Surrogacy in India: 2021 Act, Eligibility, Process & Cost

• Only altruistic surrogacy is legal in India since 2022 — the surrogate can receive medical costs, insurance and approved expenses, but no commercial payment.
• Eligibility is strict: an Indian heterosexual married couple (married 5+ years) with documented infertility, female 23-50 and male 26-55, with no living child (limited exceptions).
• The surrogate must be a married Indian woman aged 25-35 with one child of her own, a close relative or friend, and can be a surrogate only once in her life.
• The full pathway typically takes 18-24 months and costs about Rs 15-25 lakh, borne almost entirely out of pocket.
• Single women (except widows/divorcees), single men, same-sex couples, live-in partners and foreigners are currently excluded — several court challenges are pending.
• Surrogacy is legally and emotionally complex; counselling and an experienced clinic with an in-house legal team are not optional.

The Surrogacy (Regulation) Act 2021 was passed by Parliament in December 2021 and notified into force in January 2022, with detailed rules following through 2022 and 2023. It completely restructured surrogacy in India: commercial (paid) surrogacy is now banned, and only altruistic surrogacy is permitted — meaning the surrogate receives medical expenses, insurance and certain approved costs, but no other payment.

Before the Act, India was one of the world's leading destinations for commercial surrogacy, with an industry estimated at over Rs 5,000 crore a year serving foreign clients and wealthy domestic couples. The Act ended that industry and attached sharp penalties — up to 10 years' imprisonment and a Rs 10 lakh fine — for arranging commercial surrogacy.

The Act created the National Surrogacy Board (NSB) and state-level Surrogacy Boards as the regulators, working alongside the National ART and Surrogacy Board for assisted reproduction services. Every surrogacy clinic must be registered under the Act, and the law lays out eligibility for intended parents and surrogates, the legal process including court approval, medical protocols, mandatory insurance for the surrogate, and the post-birth transfer of parental rights. Arrangements already underway when the Act began were allowed to be completed under transition provisions.

The stated aim, set out in the parliamentary debates and the Act's objects, was to stop the exploitation of poor women used as commercial surrogates — often without adequate consent or medical care — and to bring surrogacy into a clear ethical framework. Supporters say it has eliminated genuine exploitation. Critics argue it has also removed the autonomous choice of women who wanted to be commercial surrogates with proper safeguards, narrowed options for couples without an eligible relative or friend, and excluded single people and same-sex couples on grounds that may not survive constitutional review.

Several challenges to specific provisions are pending — on the exclusion of unmarried women, same-sex couples and live-in partners; on the 5-year infertility requirement; and on the altruistic-only rule itself. The Supreme Court has issued interim orders in some individual cases, but the broad framework remains in force. Anyone pursuing surrogacy in India in 2026 must work within the current law, while knowing some aspects may evolve through future court rulings.

Eligibility under the 2021 Act is strict and rules out many people who might otherwise want to pursue surrogacy. The core requirements are: a heterosexual couple married at least 5 years; the intended mother aged 23-50 and the intended father aged 26-55; documented medical infertility certified by a registered medical practitioner and reviewed by the Surrogacy Board; both partners Indian citizens; and no living biological, adopted or surrogate child (with narrow exceptions for a child with a severe disability or life-threatening condition).

The 5-year infertility requirement is one of the most contested. A couple married only four years cannot pursue surrogacy even when their infertility is medically clear — a hard position for those with age-related fertility concerns, where ovarian reserve and AMH may already be declining. The 'no living child' rule also excludes couples who have one child but cannot conceive again, a situation known as secondary infertility, with exceptions only for a child with a severe documented medical condition.

The Act explicitly excludes from intended-parent eligibility: unmarried single women (with limited exceptions for widows and divorcees), single men, same-sex couples, live-in partners, transgender individuals, and foreigners. These exclusions have triggered extensive litigation, with petitions arguing they violate Article 14 (equality) and Article 21 (life and personal liberty) of the Constitution. The matter is before the Supreme Court in multiple petitions, but no final ruling has changed the framework as of 2026. We cover this evolving debate in our guide to gender-inclusive parenting and fertility rights in India.

The practical fallout is significant. Many couples who would once have pursued surrogacy in India are now ineligible. Some travel abroad despite costs of Rs 80 lakh to over a crore. Some pursue Adoption in India: CARA Process, Eligibility, Timeline & Costs, which has its own demanding process. Others accept that surrogacy is not currently an option for them and follow a different path.

Eligibility for the surrogate is equally specific and reflects the altruistic-only framework. She must be: a married Indian woman aged 25-35; have at least one child of her own; have not been a surrogate before (each woman may act as a surrogate only once in her lifetime); have her husband's consent; be certified medically and psychologically fit for pregnancy by registered medical practitioners; and be a close relative or close friend of the intended parents.

The 'close relative or friend' requirement is one of the most practically important parts of the Act. Early on, the National Surrogacy Board interpreted it strictly — effectively meaning blood relatives such as a sister, sister-in-law, cousin or aunt — which sharply limited the pool, because most couples either have no willing eligible relative or do not want to involve family this way. Later clarifications widened it to include close friends with a documented long-term relationship, but it remains a real barrier. Some couples meet every other requirement yet cannot find an eligible surrogate.

The compensation framework is altruistic: the surrogate receives no payment beyond approved costs. The rules allow prenatal medical care; delivery costs; postnatal care; nutritional supplements during pregnancy; transport to clinic visits; insurance covering pregnancy complications and postpartum care for 36 months; and counselling. Any commercial payment beyond these approved expenses is a criminal offence.

Legal protections for the surrogate are designed to prevent exploitation: she must receive comprehensive medical insurance for 36 months paid by the intended parents; she must have legal counsel separate from theirs; she must give informed consent in her own language; she keeps the right to end the pregnancy on medical or personal grounds within the legally permitted window; and she has the right to refuse to give up the child after birth (which would trigger complex proceedings). The requirement that she already has a child of her own is partly meant to ensure she has reproductive experience and is making a fully informed decision about a further pregnancy.

The surrogacy process under the 2021 Act usually runs 18-24 months from first decision to birth, in four broad phases.

Phase 1 (months 1-3): Intended parents choose a registered surrogacy clinic and are evaluated to confirm eligibility (medical infertility certificate, marriage certificate, identity and financial documents). They identify a potential surrogate who is a close relative or friend and meets eligibility, have her assessed medically and psychologically, and prepare the application to the Surrogacy Board.

Phase 2 (months 3-6): The application goes to the Surrogacy Board with all documentation; approval typically takes one to three months, after which an eligibility certificate is issued. In parallel, the IVF cycle is planned — the intended mother's eggs are retrieved (or donor eggs where needed within the Act), fertilised with the intended father's sperm, and the resulting embryos are frozen for later transfer. The clinic must be ART Act registered for the IVF portion and Surrogacy Act registered for the surrogacy portion.

Phase 3 (months 6-9): With Board approval and embryos ready, the surrogate goes through an endometrial preparation cycle and embryo transfer is performed when her lining is ready. After a positive pregnancy test, antenatal care, scans and monitoring proceed as in any pregnancy, with the surrogate's insurance in force throughout. The intended parents usually stay involved in major decisions, with the surrogate's consent.

Phase 4 (months 9-15+): The surrogate delivers, and the baby is handed to the intended parents per the agreement. Legal parenthood requires a District Court order recognising the intended parents based on the surrogacy agreement, the surrogate's post-birth consent and the documentation. The birth certificate is then issued in the intended parents' names. The surrogate receives postpartum care, and her 36-month insurance continues. The whole journey takes 15-24 months when everything goes smoothly; complications or regulatory delays can extend it.

The full altruistic surrogacy pathway in India in 2026 typically costs Rs 15-25 lakh, depending on the clinic, the complexity of the IVF portion, the surrogate's medical needs and any complications. That is well below pre-Act commercial surrogacy (which had reached Rs 25-40 lakh in metros), mainly because there is no longer a commercial surrogate fee — once Rs 5-15 lakh — to pay. The cost is also more transparent: there is no fee to negotiate.

A rough itemised breakdown: IVF cycle to create embryos Rs 1.5-3.5 lakh; legal documentation and Surrogacy Board application Rs 1-2 lakh; medical evaluation of the surrogate Rs 30,000-60,000; embryo transfer cycle Rs 50,000-1,20,000; mandatory 36-month surrogate insurance Rs 2-4 lakh; antenatal care Rs 1-2 lakh; delivery (including possible C-section) Rs 1-3 lakh; postnatal care Rs 50,000-1 lakh; approved surrogate expenses (transport, nutrition) Rs 1-2 lakh; and legal proceedings for parental rights Rs 1-2 lakh.

Hidden costs that often surprise intended parents include: pregnancy complications that raise medical bills; preterm delivery needing NICU care (roughly Rs 5,000-15,000 per day at major hospitals); a C-section adding Rs 50,000-1.5 lakh; maternal complications, which the intended parents bear; counselling for the surrogate and parents; travel if the surrogate lives in another city; and legal costs if the parental-rights transfer is delayed or contested.

Insurance for the surrogate is mandated by the Act and is a major line item. It must cover her for 36 months from the start of pregnancy — for complications, delivery, postpartum care and any treatment arising from the pregnancy. Several Indian insurers now offer surrogate maternity cover designed for Act compliance. Verify the policy carefully, because the surrogate's wellbeing legally depends on it.

If you are weighing surrogacy against other treatments, it helps to compare like with like — for example the typical cost of IUI cycle by cycle or, where you may carry your own pregnancy later, egg freezing.

Many Indian IVF chains have continued to offer surrogacy after the 2021 Act, though volumes are far lower and eligibility is narrower. Centres must hold a separate Surrogacy Act registration in addition to their ART Act registration, and not every branch of every chain offers surrogacy — usually only the larger metro branches with experienced legal and medical teams take it on.

When choosing a clinic, look for: explicit Surrogacy Act registration (verifiable via the National Surrogacy Board); a clear in-house legal team familiar with Act compliance and parental-rights court orders; a transparent itemised cost breakdown; documented altruistic compensation within Act limits; experience with eligibility-certificate applications; counselling for both parties; and coordination of the mandatory 36-month surrogate insurance.

Avoid any centre that hints at workarounds to Act provisions (these are criminal), quotes an unrealistically low cost (likely missing components), or lacks a dedicated legal team. For complex cases — such as an exception for a couple with one prior child, surrogate-relationship verification, or interstate logistics — a specialist surrogacy lawyer, in addition to the clinic's legal team, is often needed.

Public-sector surrogacy is essentially unavailable in India. Public ART centres such as AIIMS Delhi focus on IVF rather than surrogacy, and no state runs a public surrogacy scheme equivalent to public IVF as of 2026. The Rs 15-25 lakh cost is therefore typically met out of pocket or through personal loans.

For the intended mother, medical considerations include the original cause of infertility (which decides whether her own eggs can be used or whether donor eggs are needed), her general health, and any condition that drove the surrogacy decision. Common medical reasons for surrogacy include an absent or non-functional uterus (Müllerian agenesis, prior hysterectomy, severe Asherman syndrome), repeated IVF failure or recurrent pregnancy loss despite good embryos, and serious conditions that make pregnancy unsafe (severe cardiac or advanced kidney disease, certain cancers). Some of these overlap with conditions like uterine fibroids or endometriosis-related infertility.

For the surrogate, medical considerations include her fitness for another pregnancy (assessed by a full workup), her obstetric history, her BMI and metabolic health, infectious-disease screening, and psychological readiness. The Act requires a registered medical practitioner to certify her fitness. Women with high-risk obstetric histories — severe pre-eclampsia, multiple C-sections, significant complications — are usually not recommended as surrogates. Insurance covers complications, but the personal health risk is real, which is part of why a clear altruistic motivation matters.

Psychological considerations are extensive, and the Act mandates counselling for both sides. Intended parents often navigate grief about their own infertility, the complexity of building a family through a third party, communication with extended family, and the story they will eventually tell the child. The surrogate navigates the emotional experience of carrying a pregnancy for another family, the relationship with the intended parents (often a close relative or friend), her own family's response, and the postpartum adjustment after handing over the baby. Counselling should continue through pregnancy and into the postpartum period — the kind of perinatal mental-health support any pregnancy may need.

Longer term, families navigate the ongoing relationship between surrogate and intended family, the child's eventual knowledge of being born via surrogacy (most psychologists recommend age-appropriate disclosure from early childhood), and the family's communication about an unconventional birth story. There is no single right approach, but families who have these conversations openly tend to report better long-term adjustment than those who try to keep the surrogacy entirely hidden. For couples balancing cultural or faith expectations, our piece on interfaith families and fertility narratives may help.

Establishing the intended parents' legal rights requires specific court orders under the Act. It begins before embryo transfer with a comprehensive surrogacy agreement, signed by the intended parents, the surrogate and her husband, witnessed and notarised. The agreement covers consent for the arrangement, the agreement that the intended parents will be the legal parents, the surrogate's relinquishment of any parental claim post-birth (subject to her legal right to refuse in extreme circumstances), and the medical, insurance and post-birth arrangements.

After birth, the surrogate signs a post-birth consent confirming relinquishment, and the intended parents apply to the appropriate District Court for an order recognising them as legal parents. The court reviews the documentation — eligibility certificate, surrogacy agreement, post-birth consent and birth records — may hold a brief hearing, and typically issues the order within weeks. The birth certificate is then issued in the intended parents' names.

Complications, though uncommon in altruistic surrogacy between close parties, are worth knowing. If the surrogate becomes unwilling to relinquish the baby, the matter can go to contested family-court proceedings. If documentation is incomplete or the eligibility certificate is challenged, the order can be delayed. If the intended parents separate during the pregnancy, parental-rights questions become complicated. Working with experienced surrogacy lawyers from the start prevents most of these issues.

Post-birth paperwork includes the birth certificate (issued after the court order), the baby's passport if international travel is planned, and routine newborn medical records and immunisation schedule. The surrogate's 36-month insurance continues to cover any postpartum complications. Many families stay in touch with the surrogate at a level that suits the original relationship.

Some people who do not qualify under Indian eligibility — single women, same-sex couples, foreigners, or couples with one existing child who do not meet the exception — consider surrogacy abroad. In 2026, the main commercial destinations include the US (most expensive but most legally clear, roughly Rs 80 lakh to over a crore), Mexico, Georgia, Russia (legal but politically complex) and newer options like Colombia. Ukraine was historically major but has been disrupted by war, and Thailand, Cambodia and Nepal banned international surrogacy in the 2010s.

International surrogacy means far higher costs than Indian altruistic surrogacy (often five to ten times), substantial legal complexity around the child's citizenship and return to India, and the practical challenge of managing a pregnancy and birth from abroad — multiple trips, remote communication and a foreign health system.

The Indian government's position is that a child born via international surrogacy can be brought to India and registered as an Indian citizen if at least one biological parent is Indian, but the process is complex and governed by specific Ministry of External Affairs and Ministry of Home Affairs guidelines. Some parents have faced delays bringing children home. Working with experienced international surrogacy lawyers and Indian immigration lawyers from the start is essential, not optional.

For couples eligible under Indian law, pursuing surrogacy within India is generally simpler, cheaper, more clearly legal and easier to manage. International surrogacy is mainly for those explicitly excluded here, or for high-income couples who specifically want US-style legal clarity. Either way, it is a major financial, legal and logistical decision that should never be taken without thorough consultation in both countries.

For those not eligible for surrogacy under the Act, several paths to parenthood remain. Adoption in India under the Adoption Regulations administered by the Central Adoption Resource Authority (CARA) is open to single parents, married couples and, under recent rulings, some non-traditional families, though waits of 2-4 years are common and the process is bureaucratic and emotionally demanding. Adoption costs (Rs 50,000-2 lakh for the formal process) are far lower than surrogacy.

Donor-egg IVF suits women whose uterus is healthy but whose eggs are not viable, while donor-sperm IUI or IVF — within ART Act eligibility — is an option for some women without a male partner, with their own gestation rather than surrogacy. Some couples explore international adoption or foster care, or consciously choose to remain child-free.

When eligible paths are closed off, the emotional process can be very hard. Many couples report grief and frustration at having medical options that are technically possible but legally unavailable. Counselling focused on family-building decisions, through fertility counsellors or specialised therapists, helps couples work through them. Connecting with other families who have travelled a similar road often gives perspective that clinical counselling alone cannot.

Even for those who do qualify, surrogacy deserves careful thought: the process runs 18-24 months, costs Rs 15-25 lakh, requires an eligible willing surrogate from close relatives or friends, and brings a child into the family through an unusual route the family will keep navigating. Surrogacy is right for some families and wrong for others. If you are still mapping your options, our broader guide to trying to conceive and the question of whether your body is ready to conceive can help you make the decision with full information.

• You have an absent or non-functional uterus, repeated IVF failure, recurrent pregnancy loss despite good embryos, or a medical condition that makes pregnancy unsafe — talk to a fertility specialist about whether surrogacy is medically indicated.
• You think you may qualify but are unsure about the 5-year, age, or 'no living child' criteria — get a written eligibility assessment before spending on anything else.
• You have found a potential surrogate among close relatives or friends — have her medically and psychologically evaluated and counselled before any commitment.
• Before signing any agreement or transferring any money — consult an experienced surrogacy lawyer, and make sure the surrogate has her own independent legal counsel.
• If a clinic suggests any 'commercial' payment, off-the-record arrangement, or workaround to the Act — stop, because this is a criminal offence that puts you and the surrogate at legal risk.
• If at any point you or the surrogate feel overwhelmed, grief-stricken or pressured — reach out for counselling support; emotional readiness is as important as medical and legal readiness.

• The Surrogacy (Regulation) Act, 2021 — India Code, Ministry of Health and Family Welfare
• The Assisted Reproductive Technology (Regulation) Act, 2021 — India Code
• Ministry of Health and Family Welfare — National Surrogacy Board and ART/Surrogacy portal
• WHO — Infertility fact sheet
• Central Adoption Resource Authority (CARA), Ministry of Women and Child Development