An end to foreign surrogacy in India?

Indian government bans the use of gestational surrogates

While the vast majority of women who suffer from infertility, even those who need IVF are able to carry the pregnancy themselves, some women are unable to do so. This group includes in whom their uterus is incapable of carrying a pregnancy, such as those with intrauterine scar tissue, birth defects in the reproductive system or certain types of prior surgery, as well as those with serious medical problems in which a pregnancy could be life threatening to the mother. For these couples, fertility clinics such as ours, have offered a type of IVF called gestational carrier.

Understanding surrogacy and gestational carriers

Gestational Carrier IVF is type of in vitro fertilization in which a third party, which in medical terms is called the "gestational carrier" and mistakenly know to the public as a "surrogate," has the embryos implanted within her womb. The carrier is the one who will actually give birth to the child, regardless who the child's genetic parents are. 

This type of assisted reproduction is often highly successful. The problems with gestational carrier IVF are both legal and financial. In states, such as where I practice in New Jersey, the laws to protect the parents from a carrier who backs out of her agreement are flimsy or non-existent. As a result, gestational carriers are encouraged to deliver an handful of states that do provide these protections. The other problem with this type of IVF is the cost. Providing for medical care for the carrier and remunerating her for the risks of pregnancy, it no small task. Since insurance plans no matter how generous typically do not pay for this part of the cost, the onus falls on the intended parents seeking treatment, and those costs can be staggering.

India and surrogacy

This is where the India connection comes in.  In India, the costs of medical care and of renumeration to poorer lower caste gestational carriers is significantly less than here in the US, or for that matter, almost anywhere else in the west. While a discussion of the quality and regulation of that care is beyond the scope of this blog,  it has enabled couples with less means who needed this type of IVF to have a baby at much lower cost.

That option may now be coming to an end. The Indian Council for Medical Research has enacted a ban on the Indian IVF clinics from providing gestational carrier IVF for most nationals of other countries. They have reached the conclusion that these arrangements, in which the carrier is paid very little considering the risk they undertake amounts to exploitation.