Surrogacy in India: A promising new opportunity for Intending Couple

Surrogacy is an arrangement where a woman (the surrogate) agrees to carry and give birth to a child for another person or couple (the intended parents).

Prior to 2021, India was once a major hub for international surrogacy due to:

• Lower costs compared to Western countries
• A large pool of potential surrogate mothers
• Relatively lax regulations

While there are no published data, the commercial surrogacy market in India was valued at approximately USD 2 billion annually, driven largely by international demand.

With the implementation of The Surrogacy (Regulation) Act, 2021, compliance has become stringent, and this has significantly impacted surrogacy practice in India. As per the law,

• Only married Indian couples facing specific medical conditions can access surrogacy.
• Commercial surrogacy is banned.
• Surrogates must be close relatives of the intending couple.

Inspite of new regulations, the surrogacy market in India holds significant potential due to a mix of demographic, social, and medical factors.

1. Rising Infertility Rates

India’s infertility rates have been on the rise due to factors such as lifestyle changes, late marriages, pollution, and stress. The WHO estimates that about 15% of Indian couples face infertility, creating a demand for assisted reproductive technologies (ART), including surrogacy.

It is estimated nearly 30 million couples In India face fertility challenges and the gross fertility rate in India has decreased by almost 20% in the last decade.

As per a study published in the Human Reproductive Update journal, it is estimated that the human sperm count has fallen by over 50% over the last 50 years.

India is No. 3 internationally with over 2,500 fertility clinics with one new clinic being added every week

2. Growing Awareness of Assisted Reproductive Technology (ART)

With the spread of ART clinics and increasing public awareness, more couples may consider surrogacy as an option to have children. Surrogacy can be explored by those couples facing challenges such as repeated IVF failures or medical conditions that prevent pregnancy.

In customer survey undertaken by SafeTree and a leading fertility chain, it was observed that ART awareness levels among couples in Tier 2 and Tier 3 cities is similar to that in Tier 1 cities in India.

3. Favourable Demographics and Population Size

India’s large population provides a broad base of potential surrogates and intending couples. The Surrogacy (Regulation) Act, 2021 mandates that only close relatives can serve as surrogates, thus making the market more restrained than it has been in the past.

4. Shift Towards Regulated, Ethical Surrogacy Practices

India’s 2021 Surrogacy Act established strict guidelines to address ethical concerns and prevent exploitation.

Although commercial surrogacy has been banned, regulated altruistic surrogacy is permitted, creating a framework that aims to protect surrogates and ensures transparency.

There has been a relaxation in the law through Surrogacy (Regulation) Amendment Rules, 2024 and it is now possible to use an egg donor or sperm donor, provided all other conditions are met.

5. Increasing Demand for Comprehensive Surrogacy Insurance

The requirement of a 36-month insurance plan for surrogates as per the Surrogacy (Regulation) Act has created a growing need for customized surrogacy insurance policies. This covers potential medical complications during and post-pregnancy, encouraging responsible surrogacy practices and financial security for surrogates.

6. Opportunities in Medical Tourism

While international couples are no longer eligible for surrogacy in India, India’s highly qualified medical professionals and relatively affordable healthcare services make it an appealing destination for IVF and other ART related services, contributing to  indirect demand for surrogacy-related healthcare.

7. Technological Advancements in Fertility Treatments

Advances in fertility treatments and improved IVF success rates add to the appeal of surrogacy for couples. This ongoing innovation supports growth in ART services, with a positive impact on demand for surrogacy-related services.

 

While there are factors contributing to growth of Surrogacy in the country, there are challenges and market restrictions which include –

1. Regulatory Restrictions: Stringent laws limit surrogacy to altruistic models, significantly narrowing the market compared to the days of commercial surrogacy. Further, regulatory approvals take time and there is still lack of clarity in many States in the country.
2. Social and Cultural Stigma: Although awareness is increasing, surrogacy still faces cultural and social stigma in many parts of India, affecting its overall acceptance.
3. Ethical Concerns and Legal Risks: The ethical debate around surrogacy continues, especially concerning the rights and welfare of surrogates and children born through surrogacy.

With the rise in demand for surrogacy, there is a huge market potential for Surrogacy Support Services. Insurance providers, legal consultants, and counselling services tailored to surrogacy can benefit from a structured surrogacy ecosystem. With mandatory insurance requirements, insurance companies and related services have a unique market to tap into, especially as awareness and demand for compliance continues to grow.

Summary: Market Outlook

The Indian surrogacy market has growth potential but there are limitations due to regulatory restrictions on commercial surrogacy. The focus is likely to remain on altruistic surrogacy within a highly regulated framework, which can help address ethical concerns.

Estimating the market size for surrogacy in India, especially after the regulatory changes that have been implemented, is challenging due to limited available data. The ART market in India, which includes IVF, egg and sperm donation, and surrogacy, is expected to see robust growth due to rising infertility rates and increasing acceptance of ART practices.

Projections estimate that India’s fertility services market could reach USD 1 billion in the coming years, with a CAGR (compound annual growth rate) of about 15-20% as awareness and accessibility of ART services increase. Surrogacy as a part of this industry, will also increase substantially in the years to come

 

For any further information, you can reach us at vikas.anand@safetree.in

Author – Vikas Anand

CEO, Safetree Insurance