Surrogacy: All You Need To Know

Female infertility is a condition in which a woman of childbearing age is unable to get pregnant and/or carry a successful pregnancy to term. In medical terms, when a woman is unsuccessful in getting pregnant for over 12 months despite all efforts, the condition is defined as infertility.

Several conditions can cause infertility in women. These include –

    • PCOD/PCOS
    • Hormonal imbalances such as thyroid imbalance or hyperprolactinemia
    • Ovarian insufficiency
    • Hypothalamic dysfunction causing an imbalance of the Luteinizing Hormone or Follicle Stimulating Hormone
    • Endometriosis
    • Infection or trauma to the fallopian tubes causing tubal infertility
    • Cervical or uterine tumours
    • Lifestyle conditions such as obesity, stress, eating disorders etc.

Advanced fertility treatments under experienced doctors are available at Max Hospital. However, in some cases, when these treatments are not successful, surrogacy is one of the options that couples may want to consider.

What Is Surrogacy?

A surrogate is a woman who agrees to carry the foetus of a couple in her womb and deliver the child. When a woman cannot carry a pregnancy to term, surrogacy offers the couple a chance to have their genetic child.

A surrogate is a woman who conceives with the help of Assisted Reproductive Technology (ART) but does not claim parental rights or raise the child. Instead, she now carries the baby to term and delivers it to its genetic parents. Surrogacy is often the final resort for couples who wish to have a genetic baby and have failed at conceiving naturally or through fertility treatments.

What Are Types Of Surrogate Mothers?

There are two types of surrogate mothers.

    • Traditional surrogate – A traditional surrogate is a woman who agrees to bear a child through artificial insemination with the father’s sperm. In this case, the surrogate mother’s eggs are fertilized with the father’s sperm, and she is genetically connected to the baby. Once the baby is delivered, she gives up parental claim to the couple seeking the surrogate mother.
    • Gestational Surrogate – A gestational surrogate is a woman who agrees to carry a baby through IVF (in vitro fertilization). The IVF clinic or hospital collects the eggs, and the sperm from the couple fertilizes them under laboratory conditions and places the embryo in the surrogate mother. The surrogate then carries the baby to term and delivers the child to be raised by the couple. This child is genetically linked to the couple and is only carried in the surrogate mother’s womb.

Who Can Opt For Surrogacy And Who Cannot?

In India, couples may opt for surrogacy only when medically unable to conceive naturally or through assisted means. If the couple is diagnosed with health conditions that make it impossible to conceive naturally and if prolonged infertility treatments have failed, they may opt for surrogacy.

Who Can Use Surrogates?

    • Women who have an absence of uterus by birth but functioning ovaries
    • Women who suffer from uterine conditions such as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, fibroids, polyps
    • Women who have undergone hysterectomy
    • Women who suffer from pelvic diseases or conditions affecting the pelvis, including endometriosis and pelvic inflammation disease
    • Women with medical disorders such as uncontrolled diabetes, hypertension, heart disease, auto-immune disorders, renal disorder, psychiatric illness or any other illness which can worsen during pregnancy
    • Recurrent pregnancy loss
    • Recurrent implantation failure

Who Can Be A Surrogate?

According to Indian laws, a woman who opts to be between the ages of 25 and 35. She must be married or have been previously married. The prospective surrogate mother should also have her own child. A close relative of the couple can also offer to be a surrogate.

A woman can be a surrogate only once in her life. Before undertaking surrogacy, the woman must be certified medically and psychologically fit for the undertaking.

How does surrogacy work?

After having undergone unsuccessful infertility treatment, surrogacy is considered. The couple is advised and counselled. They then approach a government recognized ART bank. Once a healthy, reliable surrogate is located, the latter undergoes medical screening for disorders and infections that could affect fertility. Her uterine lining is prepared by treatment with hormones. The embryos are transferred once the uterus is prepared. This is usually done on days 15-20 of her menstrual cycle. She is given medicines for 16 days to support pregnancy, and then a pregnancy test is done.

How to find a surrogate?

ART banks set up and regulated by the government help locate healthy surrogates. The Indian legal system prohibits commercial surrogacy. This means that altruistic women choosing to be surrogates can register their willingness with ART banks. In many cases, relatives of the couple offer to be surrogates, making this process easier.

What is the chance of having a baby with surrogacy?

Currently, there are not many studies that follow surrogacy rates in India. However, at Max Hospital, surrogacy success rates are as high as 50%. There are several societal and emotional issues involved with surrogacy. If these are tackled in a sensitive way and with the help of a robust support system, surrogacy can bring joy to millions of childless couples.

Legal Issues With Surrogates

Surrogacy laws in India and many other countries are still in their nascent stages. The Assisted Reproductive Technology (ART) Regulation Act of 2021 aims to set up, regulate and supervise ART clinics and banks to enable surrogacy. The act does not permit couples who can conceive naturally or with treatment to seek surrogacy. Since surrogacy laws are in their early stages, there are several clarity issues. These will be resolved with time and as more people start to opt for surrogacy.

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