Surrogacy in India: Legal Questions, Costs and International Alternatives

For couples and individuals in India who cannot conceive naturally or through other assisted reproduction methods, surrogacy often appears to be the final option. Under Indian law, however, commercial surrogacy has been prohibited since the Surrogacy (Regulation) Act, 2021 came into force. This article explains the types of surrogacy, outlines current Indian legislation, compares key international alternatives, reviews costs and medical risks, and explores other paths to building a family.

What Is Surrogacy?

Surrogacy is an arrangement where a woman (the surrogate) carries and delivers a child on behalf of intended parents, then legally transfers parental rights after birth. It supports married heterosexual couples who are Indian citizens and have been unable to conceive for at least five years, under the 2021 Act.

Altruistic vs Gestational Surrogacy

Altruistic surrogacy: The surrogate receives no monetary compensation beyond reimbursement of medical and other reasonable expenses. This is the only form permitted under Indian law.

Gestational surrogacy: Embryos created from the intended mother’s (or an egg donor’s) eggs and the intended father’s sperm are transferred into the surrogate’s uterus. The surrogate has no genetic link to the child, simplifying legal parentage under a subsequent Guardian Order.

Surrogacy Clinics and Support

Recognised ART (Assisted Reproductive Technology) clinics regulated by the Indian Council of Medical Research (ICMR) manage the medical process, offering:

• Screening of surrogates for health and psychological fitness
• IVF procedures and cycle monitoring
• Legal documentation support for Guardian Orders
• Counselling for surrogates and intended parents

Clinics must comply with strict ICMR guidelines and maintain transparent records to ensure ethical practice.

Surrogacy in India: Legal Framework

Under the Surrogacy (Regulation) Act, 2021, only altruistic surrogacy is allowed. Key provisions include:

• Only Indian married heterosexual couples married for at least five years and infertile may commission a surrogate.
• Commercial surrogacy—payment beyond reasonable medical expenses—is banned.
• Surrogates must be close relatives of the intended parents, between 25–35 years old, and have borne at least one healthy child.
• Intended parents must obtain a Guardian Order from the relevant District Court after birth to be recognised as legal parents.

Any contract contravening these provisions is void. The Act aims to prevent exploitation of women and protect children’s rights.

Costs and Financing of Surrogacy in India

Total expenses depend on the clinic package and medical requirements. Typical line items include:

• IVF procedures and monitoring fees
• Medical investigations and medications
• Surrogate’s medical expense reimbursements
• Legal fees for Guardian Order application
• Travel and accommodation if treatment is in another city

In India, total costs generally range from ₹15 lakh to ₹25 lakh (~USD 20,000–30,000). Financing options include personal loans, fertility-specific loans, and assisted reproduction grants from NGOs.

Medical Aspects and Risks

Surrogacy in India uses in vitro fertilisation (IVF), where eggs and sperm are combined in vitro and the resulting embryos transferred into the surrogate’s uterus (Moragianni et al. 2021; Zhang et al. 2020).

Potential risks:

• Ovarian hyperstimulation syndrome (OHSS), affecting up to 5% of IVF cycles (Patient.info OHSS).
• Hormonal side-effects such as mood swings, nausea and bloating (MedlinePlus 2023).
• Increased likelihood of multiple pregnancy (twins, triplets), with higher rates of preterm birth and preeclampsia (WHO 2021).
• Psychological stress due to hormone treatments and social pressures (Burgio et al. 2022).

Close medical supervision—including regular ultrasounds, lab tests and specialist consultations—is essential to detect and manage complications early.

Criticism and Ethical Debate

Critics argue that surrogacy—even altruistic—can risk coercion and undue pressure on women. Concerns also exist about the emotional well-being of surrogates and children born via surrogacy.

Proponents assert that with the safeguards of the 2021 Act—strict eligibility, legal oversight and mandated counselling—ethical surrogacy can offer a compassionate path to parenthood in India.

International Alternatives: Overview and Regulations

Some Indian intended parents explore surrogacy abroad under different legal frameworks. Examples:

• United States: State-specific laws; commercial surrogacy regulated in states like California.
• Canada: Only altruistic surrogacy; expense reimbursement only.
• United Kingdom: Altruistic surrogacy permitted; commercial payments prohibited.
• Greece: Commercial surrogacy allowed under regulated contracts.
• Ukraine: Commercial surrogacy available under defined conditions; political risks apply.
• Russia: Both altruistic and commercial surrogacy allowed; legal grey areas exist.
• Mexico: Laws vary by state; some allow compensated arrangements.
• Australia: Commercial surrogacy prohibited; altruistic only in select states.
• Brazil: Altruistic surrogacy allowed under court approval.
• South Africa: Contracts must be court-approved prior to embryo transfer.
• Switzerland: All forms of surrogacy are prohibited.
• France: Surrogacy is banned; intended parents must seek services abroad and secure recognition.
• Sweden: Surrogacy is not permitted; many travel to neighbouring countries.
• Denmark: Both commercial and altruistic surrogacy heavily restricted, creating high legal risk.

Alternative Paths to Building a Family

Other family-building options include:

• Adoption: A legally defined process placing a child into a permanent home.
• Foster care: Temporary or long-term care coordinated by child welfare authorities.
• Sperm or egg donation: Regulated by ICMR; donors are screened and recipients matched.

Sperm Donation as an Alternative: RattleStork

Many in India now choose sperm donation instead of surrogacy. On platforms like RattleStork, users can register free and select from a network of carefully vetted donors.

Conclusion

Surrogacy in India is tightly regulated by the 2021 Act, permitting only altruistic arrangements for eligible Indian couples. Whether you comply with domestic regulations, travel abroad, or explore other options like adoption or sperm donation, expert legal advice, realistic budgeting and comprehensive medical care are essential to a successful outcome.