The recent publication of the revised Law on Persons and Family, which formally recognises surrogacy and provides guidelines on its practice, has set the stage for the procedure's implementation in Rwanda.
The law specifies that reproduction between spouses can occur naturally or with the assistance of reproductive technologies, including surrogacy. It clarifies that assisted reproduction may involve a third party, as facilitated through a written contract in accordance with relevant laws.
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Rwandan doctors who spoke to The New Times, shed light on the practice, the processes around it, as well as the hope it gives to couples struggling with infertility, and so on.
Dr Kenneth Ruzindana, a consultant at Kigali University Teaching Hospital (CHUK), said there are two primary forms of surrogacy, which include traditional and gestational surrogacy.
He noted that gestational surrogacy, which is more common, involves creating an embryo through in vitro fertilization (IVF) using the intended parents' or donors' egg and sperm. In this process, the surrogate mother carries the pregnancy but has no genetic relationship to the child.
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Furthermore, he stressed that the process of becoming a surrogate is rigorous as potential surrogates undergo an extensive application process that includes a detailed medical history, psychological evaluation, and often a background check.
"The surrogacy journey begins with a series of critical steps, starting with matching the intended parents with a surrogate. Surrogacy agencies typically handle many aspects of this process, including legal, medical, and psychological screening, ensuring that both the surrogate and the intended parents are well-prepared for the journey ahead," he explained.
He further noted that once a match is found, legal contracts are drawn up to outline the rights, responsibilities, and expectations of both the surrogate and the intended parents. These agreements cover important aspects such as compensation, medical expenses, and procedures in the event of medical complications.
The next step involves medical preparation, which is a crucial phase in gestational surrogacy. The surrogate undergoes hormone treatment to prepare her uterus for pregnancy, while the intended mother or egg donor undergoes egg retrieval, Dr Ruzindana added.
"The fertilised eggs are then transferred to the surrogate's uterus. If the transfer is successful, the surrogate carries the pregnancy to term."
Throughout the pregnancy, the surrogate receives prenatal care, and the intended parents are usually involved as much as possible, ensuring a collaborative and supportive process. After the birth, the baby is handed over to the intended parents as per the legal agreement, Dr Ruzindana added.
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Dr Emmanuel Semwaga, an obstetrician and gynecologist at Mediheal Diagnostic and Fertility Centre in Kigali, told The New Times that the new law clearly outlines the legality of surrogacy, but detailed guidelines from the Ministry of Health are still awaited.
He said the guidelines would also offer direction for couples interested in surrogacy and establish legal protections for surrogate mothers.
