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Comprehensive Guide to Surrogacy: Types, Process, Costs, and Legal Considerations

Welcome to A4’s handbook of parenthood. This segment of our website emphasises the various options and alternatives for couples battling infertility to become parents. Third-party reproduction is a viable option for various kinds of couples who are longing to embrace the beauty and happiness of having a family, and surrogacy stands as an anchor of hope for those couples. This particular third-party reproduction is practised across the globe to pass on the essence of parenthood.

Understanding Surrogacy

What Is Surrogacy?

For those who are unable to get conceived on their own or are struggling severely with infertility, surrogacy is a viable option for those couples or individuals.

Surrogacy is a reproductive method in which an individual would carry the child of the intended parents in her womb for nine months would deliver the baby on behalf of the couple. The person is known as a surrogate. This arrangement is made when the couple is struggling with infertility or if they are from the same sex.

Why Surrogacy?

In the day and age when couples are struggling with impaired fertility, surrogacy is a viable reproductive method that would give them the desired result of becoming parents:

Here are the scenarios where couples would choose Surrogacy

Medical Complications : When one of the two parents is medically incapable of contributing to the pregnancy of the mother.

Same-Sex Couples : When both parents are of the same sex, they could use the help of a surrogate to fulfil their satisfaction of raising a child.

Uterine Malfunction : When the mother is struggling with issues related to her uterine, carrying a baby would be extremely high risk and could lead to miscarriage or severe health-related repercussions.

Former Hysterectomy : For mothers who have undergone the removal of their uterus, it makes it impossible for them to carry a baby on their own as they could resort to surrogacy.

Chronic Pregnancy Losses : For those who have had recurrent miscarriages and continuous pregnancy failure could choose surrogacy for a healthy baby.

Surrogacy also is a type of reproduction method where the process may involve at least one parent’s genetics which would cause a sense of solidarity among the family. The process could be totally externalised as well, but those who are biologically potent can contribute to the delivery of a baby through a surrogate.

Types of Surrogacy

Various kinds of surrogacy can be performed. The concept of it has evolved over the years with medical advancements and the evolution of treatments

Traditional Surrogacy

Traditional surrogacy remains the most conventional form of treatment as it involves just the surrogate and the intended parents or the sperm donor. The semen from the father or the sperm donor is collected and is inseminated inside the surrogate where the egg gets fertilized. The intended parents become the legal guardians of the child after a successful pregnancy.

Pros of Traditional Surrogacy :

It is cheaper compared to others as it requires fewer medical procedures.

Unlike Gestational Surrogacy, this kind of surrogacy is more prevalent and more socially accepted.

Cons of Traditional Surrogacy :

Legal as well as emotional complexities could be faced by the intended parents and the surrogate leading to disputes and difficult challenges.

Social stigma could be one such hurdle that has to be crossed as the surrogate carries a genetic connection between the intended parents and the child, they may face discrimination in society.

Gestational Surrogacy

This kind of surrogacy involves the intervention of both the intended parents and also In Vitro Fertilization (IVF). An embryo is artificially created using the eggs and the sperm of the intended parents. It is then fertilized and transferred to the surrogate’s uterus for gestation. This is considered more legal as the surrogate would have no genetic connection with the intended parents or the child.

Pros of Traditional Surrogacy:

The Surrogate will have no genetic connection with the child eliminating any sort of emotional consequences.

Parental rights become more clearer and easier

Cons of Traditional Surrogacy:

Comparatively more expensive than other treatments as IVF is involved in this form of treatment.

Requires more medical procedures and processes

Altruistic Surrogacy

As the name suggests, this form of surrogacy is done with an unselfish motive by the surrogate. They do not charge any compensation beyond the reimbursement of pregnancy-related expenses. The leading intention of this is to help people overcome their grief of not having a child and achieve their dreams.

Pros of Altruistic Surrogacy:

The pure intentions of the surrogate to help the intended parents would boost the level of trust among the parties involved.

It's of lower cost as there is no compensation that needs to be paid.

Cons of Altruistic Surrogacy

Limited availability of surrogates

The surrogate could be faced with financial constraints due to the lack of compensation.

Commercial Surrogacy

Primarily known as compensated surrogacy, this typically means the surrogate would receive massive compensation beyond the reimbursement of pregnancy-related expenses. This form of treatment is widely practised in countries where it is legal and regulated.

Pros of Commercial Surrogacy:

Enhances the pool of potential surrogates for the intended parents.

Gains financial incentives for commercial surrogates and is widely available

Cons of Commercial Surrogacy:

Ethical and ingenuity concerns due to their commodification

This could lead to the financial exploitation of vulnerable women.

The type of surrogacy chosen depends on the preferences and circumstances of the intended parents, as well as the legal and ethical considerations in their region.

The Surrogacy Process

The Surrogacy process is quite diverse and involves stringent steps as it involves the birth of a child. Let's break down these steps:

Identifying a Surrogate

Identifying a surrogate is the first step towards any form of surrogacy. The independent search means the intended surrogate finds a surrogate independently through either personal or online communities. Most intended parents opt to go through agencies that help people find surrogates. These agencies handle every process.

Medical and Psychological Screening

The parties usually go through evaluations to make sure they are prepared to go through the surrogacy journey.


a) Surrogate Screening :

This is mainly for the surrogates as they would be the ones carrying the responsibility of delivering a healthy baby. They go through medical evaluations, undergo examinations, fertility assessments, and psychological evaluations. These are intended to ensure that the surrogate is well-prepared to step into embarking on the journey of surrogacy.

b) Intended Parent Screening :

The parents will be briefed on the processes and procedures that would be involved in the process of surrogacy. They will need to provide medical records and undergo a physical evaluation to ascertain their abilities to parent. Physiological assessment ensures their readiness for surrogacy.

Legal Agreements and Documentation

These documentations serve as a vital deed for securing the rights and responsibilities of all parties involved. They typically include:

a) Surrogacy Contract :

They include the framework of all the roles and responsibilities of the intended parents, surrogates, and any donors

Summary of any form of compensation or reimbursement, and parental rights.

b) Parentage Orders :

In case the intended parents go through traditional surrogacy, the surrogate may have a genetic connection to the child and these orders establish legal procedures that are necessary to establish the intended parents' parental rights.

Fertility Assessment :

This mainly revolves around the chosen surrogacy route. In Gestational surrogacy, in vitro fertilization (IVF) is used:

Proces of IVF :

Egg Retrieval : Eggs are collected from either the donor or the intended mother.

Sperm Collection : Sperm is secured from the intended father or a donar

Embryo Formation : An embryo is artificially created through the combination of eggs and sperm in the labs.

Embryo Transfer : The final stage involves the transfer of the fertilized embryo into the surrogate's uterus.

Prenatal Care

Following the successful formation of the child, the surrogate gets prenatal care from the providers. This step includes regular checkups, scaling the pregnancy process, and necessary medical intervention.

Aftermath of pregnancy

Once the baby is to be born, the intended parents are present for the arrival and the doctors ensure that the surrogate receives appropriate medical care.

4. Costs of Surrogacy

It is said to be a significant financial investment that includes various compensation and fees. This mainly depends on the route chosen by the intended parents. If the intended parents choose the altruistic route, the only monetary investment would be the reimbursement of pregnancy expenses. If they choose any other route, these are the potential fees involved:

Agency Fees

The agency that would technically handle everything with regard to the surrogate would charge for the processes they oversee. From screening to providing legal assistance, they would charge for a substantial portion of the overall cost.

Legal Fees

The fees involved in the documentation of the legality and deeds are one such investment involved in the process. It mainly depends on the complexity and local regulations.

Medical Expenses

These expenses revolve around prenatal care, fertility treatment, delivery costs, and every other medical intervention. The type of surrogacy chosen and the medical needs of the surrogate may impact these expenses.

5. Legal Considerations

The entire process is a complex issue that encompasses diverse fields of interest. Some of the legal considerations in India are

Legality : This law ensures the legality, eligibility, and responsibilities of the surrogate and the intended parents.

Agreement : This document is a deed that would entail every aspect of the journey ranging from the surrogate's compensation to any other medical-related process.

Citizenship : Ensures the legal citizenship of the child especially if the intended parents are from another country.

Final Documentation : This paperwork would comprise every filing and legal authentication of the relevant authorities.

The Exit : Ensures a smooth exit for the intended parents.

6. Identifying A Route and Understanding the factors

It is essential to pick the appropriate route that would ensure a seamless delivery of the child. There are far too many factors to consider and here are a few:

Genetic Connection : Choosing whether the intended parents want to have a genetic condition for the child.

Legal Regulations : Ensuring that the filled documents are valid and the laws have not been breached.

Affordability : Some routes may be cost-effective while others may cost an arm and a leg. It is essential to pick the right route as there would be no going back.

Availability of the Surrogate : It is of quintessential importance that the chosen or identified surrogate must be available around the clock and should be within calling distance in case of any emergency.

Surrogate Relationship : In traditional surrogacy where the child could have a genetic connection, it is important to identify if the intended parents are comfortable with that idea.

Making the Decision

The most important aspect is to choose the appropriate route for treatment. This could be a deeply personal decision but there is no harm in consulting with agencies and fertility doctors to gain in-depth knowledge.

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