Surrogacy / Gestational Carrier

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Basics

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Options

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Surrogate Selection

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Procedures and Legalities

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Cost

Nature has bestowed the beautiful capacity to procreate a life within women and every woman cherishes the experience of motherhood. Unfortunately, some women due to certain physiological conditions cannot give birth to their own off-spring. The desire for motherhood leads them to search for alternative solutions, and surrogacy presents itself as the most viable alternative.

Surrogacy:

According to the Artificial Reproductive Technique (ART) Guidelines, Surrogacy is an "arrangement in which a woman agrees to a pregnancy, achieved through assisted reproductive technology, in which neither of the gametes belong to her or her husband, with the intention of carrying it to term and handing over the child to the person or couple for whom she is acting as surrogate".

Intended Parent(s):

They are the Single parent or couples (married for minimum two years) who want to have the child. According to Indian ART law, the child born through surrogacy should be genetically related to at least one of Intended parent who have commissioned the surrogacy. So in case of single parents, they have to be fertile and in a position to contribute their gametes.

Surrogate:

A surrogate mother "is a woman who agrees to have an embryo generated from the sperm of a man who is not her husband, and the oocyte for another woman implanted in her to carry the pregnancy to full term and deliver the child to its biological parents(s)".

Advances in assisted reproductive techniques such as donor insemination and, embryo transfer methods, have revolutionized the reproductive environment, resulting in surrogacy as the most sought after option for couples who have failed to conceive by IVF. The system of surrogacy has given hope to many infertile couples, who long to have a child of their own through Advanced Reproductive Techniques like IVF, Egg Donation and Embryo Transfer with help of a gestational carrier or surrogate.

How is pregnancy achieved using a Surrogate ?

The Pregnancy is carried out by another women, a surrogate, who acts as a gestational carrier.

IVF surrogacy with Intended mother as egg source

If the Intended Mother is able to contribute her eggs (but unable to carry her own pregnancy), then the eggs are removed from the infertile woman, fertilized with her partner's sperm, and transferred into the gestational carrier's (surrogate) uterus by Embryo Transfer Procedure. The gestational carrier will not be genetically related to the child. The child will be genetically related to the Intended parents (biological parents). This is called IVF or Gestational Surrogacy.

IVF surrogacy with Egg Donor

If the Woman is infertile, has poor quality eggs and hence is not able to contribute to creating an embryo by IVF, the embryo is created by taking the eggs from an egg donor and fertilizing with the Intended Father’s eggs. This embryo is transferred to the surrogate. The surrogate will not be biologically related to the child, neither will be the Intended Mother. The child will however be biologically related to the Intended father.

How is the Surrogate Selected ?

As per the ART guidelines laid down by the Indian Council of Medical Research (ICMR), any women between the ages of 25 to 35 can be a surrogate if she has at least two biological children by marriage and has the consent of her husband or guardian. The surrogate cannot undergo more than two gestational pregnancies by surrogacy.

The surrogate selection process is extensive and surrogates are screened to see if they meet all the selection criteria laid down by the ICMR guidelines. These selection criteria includes a gamut of tests aimed to screen for HIV, Syphilis, Infections, blood tests, and investigations that test uterine conditions like ultrasound, HSG, Hysteroscopy (advanced test) and general physical health of both the surrogate and her husband.

Known Surrogates:

In the past, surrogacy arrangements were generally confined to kith and kin of close relatives, family, or friends, usually as an altruistic deed. This is still an option. However if the Intended parents arrange a known surrogate, then they are responsible for all the legal arrangements, surrogate’s accommodation and welfare during the pregnancy. The clinic takes no part in this proceedings beyond required treatment procedure and surrogate evaluations.

 

 

 

Process of commissioning surrogacy and Legal aspects:

All parties benefit from psychological and legal counselling before commissioning surrogacy. The surrogacy process involves extensive psychological and legal counseling for both intended parents and the surrogate. All the risks and implications related to this procedure is informed. The surrogacy is carried out only after both the parties agree to the terms and conditions and sign the legal agreements. The Intended parents also enter into an agreement with clinic that covers the terms and conditions of treatment and surrogate’s care and management from the start of the treatment till end of the surrogacy arrangement.

The signing of the agreements is a most important step in the Surrogacy Process. The surrogacy process cannot be initiated until all parties have consented, signed the agreements, and the Intended parent(s) have made the necessary advance payments to commission the surrogacy.

A crucial step before signing the agreements is surrogate selection. The Intended parents will have to bear all the costs involved in the surrogate screening for each new surrogate.

Intended parents should also be aware of the following complications that may arise and be prepared for the additional costs:
  • If the results of the screening test are not good, the surrogate may be rejected and we may have to look for another surrogate. In such cases the surrogate screening will have to be carried out again at extra cost.
  • If the surrogate’s endometrium stimulation is not satisfactory, the cycle may be cancelled. In such cases the embryos have to be cryopreserved and FET done later when the surrogate is prepared again.
  • In case of implantation failure, the couple will have to face the choice of continuing with the same surrogate again or changing the surrogate.

HOW MUCH DOES SURROGACY COST?

We offer detailed cost counseling’s to couples who want to commission surrogacy. Since Surrogacy is a complicated and time consuming process, we recommend couples to have direct consultation with us to understand the steps, and costs involved.

In general the surrogacy costs include the following procedures:

  • Surrogate Screening and preparation costs
  • Payments to surrogate agency
  • Costs for legal counsel and preparation of agreements
  • IVF Treatment and medicines costs
  • Costs of evaluations during the treatment and pregnancy till delivery
  • Egg donor costs (if needed)
  • Cryopreservation of egg/ sperm/ embryo if needed
  • Embryo transfer / Frozen embryo transfer costs
  • Costs of surrogate accommodation and welfare starting from Surrogate preparation till the end of the surrogacy arrangement.
  • Delivery costs
  • Surrogate’s compensation
  • Payment to Medical Social worker

Additional costs (If new surrogate is needed):

  • Surrogate screening and Preparation
  • Legal costs
  • Transfer cost

Surrogacy cost does not include:

  • Any additional hospitalization of the surrogate.
  • Any complication of pregnancy requiring additional intervention.
  • NICU care for the baby incase needed.