‘IVF specialists are more than happy as the new rule renews hope for couples to become parents’

At her Solo clinic in Pune, Dr Sunita Tandulwadkar, president-elect of the Federation of Obstetric and Gynaecological Societies of India (FOGSI)-2025 and president elect of the Indian Society of Assisted Reproduction (ISAR)-2026 understands this hesitation and admits that surrogacies had come to a standstill.

“Hence the new amended rules are important and IVF specialists are more than happy as it renews hope for couples to become parents,” said Dr Tandulwadkar.

#Pune | Surrogacy using a donor gamete is allowed with approval from the district medical board, says Dr Sunita Tandulwadkar of the Federation of Obstetric and Gynaecological Societies of India.@runaanu reportshttps://t.co/P7v9o5PoPC pic.twitter.com/ucWJ341DqO

— The Indian Express (@IndianExpress) February 26, 2024

What the amended rules say and why are they significant

According to the notification issued on February 21 by the Union Ministry of Health and Family Welfare, in surrogacy cases, both gametes must be contributed by the intending couple. However, the use of a donor gamete is allowed if the district medical board confirms that either the husband or wife has a medical condition. Hence surrogacy utilizing a donor gamete is then permitted.

However, one of the pre-requisites is that the child born through surrogacy must have at least one gamete from the intending couple. “For instance, there are women who have extensive endometriosis that affects ovaries. Sadly, her uterus is also damaged and she is unable to carry a pregnancy. As an ART consultant, I will be able to recommend this case for a donor egg but it will have to be ratified by the district medical board,” Dr Tandulwadkar said. The amended rule also states that a single woman (widow or divorcee) undergoing surgery must use self-eggs and donor sperm to avail surrogacy procedure.

What medical challenges and why women are encouraged to freeze their eggs

There are other conditions such as tuberculosis, that can exhaust the ovarian reserve, congenital absence of uterus and premature ovarian failure or the husband has non-obstructive dysphagia —sperms are not productive and the woman also has a uterine problem. There are other conditions such as diabetes and blood pressure, where carrying the pregnancy is not advisable.

Some cancer treatments (chemotherapy and radiation therapy) can damage ovarian function and deplete egg reserves, genetic disorders like Fragile X syndrome or autoimmune disorders, which can lead to ovarian failure and hence, reduce the chances of pregnancy. “We also strongly encourage women to freeze their eggs in the context of medical conditions to empower them with pro-active fertility preservation options and ensure they can pursue parenthood,” Dr Tandulwadkar added.

Why donor details are vital and how govt keeps a watch at each step

As per law, one cannot purchase or sell the gamete. A national ART and Surrogate Registry board has been set up and registration numbers are being issued to surrogacy clinics. States have also been asked to send data on pregnancies achieved through surrogacy and assisted reproductive technology. The regulations have laid down standards for proper functioning of the clinics and violating the ban on commercial surrogacy invites a jail term of upto 10 years and a fine of upto Rs 10 lakh.

Since the law allows altruistic surrogacy, couples have to appeal to their close relatives. If the couple is able to find an altruistic surrogate mother, as per the rules, arrangements have to be made to ensure health insurance for her for 36 months. At the local level, the municipal corporation has to certify that the surrogate mother is in the right age group.