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    Indications For Surrogacy

    • 4.6   (6 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MBBS on 29 Mar 2019 - Written by Dr. Sheetal Pandey Tejwani - MBBS - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MBBS

    The principle indications for gestational surrogacy may include recurrent pregnancy loss, congenital absence of the uterus, repeated failure of In Vitro Fertilization treatment, hysterectomy for postpartum hemorrhage and other severe medical conditions, which are incompatible with pregnancy.

    After exhausting almost all the other ways of having a baby, a couple or an individual might decide to take the route of having a baby through gestational surrogacy.

    In this article, you can find:

    In gestational surrogacy, the surrogate becomes pregnant via In Vitro Fertilization and has no biological connection to the baby. The gestational surrogate undergoes the transfer of an embryo created through assisted reproductive techniques using the gametes of the intended parent(s) and/or an egg/sperm donor.

    1. What can be the possible indications for surrogacy?

    The principle indications for gestational surrogacy can be women who have undergone a hysterectomy for carcinoma or hemorrhage and women with congenital absence of the uterus, but still have functioning ovaries, are considered to be the candidates for gestational surrogacy. Another obvious indication for surrogacy is women who have suffered recurrent miscarriages and for women for whom the chances of conceiving or carrying a baby to due term are remote. Women who have repeatedly failed to implant healthy embryos in IVF treatments for unexplained reasons are also suitable candidates for surrogacy. Women or couples request for surrogacy treatments for various life-threatening medical conditions like severe heart or renal disease. (1) 

    Gestational surrogacy treatments are straightforward and are followed by routine ART procedures for the intended parents, with the transfer of fresh or frozen-thawed embryos to the surrogate host. The success rates of the procedure are high, as would be expected from the transfer of embryos extracted from young women and transferred to fit and fertile surrogates. Clinical pregnancy rates achieved in large series are up to 40 percent per transfer and series have also reported 60 percent of hosts resulting in live births. Certain ethical or legal complications have arisen out of surrogacy from natural or partial surrogacy arrangements. The success rates of the treatment are satisfactory and the incidence of major ethical or legal complications is limited and may vary from one country to another. IVF surrogacy is considered to be a successful treatment for a group of women or individuals who would otherwise not be able to have their own genetically related children. (2)

    The absence of uterus is considered to be one of the major medical reasons for surrogacy and causes for an absent uterus can be a history of obstetrics hysterectomy or hysterectomy for gynecological indications like cervical cancer or endometrial cancer. Apart from this, significant structural abnormalities such as small unicornuate uterus, T-shaped uterus, or multiple fibroids with failed fertility treatment attempts also accounts for surrogacy indications. Surrogacy is usually considered to be the last resort for patients who have exhausted all possible tools for self-pregnancy. Other factors, which may necessitate surrogacy, can be applied to cases of biological impossibility to conceive or bear a child. (3)

    2. When to consider Surrogacy?

    Here is a list of some contributing indications to decide when to consider surrogacy:

    • Single parenthood: Single guardians who don’t want to get married but want to have their biological child, settles for surrogacy as it is considered to be a successful way for both male and female single guardians to enjoy parenthood.
    • Gay couples and LGBT: Numerous gay and LGBT couples who want to experience parenthood prefer to go for surrogacy. Surrogacy is a gift in nations where both gay relational unions and LGBT are legal. 
    • Old age pregnancy: Old couples opt for surrogacy to guarantee their family bloodline proceeds. In such cases, the male parent gives the sperm to be inseminated into a surrogate mother. (4)
    • Somatic diseases: Surrogacy can also be opted by people with problems related to serious somatic diseases where conceiving or carrying pregnancy to due term may threaten the health of the recipient.
    • Other indication: Some structural-morphological or anatomic endometrium changes may lead to loss of receptivity. (5)
    • Absent/ underdeveloped uterus: Various studies have shown that indications for surrogacy are rare and sometimes-commissioning parents are lured through unethical practices in cases where infertility can be dealt with simpler ART procedures. However, women without a uterus or women having an underdeveloped uterus would warrant the use of a surrogate. (6)

    Statistics from March 2005 to March 2008 show that 324 gestational surrogacy embryo transfer cycles were performed. Indications for surrogacy recorded were 35 percent anatomic, 20 percent systemic disorders, 20 percent multiple failed IVF, 3 percent recurrent miscarriages and 30 percent alternative couples. Clinical pregnancy was confirmed in 244 surrogate mothers for a successful 75 percent pregnancy rate. (7)

    3. Why Surrogacy is Good?

    For childless individuals or couples, surrogacy is a way to make their dreams of parenthood come real. Few advantages of surrogacy for commissioning parents and surrogates are:

    • Surrogacy allows for biological connections
    • Surrogacy is likely to be successful
    • Surrogacy is a boon for LGBT couples
    • Surrogacy allows a surrogate to experience pregnancy
    • Surrogates are legally protected
    • Surrogates are fairly and lawfully compensated

    Whether you are considering surrogacy as hopeful parents or a potential gestational carrier, Elawoman can help you in suggesting whether this is the right path for you or not. To learn more about surrogacy complications and benefits, visit If you are interested to know more about surrogacy or beginning the process, you can talk to our fertility experts at +918929020600. (8)

    Dr. Sheetal Pandey Tejwani

    Written by

    Gynecologic Surgeon, Laparoscopic Surgeon
    Dr. Sheetal Pandey Tejwani is an Infertility Specialist, Gynecologic Surgeon and Obstetrician, located in Mumbai and having an experience of almost a decade. Her alma mater is B J MEDICAL COLLEGE in Pune from where she completed her MBBS and MS in Obstetrics and Gynaecology in 2007 and 2009, respectively. In the following year, she pursued her DNB in Obstetrics and Gynecology. She received her Post Doctoral Fellowship in Reproductive Medicine from Krishna IVF Vizag and Nadkarni IVF Centre, Surat in 2013. She is the member of 3 different associations i.e. Indian Society of Assisted Reproduction (ISAR), Indian Medical Association (IMA), and Association of Medical Consultants. Her area of expertise includes Tubectomy/Tubal Ligation, Hysterectomy (Abdominal/Vaginal), Intrauterine Insemination (IUI), Caesarean Section and In-Vitro Fertilization (IVF). She is a consultant in Veda Fertility And Urology Care, Mira Road and is a visiting consultant in Wockhardt Hospital, Mira Road, Mumbai. You can get the contact details of Dr. Sheetal Pandey Tejwani at



    Riitu Jaiswal

    Women who are above thirty-five years of age are recommended surrogacy most of the times by doctors. It is because the success rate for other treatments decreases with age. At that time, surrogacy is the ultimate and best option.

    Sept. 10, 2018, 8:37 a.m. 4.5


    Pankaj Samrat

    It was my choice to be single and not get married, but the craving for a child always disturbed me. In this case, surrogacy seemed to be a good option. After finding a surrogate and a sperm donor I think I will finally become successful in having my own child.

    Sept. 9, 2018, 5:12 p.m. 4.5


    Kriya Tripathi

    There was some problem in my uterus, so it was very difficult for me to conceive and deliver successfully. But I wanted a child of my own. At that point, surrogacy was the only option left. Of course, I went for surrogacy. Fortunately, it was successful.

    Aug. 12, 2018, 4:40 p.m. 4.5


    Ronit Sahu

    Surrogacy proved to be a blessing for us. It was a successful and pleasant journey. Surrogacy has become a very good option for couples like us.

    July 2, 2018, 7:48 a.m. 5.0


    Neelesh Sonwane

    Yes, I agree that while the information given here is true at every point. People who have not thought of surrogacy will now take it as the best alternative.

    June 19, 2018, 2:06 p.m. 4.5


    Subhash Rajanna

    We were earlier planning to opt for surrogacy procedure but were in confusion. This blog cleared our confusions well and now we are ready for the same.

    May 29, 2018, 3:55 p.m. 4.5

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