ART and Surrogacy in

India
Benefits of ART and/or surrogacy:
Every couple has a chance to have their baby.

Women who donate eggs or become surrogate mothers

have financial encentive.

Government gets additional foriegn currency

transactions.
ART related malpractices/ dilemma:
for clients
People move to superspeciality clinics which may be in a

different region of India: Language barriers.

Planning stay and sustenance over-and-above the cost of

treatment.

Though regulations for ART clinics have been formed, the

transparency and information sharing is questionable.

ART related malpractices/ dilemma:
for donor women/ surrogate
mothers
No law to protect these womens rights.
Agreement with clinic often made through mediators:
Husband/ family members
How many times is enough?
Impact of frequent and prolonged hormonal
supplements over normal hormonal balance: not well
addressed in such scenario
Several pregnancies and childbirths: impact on womens
and neonates health?
 Ethical dilemma
Embryos being formed outside human body, and often
tested to avoid aneuploid/ polyploid conditions

Sex selection

Embryo freezing

What should be done with frozen embryos?

Donation
Assisted Reproductive Technology
Act (2008)
Proposed by Indian Medical and Research Council

(ICMR) in 2008

Drafted as ART rules and regulations guidelines 2010

Not passed by Government of India parliament till date.

 93 page directive on functionalizing
and regulating ART centres
Proposes three levels of ART
specialization.
Chapters on:
Minimum staff requirements
Minimum physical requirements
Procedures
Artificial Insemnisation- Husband
Artificial Insemnisation- Donor
Intra Uterine Insemnization-Husband
Intra Uterine Insemnization-Donor
InVitro Fertilization &Embryo Transfer
Intra Cytoplasmic Sperm Infiltration
Cryopreservation
Embryo donation
Culture media and lab procedures
Other chapters:
Selection of clients: no discrimination, right method for right couple

Selection guidelines for appropriate treatment: Evidence-based

guidelines

Counselling process

However: loosely framed, practical enforcement will require

ammendments and specific guidelines

 Surrogacy:
Surrogacy refers to a contract in which a woman carries a

pregnancy for another couple.Surrogacy comes as an

alternative when the infertile couple is not able to carry the

fetus till full gestation period.

Pikee Saxena, Archana Mishra and Sonia Malik. Surrogacy: Ethical and Social Issues.
Indian Journal of Community Medicine. 2012. Oct-Dec; 37(4): 211213.
 Types of surrogacy:
Surrogacy can be of two types:
Gestational Surrogacy: Infertile couple produces egg
and sperm, which in fertilized in vitro. The resulting
embryo is implanted into the surrogate mother.
Biological surrogacy: Male from the infertile couple
provides the sperm, which is artificially deposited into
the surrogate mother (IUI). In this case, the egg is from
the surrogate mother, making her also the biological
mother of the baby.
 Surrogacy in India
Commercial surrogacy is legally allowed. Rather, no law
governs commercial surrogacy.

Many American and European countries, including

Sweden, do not recognise surrogacy agreements.

As a result, India has become the hotspot of surrogacy

medical tourism. Cost is 1/3 from developed countries
allowing surrogacy.
Additional Rules:
Accreditation and registration of ART clinic
Quality control regulation
Research: with consent of clients, forwarded by director
of ART clinic and passed by Indian Medical Research
Council
Embryo handling: with respect and utmost care. Strict
prohibition on transferring human embryo to non-
human animal and vice versa
No hybridization
Directive to established process for client feedback and
complaints addressal
Legal contract
Third party donor of egg /sperm / both must waive off
their right to be known to the offspring. They will never
contact the offspring.
However, the child born- under conditions- can initiate a
search for his biological parent after obtaining legal
adulthood or anytime based on crisis.
Single mother/ father can apply for ART in India and will
not be refused treatment on this basis. Childbirn will
have full birth rights on single parent.
Pertinent to Surrogacy
The surrogate mother will be admitted and registered on her own
name, not on the name of clients seeking surrogacy.

Birth certificate will carry surrogacy-seeking-parents name.

However, the parents will also receive another certificate bearing
the name of surrogate mother.

Surrogacy-seeking-clients will bear the full cost of treatment and

sustenance for surrogate mother

Surrogate mother and the clients can together decide the

surrogacy fee.

Continued..
ART and surrogacy:
ART or surrogacy for an HIV positive parent will be taken
on a case-to-case basis after the ruling by Supreme
Court of India.
Gemetes from under 21 year old male will not be
accepted. Upper age limit for males is 48 years.
Women can donate their gamete between 18- 35 years
of age.
Sex selection and destruction of foetus based on sex is
srtictly prohibited and punishable by law.
No more than 3 embryos can be placed at a time inside
the womb barring special conditions which should be
ART and surrogacy regulations:
Couples cannot choose a sperm or oocyte donor from
their friends or relatives.
Neither the clinic nor the couple will know the gamete
donor. The identity will be safe-guarded by gamete-
banks. However, full disclosure of physical
characteristics, and when possible, DNA fingerprints will
be made available without disclosing actual identity.
Gamete donor must be free of HIV and hepatitis B and C
infections, hypertension, diabetes, sexually transmitted
diseases, and identifiable and common genetic
disorders such as thalassemia.
Oocyte sharing is encouraged.
Protecting the child:
Surrogacy-Seeking-Parent/s must leagally adopt the
child before leaving India, in case the child is not
biologically theirs.
Surrogacy can be offered only to couple who have
clinically failed to carry a pregnancy to term due to non-
treatable disorders.
ART centre cannot act as middle-man for surrogacy fee
Women over 45 years of age cannot be surrogate
mothers
No woman may act as a surrogate mother more than