Becoming a gestational surrogate represents one of the most meaningful ways to help families achieve their dreams of parenthood. However, surrogate qualifications involve comprehensive medical, psychological, and lifestyle requirements designed to ensure the health and safety of both the surrogate and the baby. This guide examines all surrogate requirements, explains the underlying medical reasons for each qualification, and provides clarity on potential disqualifications.
Understanding Surrogate Requirements
Surrogate qualifications are evidence-based standards developed by reproductive medicine professionals. These requirements serve three primary purposes: ensuring maternal health protection by confirming the surrogate can safely carry a pregnancy to term, optimizing fetal health to maximize the chances of a healthy baby, and promoting successful pregnancy outcomes by reducing complications.
All reputable surrogacy agencies, including ABC Surrogacy, follow guidelines established by the American Society for Reproductive Medicine to maintain the highest standards of care and safety.
Essential Medical and Health Requirements
Previous Pregnancy History
Requirement: Must have given birth to at least one child with no major complications.
Medical Rationale: Previous successful pregnancies demonstrate proven fertility and reduce unknown risk factors. This requirement confirms that the reproductive system functions normally and provides valuable experience with pregnancy symptoms, reducing anxiety and improving prenatal care compliance.
Major Complications Include: Examples include (and specifics may vary by IVF clinic) –severe preeclampsia, placental abruption requiring emergency intervention, spontaneous preterm birth before 32 weeks, any second or third trimester loss, insulin-dependent gestational diabetes.
Current Parenting Requirement
Requirement: Currently raising at least one child of your own.
Rationale: One of the key qualifications to become a gestational surrogate is having experience as a parent. This means you must have given birth to, and are currently parenting or have parented, at least one child of your own.
This requirement exists for an important reason: it helps ensure that surrogates fully understand the physical, emotional, and mental demands of pregnancy and parenthood. Agencies and clinics want to be confident that a potential surrogate has already had a healthy pregnancy and delivery, and is emotionally prepared for the unique journey of carrying a baby for someone else.
Body Mass Index (BMI) Guidelines
Requirement: BMI must be 32 or below.
Medical Safety Rationale: Higher BMI significantly increases risks of gestational diabetes, preeclampsia, blood clots, delivery complications, and anesthesia risks. Lower BMI improves IVF success rates and makes monitoring fetal development easier through physical examinations and ultrasounds.
Age Requirements
Requirement: Must be between ages 21 and 40.
Age Rationale: The minimum age of 21 ensures legal maturity, complete physical development, life stability, and optimal reproductive health. The maximum age of 40 addresses pregnancy risk factors, as advanced maternal age increases risks of complications, and affects recovery capacity and hormonal response to fertility treatments.
Lifestyle and Legal Requirements
Substance Use and Health
Requirements: Must be a non-smoker with no illegal drug use and compliance with alcohol and marijuana restrictions during treatment and pregnancy.
Health Impact: Smoking causes low birth weight, premature birth, developmental issues, and reduces IVF success rates. Drug use can cause birth defects, legal complications, and indicates potential inability to comply with medical protocols.
Geographic and Legal Requirements
Requirement: Must reside in the United States with valid driver’s license.
Rationale: U.S. residency ensures access to quality prenatal care, clear legal protections under state surrogacy laws, reliable transportation to medical appointments, and proximity to emergency medical facilities.
Psychological Qualifications
Mental Health Assessment
Comprehensive psychological evaluation includes assessment of emotional stability, support systems, and motivation. Key factors include the ability to handle pregnancy’s emotional demands, stable personal relationships, resolved trauma history, partner and family support, and primarily altruistic motivation to help others achieve parenthood. This is also an opportunity for a therapist to share how a surrogacy pregnancy can impact a family to ensure that the surrogate (and partner, if applicable) is totally prepared once the journey begins.
Background and Legal Screening
The screening process includes criminal history verification, financial stability assessment, reference checks, and home environment evaluation. Legal compliance requires clean criminal background, particularly regarding crimes involving children, and sufficient financial stability to ensure the surrogacy decision is made from choice, not financial necessity. While it is understood that the money earned from surrogacy will enhance the lives of the surrogate and her family, it should not be needed in order for the surrogate to pay her daily living expenses.
Common Disqualifications and Special Considerations
Automatically Disqualifying Conditions
- Active substance abuse or addiction.
- Untreated mental health conditions requiring hospitalization.
- History of recurring pregnancy complications.
- Chronic conditions requiring pregnancy-incompatible medications.
- BMI above 32.
Conditions Requiring Individual Assessment
Controlled chronic conditions like mild hypertension that are well-managed may be acceptable or gestational diabetes that was manage with diet modification during pregnancy would need to be evaluated on a case by case basis, but is not an immediate disqualification. Someone with insulin dependent diabetes cannot be a surrogate unfortunately. Successfully treated minor mental health history, minor previous pregnancy complications that resolved, and surgical history not affecting reproductive capacity are evaluated case-by-case. Additionally, if you experienced more than 3-sections / more then 5 vaginal deliveries, multiple abnormal pap smears requiring a LEEP procedure, would all need to be assessed and reviewed on a case by case basis.
The goal isn’t to exclude, but to ensure that both your health and the baby’s health are protected throughout the journey. Every surrogacy case is unique and sometimes, all it takes is a personalized medical review to determine eligibility.
Government Assistance Considerations
Enrollment in cash assistance, welfare, public housing, or Section 8 typically disqualifies applicants. Participation in food stamps, WIC, or subsidized childcare may be affected by surrogate compensation. ABC Surrogacy takes the surrogate and her family’s personal situation into consideration.
The Screening Process
Becoming a gestational surrogate is a generous and life-changing decision, and it comes with a thorough screening process to ensure the health, safety, and well-being of everyone involved.
The comprehensive evaluation includes five phases:
Phase 1: Initial application, assessment and preliminary qualification verification.
Phase 2: Medical records evaluation by agency team (experienced RN), including a current pap and signed OB clearance letter noting current weight and blood pressure.
Phase 3: Background checks completed on surrogate and all adults living in her household.
Phase 4: Psychological assessment and counseling session with GC/partner, including completion of a personality inventory.
Phase 5: Review of medical history with Maternal Fetal Medicine Specialist.
Phase 6: Final approval and agency paperwork, including reviewing and approving agreed upon financial terms (Benefit Package).
Medical Testing: Required examinations include complete physical, gynecological exam, blood work, hormone assessment, uterine evaluation with the Intended Parents fertility doctor.
Frequently Asked Questions About Surrogate Eligibility
Am I Too Old to Be a Surrogate?
The age limit is typically 40 years, though some agencies may consider candidates up to 42 case-by-case. This limit exists because advanced maternal age significantly increases pregnancy risks. However, if you’re approaching the age limit but in excellent health with previous uncomplicated pregnancies within the last 3 years, individual health factors may outweigh chronological age.
Can I Be a Surrogate If I Have Anxiety or Depression?
Mental health history of anxiety or depression doesn’t automatically disqualify you. Successfully treated and stable mental health may be acceptable if well-managed with appropriate support systems and tools. The key factors are current stability, treatment compliance, and ability to handle pregnancy’s emotional demands without the use of an SSRI.
What If My BMI Is Just Over 32?
BMI requirements are generally firm, but individual circumstances may allow flexibility if you’re in excellent physical condition with no obesity-related health issues and previous uncomplicated pregnancies. However, reaching the BMI goal before applying or with a goal of releasing weight is generally recommended. ABC Surrogacy does offer nutrition support with a staff nutritionist.
Can I Be a Surrogate With a History of C-Sections?
Previous cesarean sections don’t automatically disqualify you, but the number and reasons matter. One or two C-sections for reasons like breech presentation may be acceptable, but multiple C-sections (three or more) may be disqualifying due to increased risks.
What If I’m Currently Breastfeeding?
Active breastfeeding typically requires completion before beginning surrogacy, as it affects hormone levels and may interfere with IVF protocols. Most agencies require weaning and at least two normal menstrual cycle before the IVF doctor would see you for an in person screening. Initial application process may begin while a woman is still breastfeeding.
Can I Be a Surrogate With Gestational Diabetes History?
Mild gestational diabetes that was diet-controlled may be acceptable, especially with current healthy weight and normal blood sugar. However, severe gestational diabetes requiring insulin or causing complications may be disqualifying due to recurrence risk.
Financial Considerations
Compensation Overview: Base compensation ranges from $55,000 to $65,000+ for first-time surrogates, with additional allowances bringing total compensation to $85,000+. Experienced surrogates base fee ranging from $70,000 to $85,000 (please reach out to discuss.). All surrogates receive a $4,000 bonus ($1,000 at medical clearance by IVF doctor, $3,000 at legal clearance with Intended Parents (all have signed and notarized agreement and official clearance letter sent to IVF doctor).
No Out-of-Pocket Expenses: Intended parents cover all pregnancy-related costs, including attorney fees.
Important Considerations: Compensation may affect government assistance eligibility, has tax implications (although no documentation is provided in the form of a 1099, you may wish to discuss this with your tax preparer), and varies by experience and location.
Next Steps
If you meet the requirements, begin with honest self-assessment, ensure family support, please reach out and schedule a consultation with ABC Surrogacy at (323) 207-5762. We are happy to answer any questions you may have about the process and to see if you qualify.
Timeline Commitment
Surrogacy typically requires 12-18 months total commitment, including 2-6 months of pre-pregnancy preparation, 9 months of pregnancy, and 6-8 weeks of post-delivery recovery.
Surrogate eligibility requirements represent a comprehensive framework designed to ensure successful outcomes for all parties involved. These medically-based requirements prioritize safety, health, and emotional well-being while recognizing that individual circumstances may allow for flexibility within established guidelines.
Ready to Learn More? If you believe you meet these surrogate qualifications, contact ABC Surrogacy for a confidential consultation. The agency’s experienced team can provide personalized guidance through the application and screening process.
Remember: meeting these requirements is just the beginning of a journey that many women describe as one of the most meaningful experiences of their lives – the opportunity to give the ultimate gift of family to those who cannot achieve it on their own.