for the surrogacy arrangement, it is considered commercial surrogacy. Recently, it is banned in India.
2. Altruistic – If surrogate receives no compensation beyond reimbursement of her medical and other pregnancy-related expenses along with the insurance coverage for her, it is considered as altruistic surrogacy. Only this type of surrogacy is legal in India now.

Ways of doing Surrogacy

• Self egg Surrogacy – In this embryos are generated from own eggs and husband sperms and are placed in uterus of surrogate.
• Donor egg Surrogacy – In this embryos are generated from donor eggs and husband sperms and are placed in uterus of surrogate.

Indications of surrogacy

You need to fulfill the conditions of surrogacy as stated by the new law as stated below:

1. No uterus or missing uterus or abnormal uterus (like hypoplastic uterus or intrauterine adhesions or thin endometrium or small uni-cornuate uterus, T-shaped uterus) or if the uterus is surgically removed due to any medical conditions such as gynaecological cancer.
2. Repeatedly failed to conceive after multiple IVF or Intracytoplasmic sperm injection attempts (Recurrent implantation failure)
3. Multiple pregnancy losses resulting from an unexplained medical reason
4. Any illness that makes it impossible for a woman to carry a pregnancy to viability or pregnancy that is life threatening. 

Eligibility criteria for Surrogacy

For Intended Parents (IPs)/ Intending woman

• Should have medical indication necessitating gestational surrogacy
• Couple or single woman of Indian origin with specified age group
  • Should be legally married and between the age of 23 to 50 years in case of female and between 26 to 55 years in case of male on the day of certification
  • Intending woman - an Indian woman who is a widow or divorcee between the age of 35 to 45 years
• Should not have surviving child biologically or through adoption or through surrogacy earlier (In special circumstances - IPs who have a child and who is mentally or physically challenged or suffers from life threatening disorder or fatal illness with no permanent cure and approved by the appropriate authority with due medical certificate from a District Medical Board)

For Surrogate mother

• Willingly to act as surrogate
• Age of 25 to 35 years on the day of implantation
• Married woman having a child of her own
• Medically and psychologically fit
• Cannot provide her own eggs
• Cannot be surrogate more than once in her lifetime

Steps for doing surrogacy

• Medical Consultation of couple/single woman
• Counselling of couple/single woman
• Legal certification for surrogacy (through National board)
• Surrogate recruitment (through altruistic manner)
• Medical procedure (IVF) – Self/donor egg surrogacy