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Low Cost Surrogacy in India - FAQ & Procedure Overview :
In-Vitro Fertilisation (IVF)
Low Cost Surrogacy India offers information on Low Cost Surrogacy in India, Low Cost Surrogacy cost India, Low Cost Surrogacy hospital in India, Delhi, Mumbai, Chennai, Hyderabad & Bangalore, Low Cost Surrogacy Surgeon in India

Surrogacy Package Cost: 15,000 to 20,000 US Dollars

{Surrogacy package price estimate above covers doctor fees, legal fees, surrogate work up, antenatal care, delivery charges, surrogate compensation, egg donor, drugs and consumables, & IVF costs}

(IVF, Surrogacy and Egg Donor partner Clinic of We Care India in New Delhi)

The cheaper availability of surrogates in India is attracting a lot of interest. Below are frequently asked questions on the surrogacy procedure & an overview on how the surrogacy process takes place in our network hospital in India.

1 ) What is surrogacy?

Surrogacy is a method of assisted reproduction. The word surrogate originates from Latin word surrogatus (substitution) - to act in the place of. The term surrogacy is used when a woman carries a pregnancy and gives birth to a baby for another woman.

Surrogacy is gaining popularity as this may be the only method for a couple to have their own child and also because adoption process may be a long drawn out process.

2 ) What are the types of surrogacy?

IVF / Gestational surrogacy - This is more common form of surrogacy. This is where a woman carries a pregnancy created by the egg and sperm of the genetic couple. The egg of the wife is fertilized in vitro by husband's sperms by IVF/ICSI procedure, embryo transfer is performed into the surrogate's uterus and the surrogate carries the pregnancy for nine months. The child is not genetically linked to the surrogate.

Traditional / Natural surrogate - This is where the surrogate is inseminated or IVF/ICSI procedure is performed with sperms from the male partner of an infertile couple. The child that results is genetically related to the surrogate and to the male partner but not to the female partner.

3 ) To whom surrogacy is advised?

A. IVF Surrogacy
  1. Most commonly it is indicated in women whose ovaries are producing eggs but they do not have a uterus in cases like :

    • Congenital absence of uterus (Mullerian ageneris)

    • Surgical removal of uterus (hysterectomy) due to cancer, severe hemorrhage in Caesarian section or rupture uterus.

  2. A woman whose uterus is malformed (unicornuate uterus, T shaped uterus, bicornuate uterus with rudimentary horn) or damaged uterus (T.B of the endometrium, severe Asherman's Syndrome) or at high risk of rupture (previous uterine surgeries for rupture uterus or fibroid uterus) and is unable to carry pregnancy to term can also be recommended IVF surrogacy.

  3. Women who have repeated miscarriages or have repeated failed IVF cycles may be advised IVF surrogacy in view of unexplained factors which could be responsible for failed implantation and early pregnancy wastage.

  4. Women who suffer from medical problems like diabetes, heart or kidney diseases like chronic nephritis whose long term prospect for health is good but pregnancy would be life threatening.

  5. Woman with Rh incompatibility.
B. Traditional Surrogacy
  1. Women who have no functioning ovaries due to premature ovarian failure. Here egg donation also can be an option.

  2. A woman who is at risk of passing a genetic disease to her offspring may also opt for traditional surrogacy.

4 ) Is Surrogacy right for you?

For some couples opting for surrogacy is a very straight forward decision but for others there are lots of things to be considered and thought about before taking the decision about surrogacy. There are lots of complex issues involved. It is an emotional roller coaster ride for the couple, the families and friends. It is a decision where the 'right' and the 'wrong' are very individual things. An infertility specialist or a counselor can help the couple seeing things in perspective. Other options to surrogacy like adoption or further infertility treatment can be considered.

5 ) What are the screening criteria for surrogate? How is a surrogate chosen?

We Care India network hospital in India has a very meticulous and stringent criteria for choosing a surrogate. The surrogates are between 21-35 years of age. They are married with previous normal deliveries and healthy babies. Detailed medical history, surgical history, personal history, family history is looked into. History of blood transfusion and addiction is also taken. It is made sure that the surrogate has an uneventful obstetric history (like no repeated miscarriages, no antenatal, intranatal and postnatal complications in previous pregnancies). The surrogate and her partner are screened for infectious diseases like sexually transmitted diseases, Hepatitis B, Hepatitis C, HIV, VDRL. Thalassemia screening is also done. Detailed pelvic sonography is done and other tests for uterine receptivity are done to ensure maximum chances of success. A detailed financial and legal agreement is then made between the surrogate and the commissioning couple.

6 ) What is the procedure involved?

For IVF surrogacy matching of cycles of the genetic mother and the surrogate is done by adjusting menstruation dates by oral contraceptive pills. When the cycle starts, the surrogate is put on estrogen tablets to prime the uterus. Protocol used for genetic mother is day 2 protocol or day 21 protocol depending on the age of the genetic mother and other test results. For the day 2 protocol called the antagon protocol, oral contraceptive pills are given in the previous month. On 2nd day of the periods gonadotropin injections are started. USG Monitoring is done daily. When the size of the follicle reaches 14 mm the genetic mother is given antagon injection to prevent surge of endogenous hormones. For the day 21 protocol called the long protocol GnRH analogues are started on day 21 of the previous cycle. Once the genetic mother gets her periods, gonadotropin injections are started. In both the cases the patients are monitored daily. When the follicle reaches 18 mm size hCG trigger is given. The surrogate is started on progesterone tablets on the day of hCG injection to the genetic mother. Oocyte retrieval is done 36 hours later which is generally day 12/13 of the cycle. On the same day the genetic father gives his semen sample. The eggs of the genetic mother are fertilized with sperms of the genetic father in the laboratory by IVF / ICSI procedure. The embryo which has resulted from the above mentioned procedure is transferred into the womb of the surrogate under ultrasound guidance. The surrogate is then put on luteal support using progesterone tablets / injections and pregnancy is confirmed 15 days later.

7 ) How is the nine months journey like with surrogate?

The surrogate is treated as a high risk pregnancy and is cared for by 2 consultant gynecologists in our hospital. Appointments are scheduled with the consultants every three weeks for the first 6 months, then every 15 days for the next 2 months and then weekly / biweekly in the last month. Blood tests and ultra sound are done as and when required. Routine blood tests like hemoglobin, blood group, VDRL, HBsAG & HIV are done. Special care and tests are done to pick up any obstetric or medical complications like hypertension, diabetes etc. at the earliest. 2 doses of Inj. Tetanus are given during pregnancy. The baby's growth is monitored stringently. Ultrasound is done at 6 weeks to confirm pregnancy and the viability of the baby, then at 12 weeks to assess growth and certain parameters like nuchal thickness. At 18 -20 weeks a detailed level III ultrasound is done to detect any abnormalities in the baby. At 16 weeks amniocentesis is performed if the genetic mother's age is more than 35 years after counseling and in consultation with the genetic parents. At 28 weeks and 34 weeks color Doppler is performed to assess the growth of the baby and rule out intra uterine growth retardation. Fetal well being tests like non stress test are done as and when required. Detailed information is given to the surrogates about diet during pregnancy. They are regularly provided with supplements from the hospital.

Thus it is taken care that adequate nutrition reaches the baby and baby's growth is maintained. We have an LDRP (Labor Delivery Recovery Puerperium) room for delivery which is equipped to handle any obstetric emergency. Our NICU setup is also completely equipped to handle any neonatal complications, with a neonatologist who is available round the clock. We keep the couple posted on the progress of the baby and send them ultrasound pictures and blood reports as and when they are done.

8 ) What is the success rate of surrogacy?

The success rate(carry home baby) of surrogacy is around 45% in case of fresh embyos. In case of frozen embryo's it is about 25%.

9 ) What are the different ways children born through surrogacy may receive breast milk?

Just because baby is born through surrogacy does not mean he or she cannot receive breast milk and the many health benefits it provides. Breast fed babies have been found to have higher IQs, more protected from leukemia and be less likely to have problems with obesity. Breast milk protects babies from getting diarrhea, ear infections and respiratory problems such as asthma. Premature babies who receive breast milk are more protected from infections and high blood pressure later in life. Breast milk contains the protein CD14 which works to develop B cells which are immunity cells that are needed in the production of antibodies in an infant to build the babies immunity system.

The babies may drink breast milk acquired through milk bank, breast milk donor may be located or the intended mother may induce lactation before birth of the baby. Induced lactation has been embraced by the nursing community as a welcome method to enhance the bonding relationship between a new mother and baby born through surrogacy. It is best to make the goal “ bonding & enjoyable breast feeding rather than producing as much breast milk as possible. Prolactin and oxytocin are the two pituitary hormones that cause lactation to occur. They may be stimulated despite the woman's inability to carry a child. Lactation may be induced a number of ways and the amount of milk a non lactating woman can produce through inducement varies from woman to woman. The most common way women induce lactation is through manual or mechanical stimulation. With this method lactation is induced by massage, nipple manipulation and sucking either by the baby or breast pump. The second common method used is hormone therapy whereby a woman uses herbal remedies such as Fenugreek or is prescribed medications such as Domperidone and Metoclopromide (Reglan) to induce and increase her milk supply. Induced lactation milk skips the colostrum phase and more resembles mature breast milk.

Manual stimulation of lactation usually takes between two and seven weeks and hormone therapy usually takes between one to four months. For this reason intended mothers usually begin during the final trimester of their surrogate mother's pregnancy.

10 ) What are the advantages of surrogacy?

A. This may be the only chance for some couples to have a child which is biologically completely their own (IVF surrogacy ) or partly their own (gestational surrogacy)

B. The genetic mother can bond with the baby better than in situations like adoption.

11 ) What are the disadvantages of surrogacy?

A. It is highly controversial topic and can involve many legal complexities.

B. Some surrogates have a problem parting with the baby.

C The surrogates may face medical / obstetric complications during pregnancy which puts extra financial burden on the commissioning couple.

D In some cases the surrogacy technique may be 'misused' like career oriented women, figure conscious woman, models etc. may just 'hire' women on 'rent' to carry their biological child.

In short, surrogacy is an innovative albeit complex to achieve parenthood.

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