The IVF surrogacy process is the process by which a fertile woman (the surrogate) carries a pregnancy created by the sperm and egg of a couple struggling with infertility (the biological, or genetic, parents). It is often a secret, wrapped in a whisper: Though many Indian couples who struggle with infertility conceive via surrogacy, it is still not a widely accepted route to parenthood and a decision not typically publicized outside the community or family.

But attitudes are changing. Earlier, surrogates were part of the extended family and carried a baby out of compassion toward the infertile couple. Today, as minds expand, IVF surrogacy is being carried out in a more professional fashion by women who receive remuneration. The first step in this path to parenthood is selecting a surrogate to carry your child. Below are some practical tips around choosing the right woman and protecting both her and your rights, compiled in consultation with fertility expert Dr. Ajanta Narvekar.

A guide to starting the IVF surrogacy process

Selecting a surrogate

While this move toward professionalism is good on one hand – it helps solidify the rights and roles for all involved – it can also make choosing a surrogate more difficult. Not personally knowing the person who will carry your child can be a stumbling block for some. Whether or not the surrogate is related to the baby, she should meet these five requirements, advises Dr. Narvekar:

1. The surrogate should be under the age of 35 to reduce the chances of any kind of complication when pregnant, during and after childbirth.
2. She should have had at least one, previous live birth, free of any complication.
3. She should not have a medical history of diabetes and hypertension, which could affect the health of the fetus.
4. She should be a non-smoker who does not consume alcohol or drugs.
5. She should, ideally, be married or in a stable, happy and supportive relationship.

Understanding your rights and your surrogate’s rights

In addition to finding the surrogate right for you, Dr. Narvekar says, it is also important to be familiar with the legal rights of both the biological parents as well as surrogate’s rights:

1. The Assisted Reproductive Technology clinics of India are not authorized to make any arrangements around finding or compensating a surrogate. Finding a surrogate is the responsibility of the couple. This is usually done with the help of an agency; surrogacy agencies will not only help to locate the appropriate surrogate, they will also handle logistics, legalities, and check-ins with the surrogate as the pregnancy progresses. It is best to ask a doctor or trusted family member or friend to recommend a reputable agency.
2. The surrogate and her partner should receive legal advice independent from that received by the commissioning couple. Ensure all terms are in writing. All the mandatory legal documents should be executed by both parties before the treatment begins.
3. All possible issues – including termination of pregnancy under all clearly defined medical circumstances, responsibility towards the surrogate if faced with high risks during pregnancy, the course of action in case of fetus abnormality, etc. – should be discussed and legally accepted by the surrogate, her partner, and the couple.
4. The commissioning couple should make arrangements for a legal guardian in the event of their deaths.
5. Both the surrogate and the couple should be very clear that the surrogate is not the mother of the child. If a surrogate develops an attachment towards the baby and declines to hand over the child, she can be forced by law to give up the child to the commissioning couple (the biological parents).
6. The commissioning couple (the biological parents) must adopt a child born via surrogacy by Indian law, unless they can prove via DNA testing that the child is not theirs (i.e., was not conceived using the sperm and egg they provided).