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What is Surrogacy?
The word surrogate is rooted in Latin SUBROGARE (to substitute) that is “appointed to act in place of”. Surrogacy implies that a woman becomes pregnant and gives birth to a child with the intention of giving away this child to another person or couple, commonly referred to as “intended” or “commissioning” couple.
The earliest known description of surrogacy is claimed to be the servant Hagar begetting a child for the childless Sarah through her husband Abraham, described in the biblical book of genesis.
In Hindu mythology, despite taking birth from the womb of Rohini, Balram is regarded as the son of mother Devaki.
There are two main kinds of surrogacy, Traditional and Gestational.
Traditional Surrogacy
Traditional Surrogacy is also commonly known as Genetic Surrogacy, Partial Surrogacy, or Straight Surrogacy.
It is the result of artificial insemination of the surrogate mother with the intended father’s sperm which means the surrogate mother’s eggs are used, making her a genetic parent along with the intended father. In view of the genetic involvement of traditional surrogate, this is no longer practiced worldwide.
According to an International Federation Of Gynecology and Obstetrics (FIGO) committee and Indian Council of Medical Research (ICMR) report, only gestational surrogacy is nowadays acceptable.
Gestational Surrogacy
Gestational Surrogacy is also commonly known as IVF Surrogacy, Host Surrogacy, or Full Surrogacy.
It is defined as an arrangement in which an embryo from the intended parents is transferred to the surrogate’s uterus. The surrogate here has no genetic connection to the child.
The first successful IVF surrogacy was reported in 1985 in the USA.
Surrogacy can be commercial or altruistic depending upon whether the surrogate receives a financial reward for her pregnancy. If she receives money for the surrogacy arrangement it’s considered Commercial Surgery and if she receives no compensation beyond reimbursement of her medical and other pregnancy-related expenses along with the insurance coverage for her, it is Altruistic Surrogacy.
In India only Altruistic Surrogacy is allowed.
Indications of Surrogacy
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Congenital absence of uterus e.g. Mayer Rokitansky Kuster Hauser (MRKH) Syndrome
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Loss of uterus following serious obstetrical complications such as intra and postpartum haemorrhages or rupture uterus.
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Repeated miscarriages
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Severe medical conditions, (for example heart and renal diseases) in whom pregnancy would be life-threatening. However, their long term prospect for health is good.
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After removal of the uterus (Hysterectomy) for any reason like cancer in the cervix etc.
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Repeated unexplained IVF failures despite the retrieval of good quality embryos.
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Persistent thin endometrium.
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Inoperable Asherman Syndrome (Uterine Synechiae)
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High risk of Uterine rupture (e.g. after multiple Cesarean deliveries)
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Severe Adenomyosis.
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Women with disorders that prevent conception or causes miscarriage e.g. Women with Auto-Immune disorders, blood clotting disorders like Factor V Leiden, etc.
