1. What is surrogacy?
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.
3. Indications of surrogacy
A. 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. What are the screening criteria for surrogate? How is a surrogate chosen in India? 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.