What is surrogacy?

When a couple cannot have a baby because of certain problems with the female partner that does not allow her to successfully complete a pregnancy, surrogacy is an option. If the female partner has viable eggs, but is still unable to complete a pregnancy due to other reasons, the embryo (baby) is formed using the couples own egg and sperm. The surrogate carries the embryo till a successful delivery. In other words, the baby is genetically the couple's and the surrogate mother just carries the baby till delivery.

Who are benefitted from surrogacy?

Women with the following problems are greatly benefitted from a surrogacy program.

Defective uterus: Women with defective uterus which is either absent or malformed beyond correction can still good ovaries and therefore have their own babies. A surrogate mother is used to carry the baby so that pregnancy is successful.

Recurrent pregnancy loss: Some women may be able to conceive normally but have recurrent abortion. A thorough evaluation is performed to analyse the cause of pregnancy loss. Please refer to our section on recurrent abortions for more information on this condition. If this is not correctable despite all measures, then surrogacy is required for a successful pregnancy.

Repeated IVF implantation failures: Some couples may repeatedly form good embryos with IVF, but fail to have pregnancy. They are said to have implantation failures suggesting that the uterus is incapable of allowing the embryo to implant in its cavity and grow. In such cases, surrogacy is beneficial.

How is the procedure done?

Once the need for surrogacy is determined, a surrogate is chosen. The surrogate is screened to ensure that she is healthy and capable of carrying a successful pregnancy. The mother (genetic mother) is stimulated with drugs to produce adequate eggs and the eggs are retrieved from the mother. The egg is injected with the genetic father's sperm through the method called ICSI (refer to our section on ICSI for more information). An embryo is formed outside the body and is then transferred to the surrogate who then carries the embryo till delivery.

What are the factors which affect the success rate of surrogacy?

The age of the genetic mother who provides the egg is the most important factor that affects chances of pregnancy. Other factors include the surrogate's ability to get pregnant, the quality of gamete provided by the genetic parents

How is the surrogate screened?

A surrogate should not be over 45 years of age. Before accepting a woman as a possible surrogate for a particular couple's child, we will ensure (and put on record) that the woman satisfies all the testable criteria to go through a successful full-term pregnancy.

A relative, a known person, as well as a person unknown to the couple may act as a surrogate mother for the couple. In the case of a relative acting as a surrogate, the relative should belong to the same generation as the women desiring the surrogate.

A prospective surrogate mother will be tested for HIV and hepatitis B and shown to be seronegative for this virus just before embryo transfer.

Guidelines on surrogacy

A surrogate mother carrying a child biologically unrelated to her must register as a patient in her own name. While registering she must mention that she is a surrogate mother and provide all the necessary information about the genetic parents such as names, addresses, etc. She must not use/register in the name of the person for whom she is carrying the child, as this would pose legal issues, particularly in the untoward event of maternal death. The birth certificate shall be in the name of the genetic parents. We will, however, provide a certificate to the genetic parents giving the name and address of the surrogate mother. All the expenses of the surrogate mother during the period of pregnancy and post-natal care relating to pregnancy should be borne by the couple seeking surrogacy. The surrogate mother would also be entitled to a monetary compensation from the couple for agreeing to act as a surrogate; the exact value of this compensation should be decided by discussion between the couple and the proposed surrogate mother. An oocyte donor cannot act as a surrogate mother for the couple to whom the ooctye is being donated.

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