Surrogacy Is a Last Resort — and a Genuinely Life-Changing One
Following the Surrogacy (Regulation) Act 2021 and the ART Act 2021, surrogacy in India is permitted only on medical grounds and only within a defined legal framework.
Medical Indications for Surrogacy — Who Genuinely Needs It
Under Indian law, surrogacy is only permitted for medically indicated reasons. The medical conditions that qualify include:
Absence of a Uterus (MRKH Syndrome)
Some women are born without a uterus or with a non-functional rudimentary uterus — Mayer-Rokitansky-Küster-Hauser syndrome. For these women, surrogacy is the only path to biological parenthood without uterus transplantation, which is still experimental.
Surgical Removal of the Uterus (Hysterectomy)
Women who have had a hysterectomy — for fibroids, cancer, severe haemorrhage, or other reasons — cannot carry a pregnancy. If the ovaries remain functional, their eggs can be used.
Repeated IVF Failure With Good Embryos — Uterine Factor
When a uterine condition (severe Asherman's syndrome, severe adenomyosis, failed uterine reconstruction, uterine anomalies that cannot be corrected) prevents implantation despite multiple good embryo transfers.
Medical Condition Making Pregnancy Life-Threatening
Severe heart disease, certain cancers in remission, severe pulmonary hypertension, or other conditions where the risks of pregnancy would be unacceptably high for the mother.
Recurrent Pregnancy Loss Due to Uterine Cause
When recurrent miscarriage is definitively attributed to a uterine factor that cannot be corrected surgically.
Who Is Eligible to Commission Surrogacy Under India's Surrogacy Act 2021?
Eligible Intended Parents
- Legally married Indian couples (man and woman)
- Married for a minimum of 5 years
- One partner must be proven medically infertile (through a certificate from a medical board or registered medical practitioner)
- The husband must be between 26 and 55 years old
- The wife must be between 23 and 50 years old
Widows and Divorced Women
- A widow or divorcee between the ages of 35 and 45 years is eligible to commission surrogacy
Not Currently Eligible Under the Law
- Unmarried couples
- Same-sex couples
- International (foreign) intended parents
- Couples who already have children (biological or adopted) — with exceptions for children who are mentally or physically challenged, have a life-threatening illness, or other specified circumstances
Who Can Be a Surrogate in India?
Under the Surrogacy Act:
| Requirement | What the Law Specifies |
|---|---|
| Relationship | Must be a close relative of the intended couple — altruistic surrogacy only, no commercial surrogacy |
| Marital and family status | Must be a married woman who already has at least one biological child |
| Age | Between 25 and 35 years |
| Frequency | Can serve as a surrogate only once in her lifetime |
| Consent | Must give free, informed, written consent — with the right to withdraw before embryo transfer |
| Compensation | Cannot receive payment beyond medical expenses and health insurance coverage |
The Surrogacy Procedure — Step by Step Under India's Legal Framework
Step 1: Medical Eligibility Certificate
The intended couple obtains a certificate from a registered medical practitioner confirming medical necessity for surrogacy.
Step 2: Identifying a Surrogate
A close relative — as defined by the law — who meets the eligibility criteria must voluntarily agree to be the surrogate.
Step 3: State Surrogacy Board Approval
The couple applies to the relevant State Surrogacy Board, which reviews the application, verifies eligibility, and grants approval.
Step 4: Legal Agreement
A legally valid surrogacy agreement is drawn up, covering medical responsibilities, compensation (limited to medical expenses and insurance), and the rights and obligations of all parties.
Step 5: Medical Procedures
- If the intended mother has functional ovaries: her eggs are retrieved through an IVF cycle, fertilised with the intended father's sperm, and embryos are created
- If she cannot produce eggs: donor eggs are used (from a registered ART bank)
- An embryo is transferred to the surrogate's prepared uterus
Step 6: Pregnancy and Monitoring
The surrogate attends all antenatal appointments. The intended couple may be present and involved as agreed. The surrogate's health is the medical and legal responsibility of the clinic and the intended couple.
Step 7: Birth and Legal Parentage
At birth, the child is legally the child of the intended parents. The intended mother's name goes on the birth certificate as the legal mother. The surrogate has no parental rights or obligations. Legal documentation is completed immediately after delivery.
Is Surrogacy Appropriate in Your Situation?
Surrogacy is considered only after other options have been exhausted, and eligibility depends on both medical and legal criteria. Consult Dr. Dipesh Sorathiya at Khushhi IVF, Thaltej, Ahmedabad to understand where you stand.
Book an Appointment Learn About the ClinicFrequently Asked Questions
Can we use surrogacy if I simply don't want to carry a pregnancy myself?
No. Indian law restricts surrogacy to specific medical indications. Surrogacy for convenience or personal preference (without a medical indication) is not legally permitted.
What if we cannot find a close relative who is willing to be a surrogate?
This is one of the most significant practical challenges created by the altruistic model. The law requires a close relative — and the definition of "close relative" is specific. Couples facing this challenge should consult both a fertility specialist and a family law attorney for guidance on their options.
Does the surrogate have any rights over the child?
No. Under India's law, the surrogate has no parental rights. The intended parents are the legal parents from birth.
Is surrogacy available to NRI Indian couples?
NRI (Non-Resident Indian) couples with Indian citizenship may be eligible — the law applies to Indian citizens. However, the legal processes for NRI couples involve additional steps. Specialist legal advice is essential.
Khushhi IVF 5th Floor, Soham Pristine, Off Sindhubhavan Road, Thaltej, Ahmedabad, Gujarat 380054, India.
