Dr Desai is a consultative member on the committee set up to draft a proposed Bill on surrogacy laws. The Bill proposes to bring both IVF (in-vitro fertilisation) and surrogacy under stringent legal scrutiny.

Though surrogacy is perceived as renting a womb, there are many shades to it. Surrogacy with oocyte, or egg donation, is considered “partial surrogacy”. But because the procedure is performed through IVF, in practice this is also termed “gestational surrogacy”, for which legal and ethical acceptability varies from country to country. Under the ICMR guidelines, surrogacy with oocyte donation has not been specifically mentioned, says Dr Desai.

In the UK, in contrast, “gestational surrogacy” is allowed only for exceptional reasons, but without commercial involvement.

In addition to the actual act of surrogacy, the sourcing of surrogate mother also has an ethical dimension. In Israel, law does not allow the commissioning couple to have a relative as a surrogate mother because the law accepts surrogate mother as the real mother. This is obviously contrary to the Indian experience, where grandmothers have become surrogate mothers.

In the UK, the surrogate (host) may be a member of the family of the genetic parents or may be procured through patient infertility support groups. In the US, highly professional commercial agencies — many of them run by lawyers — bring intended couples and women who are willing to act as surrogate hosts together.