Who are the Candidates for IVF Surrogacy?

Author Name: Dr. Priya Singh || Mentor Name:Dr. Jyoti Gupta on April 13, 2020

It is likely that surrogacy has been used through the ages to help women who are unable to have children themselves, but no specific evidence or data exists as per historical texts.

Surrogacy by definition is an arrangement supported by legal documentation whereby a woman agrees to bear child for another person/couple who will eventually become the child’s parents after birth. This type of surrogacy in present scenario is also called IVF Surrogacy or Gestational Surrogacy as the embryo that is implanted in a gestational surrogate is prepared via the IVF technique.

Before the present era of revolutionised assisted reproductive techniques, “surrogacy” was the only means of helping women who had either absent uterus or some major abnormalities of the same, made it not feasible for carrying pregnancy. Over the years many attempts have been made to regularise surrogacy and recently the government of India has passed the surrogacy regulation bill in 2019.

As per the surrogacy regulation bill “surrogacy is defined as a practice where a woman gives birth to a child for an intending couple with the intention to hand over the child after the birth to the intending couple.”
The bill prohibits commercial surrogacy, but allows altruistic surrogacy where the surrogate does not receive any monetary compensation.

In altruistic surrogacy:

Hence, the myth that surrogacy can be done at any age needs to end and people who need the option of gestational surrogacy need to be addressed and guided the right way to achieve parenthood.

Now, lets discuss which all couples who might need or will be counselled for IVF Surrogacy. In general, when pregnancy is medically impossible for a lady or when pregnancy risks are too dangerous for the intended mother, surrogacy becomes the option for such couples to attain parental bliss. Surrogacy is considered as one of the ART techniques.

IVF Surrogacy or gestational surrogacy is achieved when an embryo created by IVF technology is implanted in a surrogate also can be termed as gestational carrier.

It has several forms but in each form resulting child is genetically unrelated to the surrogate:

Embryo: intended father’s sperm + intended mother’s egg

Embryo: intended father’s sperm + donor egg

Embryo: intended mother egg + donor sperm

The couples who are candidates of IVF SURROGACY:

1. WOMEN WITH ABSENCE OF UTERUS BY BIRTH.

2. WOMEN WHO HAVE HAD A HYSTERECTOMY FOR CARCINOMA OR HEMORRHAGE OR ANY OTHER UNFORSEEN OR MEDICAL EMERGENCY LEADING TO IT.(but still have functional ovaries).

*women who are undergoing treatment for cancer and are on immunosuppressive drugs for the same due to which pregnancy in the concerned woman is not feasible. In such patients the ovaries can be salvaged and oocyte preservation can be done which can be used at a later stage for embryo formation.

3. WOMEN WHO HAVE HAD REPEATED MISCARRIAGES

4. WOMEN WHO HAVE HAD REPEATED FAILURES OF IMPLANTATION OF HEALTHY EMBRYOS BEING TRANSFERRED AFTER PREPARING THEM VIA STANDARD IVF TECHNIQUE.

*usually such conditions arise when the uterine tissue is severly damaged due to conditions such as ashermann syndrome,uterine tuberculosis,frozen pelvis.

*conditions such as severe adenomyosis which makes the uterus sevserly bulky and endometrial lining gets buried and suppressed,similar scenarios arise in multiple intramural fibroids which make it increasingly unfit to carry a healthy pregnancy despite repeated surgeries to correct the condition.

5. MEDICAL DISORDERS WHICH MAKE A WOMAN UNFIT TO CARRY A PREGNANCY: SEVERE RENAL DISEASE WHICH NEEDS DIALYSIS,SEVERE HEART DISEASE.
With the above information we hope that a fair idea has been imparted that which couples are possible candidates of surrogacy.

As per Surrogacy bill, altruistic surrogacy can be availed only via centres registered for surrogacy under national and state surrogacy boards which are bodies working under Government of India.

I would like to conclude that surrogacy is an option for couples who are out of all other options. Such couples need to be guided by infertility experts to deal with both the legal as well as psychological aspects of surrogacy with utmost empathy and clarity so that it is accepted wholeheartedly by the couple. This will bust the myths surrounding surrogacy and their journey to a healthy parenthood will be smooth as well as it will minimise any health hazards on the surrogate.

It may be surprising that surrogacy did exist in ancient times and was socially accepted as well as respected. We need to follow our ancestors but with more sophistication. Scientific as well as legal approach along with an empathetic guidance of a good infertility expert will make surrogacy widely approachable to the couples who have till now refrained from approaching it because of myths and social bullying.

• The surrogate mother has to be a close relative of the intending couple.
• Her age should be between 25 to 35 years.
• She should be married and should have a child of her own.
• She can be a surrogate only only once in her lifetime.