From global surrogacy hub to strictly regulated practice - understanding India's complex journey
The desire for parenthood is a powerful, universal human experience. For countless couples and individuals, this journey is straightforward, but for others, it's a path marked by biological challenges and medical complexities.
In India, the solution of surrogacy—where one woman carries a child for another person or couple—has ignited a national conversation that intertwines deep-seated emotions, cutting-edge medicine, stringent laws, and profound ethical questions. Once celebrated as the world's surrogacy capital, India has undergone a dramatic transformation, shifting from a booming international hub to a nation with one of the most restrictive surrogacy frameworks globally 8 .
India shifted from being a global surrogacy hub to implementing one of the world's most restrictive surrogacy frameworks with the 2021 Regulation Act.
This article explores the multifaceted landscape of surrogacy in the Indian context. We will unravel the tight legal knots of the Surrogacy (Regulation) Act of 2021, weigh the ethical scales of commercial versus altruistic arrangements, understand the medical procedures that make it possible, and examine the social ramifications that affect all parties involved.
India's relationship with surrogacy has evolved through distinct phases. Prior to 2021, the country was a global hub for commercial surrogacy, attracting international clients with its advanced medical facilities, skilled doctors, and relatively low costs. This period, however, was also marked by growing concerns about the exploitation of surrogate mothers, particularly those from economically disadvantaged backgrounds, and complex legal issues surrounding children's citizenship 8 . In response, the Indian government enacted the Surrogacy (Regulation) Act in 2021, a landmark legislation that fundamentally reshaped the practice.
The Act draws a firm line in the sand, establishing strict eligibility criteria for both intended parents and surrogate mothers, and clearly defining what types of surrogacy are permissible.
| Stakeholder | Eligibility Criteria |
|---|---|
| Intending Couple |
|
| Surrogate Mother |
Navigating the legal process is a meticulous undertaking. Intending parents must first obtain an Essentiality Certificate confirming their infertility, followed by an Eligibility Certificate from the appropriate government authority 2 5 . A critical step is finding a surrogate who meets all legal criteria, which is often the most significant hurdle given the "close relative" requirement.
Obtain certification of infertility from registered medical practitioner
Identify a close relative who meets all legal criteria for being a surrogate
Secure Essentiality Certificate and Eligibility Certificate from appropriate authority
Execute legally binding surrogacy agreement between all parties
Undergo IVF and embryo transfer at registered surrogacy clinic
Register the child born through surrogacy with intended parents as biological parents
A legally binding contract must then be signed between the parties, and the entire process must be conducted at a registered surrogacy clinic 5 9 . Violations of the Act can lead to severe penalties, including imprisonment of up to 10 years and heavy fines 3 .
The legal landscape remains dynamic. In a significant ruling in October 2025, the Supreme Court of India held that the age restrictions under the Act cannot be applied retrospectively 4 7 . The court protected the reproductive autonomy of couples who had already created and frozen their embryos before the law came into force, allowing them to proceed with surrogacy even if they now fell outside the prescribed age limits 4 . This decision underscored the constitutional right to reproductive freedom and highlighted the ongoing tension between well-intentioned regulation and the personal journeys of aspiring parents.
The restrictive nature of India's surrogacy law has placed it at the center of a heated ethical debate, with compelling arguments on all sides.
The government's push for purely altruistic surrogacy is intended to prevent the commodification of women's bodies and protect economically vulnerable women from exploitation 9 . However, critics argue that this model is deeply problematic. They question the practicality of expecting a woman to undergo the significant physical and emotional demands of a nine-month pregnancy, with all its attendant risks, purely out of altruism, especially when it must be a "close relative" 3 .
As voiced by the Fertility Dost community, a major concern is that in today's nuclear family structure and fast-paced urban life, it is often unrealistic to expect a sister or sister-in-law to willingly bear a child for a couple 3 . This can force couples to "beg" a family member, creating relational pressure and potential coercion that is a far cry from true altruism. Furthermore, the ban on compensation ignores the reality that a surrogate, even a relative, may need to take a sabbatical from work, facing not just physical strain but also financial loss 3 .
The law has been widely criticized for being non-inclusive and discriminatory. By limiting surrogacy to married, heterosexual Indian couples, it shuts the door on single parents, LGBTQ+ individuals, and live-in partners, effectively denying them a path to biological parenthood 1 9 . As one critic noted, the law fails to acknowledge that "parenting cannot wait" for societal acceptance to catch up 3 .
| Ethical Perspective | Key Arguments |
|---|---|
| Protectionist |
|
| Autonomist | |
| Pragmatic |
"The current law fails to acknowledge that parenting cannot wait for societal acceptance to catch up. It denies biological parenthood to single individuals, LGBTQ+ couples, and unmarried partners based on an exclusionary vision of family."
Medically, surrogacy in India is a sophisticated procedure falling under the umbrella of Assisted Reproductive Technology (ART). The only form permitted is gestational surrogacy, where an embryo created via In Vitro Fertilisation (IVF) is implanted into the surrogate's uterus 2 5 . Crucially, the surrogate has no genetic link to the child; the embryo is formed using the eggs and sperm of the intended parents or donors 2 9 . This is distinct from traditional surrogacy (which uses the surrogate's own egg and is now prohibited in India) and helps simplify the legal establishment of parentage.
Eggs are retrieved from the intended mother or donor after ovarian stimulation
Eggs are fertilized with sperm in a laboratory to create embryos
Selected embryo is transferred to the surrogate's uterus for implantation
The medical journey involves several steps: ovarian stimulation and egg retrieval from the intended mother or donor, fertilisation in a lab to create embryos, embryo transfer to the surrogate's uterus, and careful monitoring of the pregnancy until delivery 2 . Success is not guaranteed and depends on various factors.
Source: 6
India's journey with surrogacy reflects a global dilemma: how can we harness medical science to fulfill the profound human desire for parenthood while ensuring ethical, equitable, and compassionate practices?
The current legal framework, born from a legitimate desire to protect women from exploitation, has succeeded in shutting down a largely unregulated commercial industry but has also created new problems of exclusion, impracticality, and inequity.
The future likely lies in a middle ground—a transparent, regulated commercial system with fair compensation, psychological support, and ethical oversight that respects reproductive autonomy while preventing exploitation.
The recent Supreme Court ruling on reproductive autonomy is a reminder that the conversation is far from over. The future of surrogacy in India likely lies in finding a middle ground—a model that moves beyond the rigid altruism versus commercialism debate. As suggested by voices from the fertility community, this could involve a transparent, tightly regulated commercial system managed by government-licensed clinics, with fair compensation for surrogates, robust psychological support, and unwavering ethical oversight 3 .
For surrogacy to truly be a "win for all," Indian law and society must grapple with the need for greater inclusivity and a more realistic understanding of modern family structures and relationships. The womb may be a site of biological reproduction, but it is also, as India's experience shows, a mirror reflecting our deepest values about life, choice, and the families we yearn to create.
The Social Fabric: Stigma, Family, and a Shifting Landscape
Socially, surrogacy in India operates within a complex web of cultural norms and stigmas. Infertility remains a potent social taboo, often causing immense emotional distress and shame for couples 3 . This makes the search for a "close relative" surrogate even more challenging, as many couples are reluctant to openly discuss their fertility struggles with extended family.
of Indian couples facing infertility report experiencing social stigma
decline in international surrogacy cases after 2021 Act
estimated annual revenue loss from medical tourism
"How can a sister carry a brother's child? The very idea creates discomfort and moral shock in traditional Indian families, making the 'close relative' requirement practically challenging for many couples."
The very idea of a relative carrying a child can be met with discomfort or moral shock, with older generations sometimes questioning, "How can a sister carry a brother's child?" 3 . This places intending parents in a difficult position, torn between their deep desire for a child and the fear of social judgment.
The 2021 law has had a significant macroeconomic impact, effectively ending India's lucrative medical tourism industry for surrogacy 8 . This has shifted global demand to other countries like:
The restrictive law has given rise to concerns about potential negative consequences: