What is Surrogacy? Process, Cost and Legal Considerations

• Written by Sejal Singhania

  Reviewed by Akhil Pillai

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Becoming a parent is a cherished dream for many. But for some, the journey is more difficult, often involving medical treatments, failed IVF attempts, or health risks during pregnancy. When traditional methods are challenging, surrogacy provides a heartfelt and deeply emotional alternative to bringing a child into your life.

Surrogacy has increasingly become an option for couples who cannot carry a pregnancy, whether due to infertility or personal reasons. It is a medical process that involves significant legal issues, delicate decisions, and emotional bonds. In this blog, we will cover all aspects of surrogacy, including the process, relevant laws, advantages, expenses, and some lesser-known facts.

What is Surrogacy?

Surrogacy is a process in which a woman (the surrogate) carries and delivers a baby for another person or couple (the intended parents), who then become the legal parents of the child. This option for becoming parents is often selected when individuals or couples are unable to carry a pregnancy themselves due to health issues or infertility. Intended parents can set up surrogacy privately or through a licensed agency.

Types of Surrogacy: Different Paths of Love

Each surrogacy journey is unique. Before moving forward, it's essential to understand the different types of surrogacy and their meanings. There are two types of surrogacy:

Traditional Surrogacy

Traditional surrogacy involves a surrogate mother using her egg and the sperm of either the intended father or a sperm donor, resulting in the surrogate being the biological mother of the child.

Gestational Surrogacy

Gestational surrogacy is the process where doctors place an embryo, usually made from the intended parents' egg and sperm, into another woman (surrogate). This is done by fertilising the intended parents' eggs and sperm through IVF. Throughout this process, both the intended parents and the surrogate go through medical and psychological evaluations to confirm their suitability. In this type of surrogacy, the surrogate does not have a genetic connection to the child.

Altruistic Surrogacy

This type of surrogacy refers to a situation where a woman carries a baby for intended parents without getting paid, except for essential medical costs and insurance. Altruistic surrogacy is legal in India.

Compensated Surrogacy

Compensated surrogacy, also known as commercial surrogacy, is a type of surrogacy in which a surrogate mother is paid not only for her medical expenses but also receives additional financial compensation for carrying a child to term for the intended parents.

Independent Surrogacy

This type of surrogacy involves intended parents and the surrogate contract directly, without the help of a surrogacy agency. This method offers more control and flexibility, as the intended parents handle all parts of the process, such as legal, medical, and emotional support.

Agency Surrogacy

This type of surrogacy involves a professional agency to help with the surrogacy process. The agency connects intended parents with appropriate surrogates and offers support throughout the journey.

Did you know that the Care Classic plan from Care Health Insurance includes coverage for IVF treatments for the insured individual? If you have this plan with a sum insured of Rs 5 lakhs or more, you can claim up to Rs 1 lakh for IVF treatment costs.

* Surrogacy is not covered by health insurance plans. Please read the terms & conditions before purchasing any health insurance plan.

The Surrogacy Process: Step-By-Step

The surrogacy process varies based on whether it's gestational (where the surrogate is not genetically related to the child) or traditional (where the surrogate is the biological mother). Here's how the surrogacy process unfolds:

Step 1 - Consult and Decide

Intended parents meet with fertility experts or surrogacy agencies to discuss choices, expenses, and legal matters. They review their fertility background and determine if surrogacy is the best option. In India, only altruistic surrogacy is allowed for married Indian couples dealing with medical infertility.

Step 2 - Legal Agreements

Legal contracts are created and signed, detailing the rights and duties of everyone involved (intended parents, surrogate, and agency). These agreements address matters such as parental rights, payment, and medical procedures.

Step 3 - Matching with a Surrogate

Intended parents work with an agency to find a suitable surrogate, who undergoes medical and psychological evaluations. The surrogate must fulfil certain requirements (age, number of children, etc.) according to legal standards.

Step 4 - Medical Procedures & Maternal Care

In this stage, IVF is performed, and the embryos are placed into the surrogate's uterus. The doctors will monitor the pregnancy regularly.

Step 5 - Delivery and Post-Delivery

After the baby is born, the surrogate gives the baby to the intended parents, and legal parental rights are then transferred accordingly.

Risks and Complications of Surrogacy

Building a family through surrogacy has its challenges and rewards. Intended parents often face common risks, such as:

• Emotional stress from issues with fertility treatments or unforeseen circumstances.
• Financial burden, as surrogacy is costly and does not guarantee success.
• The possibility of pregnancy failure or not reaching full term.
• A sense of detachment from the pregnancy and the developing baby.

Gestational surrogacy also comes with its own set of risks, including:

• Pregnancy-related risks include infections, gestational diabetes, and preeclampsia (high blood pressure during pregnancy).
• Issues within the family can create challenges for their children and partner.
• Forming an emotional connection with the baby during pregnancy may cause feelings of sadness after birth.

Do you know that family health insurance can protect your child from medical emergencies if you enrol them within 90 days of their birth? This insurance policy also aids in preparing for emergencies, ensuring financial stability, and addressing other concerns, making it a useful resource for life's unpredictability. Keep in mind, while we can't avoid every situation, being prepared gives us the strength to confront anything with confidence.

Reasons for Choosing Surrogacy Process: Why & Who?

A surrogacy arrangement might be an option if:

• Women who cannot get pregnant or carry a pregnancy due to having a hysterectomy.
• Missing parts of her uterus, ovaries, or other reproductive organs.
• A woman has a condition that poses risks during pregnancy.
• Serious health issues that could significantly risk either the mother or the fetus during pregnancy.
• A biological inability to carry a child (for instance, a same-sex male couple).
• A single man wants to have a child using his sperm.
• If a woman with frozen embryos passes away, her male partner wants to use those embryos to have a child.
• Patients who have undergone several unexplained IVF cycles or show signs of an unknown endometrial issue.

Is Surrogacy Legal in India?

Yes, surrogacy is allowed in India, but only altruistic surrogacy is legal. Commercial surrogacy, which includes payment beyond basic medical costs, is banned under the Surrogacy (Regulation) Act of 2021. This means a surrogate mother can only be reimbursed for medical expenses and provided with insurance coverage for carrying the child.

Eligibility for Surrogacy in India

According to the Surrogacy Law, surrogacy is only permitted for eligible Indian citizens who meet specific requirements. Additionally, commercial surrogacy is prohibited in India. The eligibility criteria for intended parents may include:

• Only legally married Indian couples or those holding an OCI card are eligible for surrogacy.
• The couple must have been married for almost five years.
• A medical condition that prevents the female partner from carrying a pregnancy to term must be documented.
• The female partner should be between 23 and 50 years old, while the male partner should be between 26 and 55 years old.
• The couple must not have any surviving biological, adopted, or surrogate children. An exception is made if the child has a life-threatening illness or a physical/mental disability.
• The intended couple must use their gametes (sperm and eggs) for the surrogacy process.

Documents Requirements Before the Surrogacy Process

The Surrogacy Law stipulates that the following steps must be completed before initiating the surrogacy process. The couple intending to have a child needs:

• A Certificate of Medical Indication from the Relevant Authority.
• An eligibility certificate.
• A court order from a Magistrate regarding the child's parentage and custody.
• Sufficient insurance coverage for the surrogate mother for 36 months, provided by the insurance company.
• A Certificate of Essentiality from the Relevant Authority confirming that all conditions are met.

Who Can Be a Surrogate?

Any woman from India who is willing can act as a surrogate. She should be between 25 and 35 and meet these criteria:

• Be married and have at least one child of her own.
• Not have previously served as a surrogate.
• Will not provide her gametes as a surrogate.
• Be physically and mentally healthy.
• Hold an Eligibility certificate from the Appropriate Authority.

Current Status of Surrogacy In India: Facts & Legalities

Here are some important facts about surrogacy that you should be aware of:

Cost of Surrogacy in India

The total cost of surrogacy in India can differ significantly, but it usually ranges from Rs 10 lakh to Rs 20 lakh.

Babies Born Through Surrogacy Can Be Healthier

Since surrogates go through careful medical checks, their pregnancies are usually watched carefully, and they tend to be healthier, resulting in safer births and healthier infants.

Commercial Surrogacy Ban

The Surrogacy (Regulation) Act, 2021, bans commercial surrogacy, which means paying the surrogate more than just basic medical costs is not allowed in India.

Legal Rights

A child born via surrogacy is legally recognised as the biological child of the intended parents.

Success Rate of Surrogacy in India

Success rates range from 60% to 75%, influenced by factors such as the quality of the embryo, the health of the surrogate, and the skill of the clinic.

International Surrogacy

Transnational surrogacy, which involves intended parents and surrogates from different nations, brings up extra legal and ethical issues.

Age Limit for Surrogacy in India

The female partner of intended parents should be aged 23 to 50, while the male partner should be between 26 and 55 years old. Whereas, the surrogate mother must be aged 25 to 35.

>> Also Read: Is Surrogacy Covered under Health Insurance?

A Bond Beyond Biology!

Surrogacy goes beyond just a medical procedure; it represents trust, generosity, and hope. It provides an opportunity for individuals who once believed they could never become parents. While surrogacy remains a viable option in India, it is now subject to stricter regulations due to the Surrogacy Act, 2021. Intended parents are required to meet medical, psychological, and legal criteria and must ensure that their surrogacy process takes place at a registered clinic.

Whether you are exploring for personal reasons or just for knowledge, learning the concept of surrogacy allows us to value the remarkable power of human relationships. The regulations are designed to make sure that surrogacy is carried out responsibly, prioritising the child's well-being and a secure family setting. By staying informed about all the legal obligations and rules, both individuals and couples can safely navigate the surrogacy process in India.

Disclaimer: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. Health insurance benefits are subject to policy terms and conditions. See policy documents for details.