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Risks & Complications in Surrogacy

Clinical Safety & Mitigation

An honest, transparent analysis of medical, psychological, legal, and clinical risks associated with IVF and surrogacy, and how our independent advisory safeguards intended parents.

Risks & Complications in Surrogacy

Medical ones and emotional ones, and the surrogate carries the greater share of both. A surrogacy is a pregnancy, so it brings whatever any pregnancy brings. It is an IVF cycle as well, which brings more again. Most of what follows is well understood and manageable with proper screening, monitoring and experienced medical care. What it is not is hidden. So here it is plainly, each risk alongside what good clinical practice does about it.

Understanding surrogacy risks

Risk exists in every pregnancy. Surrogacy layers IVF over that, and adds one thing more: the woman carrying the pregnancy has no genetic tie to it. Proportion matters, though. Serious complications stay uncommon. Nobody becomes a surrogate without being screened hard for good health first. And a fair number of the risks that came with older approaches have shrunk since, thanks mostly to single-embryo transfer and the monitoring that now runs alongside it.

Say none of that softens the list. It should not. Nobody is well served by a guide that minimises, and being fully informed is part of what makes surrogacy ethical to begin with. Treat this page as general information. Your own medical picture belongs in front of a qualified doctor.

Medical risks for the surrogate

Ordinary pregnancy risk applies to a surrogate the way it applies to anybody. A few sit slightly higher in IVF and gestational-carrier pregnancies:

  • Blood pressure gets watched closely from the very start. Pre-eclampsia and high blood pressure disorders show up somewhat more often, research suggests, where the embryo is genetically unrelated to the woman carrying it.

  • Gestational diabetes is handled through monitoring and, when it is called for, dietary and medical support.

  • Delivery before 37 weeks, which IVF pregnancies see somewhat more of. Preterm birth takes a toll on her recovery as much as on the newborn.

  • Placental abruption, and placental problems more broadly. All of them need medical attention.

  • Some surrogate pregnancies end in a caesarean delivery where others would not.

  • Postpartum haemorrhage and anaemia, watched for through delivery and afterwards, and managed.

Gestational carriers do run higher rates of serious complications than pregnant women generally, and recent studies say so plainly. Read that as the case for rigorous pre-screening and continuous physician oversight. Not as a case for alarm.

Risks related to IVF and fertility medication

The treatment carries risk of its own, quite apart from the pregnancy. IVF is what surrogacy runs on, after all.

  • Ovarian Hyperstimulation Syndrome (OHSS) affects whoever provides the eggs. Usually the intended mother or a donor. Not usually the surrogate. Mild cases mean bloating and nausea. Severe cases are uncommon and need medical monitoring.

  • Reaction to fertility medication. Injection-site irritation, hot flashes, mild discomfort. Common, usually minor.

  • Ectopic pregnancy - an embryo implants outside the uterus. Rare. Slightly more common with IVF. Monitored for early on.

Where these steps sit in the wider journey: our surrogacy process, step by step page.

The risk of multiple pregnancy, and how it is reduced

Transfer more than one embryo and the chance of a multiple pregnancy rises sharply. Twins or more carry higher risks across the board. Preterm birth. Low birth weight. Pre-eclampsia. Other complications too, for the surrogate and for the babies both.

Best practice in India and internationally now favours single-embryo transfer wherever appropriate. One embryo at a time lowers those risks meaningfully. It still supports a healthy pregnancy. Of everything on this page, it is the clearest example of a clinical decision doing the work.

Emotional and psychological considerations

The risks are not all physical, and the emotional side gets underestimated more or less constantly.

  • For the surrogate: Pregnancy anxiety is real, post-birth adjustment is real, and handing over the baby is an experience that deserves honest preparation and proper support rather than reassurance.

  • For the intended parents: It is the waiting. The uncertainty, the emotional intensity of the whole thing, all of it is stressful.

  • Counselling is mandatory in India: For the intended parents and for the surrogate. Emotional support here is not an optional extra bolted on at the end. It is built into ethical surrogacy. If you want to understand who is involved and how that support works, see our what is altruistic surrogacy page.

How are risks managed and reduced?

Good clinical and legal practice is built to lower these risks. The protections that matter:

  • Thorough medical and psychological screening of the surrogate, before anything begins

  • Single-embryo transfer where appropriate, which is the multiple-pregnancy safeguard

  • Continuous antenatal monitoring, across all three trimesters

  • Mandatory 36-month insurance for the surrogate, covering pregnancy-related and postpartum complications

  • Care only at clinics registered under the National ART and Surrogacy Board

  • Full informed consent, so nobody is learning about a risk after the fact

A large part of why the choice of clinic matters is sitting in that list. For the legal protections behind all of it, see our surrogacy law in India page.

Our commitment to transparency

Talking about risk honestly is part of looking after you. At Oji Surrogacy & IVF Care we commit to:

  • No guaranteed pregnancy or treatment-outcome claims. 

  • Honest, balanced information about risk, neither played down nor played up

  • Individual medical assessment rather than one-size-fits-all promises

  • Evidence-based information, reviewed by qualified professionals

  • A clear explanation of what an online consultation can and cannot provide

  • Respect for the privacy of intended parents and surrogates alike

This page is general information about surrogacy risks and complications and is not a substitute for personalised medical advice. Every situation is different. The risks that apply to yours are worth discussing with a qualified doctor before you decide anything.

This page discusses sensitive medical topics. If you have concerns about your own health or about a specific pregnancy, please speak to a qualified medical professional.

Talk to Oji Surrogacy & IVF Care

If the risks are what is on your mind, that is a good reason to talk to someone. We offer personalised, honest online consultations, with clear evidence-based guidance and no misleading claims.


  • Single Embryo Transfer (eSET) priority
  • Comprehensive 36-month surrogate insurance
  • Third-party lab quality auditing

How We Support You

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Please note: We do not provide medical treatment or act as a surrogacy agency. Our role is to educate, guide, and connect you with the right professionals.

Frequently Asked Questions

It carries the same risks as any pregnancy, with the IVF risks added on. Serious complications are uncommon. Careful screening, single-embryo transfer and continuous monitoring make it about as safe as a pregnancy gets. No pregnancy is entirely without risk, which is why honest information and good medical care are most of the answer here.

Pre-eclampsia, meaning high blood pressure. Gestational diabetes. Preterm birth. Caesarean delivery. Those four are the best documented, and all four are generally manageable with proper monitoring and experienced care.

Some research links carrying a genetically unrelated embryo to a somewhat higher chance of pre-eclampsia. It is one of the reasons blood pressure and general health get monitored as closely as they do throughout the pregnancy.

By transferring one embryo where that is appropriate. Single-embryo transfer brings the chance of a multiple pregnancy down significantly, and the complications that travel with it along with it.

Yes. Pregnancy anxiety, post-birth adjustment for the surrogate, the emotional intensity for intended parents. All real, all common. Hence mandatory counselling for both parties in India.

Screening, single-embryo transfer, continuous monitoring, mandatory insurance, full informed consent, and a registered clinic. Choosing an experienced and compliant clinic is most of it.

Medical Disclaimer

The information provided on this website is for general informational purposes only and does not substitute professional medical advice, diagnosis, or treatment. Please consult a qualified healthcare professional for personalized medical guidance.

Content Review & Medical Review

All content on this website is written by experienced medical writers and reviewed by qualified experts to ensure accuracy, reliability, and alignment with current medical standards.

Last Reviewed: May 15, 2025
REVIEWED BY MEDICAL
EXPERTS
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