The advancement of science and medicine has allowed for new and innovative family building options. Surrogacy is a family building option for couples who cannot successfully carry a pregnancy.
Who Uses Surrogacy?
The American Society for Reproductive Medicine states that gestational carriers may be used when there is a clear and definitive medical indication that prevents the intended couple from carrying a child. Examples of some such conditions include:
- Significant uterine anomalies or the absence of a uterus
- Major medical conditions that would cause significant risk to either the mother or the fetus in pregnancy
- Biologic inability to carry a child (e.g. same-sex male couple or single male)
- Patients with a history of multiple unexplained IVF cycles or other suggestion of an unidentified endometrial factor
Finding a Surrogate
What to Consider with Surrogacy
Surrogacy involves many legal, ethical, and financial considerations. Usually, intended parents pay the surrogate for her medical expenses; there are also significant legal expenses.
Surrogacy within the entire country is possible if medically required. The clauses for non-resident Indians and persons of Indian origin are still not clarified.
Only gestational surrogacy is permitted by our law, in which the surrogate carries a pregnancy by conceiving an embryo created with the sperm and egg of the intended parents. A gestational surrogate has no genetic relationship to the child.
Surrogacy is an option for women with absent uterus, severely distorted uterus, uterine causes of miscarriage and medical disorders, which prevent a woman from carrying a pregnancy to term without complications. Even women who had repeated IVF failures, multiple miscarriages or hysterectomy, might need surrogacy.
A couple opting for surrogacy needs to undergo a psychological counselling to ensure that they understand the implications. Once the medical formalities are done, the intending parents sign a legal contract with the surrogate and her husband/ guardian to state the legal surrogacy and the right of intending parents to the offspring, as well as medical and social care for the surrogate.
A surrogate mother should not be less than 21 years or over 35years of age. Before accepting a woman as a possible surrogate, the ART (assisted reproductive technique) clinic must ensure and put on record that the surrogate satisfies all the criteria required to go through a successful full-term pregnancy. Also, ensure that surrogate had no more than two previous pregnancies in her lifetime and is voluntarily willing for surrogacy.
No. It is a punishable legal offence in India.
The selection and evaluation of a surrogate may take 15-20 days. The treatment itself will take another 15 days or so. The results for pregnancy are earliest evaluated 12-15 days after transfer.
Multiple births depend upon the number of embryos transferred. In the case of surrogacy, the efforts are to limit this by not transferring more than one or two best embryos. This can be achieved by better grading system, blastocyst culture and preimplantation genetic screening. If we have to avoid SET(Single Embryo Transfer) can also be done.
For patients who have failed with self-embryos in surrogacy as well, genetic testing (PGS) of embryos is essential before next transfer.
In the case of surrogacy with parent s gametes, the genetic or physical trait of the offspring is not affected by the surrogate at all.
The overall health of the surrogate (emotional, physiological and physical status) is of prime importance. It is best to transfer fewer but healthy embryos to have a smooth pregnancy without compromising the health of the surrogate or the baby.