‘Gestational Surrogacy’ or otherwise also referred to as “IVF surrogacy” or “Full surrogacy” is defined as a treatment by which the gametes of the ‘genetic couple’, ‘commissioned couple’ or ‘intended parents’ in the surrogate arrangement are used to produce embryos and these embryos are subsequently transferred to a woman who agrees to act as a ‘host’ for these embryos. The ‘surrogate host’ is therefore genetically unrelated to any offspring that is born of this arrangement. In ‘Partial surrogacy’ or ‘natural surrogacy’ the woman is inseminated with the semen of the husband and therefore is genetically related to the offspring.
Indications:
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Hysterectomy after cancer |
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Congenital absence of the uterus |
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Hysterectomy from post partum hemorrhage |
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Repeated IVF failure |
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Recurrent Abortion |
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Hysterectomy for menorrhagia |
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Severe medical conditions incompatible with pregnancy |
Needles to say the in depth counseling is required for both the ‘genetic parents’ as well as the ‘Host’ For the genetic parents a review of all the other treatment options should be explicitly explained. The couple should be explained about the medical, physiological, the potential psychological problems and also the cost of the whole treatment. The control of the genetic parent over the host, its limitations and also the risk of the child being born with a handicap are also to be explained. The couple is advised to take an insurance cover for the host, to take legal advice and also be prepared that the host might not want to give up the child after being born, as surrogacy contracts are not enforceable.
The “host” on the other hand should also be counseled in depth as above and explained also about physiological the risks of multiple pregnancy, the social implications, and the need to abstain from unprotected sexual intercourse during the course of pregnancy. Along with all this she should also be made to understand the sense of loss and guilty that she may feel after giving up the baby.
ICMR has now laid down guidelines in India. The salient features are:
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A child born through surrogacy must be adopted by the genetic parents unless they can establish through genetic fingerprinting that the child is theirs. |
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Surrogate mother should be younger than 45 years. |
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Documentary evidence of the financial arrangement for surrogacy must be available. ART clinic should not be involved in the monetary aspect. |
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No relative or person known to the couple may act as surrogate. (this point is under consideration.) |
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