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What is surrogacy?

Posted by on Jan.16, 2014
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Surrogacy is the method of assisted reproduction where woman carries and delivers a child for another couple or person.

What are the indications of surrogacy?

  1. After hysterectomy
    • For cancer
    • For post partum Hemorrhage
    • For menorrahgia
  2. Congenital absence of the uterus
  3. Repeated failure of IVF
  4. Recurrent abortion
  5. Severe medical conditions incompatible with pregnancy

What are the types of surrogacy?

  1. Commercial / Altruistic – It describes a woman who is financially compensated – beyond expenses associated with pregnancy – for carrying the baby of another couple.
  2. Traditional surrogacy (TS) – In this surrogate acts as both the egg donor and as the actual surrogate for the embryo, and she is impregnated using a process known as intrauterine insemination, or IUI.
  3. Gestational Surrogacy (GS) –In this the surrogate’s eggs are not used at all. Therefore, the child will not be related to the surrogate biologically. Using the gestational type of surrogacy, the embryo is actually created by using both the biological father’s sperm and the biological mother’s egg through a process called in vitro fertilization.

What are the criteria for selecting surrogate?

  1. Age – 21 to 35 years
  2. Should be in good health.
  3. Must have given birth to at least one child
  4. Not having any serious medical complications during any prior pregnancies or deliveries.
  5. Surrogates and their partners must be non-smokers, drug-free, and not abuse alcohol

What are the steps in surrogacy?

  1. Preparation of Surrogate –
    • Birth control pills (regulate her menstrual cycle and to coordinate with Prospective Mother’s or Egg Donor’s menstrual cycle)
    • Injectable hormone medication (GnRH agonist) to control Surrogate’s hormone production / menstrual cycle.
    • Oral Estrogen – To increase endometrial lining from Day1/2
  2. Preparation of Prospective Mother or Egg Donor –
    • Ovarian stimulation
    • Egg retrieval
    • Insemination / fertilization
    • Embryo culture
  3. Embryo transfer in surrogate
  4. Luteal phase support to surrogate

Is surrogacy legal in India?

Commercial surrogacy is legal in india. The availability of medical infrastructure and potential surrogates, combined with international demand, has fueled the growth of the industry. Surrogate mothers receive medical, nutritional and overall health care through surrogacy agreements. The Home Ministry in Jan 2013 enacted discriminatory rules banning gays and singles of either sex from surrogacy in India. Age restrictions for surrogates requires women to be between 21 and 35.

The Indian Council for Medical Research (ICMR) has given some Guidelines for surrogacy. The Law Commission of India submitted the 228th report on Assisted Reproductive Technology procedures discussing the importance and need for surrogacy, and also the steps taken to control surrogacy arrangements. The following observations had been made by the Law Commission:

  1. Surrogacy arrangement will continue to be governed by contract amongst parties, which will contain all the terms requiring consent of surrogate mother to bear child, agreement of her husband and other family members for the same, medical procedures of artificial insemination, reimbursement of all reasonable expenses for carrying child to full term, willingness to hand over the child born to the commissioning parent(s), etc. But such an arrangement should not be for commercial purposes.
  2. A surrogacy arrangement should provide for financial support for surrogate child in the event of death of the commissioning couple or individual before delivery of the child, or divorce between the intended parents and subsequent willingness of none to take delivery of the child.
  3. A surrogacy contract should necessarily take care of life insurance cover for surrogate mother.
  4. One of the intended parents should be a donor as well, because the bond of love and affection with a child primarily emanates from biological relationship. Also, the chances of various kinds of child-abuse, which have been noticed in cases of adoptions, will be reduced. In case the intended parent is single, he or she should be a donor to be able to have a surrogate child. Otherwise, adoption is the way to have a child which is resorted to if biological (natural) parents and adoptive parents are different.
  5. Legislation itself should recognize a surrogate child to be the legitimate child of the commissioning parent(s) without there being any need for adoption or even declaration of guardian.
  6. The birth certificate of the surrogate child should contain the name(s) of the commissioning parent(s) only.
  7. Right to privacy of donor as well as surrogate mother should be protected.
  8. Sex-selective surrogacy should be prohibited.
  9. Cases of abortions should be governed by the Medical Termination of Pregnancy Act 1971 only.

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