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What Is Surrogacy and How Does the Process Work?

Surrogacy is a way for people who cannot carry a pregnancy themselves to have a baby with the help of another woman, called a surrogate. In this arrangement, the surrogate carries and gives birth to the child for the intended parents with the aim of handing the baby over to them after birth. Surrogacy uses assisted reproductive technologies like in vitro fertilisation (IVF) to create an embryo that is placed in the surrogate’s uterus.

There are two main approaches:

● In traditional surrogacy, the surrogate’s own egg may be used, so she is also the biological mother.

● In gestational surrogacy, the embryo is created using the intended parents’ or donors’ eggs and sperm, and the surrogate has no genetic link to the baby.

Surrogacy is often chosen when pregnancy is medically risky or impossible for the intended parents

Purpose & Benefits of Surrogacy

● Helps people who cannot carry a pregnancy to have a biological child.

● Supports couples with infertility, repeated failed IVF, or absence of a uterus.

● Allows same-sex couples or single individuals to become parents (depending on local law).

● Gestational surrogacy ensures only intended parents are genetically linked to the child if donor eggs/sperm are not used.

● Can provide emotional fulfilment for people who cannot conceive naturally.

Who May Need Surrogacy?

Surrogacy might be considered by:

● Women with no uterus or serious uterine conditions.

● People with repeated IVF failures, recurrent miscarriages, or infertility issues.

● Couples are at high risk if pregnancy is attempted medically.

● Same-sex male couples who want a biological child.

● Individuals who cannot safely carry a pregnancy due to health issues.

In India, eligibility is controlled by law, which currently allows only altruistic surrogacy for eligible Indian couples and not commercial arrangements.

Types of Surrogacies

Traditional Surrogacy

In traditional surrogacy, the surrogate’s own egg is fertilised, making her the biological mother of the child. This type is less common today.

Gestational Surrogacy

This is the more common modern method. An embryo created by IVF, using the eggs and sperm of the intended parents or donors, is implanted in the surrogate’s uterus. The surrogate has no genetic connection to the baby.

Altruistic Surrogacy (India)

Under Indian law, this form is allowed. The surrogate does not receive financial compensation beyond medical expenses and insurance.

Commercial Surrogacy (India)

This form, where the surrogate is paid beyond medical costs, is prohibited in India under the current Surrogacy (Regulation) Act.

Surrogacy Procedure: Step-by-Step

1. Initial Consultation and Eligibility Checks: The intended parents meet fertility specialists to review medical history, tests, and suitability for surrogacy.

2. Medical and Legal Certification: In places like India, medical boards and courts assess eligibility and grant permission before any procedure begins.

3. Choosing the Surrogate: A surrogate is selected, often a close relative in India, because commercial recruitment is banned.

4. IVF and Embryo Creation: Eggs and sperm from the intended parents or donors are fertilised in a lab to create embryos.

5. Embryo Transfer: A chosen embryo is placed into the surrogate’s uterus.

6. Pregnancy and Monitoring: The surrogate undergoes regular prenatal check-ups throughout pregnancy.

7. Birth of the Baby: After delivery, legal steps are taken for custody and parentage transfer from the surrogate to the intended parents.

8. Post-Birth Care: Medical and legal follow-up ensures the well-being of the baby, surrogate, and parents.

Recovery & Aftercare

After the baby is born, the surrogate needs standard postpartum care similar to any pregnancy, including rest, nutrition, and medical follow-ups. The intended parents arrange for the baby’s care and legal documentation, including a birth certificate and parental rights transfer as per law.

Risks & Possible Complications

Surrogacy involves pregnancy-related risks for the surrogate, similar to any pregnancy, such as high blood pressure, gestational diabetes, or preterm labour.

Other possible issues include:

● Emotional challenges for all parties during pregnancy and after birth.

● Legal and ethical complexities if the agreement is not clear or if laws differ across regions.

● Possible medical risks associated with IVF procedures or embryo transfer.

Counselling and legal guidance are important to help manage these aspects.

Frequently asked questions

What is surrogacy used for?

Surrogacy is used to help people become parents when they can’t carry a pregnancy themselves due to infertility, medical conditions, or absence of a uterus.

Is surrogacy painful?

The embryo transfer and pregnancy itself are usually not painful procedures, but there may be discomfort during IVF hormone treatments and normal pregnancy symptoms.

How long does the surrogacy process take?

From initial evaluation to birth, the process can take 1 year or more, considering medical preparation, pregnancy, and legal steps.

How many times can it be done?

The number of attempts depends on medical advice, fertility clinic protocols, and legal guidelines in your region.

Is surrogacy safe?

Surrogacy is generally safe but carries typical pregnancy risks, so close medical care and counselling are important.

Can anyone use surrogacy?

Eligibility depends on local laws. For example, in India only altruistic surrogacy for eligible heterosexual couples is allowed.

What happens after the baby is born?

Legal procedures transfer parental rights from the surrogate to the intended parents, and the birth certificate is issued in the parents’ names.

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