Surrogacy is an arrangement in which a woman carries and gives birth to a baby for an intended parent or couple. In gestational surrogacy, an embryo created through IVF is transferred to the surrogate’s uterus, and the surrogate does not provide the egg.
For patients considering surrogacy, understanding the medical process, eligibility requirements, legal framework, and potential costs is important before making any decision. This article explains what surrogacy means, how the process works in India, who may be eligible, and what patients should know before consulting a fertility specialist.
How Does Surrogacy Work?
Surrogacy generally begins with a thorough medical evaluation of both the intended parent(s) and the surrogate, followed by IVF to create an embryo, which is then transferred to the surrogate’s uterus. The surrogacy process typically involves embryo creation through ovarian stimulation, egg retrieval and fertilisation, before embryo culture and transfer take place. Throughout the treatment cycle, pregnancy monitoring ensures the surrogate and pregnancy remain healthy. It’s important to note that surrogacy in India is governed by specific legal and regulatory requirements, which intended parents and surrogates must fulfil before treatment begins.
Medical Evaluation and Preparation
- Fertility assessment for intended parent(s)
- Relevant investigations, including blood tests and scans
- Medical and psychological evaluation for the surrogate
- Preparation and planning for the treatment cycle
Embryo Transfer and Pregnancy Monitoring
- An embryo created through IVF is transferred into the surrogate’s uterus using a thin catheter.
- Pregnancy is confirmed and monitored through routine medical care, including regular check-ups and scans, similar to any other pregnancy.
What Are the Steps in the Surrogacy Process?
Surrogacy involves IVF treatment to create an embryo, which is transferred to the surrogate’s uterus. The surrogacy process includes a fertility evaluation of the intended parent(s) and surrogate, followed by ovarian stimulation, egg retrieval and embryo culture, before embryo transfer. Pregnancy monitoring then follows through routine care, subject to India’s legal and regulatory requirements.
Steps in the Surrogacy Process
- Medical assessment of the intended parent(s) and surrogate.
- Eligibility and legal assessment under applicable Indian regulations.
- IVF treatment and embryo creation, where clinically appropriate.
- Preparation of the surrogate for embryo transfer.
- Embryo transfer into the surrogate’s uterus.
- Pregnancy monitoring through appropriate antenatal care.
- Delivery and post-delivery care for the surrogate and baby.
Medical Evaluation and Preparation
- Fertility evaluation for intended parent(s)
- Investigations, including blood tests and scans
- Medical and psychological evaluation for the surrogate
- Preparation for the treatment cycle
Embryo Transfer and Pregnancy Monitoring
- Embryo transferred into the surrogate’s uterus via a thin catheter
- Pregnancy monitored through routine check-ups and scans, as in any pregnancy
Real Data Point
Surrogacy in India is regulated under the Surrogacy (Regulation) Act, 2021; no verified national statistic on success rates or procedure volumes is currently published officially.
Who Can Consider Surrogacy and What Are the Requirements in India?
Surrogacy in India is legally regulated and not available simply as a commercial arrangement. The Surrogacy (Regulation) Act, 2021, governs surrogacy nationwide and prohibits commercial surrogacy entirely. Understanding what the procedure of surrogacy is also means understanding that eligibility depends on statutory requirements, documented medical indications, and certificates issued by the appropriate authority, rather than personal preference alone.
Both the intending parent(s) and the surrogate must meet prescribed eligibility requirements, which are assessed by a registered medical practitioner and approved under the Surrogacy (Regulation) Rules, 2022. The surrogate herself must also meet specific eligibility criteria and provide informed consent before proceeding, with her welfare protected throughout the process. Because eligibility rules and criteria have been amended since the Act’s original notification, patients should always confirm the current requirements with a fertility specialist or the National Assisted Reproductive Technology and Surrogacy Board rather than relying on older information.
Altruistic Surrogacy in India
Only altruistic surrogacy is permitted under India’s legal framework; commercial surrogacy is strictly prohibited (India Code). In altruistic surrogacy, the surrogate receives no financial compensation for carrying the pregnancy; only medical expenses, insurance, and related costs may be covered, with no payment permitted as a commercial service.
Client/Patient Example (Illustrative, Anonymised)
A woman with a medically indicated condition preventing pregnancy underwent fertility assessment, followed by IVF to create an embryo, embryo transfer to the gestational surrogate, and ongoing pregnancy monitoring. This is a representative example only, not an actual patient case.
What Does Surrogacy Cost in India?
Surrogacy cost in India isn’t a single generic “surrogacy package” price—expenses vary depending on the fertility treatment required, investigations, IVF procedures, medicines, pregnancy care, and legally mandated insurance. Costs differ significantly between patients based on individual medical needs and the treatment cycle involved.
Indian law includes specific insurance requirements for the surrogate mother. Under the Surrogacy (Regulation) Rules, 2022, general health insurance coverage is prescribed for 36 months, protecting the surrogate throughout the surrogacy period and beyond.
| Cost Component | What It May Include |
| Medical assessment | Consultations, fertility evaluation and investigations |
| IVF treatment | Ovarian stimulation, egg retrieval, fertilisation and laboratory procedures |
| Embryo transfer | Preparation and transfer of the embryo |
| Pregnancy care | Antenatal consultations, scans and medically required care |
| Insurance | Prescribed health insurance coverage for the surrogate |
| Additional medical care | Treatment or investigations required based on clinical circumstances |
“Since I don’t have access to Womb’s actual pricing, and their website does not list any specific surrogacy costs…
FAQ
Q1: What are the eligibility requirements for surrogacy in India?
Surrogacy in India is permitted only when specific legal and medical eligibility requirements are met. Intended parents and the surrogate must undergo medical assessment, fertility evaluation, and required screening, with informed consent and legal documentation completed as prescribed.
Q2: Is commercial surrogacy legal in India?
No. Commercial surrogacy is not legal in India. Under India’s Surrogacy (Regulation) Act, 2021, commercial surrogacy—where the surrogate receives payment beyond permitted medical expenses and prescribed insurance—is prohibited.
Q3: What is gestational surrogacy and how does it work?
Gestational surrogacy involves a surrogate pregnancy where the surrogate doesn’t provide the egg. In vitro fertilisation creates an embryo through embryo culture, followed by embryo transfer into the surrogate’s uterus, with ongoing pregnancy monitoring through IVF treatment protocols.
Q4: What medical tests are needed before starting a surrogacy procedure?
Medical screening includes fertility assessment through blood testing, ultrasound examination and reproductive evaluation for both intended parents and the surrogate. This reproductive health assessment ensures suitability before treatment, alongside relevant antenatal care planning throughout the process.
Q5: What factors can affect the outcome of a surrogacy treatment cycle?
Surrogacy success depends on several fertility factors, including embryo quality assessment, ovarian response to stimulation, and overall reproductive health. Treatment outcome varies between individuals in assisted reproduction, making the fertility treatment cycle unpredictable and patient-specific.
Q6: How long does the surrogacy process take?
The surrogacy timeline varies depending on the IVF cycle, embryo transfer and pregnancy duration. From fertility assessment to birth, the process typically spans several months, with ongoing pregnancy monitoring and antenatal care throughout.
CONCLUSION
Surrogacy is a medically and legally regulated pathway in which a surrogate carries a pregnancy for intended parent(s). In gestational surrogacy, IVF is generally used to create an embryo before it is transferred to the surrogate.
Because eligibility, medical indications, and legal requirements matter, patients should understand the process carefully before proceeding.
Considering surrogacy? Book a consultation with a qualified fertility specialist to discuss your medical situation, eligibility and available treatment options.
Dr Loukya
Dr Loukya specializes in fertility care, reproductive medicine and minimally invasive gynaecological surgery. She works with couples to understand their fertility concerns, review previous treatment history and create an individualized treatment plan. Her approach focuses on clear explanations, appropriate evaluation and continued guidance throughout treatment.