Surrogacy Treatment Delhi: The Legal and Medical Process, Step by Step

Once a couple knows they are eligible, the next question is always the same: what happens first, and how long will it take? Planning surrogacy treatment Delhi couples can rely on means working through a fixed sequence of legal certificates before the medical IVF steps begin. This article sets out that sequence in order, explains what each document is for, and is clear about what a fertility clinic can and cannot do for you. Whether you qualify in the first place is covered in our separate guide to surrogacy eligibility in India; here we assume you have already cleared that hurdle.

The big picture: law first, laboratory second

The Surrogacy (Regulation) Act, 2021 and the Surrogacy Rules, 2022 apply across India, and in Delhi they are administered through the appropriate authority and District Medical Boards set up by the Delhi government. The structure is the same everywhere:

1. Medical evaluation at a registered surrogacy clinic.
2. A certificate of medical indication from the District Medical Board.
3. A willing, eligible surrogate who is medically and psychologically fit.
4. Insurance for the surrogate and a parentage and custody order from a Magistrate’s court.
5. A certificate of essentiality and a certificate of eligibility from the appropriate authority.
6. Only then, the IVF cycle, embryo transfer and pregnancy care.

Treating this as a checklist, rather than starting IVF and “sorting the paperwork later”, avoids months of delay and the risk of embryos that cannot legally be used.

Step 1: Medical assessment at a registered clinic

Surrogacy procedures may be carried out only at a clinic registered under the Act, so ask to see the registration before you start. The first consultation is a detailed review of your history: previous pregnancies, surgeries, IVF cycles, uterine imaging and any illness that makes pregnancy unsafe. Your specialist may advise further tests, such as a hysteroscopy, before deciding whether the case for surrogacy is strong enough to present.

Both partners also have baseline tests. For the woman, these usually include ovarian reserve tests and an ultrasound; for the man, a semen analysis. These results decide whether the couple can use their own eggs and sperm, or whether a donor egg or donor sperm will need to be justified to the Board.

Step 2: The District Medical Board certificate

The District Medical Board is a panel of specialist doctors constituted at district level. Its job is to confirm, independently of your clinic, that there is a genuine medical indication for gestational surrogacy. The application is supported by your clinic’s medical summary and all relevant reports.

What strengthens the application

• Clear documentation of the condition, such as an absent or non-functional uterus, repeated implantation failure with good embryos, recurrent pregnancy loss, or a medical illness that makes pregnancy life-threatening.
• Evidence that treatable causes have been looked for and addressed.
• If a donor egg or donor sperm is needed, a specific medical reason in one partner. Since the March 2024 amendment, the Board can certify this, but at least one gamete must still come from the couple.

The Board may call the couple for an appearance or ask for more tests. Answering queries promptly and completely is the single most useful thing you can do to keep the process moving.

Step 3: The surrogate’s fitness and consent

The surrogate must be a married woman aged 25 to 35 with a child of her own, acting as a surrogate for the first and only time. She needs a certificate of medical and psychological fitness, which involves a physical examination, blood tests, an ultrasound and a counselling assessment.

The surrogacy must be altruistic. The couple pays her medical expenses and insurance, and nothing else. A clinic may counsel her and explain the procedure, but it must not recruit surrogates for money, broker a deal or advertise for surrogates. She gives informed written consent, and she can withdraw that consent before the embryo is transferred.

Step 4: Insurance and the Magistrate’s order

Two documents protect the surrogate and the child:

• Insurance: the intending couple must buy general health insurance cover for the surrogate for a period of 36 months, from an insurer recognised under Indian regulations, sufficient to cover complications arising from pregnancy and childbirth.
• Parentage and custody order: the couple applies to a Magistrate’s court for an order confirming that the child born through surrogacy will be their child, in their custody. This order is required before the treatment proceeds, so that the child’s legal status is settled in advance.

Most couples engage a lawyer familiar with surrogacy matters for the court application. Your clinic will provide the medical documents the court needs, but it cannot act as your legal representative.

Step 5: Certificates of essentiality and eligibility

With the Board’s certificate, the court order and the insurance in hand, the couple applies to the appropriate authority. Two certificates are issued:

Only when all of these are issued can the clinic begin the surrogacy-related procedures.

Step 6: The medical steps of surrogacy treatment Delhi couples go through

The medical part follows the familiar IVF treatment pathway, with two people being prepared in parallel.

For the intending mother (or egg donor)

1. Ovarian stimulation with injections and monitoring scans over roughly 10 to 12 days.
2. A trigger injection, then egg collection under short anaesthesia.
3. Fertilisation in the laboratory by conventional IVF or ICSI, depending on sperm quality.
4. Embryo culture, often to the blastocyst stage on day 5, with freezing of suitable embryos.

For the surrogate

1. Preparation of the uterine lining with hormone tablets or patches and scans.
2. Thawing and transfer of an embryo when the lining is ready. Most specialists favour transferring a single embryo, which keeps the pregnancy safer for her.
3. A pregnancy blood test about two weeks later, followed by early scans.
4. Regular antenatal care and delivery, with the costs borne by the intending couple.

Freezing embryos and transferring them in a later, prepared cycle is common in surrogacy because it lets the two women’s cycles be coordinated without pressure.

Realistic timelines

There is no fixed number of weeks for the legal stage. In practice, the Board review, court order and authority certificates together commonly take several months, depending on how complete the documents are and how quickly queries are answered. Some couples complete their own IVF cycle and freeze embryos during this period where medically sensible, so that transfer can happen soon after the certificates arrive; discuss with your doctor whether this makes sense for you. The medical stage from preparing the surrogate’s lining to a pregnancy test is usually four to six weeks, and a successful pregnancy then runs its normal course.

What a clinic can and cannot do

A responsible clinic offering surrogacy treatment Delhi patients can trust will:

• Assess you honestly, prepare medical summaries and answer Board and court queries on the medical side.
• Counsel both the couple and the surrogate, and keep confidential records as the law requires.
• Carry out IVF, embryo freezing, embryo transfer and early pregnancy monitoring.

It must not:

• Pay, recruit or advertise for surrogates, or arrange any payment beyond medical expenses and insurance.
• Offer or perform sex selection, which is illegal under the ART Act and the PCPNDT Act.
• Begin surrogacy procedures before the certificates are issued, or promise a particular outcome.

Our team, including Dr. Ruchi Hooda, works through each medical step with couples and explains which documents come from the clinic and which come from you. You can learn more about our surrogacy services within the law before your visit.

Talk to a Ridge IVF specialist

If you are ready to plan the sequence for your own case, book a consultation at our Jawahar Nagar centre, the Fortis Ridge Fertility & IVF Centre in Shalimar Bagh, or our Burari centre, or call or WhatsApp +91 88001 00326. We will review your records, tell you what the Board is likely to ask for, and help you prepare a clear, complete medical file.

This article is for general information and is not a substitute for a personal consultation with a fertility specialist.