1. What is Surrogacy?

Ans.Surrogacy is a method of assisted reproduction. The word surrogate originates from
Latin word surrogatus (substitution) - to act in the place of. The term surrogacy is used when
a woman carries a pregnancy and gives birth to a baby for another woman.

Surrogacy is gaining popularity as this may be the only method for a couple to have their own
child and also because adoption, process may be a long drawn out process.

Why Surrogacy?

Surrogacy is when another woman carries a baby for a couple/ individual who are unable to
conceive or carry a child themselves. This Treatment is offered usually due to inability of
Intended Mother/ Intended Parents to conceive, or carry a child to term, due to medical or
other problems.

• Recurrent miscarriages despite of all possible treatments.
• Repeated failures in IVF treatment
• Premature menopause, often as a result of cancer treatment
• A hysterectomy, or an absent or abnormal Uterus
• Inability to conceive in case of Single Parents
• Possibility of a Health condition which makes pregnancy and birth dangerous.

2. What are the Types of Surrogacy?
Ans. IVF / Gestational surrogacy&Traditional / Natural surrogacy
IVF / Gestational surrogacy - This is a more common form of surrogacy. In this procedure, a
woman carries a pregnancy created by the egg and sperm of the genetic couple. The egg of
the wife is fertilized in vitro by the husband's sperms by IVF/ICSI procedure, and the embryo
is transferred into the surrogate's uterus, and the surrogate carries the pregnancy for nine
months. The child is not genetically linked to the surrogate.
Traditional / Natural surrogacy - This is where the surrogate is inseminated or IVF/ICSI
procedure is performed with sperms from the male partner of an infertile couple. The child
that results is genetically related to the surrogate and to the male partner but not to the
female partner.

3. To whom Surrogacy is Advised?
Ans. IVF Surrogacy
1. Primarily, IVF surrogacy is indicated in women whose ovaries are producing eggs but
they do not have a uterus. For e.g., in the following cases:
a) Congenital absence of uterus (Mullerian agenesis)
b) Surgical removal of the uterus (hysterectomy) due to cancer, severe hemorrhage in
Caesarian section or a ruptured uterus.
2. A woman whose uterus is malformed (unicornuate uterus, T shaped uterus, bicornuate
uterus with rudimentary horn) or damaged uterus (T.B of the endometrium, severe
Asherman's Syndrome) or at high risk of rupture, (previous uterine surgeries for rupture
uterus or fibroid uterus) and is unable to carry pregnancy to term can also be recommended
IVF surrogacy.
3. Women who have repeated miscarriages or have repeated failed IVF cycles may be
advised IVF surrogacy in view of unexplained factors which could be responsible for failed
implantation and early pregnancy wastage.
4. Women who suffer from medical problems like diabetes, cardio-vascular disorders, or
kidney diseases like chronic nephritis, whose long term prospect for health is good but
pregnancy would be life threatening.
5. Woman with Rh incompatibility.
B. Traditional Surrogacy
1. Women who have no functioning ovaries due to premature ovarian failure. Here egg
donation also can be an option.
2. A woman who is at a risk of passing a genetic disease to her offspring may also opt for
traditional surrogacy.

Screening the Surrogate

Once the surrogate has been inducted, she will undergo thorough medical and psychological
evaluations,including:

Psychological Interviews to determine that Surrogate Mother is mentally healthy and to
ensure that she will be able to follow the protocols provided to her in due course of becoming
a Surrogate Mother and during her Pregnancy period and later. Careful evaluation
psychologically as well as physically is carried out to ensure that the surrogate has not been
subjected to any pressure or coercion.

Blood tests (as appropriate) for sexually transmitted diseases and all communicable diseases
are carried out. Variety of Blood-Hormone tests, such as the measurement of Plasma
Prolactin, to ascertain her immunity to the development of Rubella (German measles) and
Thyroid- Stimulating Hormone (TSH) are also performed.

4. Is Surrogacy right for you?
Ans. For some couples opting for surrogacy is a very straight forward decision, while, for
others there are lots of things to be considered and thought about before taking the decision.
There are lots of complex issues involved. It is an emotional roller coaster ride for the couple,
the families and friends. It is a decision where the 'right' and the 'wrong' are very individual
things. An infertility specialist or a counselor can help the couple seeing things in the right
perspective. Other options such as, adoption or further infertility treatment can also be
considered.

5. What are the screening criteria for surrogate? How is a surrogate chosen in India?
Ans. Medical Tourism's network of hospitals in India, has a very meticulous and stringent
criteria for choosing a surrogate. The surrogates are between 21-35 years of age. They are
married with previous normal deliveries and healthy babies. Detailed medical history,
surgical history, personal history, and family history is looked into. History of blood
transfusion and addiction is also taken. It is made sure that the surrogate has an uneventful
obstetric history (no repeated miscarriages, no ante-natal, intra-natal and post-natal
complications during previous pregnancies). The surrogate and her partner are screened for
infectious diseases like sexually transmitted diseases, Hepatitis B, Hepatitis C, HIV, VDRL.
Thalassemia screening is also done. Detailed pelvic sonography is done and other tests for
uterine receptivity are performed to ensure maximum chances of success. A detailed financial
and legal agreement is then drawn up between the surrogate and the commissioning couple.

6. What is the success rate of surrogacy in India?
The success rate (carry home baby) of surrogacy is around 45% in case of fresh embyos. In
case of frozen embryo's it is about 25%. High success rates and low medical costs are the
highlights of surrogate pregnancy in India. No wonder many couples from the US, Australia,
the UK, and other European countries seek surrogacy in India.

7. What are the advantages of surrogacy?
a) This may be the only chance for some couples to have a child, which is biologically
completely their own (IVF surrogacy) or partly their own (gestational surrogacy)
b) The genetic mother can bond with the baby better than in situations like adoption.