Surrogacy is perhaps the most complex
and difficult way to achieve parenthood. A surrogate
mother is one who lends her uterus to another couple
so that they can have a baby, the word “surrogate”
meaning substitute or replacement .
Which kinds of infertile women need surrogates? Medically,
the indications for surrogacy are few and far between,
and most infertile patients can be helped with much
simpler and easier treatment options. The commonest
reason is a woman who has no uterus. The uterus may
be absent from birth (Mullerian agenesis); or may have
been removed surgically (hysterectomy for life-saving
reasons, such as excessive bleeding during a caesarean).
Other women who may wish to explore surrogacy include
those whose uterus is incapably damaged because of uterine
tuberculosis or Ashermann's s syndrome; or those who
have had multiple miscarriages; or who have failed repeated
IVF attempts for unexplained reasons.
Deciding to go in for surrogacy is a very hard decision
for most couples, because of the many variable involved,
and they have many concerns - social, legal, emotional
and medical.
Finding a surrogate can be extremely difficult ! If
you have a friend or relative who agrees to be your
surrogate, then your best option is altruistic surrogacy.
Not only is this much less expensive, the risk of this
going sour is much less. Commercial surrogacy is much
trickier, because you then need to take extensive steps
to protect your interests, and ensure that the surrogate
will hand over the child to you after birth. Finding
a reliable clinic, an honest surrogate and a good lawyer
can be hard work. It is also very expensive. The good
news is that we can help you to find a surrogate - please
contact us for details.
Women who agree to become surrogates may do so for
compassionate reasons. These include a sister, mother
or close friend of the couple. They may also do so for
financial remuneration - and this could be a woman,
with or without children, known or unknown to the couple,
who rents her womb for a fee.
There are two main kinds of surrogacy:-
1. The surrogate mother provides the egg. In this case,
the surrogate is inseminated artificially by the husband's
sperm. In this case, the infertile woman has no genetic
relationship to the baby.
2. More commonly, the infertile woman provides the
egg, which is then either transferred to the surrogate
mother by GIFT along with her husband's sperm; or fertilised
in vitro by IVF with her husband's sperm and an embryo
transfer performed to the surrogate's uterus, which
then acts as an incubator for the next nine months.
Certain guidelines have been laid down to try to minimise
misuse of the surrogacy technique; and a surrogate motherhood
contract needs to be drawn up, which should specify
that the child will become the legitimate adopted child
of the infertile couple, i.e, the intended parents.
This needs to be signed by the couple, the surrogate,
and her husband.
The “legal waters” of surrogate motherhood
will continue to be murky, and there are no laws or
guidelines in India as yet. At present, the couple would
have to adopt their genetic baby after birth, though
a law is likely to be passed soon which acknowledges
that the genetic parents are the child's parents. This
is why the element of trust between the couple and the
surrogate mother is so important.
It is vital that the surrogate and the couple consider
the future of the child. The receiving mother should
ideally be present at the birth and care for the baby
in hospital. She can even be prepared for breast feeding
(induced lactation) by hormone treatment.
Surrogacy has spawned a host of legal and emotional
issues to which there are no "right" answers.
For example,
* What will you do if the surrogate insists on keeping
the child?
* How much should you pay the surrogate?
* If she gets ill as a result of the pregnancy who
will pay the medical costs?
* Is it possible to put the receiving mother's name
as mother on the birth certificate?
* Will you tell the child about the surrogacy?
* Will surrogates undertake pregnancy for profit?
* What happens if the child is handicapped and is unwanted
by the couple and the surrogate mother?
* What happens if the surrogate dies during child birth?
Many people are worried about the possibility of the
surrogacy technique being misused. They feel it may
allow the exploitation of poor women who may be used
as "mother machines" to bear babies - much
like the wet nurses of yesteryear.
Surrogacy has received quite a lot of bad press recently,
especially when the contract goes sour and there is
a dispute over the baby between the commissioning parents
and the surrogate mother. Such a situation makes headline
news. The Courts then need to have the wisdom of Solomon
to assign the rights of the "genetic" mother;
the "birth" mother; and the "social or
rearing" mother.
Nevertheless, we must remember that surrogacy does
offer one method of achieving parenthood to a few couples
who could never have a baby by any other means.
The road to surrogacy is a rocky one and requires much
thought. This is perhaps the most complex and difficult
way to achieve parenthood.
Also Read
| 
