Surrogacy in India is regulated by the Surrogacy (Regulation) Act, 2021, and its 2024 Amendment Rules. Only altruistic surrogacy is legal; commercial surrogacy is banned. Eligibility is limited to Indian married heterosexual couples (including NRIs and OCI cardholders) with a documented medical need, and to widowed or divorced women aged 35 to 45. Single men, same-sex couples, and live-in couples are not currently permitted.
Surrogacy is an arrangement in which a woman (the surrogate) agrees to carry and deliver a child for an intending individual or couple (the commissioning parents). Indian law recognises only gestational altruistic surrogacy, where the surrogate carries an embryo created through IVF (In-vitro Fertilization, the process of fertilising an egg outside the body) and is not the genetic mother of the child. She receives no payment beyond defined medical expenses and insurance. Every step is governed by the Surrogacy (Regulation) Act, 2021, the Surrogacy (Regulation) Rules, 2022, and the Surrogacy (Regulation) Amendment Rules notified in February 2024.
For nearly a decade, India was a global hub for commercial surrogacy, with limited oversight and frequent reports of surrogate exploitation. The Surrogacy (Regulation) Act, 2021, ended that model overnight, but the original rules were so restrictive that many medically deserving patients were left without a path forward. The February 2024 Amendment Rules addressed several of these gaps: donor eggs and donor sperm are now permitted in specified medical situations, the definition of infertility was broadened, and surrogate welfare protections were strengthened. For Indian couples, NRIs (Non-Resident Indians), and OCI cardholders considering surrogacy in 2026, the framework is clearer than it has been at any point in the past five years, but it is also far more selective about who qualifies and how the process must be conducted.
Eligibility under the current law has three layers: who the intending parent or couple is, what medical condition justifies surrogacy, and who the surrogate herself can be. All three must be satisfied for the process to proceed legally.
Legally married Indian heterosexual couples are the primary category eligible for surrogacy. The female partner must be aged 23 to 50, the male partner 26 to 55, and the couple must have been married for at least 5 years. They must hold a Certificate of Essentiality from the District Medical Board confirming a medical need for surrogacy and a Certificate of Eligibility from the Appropriate Authority. The couple must not have a surviving biological or adopted child, with limited exceptions for children with severe medical conditions.
Non-Resident Indians and Overseas Citizens of India cardholders are eligible on the same terms as resident Indian couples. They must be in a heterosexual marriage for at least 5 years, meet the age and medical criteria, and submit additional documentation, including valid OCI cards, foreign passports, an attested marriage certificate, and FRRO (Foreigners Regional Registration Officer) clearance. Foreign nationals who are not OCI cardholders are not eligible.
Under the 2021 Act, a single woman who is widowed or divorced and aged 35 to 45 is eligible to commission a surrogacy. She must hold the same Certificate of Essentiality and Certificate of Eligibility and meet the medical and documentation criteria. Never-married single women are not currently eligible, although this restriction is being challenged in court and may evolve in the coming years.
The Act expressly excludes single men, same-sex couples, live-in couples, and never-married single women. Foreign nationals without OCI status are also excluded. These restrictions are central to the legislation as it currently stands.
The intending mother must have a documented medical condition that prevents her from carrying a pregnancy safely. Common qualifying conditions include absence of the uterus, Mayer-Rokitansky-Küster-Hauser syndrome (MRKH, a condition where a woman is born without a functional uterus), severe Asherman's syndrome (extensive scarring inside the uterus), recurrent pregnancy loss with confirmed uterine cause, repeated unexplained IVF failure with proven embryo quality, and severe medical conditions where pregnancy is contraindicated for the mother's life. The District Medical Board reviews each case.
Surrogacy is never the first treatment offered. It is recommended only when a woman cannot safely carry a pregnancy herself, even with the most advanced fertility treatments. The most common medically certified reasons fall into the categories below.
•Absence of the uterus: Either congenital, as in MRKH syndrome, or surgical, after a hysterectomy performed for cancer, severe fibroids, or postpartum complications.
• Severe uterine damage: Asherman's syndrome with extensive intrauterine adhesions, severe adenomyosis, or repeated unsuccessful uterine reconstruction.
• Recurrent pregnancy loss: Three or more miscarriages with a confirmed uterine cause that cannot be corrected through medical or surgical intervention.
• Repeated implantation failure: Multiple high-quality embryo transfers that consistently fail to implant despite a thorough workup.
• Medical risk to the mother: Conditions such as severe cardiac disease, advanced kidney disease, or a cancer history, where pregnancy poses a serious risk to the intending mother's life.
• Cancer treatment history: Where prior pelvic radiation or chemotherapy has compromised the uterus or made pregnancy unsafe.
If a fertility specialist has raised surrogacy as a possible path forward, the next steps are mostly administrative and legal rather than medical. The process is well-defined, but document-heavy, and missing paperwork is the single most common reason a surrogacy file is delayed or rejected.
The first step is a focused consultation to confirm whether the medical condition meets the District Medical Board criteria and whether the couple or individual meets the age, marriage duration, and family-status requirements. Many patients underestimate the documentation burden, so this is also the right moment to discuss whether donor egg IVF or other ART options might still be viable before moving to a full surrogacy pathway. You can book a fertility consultation at a Cloudnine Fertility centre near you to begin this assessment.
Once eligibility looks viable, the next step is to assemble the document set: marriage certificate, medical certificates from a registered government clinic, identity proofs, and for NRI or OCI couples, FRRO clearance and attested foreign documents. Counselling for both intending parents and the prospective surrogate is mandatory and should begin early. Reading about recurrent miscarriage causes and treatment can also help intending parents understand where surrogacy sits relative to other treatment options that may still be on the table.
Some clinical situations make surrogacy a likely path forward, and earlier conversations make the documentation and matching process smoother. The signs below typically prompt a same-week consultation rather than a wait-and-see approach.
If any of these situations apply to you, the most useful next step is a confidential consultation with a Cloudnine specialist who can review your medical history, assess eligibility under the 2021 Act, and walk you through documentation and timelines. Book a fertility consultation at a Cloudnine Fertility centre near you.
Even though commercial surrogacy is banned, surrogacy is not inexpensive. The total cost is the sum of medical treatment, surrogate care, insurance, legal fees, and ongoing administrative compliance through the Appropriate Authority. The ranges below reflect typical figures at well-regulated, registered surrogacy clinics; exact figures depend on the city, the IVF protocol, and whether donor gametes are used.
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