Testimonials

Can I Be a Surrogate with Medical History?

October 27, 2025

Picture this: You’ve just finished reading a heartfelt story about a couple who finally held their baby after years of infertility struggles, made possible by a generous surrogate. Your heart swells with the idea of giving such an incredible gift. But then doubt creeps in. You had gestational diabetes with your second pregnancy. Or maybe you’ve had three C-sections. Perhaps you take medication for anxiety. The question weighs heavy: Can I still become a surrogate?

You’re not alone in this concern. Many women who feel called to surrogacy worry that their medical history might close the door before it even opens. The truth is more nuanced and hopeful than you might think. The surrogacy screening process is undeniably thorough—designed to protect all parties-surrogate, the intended parents, and the future baby. However, having a medical history doesn’t automatically disqualify you from becoming a surrogate and experiencing this life-changing journey.

Medical screening exists not as a gatekeeping exercise, but as a careful evaluation to ensure everyone’s safety and to maximize the chances of a healthy, successful pregnancy. Some conditions require additional medical clearance. Others may genuinely be disqualifying. But many common medical histories that prospective surrogates worry about don’t eliminate them from consideration at all.

The decision to become a surrogate is one of the most generous acts imaginable. Medical screening exists to protect that gift—for you, the intended parents, and the baby you’ll help bring into the world.

At Pathways to Parenthood, we believe in transparency from day one. We understand that deciding to become a surrogate is deeply personal, and you deserve honest, compassionate guidance about what the medical evaluation process entails and how your individual health history factors into eligibility. This article will walk you through the foundational health requirements, explain each phase of the comprehensive screening process, address specific medical conditions and their impact on eligibility, and provide practical guidance on preparing for success. By the end, you’ll have a clear understanding of whether surrogacy might be the right path for you—and what steps to take next.

Key Takeaways

• The surrogacy screening process is rigorous but designed to protect everyone’s health and wellbeing, not to exclude unnecessarily
• A history of successful, uncomplicated pregnancies is required, with limits on previous births and C-sections
• Many common medical concerns don’t automatically disqualify candidates—conditions are evaluated individually with medical clearance requirements
• BMI, lifestyle factors (smoking, substance use), and current medications are critical screening components
• Complete honesty about your medical history from the beginning provides the best possible outcome and prevents disappointment later in the process

Understanding Basic Surrogate Medical Requirements

Before the in-depth screening begins, prospective surrogates must meet foundational health and lifestyle criteria. These requirements aren’t arbitrary—they’re established based on medical research and guidelines from organizations like the American Society for Reproductive Medicine (ASRM) to optimize pregnancy success and minimize risks.

Age matters significantly in surrogacy. Most agencies, including Pathways to Parenthood, require surrogates to be between 21 and 40 years old. This range represents the sweet spot where women are mature enough to make informed decisions while their bodies are optimally prepared for pregnancy without age-related complications. Younger candidates may lack the emotional maturity and life experience needed, while those over 40 face increased pregnancy risks.

Your pregnancy history serves as the most important predictor of your ability to carry another successful pregnancy. You must have given birth to at least one child whom you’re currently raising. This requirement serves two purposes: it confirms your body can carry a pregnancy to term, and it makes certain you understand the physical and emotional realities of pregnancy and childbirth.

Additionally, your previous pregnancies should have been relatively uncomplicated. Most agencies set limits—typically:

• No more than five previous births
• No more than three previous Cesarean sections

These limits exist because multiple C-sections and vaginal deliveries compromise uterine integrity, increasing risks in subsequent pregnancies.

Body Mass Index (BMI) requirements reflect medical necessity, not judgment. A BMI generally under 33 is required because fertility treatments are significantly less effective in women with higher BMIs, and pregnancy complications like gestational diabetes and preeclampsia increase substantially. Achieving and maintaining a healthy weight before screening improves your chances of qualifying and having a healthy pregnancy.

Lifestyle Factors and Requirements

Lifestyle factors are non-negotiable when it comes to surrogate health requirements:

• No smoking: You must be a non-smoker with no use of tobacco, vaping products, or e-cigarettes. Smoking during pregnancy causes serious harm to developing babies.
• No substance use: You must abstain from alcohol, cannabis (even in states where it’s legal), and all illicit drugs. These substances cross the placenta and can cause developmental problems.
• Financial stability: Compensation should improve your life, not serve as essential income. You shouldn’t be reliant on government assistance programs. This requirement makes certain you’re pursuing surrogacy for the right reasons—the desire to help a family—rather than out of financial desperation.

Finally, comprehensive background checks are conducted on both you and your partner or spouse. Any history of violent crimes, felony convictions, or child safety concerns will disqualify a candidate.

The Complete Surrogacy Screening Process: What to Expect

Understanding the full scope of the surrogate screening process helps you prepare mentally and practically for what lies ahead. While the thoroughness might feel intimidating, remember that every requirement exists to protect your health, increase the likelihood of success, and make certain you’re fully prepared for this commitment.

Phase 1: Initial Application, Medical Records Review, Background Check

First comes the initial application, where you provide basic information about your health, pregnancy history, and lifestyle. If you meet preliminary requirements, the process moves to a more extensive medical records review. We’ll obtain comprehensive documentation from all relevant healthcare providers to review:

• Obstetric records from every previous pregnancy and delivery
• Gynecological records
• Medical clearance from current Ob/Gyn
• Any fertility treatment documentation
• Criminal and child abuse background checks

Our team will review these records for any complications or red flags, and if necessary, we may request additional documentation, such as updated screenings or clearance letters from your current providers. This behind-the-scenes review can take two to four weeks but serves as an important filter before you invest time in further screening.

Phase 2: Psychological Evaluation

Simultaneously or shortly after, you’ll go through a psychological evaluation with a Licensed Mental Health Professional specializing in third-party reproduction. This assessment includes both a clinical interview and standardized personality testing. The purpose of the evaluation is to ensure that you and your partner/spouse are psychologically and emotionally prepared for the special challenges of you carrying a baby for someone else.

Phase 3: In-Person Medical Screening

Once you have completed the agency screening process and you’re matched with intended parents, you’ll attend an in-person medical screening at the intended parent’s chosen fertility clinic.  This comprehensive evaluation includes consultations, physical examinations, possibly imaging, and extensive laboratory testing including drug and nicotine testing. Results from this appointment can take another two to four weeks to finalize.

This holistic evaluation confirms you have a stable, supportive environment for the pregnancy.

Throughout this entire process, Pathways to Parenthood is here to guide you through each step, answers questions, and provide reassurance. The timeline from initial application to final medical clearance typically spans six to twelve weeks, though it can vary based on clinic scheduling and how quickly medical records are obtained.

Medical Records Review and Pre-Screening

The medical records review happens largely behind the scenes, but it’s one of the most critical phases of the surrogate medical evaluation. After you’ve submitted your initial application and self-disclosed your medical history, our team formally requests comprehensive records from your healthcare providers. We’ll analyze the documents, looking for patterns of successful, uncomplicated pregnancies and identifying any potential concerns. We specifically look for complications like:

• Preterm labor
• Preeclampsia
• Gestational diabetes
• Placental problems
• Postpartum hemorrhage

We’ll also verify the number of previous deliveries and C-sections to make certain you’re within safe limits.

In-Person Medical Evaluation and Testing

After your medical records are approved, the in-person screening at the fertility clinic is where the most comprehensive medical clearance for surrogacy evaluation takes place. This appointment is scheduled after you’ve been matched with intended parents, making it an exciting milestone in your experience.

The surrogacy medical tests conducted during this appointment are extensive. You’ll need to provide blood and urine samples for a comprehensive panel:

• Infectious disease screening: HIV, Hepatitis B and C, other STDs
• Hormone and thyroid panels: Making certain your levels are optimal for supporting a pregnancy
• Immunity screening: Checking protection against rubella, measles, mumps, and chickenpox
• Complete Blood Count (CBC): Screening for anemia and other blood disorders
• Vitamin levels: Particularly Vitamin D, which plays a role in pregnancy health
• Comprehensive toxicology screening: Via blood and urine tests confirming you are substance-free

Lab results can take two to three weeks to be finalized and reviewed by the Reproductive Endocrinologist. Once all results are in and assessed, the doctor provides final medical clearance—the green light that you’re physically ready to proceed.

Common Medical Conditions and Their Impact on Surrogacy Eligibility

This is likely the question weighing heaviest on your mind: Will my specific medical condition disqualify me? The honest answer is: it depends. Surrogacy eligibility with medical conditions is evaluated on a case-by-case basis. Some conditions are absolute disqualifiers because they pose significant risks during pregnancy. Others may require additional medical clearance but don’t necessarily eliminate you from consideration. Still others, particularly conditions that have fully resolved, may have no impact on your eligibility at all.

What matters most is complete transparency. Being upfront about your entire medical history—even conditions that don’t appear in your medical records—allows the medical team to make informed assessments and, if necessary, request appropriate clearances from specialists. Hiding or downplaying medical issues creates risks for everyone and will likely be discovered during the thorough screening process anyway.

Let’s address the most common medical concerns that prospective surrogates bring to their initial consultations and explore how each typically impacts eligibility.

Pregnancy-Related Conditions

If you experienced complications in a previous pregnancy, you might worry those issues will repeat themselves or disqualify you from surrogacy. The reality is nuanced and depends heavily on the specific condition and its severity.

Gestational Diabetes

This condition, where blood sugar levels become elevated during pregnancy but typically resolve after delivery, doesn’t automatically disqualify you. However, it does require medical clearance. Your Reproductive Endocrinologist will want:

• Documentation confirming the gestational diabetes was pregnancy-specific and resolved after you gave birth
• Current lab work showing normal fasting glucose and hemoglobin A1C levels

If gestational diabetes occurred in multiple pregnancies, or if you’ve since developed pre-diabetes or Type 2 diabetes, disqualification becomes more likely because the risks of recurrence and complications increase substantially.

Preeclampsia

A history of preeclampsia requires careful evaluation. Mild preeclampsia that developed late in pregnancy and resolved without complications may be acceptable, particularly if it occurred only once. However, severe preeclampsia, especially if it developed early in pregnancy or required preterm delivery, is often disqualifying due to high recurrence risk and serious maternal health dangers.

Previous C-Sections

The number of previous C-sections directly impacts your eligibility. Most agencies and fertility clinics set a maximum of three prior Cesarean deliveries. Each C-section creates scar tissue on the uterus, and with multiple surgeries, the risk of serious complications like uterine rupture, placenta accreta (where the placenta grows too deeply into the uterine wall), and hemorrhage increases significantly.

Preterm Labor, Placental Issues, or Postpartum Hemorrhage

A history of preterm labor, placental complications (such as placenta previa or placental abruption), or postpartum hemorrhage doesn’t automatically exclude you—but it does trigger a closer look. The reviewing physician will assess how early the preterm birth occurred, whether it was spontaneous or medically indicated, and whether complications could recur. Candidates with mild or resolved issues may be approved with specialist clearance, while severe or recurrent events may lead to disqualification for safety reasons.

Multiple Miscarriages

Most agencies require a record of healthy, full-term pregnancies. Having one miscarriage doesn’t typically affect eligibility, but a history of two or more consecutive miscarriages raises concerns about underlying reproductive or hormonal issues. Depending on your medical evaluation and testing results, this may disqualify you or require further review before proceeding.

Chronic Health Conditions

Ongoing health conditions are evaluated individually. Some can be managed safely during a surrogate pregnancy, while others pose unacceptable risks. Controlled hypothyroidism is often acceptable if your thyroid levels are stable with medication and monitored regularly. In contrast, Type 1 or Type 2 diabetes is generally disqualifying because it increases risks for both surrogate and baby.

Autoimmune disorders can vary — well-controlled conditions may be permitted, while conditions like lupus or multiple sclerosis typically are not. Hypertension (high blood pressure), even when controlled by medication, often excludes candidates because of heightened pregnancy risks.

Mental health is also reviewed carefully. A history of mild anxiety or depression may be acceptable with documented stability and no recent medication changes, but ongoing or severe mental health conditions usually require a longer period of demonstrated stability before approval.

Lifestyle and Medication Considerations

Lifestyle and prescription habits play an important role in medical clearance. Many prescription medications—especially antidepressants, mood stabilizers, and blood pressure drugs—aren’t considered safe during pregnancy and may need to be discontinued for several months before screening. Candidates must show they can remain healthy and stable without them.

A history of substance abuse typically requires at least two years of documented sobriety. Smoking and vaping are automatic disqualifiers, and agencies require full abstinence before application. Maintaining a healthy lifestyle—including balanced nutrition, regular exercise, and stress management—strengthens your eligibility and helps ensure a positive pregnancy outcome.

Why Medical Screening Is So Thorough: Protecting Everyone’s Journey

It’s natural to feel nervous about such an in-depth process, but thorough medical screening protects everyone involved. The primary goal is your health and safety—ensuring you can safely complete the pregnancy and return home healthy to your own family.

The process also safeguards the intended parents’ emotional and financial investment, verifying that every surrogate is physically and emotionally ready for the responsibility. By identifying potential risks early, doctors can make informed decisions, reducing complications later.

At Pathways to Parenthood, screening isn’t about exclusion—it’s about ensuring the foundation of a safe, rewarding journey for everyone.

Beyond Medical Health: Psychological and Social Screening Components

Surrogacy is both a medical and emotional commitment. Beyond physical health, you’ll complete a psychological evaluation with a Licensed Mental Health Professional who specializes in third-party reproduction. This ensures emotional readiness and evaluates your motivations, coping skills, and support network.

How to Prepare for Successful Medical Screening

• Physical Health Optimization: Aim for a healthy BMI, stay active, and maintain balanced nutrition. Complete any overdue medical checkups, such as a Pap smear or dental cleaning, and begin prenatal vitamins early to boost nutrient levels.
• Documentation and Transparency: Gather your medical records in advance and be honest about every condition or medication. Full transparency allows for smoother processing and prevents delays.
• Mental and Emotional Preparation: Discuss your decision with your family, make sure you have their full support, and approach the process with patience—thoroughness takes time, but it ensures success.

What Happens If Medical Issues Are Identified During Screening

If screening reveals potential concerns, don’t lose hope. Some findings—like elevated BMI or vitamin deficiencies—are temporary disqualifiers that can be corrected with lifestyle changes or treatment. Others, like certain chronic illnesses or uterine abnormalities, may be permanent exclusions for your safety.

Even if surrogacy isn’t possible right now, Pathways to Parenthood helps candidates explore options for reapplying or supporting the surrogacy community in other ways. Every step taken shows your generosity and commitment to helping families grow.

Pathways to Parenthood’s Approach to Medical Screening

At Pathways to Parenthood, transparency and compassion define our screening process. From our first conversation, we’ll be here to help guide you through each step of the process, explaining results, and answering every question.

We partner with respected fertility clinics and Reproductive Endocrinologists across the Midwest to ensure safe, evidence-based care. Our proactive approach minimizes disappointment and respects your time and emotional investment.

You’re never alone in this process. From application to approval and beyond, our team is committed to making your experience supportive, empowering, and rewarding.

Conclusion

Becoming a surrogate is an extraordinary act of compassion and courage. While the surrogacy screening process is detailed and sometimes daunting, it exists to protect your wellbeing and the success of the intended parents’ dream.

Many women with prior medical conditions discover that they still qualify once evaluated honestly and individually. The key is transparency, patience, and guidance from a trusted agency like Pathways to Parenthood.

If you’re ready to explore whether surrogacy is right for you, contact Pathways to Parenthood today to start a confidential conversation. Your story could help create a family’s future.

Frequently Asked Questions

1. Can I be a surrogate if I had gestational diabetes?
   Yes—if it was pregnancy-specific, resolved postpartum, and your current bloodwork shows normal glucose levels. Recurrent gestational diabetes or pre-diabetes may disqualify you.
2. What medical conditions automatically disqualify someone?
   Conditions such as Type 1 or 2 diabetes, uncontrolled hypertension, severe autoimmune diseases, or significant uterine abnormalities typically disqualify candidates. Each case is reviewed individually.
3. How long does the medical screening process take?
   Initial agency screening is 4-8 weeks. Fertility clinic medical screening typically takes 6-8 after matching. It includes medical records review, an in-person exam, lab work and final clearance from the fertility specialist.
4. Who pays for the medical screening?
   All costs related to surrogacy medical evaluations are covered by the intended parents, not the surrogate.
5. Can I apply if I’m taking prescription medication?
   It depends on the medication. Some must be discontinued before pregnancy, with stability demonstrated off treatment. Always disclose medications early for proper guidance.

 

Surrogate Preparation Made Simple: What to Expect & How to Prepare

October 14, 2025

Picture standing at the edge of a decision that will forever change a family’s world. You’re not just considering a commitment—you’re contemplating becoming the bridge between longing and love, between waiting and welcoming. For many women, the journey to becoming a surrogate begins with a simple question: “Could I do this?” followed quickly by “What does it actually take?”

The path to surrogacy isn’t shrouded in mystery, though it might feel that way at first. Prospective surrogates often wonder about the medical procedures, the time commitment, and the emotional aspects they’ll navigate. Meanwhile, intended parents—whether facing infertility, LGBTQ+ couples, or single parents by choice—seek confidence that their surrogate will be thoroughly prepared for the road ahead.

Here’s what makes surrogacy preparation less daunting than you might think: it’s a structured, well-supported process with clear milestones. From your initial application through medical screening, legal agreements, and finally pregnancy and birth, each phase builds on the last.

At Pathways to Parenthood, we guide surrogates through every step, so you’re never alone in the process. When you understand what’s coming, you can prepare your body, your schedule, and your heart for one of the most meaningful experiences of your life.

This guide walks you through the complete preparation process—the screenings you’ll undergo, the lifestyle adjustments you’ll make, the relationships you’ll build, and the profound rewards waiting at the end. Whether you’re just starting to explore surrogacy or you’re ready to take the next step, you’ll find practical answers to help you move forward with confidence.

Key Takeaways

• Surrogate preparation typically takes 18-24 months from application to birth, with thorough screening in the first 4-8 weeks covering medical history, psychological evaluation, and physical health assessments.
• You’ll need to meet specific requirements: age 21-40, at least one previous successful pregnancy, healthy BMI, stable lifestyle, and strong emotional support system.
• Medical preparation for embryo transfer involves 15-18 days of hormone medications to optimize your uterine lining, followed by monitoring appointments and the transfer procedure itself.
• Legal contracts are finalized before any medical procedures begin, with independent attorneys representing both surrogate and intended parents to protect everyone’s rights and clarify compensation.
• Comprehensive support throughout your experience—including medical coordination, psychological counseling, and relationship guidance—helps you prepare for each phase.
• The surrogate-intended parent relationship is collaborative and supportive, with opportunities to create lasting bonds through shared milestones and open communication.
• Proper preparation leads to confidence, better outcomes, and the profound satisfaction of giving the gift of parenthood to a family who cannot achieve it alone.

Understanding Surrogate Requirements: Are You Ready?

Becoming a surrogate represents a significant commitment, and agencies establish specific requirements not to create barriers, but to protect your health and provide the best possible outcomes for everyone involved. Understanding these qualifications helps you assess whether you’re ready for this experience.

Age matters in surrogacy for important medical reasons. Most programs require surrogates to be between 21 and 40 years old, ensuring surrogate eligibility criteria are met. This range reflects optimal reproductive health and pregnancy outcomes. Women in their twenties and thirties typically experience fewer pregnancy complications and respond better to fertility medications. At 21, you’ve had time to establish your own family and make an informed decision about carrying for someone else. The upper age limit of 40 reflects medical data showing that pregnancy risks increase beyond this point.

Previous pregnancy experience stands as one of the most critical requirements. You must have successfully carried and delivered at least one child without significant complications, demonstrating successful pregnancy history. This requirement serves multiple purposes beyond proving your fertility:

• It demonstrates your body’s ability to handle pregnancy
• It gives you realistic expectations about what you’re committing to
• It confirms you enjoy pregnancy enough to be pregnant again

Women who have experienced pregnancy understand the physical demands, emotional changes, and daily realities of carrying a child. You can’t truly consent to something you’ve never experienced.

Physical and Lifestyle Requirements

Physical health criteria extend beyond basic wellness. Your body mass index (BMI) typically needs to fall within a specific range—usually between 19 and 32, though some programs have stricter limits for surrogate health requirements. This isn’t about appearance; it’s about medical safety. Women outside this range face higher risks for pregnancy complications like gestational diabetes, preeclampsia, and difficulties during delivery.

Your overall health matters too. You’ll need to be free from chronic conditions that could complicate pregnancy or require medications that might affect a developing baby.

Lifestyle factors play a substantial role in surrogate eligibility:

• You must be a non-smoker, as smoking dramatically increases pregnancy risks
• Alcohol consumption needs to be minimal or absent
• Your living situation should be stable—meaning you have secure housing
• You shouldn’t be experiencing major life upheavals like divorce, recent deaths in the family, or financial crisis

These requirements protect your ability to focus on a healthy pregnancy without overwhelming stress.

Emotional readiness proves just as important as physical health when considering the surrogacy process. You need psychological stability and a strong support system. That means no untreated mental health conditions, no history of severe postpartum depression, and access to family or friends who will support you through this experience. If you have a partner or spouse, their support is necessary. They’ll be affected by your commitment too—from fertility medications that may cause mood swings to the physical limitations of late pregnancy.

Legal and Financial Considerations

Legal considerations include U.S. citizenship or legal permanent residency, as international surrogacy laws create complications. You’ll need to pass background checks to maintain child safety. Financial stability requirements might seem counterintuitive since surrogacy provides compensation, but they exist to confirm you’re choosing surrogacy for the right reasons rather than out of desperation.

The commitment timeline deserves serious consideration. From application to holding the baby at delivery, you’re looking at 18-24 months minimum. This includes:

• Several months of screening and matching
• Weeks of medical preparation
• Nine months of pregnancy
• Recovery time afterward

During this period, you’ll attend numerous medical appointments, take daily medications, follow pregnancy restrictions, and maintain regular communication with intended parents. You need flexibility in your schedule and understanding employers if you work outside the home.

These requirements exist to protect you, the baby you’ll carry, and the intended parents who are placing their trust in you. Meeting these qualifications doesn’t just make you eligible—it positions you for a positive, healthy surrogacy experience.

The Surrogate Application and Screening Process

Once you’ve decided to pursue surrogacy, the screening process becomes your gateway to this experience. This comprehensive evaluation typically takes 4-8 weeks and examines every aspect of your readiness to carry a pregnancy for another family through surrogate screening requirements. Rather than viewing screening as an obstacle, think of it as a protective framework for everyone’s best interests.

The process begins with your initial application, which gathers detailed information about your background. You’ll provide your pregnancy history, including any complications or special circumstances from previous deliveries. The application asks about your current health status, medications, lifestyle habits, and family medical history. You’ll also answer questions about your motivations for becoming a surrogate and your preferences for intended parents.

Medical History and Evaluation

Medical history review comes next. The agency and fertility clinic will request records from your previous pregnancies and deliveries, often going back to your OB-GYN or the hospitals where you gave birth. They’re looking for documentation of healthy, full-term pregnancies without significant complications.

If you had a C-section, the number of previous cesarean deliveries matters because most doctors limit how many a woman should undergo. If you had gestational diabetes that resolved after pregnancy or mild preeclampsia that was successfully managed, these won’t necessarily disqualify you, but they require thorough evaluation.

Psychological evaluation serves as a cornerstone of the screening process. A licensed mental health professional specializing in reproductive psychology will meet with you, typically for 1-2 hours, as part of psychological evaluation for surrogates. This isn’t an interrogation—it’s a thoughtful conversation about your emotional readiness.

The psychologist assesses:

• Your understanding of what surrogacy entails
• Your motivations for choosing this path
• Your support system
• How you cope with stress
• Your history of mental health treatment
• Your ability to maintain appropriate boundaries while building a relationship with intended parents

If you’re married or in a committed relationship, your partner will usually participate in part of this evaluation since their support is necessary to your success.

Background Checks and Medical Screening

Background checks and home assessments protect the baby you’ll carry. You’ll undergo criminal background screening and child abuse registry checks. A social worker may visit your home to confirm it’s a safe, stable environment. This visit isn’t about judging your housekeeping or décor—they’re confirming you have adequate housing, a supportive family environment, and the stability needed for the road ahead.

Medical screening with fertility specialists represents the most intensive phase of evaluation. You’ll meet with a reproductive endocrinologist who will perform a complete physical examination focused on reproductive health during medical screening.

Blood work tests:

• Your hormone levels
• Blood type
• Screens for infectious diseases including HIV, hepatitis B and C, syphilis, and other sexually transmitted infections

These tests protect both you and the baby, and they’re repeated throughout the process to maintain ongoing health.

Your uterus undergoes thorough evaluation through transvaginal ultrasound. The doctor examines your uterine cavity for fibroids, polyps, or structural abnormalities that could interfere with embryo implantation or pregnancy. They measure your ovarian reserve and assess your overall reproductive anatomy.

Many clinics perform a mock embryo transfer during this phase. This procedure simulates the actual transfer process, allowing the doctor to map the best pathway to your uterus and identify any potential difficulties before the real transfer day.

Partner and Genetic Screening

If you have a partner or spouse, they’ll undergo some screening too. They’ll need infectious disease testing to protect you and the baby, and they’ll participate in psychological evaluation and background checks. Their understanding and support of your surrogacy experience directly affects your outcome, so their buy-in matters tremendously.

Pathways to Parenthood coordinates this entire screening process, scheduling appointments, collecting results, and communicating with all the professionals involved. You’re not navigating a maze of doctors and clinics alone—your agency serves as the central hub, confirming nothing falls through the cracks.

Transparency about approval rates helps set realistic expectations. Not everyone who applies will be approved, and that’s okay. Common reasons for disqualification include undisclosed medical issues that surface during screening, BMI outside the acceptable range, insufficient support system, or psychological factors that suggest someone isn’t ready for the demands of surrogacy.

If you’re not approved initially, it doesn’t mean never—sometimes it means not right now.

Addressing the issue (like losing weight, completing mental health treatment, or waiting until your home life stabilizes) might make you eligible in the future.

This thorough screening benefits everyone. For you as a prospective surrogate, it confirms you’re physically and emotionally prepared for the experience. For intended parents, it provides assurance that their surrogate meets the highest standards. For the baby, it creates the safest possible environment for development and birth. 

Navigating the Legal Requirements and Contracts

Once you’ve been approved through screening and matched with intended parents through the matching process, legal work becomes the next milestone. No medical procedures can begin until you’ve signed a comprehensive surrogacy contract. This legal framework protects everyone involved by clearly defining rights, responsibilities, and expectations.

The surrogacy contract serves as the foundational document for your entire experience, outlining surrogacy legal requirements. Think of it as a detailed roadmap that addresses every possible scenario you might encounter. This isn’t just paperwork—it’s your protection and your guide when questions arise about compensation, medical decisions, or relationship expectations.

Independent Legal Representation

Independent legal representation for both parties stands as an absolute requirement and an ethical necessity. You and the intended parents must have separate attorneys who specialize in reproductive law. Your attorney represents only your interests, while the intended parents’ attorney represents only theirs.

This separation prevents conflicts of interest and confirms both parties receive objective legal advice. Most surrogacy arrangements have the intended parents pay for both attorneys’ fees, though this is negotiated and specified in the contract.

Your attorney will meet with you privately before the contract is drafted and again after receiving the draft from the intended parents’ lawyer. These meetings provide opportunities to discuss every aspect of the agreement in detail. Your lawyer explains legal terms, confirms you understand each clause, and verifies that the contract reflects what you and the intended parents discussed during matching.

Key Contract Elements

Key elements covered in surrogacy agreements span a wide range of topics:

Compensation Structure:

• Your base compensation amount
• When payments begin (typically after heartbeat confirmation around 6 weeks)
• The payment schedule through surrogate compensation structure (usually monthly throughout pregnancy)
• Additional compensation for multiple pregnancies, cesarean delivery, invasive procedures, or other circumstances requiring extra compensation

Everything gets documented clearly so no confusion arises later.

Expense Reimbursement: You’ll be reimbursed for medical appointments, travel to the fertility clinic, maternity clothing, prenatal vitamins, health insurance premiums or copays, life insurance premiums, and childcare costs when you attend appointments. The contract establishes how these reimbursements work—whether you submit receipts for payment or receive a monthly allowance to cover these costs.

Medical Decision-Making Authority: The contract specifies who makes decisions about prenatal testing, procedures, and medical interventions during pregnancy. It addresses sensitive topics like selective reduction (if multiple embryos implant) and pregnancy termination for severe fetal abnormalities or risks to your health.

While intended parents have significant input since it’s their baby, your bodily autonomy is protected. These discussions happen before pregnancy so everyone understands the decision-making framework if difficult situations arise.

Relationship and Timeline Considerations

Relationship expectations during pregnancy get outlined too. How often will you communicate with intended parents? Will they attend prenatal appointments with you? Can they be in the delivery room? What level of contact do you want after birth?

These details create clarity and prevent misunderstandings. Some surrogates want very close relationships with frequent video calls and shared experiences. Others prefer more independence with regular updates at scheduled intervals. Neither approach is wrong—what matters is that the contract reflects what you and the intended parents agreed upon.

Timeline for contract negotiation and signing varies based on how quickly both parties review and approve the terms. Simple, straightforward agreements might be finalized in 2-3 weeks. More situations with circumstances or extensive negotiations can take 4-6 weeks or longer.

Patience during this phase pays off—a well-drafted contract that everyone understands and agrees to prevents problems throughout the experience.

Once both attorneys approve the final contract and you and the intended parents sign, the agreement becomes legally binding. At this point, you typically begin receiving your monthly allowance to cover incurred expenses. This payment begins even before medical procedures start, acknowledging that you’re already investing time and effort into the surrogacy.

Establishing Parental Rights

Establishing parental rights through pre-birth orders is a critical legal step for intended parents. After your first trimester, their attorney will file a petition with the court in your state seeking a pre-birth order to establish parental rights. This court order legally declares the intended parents as the legal parents of the child you’re carrying, even before birth. It ensures their names appear on the birth certificate and you have no legal parental rights or responsibilities for the baby.

Pre-birth orders provide legal clarity and peace of mind for everyone. The process and availability of these orders vary by state, which is why working with attorneys experienced in reproductive law in your jurisdiction is essential.

Lifestyle Adjustments During Medical Preparation

Preparing for surrogacy involves more than medical appointments—it often means making small but meaningful lifestyle changes to ensure your body is in the best condition for pregnancy. Once legal contracts are finalized, you’ll begin the medical preparation phase at your fertility clinic.

Medication & Monitoring: Most surrogates follow a 15–18 day protocol of hormone medications to prepare the uterine lining for embryo transfer. These may include estrogen and progesterone, taken through pills, patches, or injections. You’ll attend several monitoring appointments for bloodwork and ultrasounds to confirm your body’s readiness for implantation.

Diet & Exercise: Your fertility team will recommend a balanced diet rich in protein, leafy greens, and hydration while limiting caffeine and alcohol. Light exercise like walking or yoga is encouraged, but high-intensity workouts, hot tubs, and saunas should be avoided.

Daily Life & Work Balance: The medical prep phase can require flexibility in your schedule. Communicate early with your employer or family about time off for appointments and procedures. Organizing childcare and transportation in advance helps reduce stress.

Managing Medication Side Effects: Hormone medications can cause bloating, mood swings, or mild discomfort at injection sites. Many surrogates find relief with heating pads, hydration, and gentle activity. Remember—your clinic and agency team are available if side effects become difficult to manage.

Emotional and Lifestyle Preparation for the Surrogacy Journey: The emotional journey of surrogacy begins long before pregnancy. You’re giving an incredible gift, and it’s essential to nurture your mental and emotional wellbeing throughout the process.

Building a Support Network: Having the encouragement of your partner, family, and friends will help you stay grounded. Be open about your reasons for becoming a surrogate and the time commitment it involves. If you have children, prepare them with age-appropriate conversations about what surrogacy means.

Setting Realistic Expectations: While most surrogacies go smoothly, it’s important to prepare for both the joys and the challenges. There may be delays, failed transfers, or physical fatigue. Being mentally ready for these possibilities allows you to remain positive and flexible.

Financial & Practical Planning: Even with compensation, consider how time off work, travel, or recovery may temporarily affect your income. Setting aside an emergency fund or using part of your surrogate allowance for practical needs can provide peace of mind.

Ongoing Self-Care: Surrogates benefit from maintaining self-care routines—rest, nutrition, counseling, and mindfulness. Pathways to Parenthood encourages regular check-ins with mental health professionals who understand third-party reproduction.

Building Your Relationship with Intended Parents

One of the most meaningful parts of the surrogacy experience is the relationship you form with the intended parents. This connection, built on trust and communication, transforms the process into something deeply personal.

The Matching Process

Once medically and legally cleared, you’ll be matched with intended parents whose goals, expectations, and personalities align with yours. You’ll have an opportunity to meet—virtually or in person—to establish rapport and discuss how you’ll communicate throughout the journey.

Communication & Boundaries

Some surrogates and parents connect daily, while others prefer weekly updates. Establishing your preferences early avoids misunderstandings. Sharing pregnancy milestones, photos, and appointment updates helps intended parents feel included, even from afar.

During Pregnancy and Beyond

As the pregnancy progresses, many surrogates develop close friendships with the families they’re helping. Pathways to Parenthood provides guidance if differences arise and encourages open dialogue so everyone feels respected. After birth, ongoing contact varies—some families stay closely connected, while others maintain occasional updates.

The bond formed through surrogacy is often lifelong—built on shared gratitude, respect, and the miracle of new life.

Conclusion

Preparing to become a surrogate is a journey of courage, compassion, and commitment. While the process includes many steps—screening, medical evaluations, legal agreements, and emotional preparation—each stage brings you closer to changing a family’s future forever.

At Pathways to Parenthood, surrogates receive personalized guidance at every step, from your first conversation through delivery and beyond. By understanding what to expect, you can move forward with confidence, knowing you’re supported, protected, and valued for the incredible gift you’re giving.

If you’re ready to take the next step, contact Pathways to Parenthood today to start your application or ask questions about becoming a surrogate. The journey ahead may be one of the most meaningful experiences of your life.

Frequently Asked Questions

How long does the surrogacy process take?
The full journey usually lasts 18-24 months, including screening, matching, medical preparation, pregnancy, and recovery.

When do surrogates start receiving compensation?
Base compensation typically begins after heartbeat confirmation, about six weeks into pregnancy, with monthly payments thereafter.

Can I become a surrogate if I’ve had a C-section or tubal ligation?
Yes. Most surrogates with up to three previous C-sections or a prior tubal ligation qualify, provided medical evaluations confirm uterine health.

What happens if the first embryo transfer doesn’t work?
It’s common to need more than one attempt. Most contracts allow two to three transfer cycles, and clinics adjust treatment protocols between attempts.

How much will surrogacy affect my daily life?

Appointments are most frequent during the medical prep and early pregnancy phases. With planning and agency support, most surrogates balance work, family, and appointments comfortably.

 

Become A Surrogate: Understanding the Screening Process

October 14, 2025

Many women describe being a surrogate as one of the most rewarding experiences of their lives. Helping another family bring a child into the world is a powerful act of compassion and generosity. But before that incredible ending comes the beginning—the surrogacy screening process.

At Pathways to Parenthood, we guide you through every step with honesty, compassion, and transparency. Understanding what’s involved and preparing in advance helps your journey move forward more smoothly, allowing you to be matched with intended parents sooner.

Why the Surrogacy Screening Process Matters

Becoming a surrogate is more than a medical procedure—it’s a commitment that affects your health, your family, and the family you’re helping. The screening process ensures that you’re physically, emotionally, and mentally ready to take on this life-changing role.

Screening protects everyone involved—the surrogate, the intended parents, and the baby—by confirming that all parties can safely and confidently begin the journey. While thorough, this process is also supportive, designed to set you up for success.

Step One: The Pre-Screening Application

You can take the first step to becoming a surrogate by completing the pre-screening application.

This quick online form gathers essential details about your background, lifestyle, and medical history. If you meet the initial requirements, our team will contact you to continue the process. During this stage, honesty and transparency are key—your answers help us ensure the process is the right fit for you.

Step Two: Meeting Basic Surrogate Qualifications

Before proceeding to the medical and psychological phases, applicants must meet foundational criteria set by both Pathways to Parenthood and our partner fertility clinics. These standards align with recommendations from the American Society for Reproductive Medicine (ASRM) to maximize safety and success.

Basic Criteria for Gestational Surrogate Candidates

• Be a U.S. citizen or permanent resident
• Hold a valid driver’s license
• Be a non-smoker and abstain from vaping or drug use
• No new tattoos or piercings within the past 12 months
• Be between ages 24 and 38
• Have had at least one healthy, full-term pregnancy and delivery
• Maintain a Body Mass Index (BMI) under 30
• Be mentally and physically healthy
• Not receive public assistance or government aid
• Be able to pass a criminal background check
• Be free of sexually transmitted diseases (STDs)
• Have reliable transportation for appointments
• Live in a stable home environment
• Have the support of your spouse or partner, if applicable

These guidelines ensure you’re in the best position for a safe, healthy, and successful surrogacy experience.

Step Three: Medical History Review

Once you meet basic qualifications, you’ll move on to the medical assessment phase. This precedes the formal medical evaluation that will be done after matching at the fertility clinic:

• Health & pregnancy history review
• Ob/Gyn medical clearance
• Pregnancy medical records review

Every aspect of the medical review helps determine whether your body can safely carry a pregnancy for someone else. If any questions arise—such as past medical conditions or pregnancy complications—we will consult with fertility specialists to determine ability to proceed with screening.

For a deeper explanation of how specific medical conditions affect surrogacy eligibility, read our related article: Can I Be a Surrogate with Medical History? 

Step Four: Psychological and Emotional Readiness Evaluation

Carrying a child for another family is an emotional journey. To ensure readiness, every surrogate completes a psychological evaluation with a licensed mental health professional experienced in third-party reproduction.

This evaluation includes:

• A clinical interview to explore your motivations and expectations
• Discussion about emotional support systems (partner, family, friends)
• Personality assessment to ensure emotional resilience

This part of the process isn’t about judgment—it’s about ensuring that you have the support, stability, and mental health needed for a positive experience.

Step Five: Background and Lifestyle Verification

The final step in the screening process is background and lifestyle verification. This includes:

• Criminal and child safety background checks for you and your partner
• Home environment review to confirm a safe, supportive living situation
• Verification of financial stability—compensation should be a benefit, not a necessity

These checks protect you, your family, and the intended parents, ensuring a trustworthy, respectful match.

What Happens After Screening?

Once all agency evaluations are completed, you’re officially ready to be matched with intended parents. From there, our team helps guide introductions and matching process, oversee fertility clinic medical clearance process, legal contracts, and coordination of the medical cycle that leads to embryo transfer.

Pathways to Parenthood is with you every step of the way—offering guidance, emotional support, and expert coordination to make the journey smooth and rewarding.

Begin Your Journey with Pathways to Parenthood

The surrogacy screening process may seem extensive, but it exists to ensure your health, safety, and success. Each requirement is a step toward creating a family’s dream come true—safely, responsibly, and joyfully to ensure best outcomes for everyone.

If you meet the basic surrogate requirements and feel ready to take the next step, we’d love to talk with you. Contact Pathways to Parenthood today to begin your application or learn more about becoming a gestational surrogate.

Your journey starts with one step that may change someone’s life forever.

Surrogate Requirements: Do You Qualify for Surrogacy?

August 28, 2025

The idea of becoming a surrogate is the first step in an amazing journey to help intended parents grow their families. But before starting the surrogacy process, it’s important to understand the medical and lifestyle requirements that determine who can qualify to become a surrogate. These guidelines exist to protect both surrogates and the babies they carry.

Why Surrogate Requirements Matter

Not every woman who is willing to give the gift of life by becoming a surrogate mother will qualify. This doesn’t mean you aren’t healthy or capable of carrying your own children—it simply means that a surrogate pregnancy comes with additional risks, and specific criteria are in place to reduce complications.

The American Society for Reproductive Medicine (ASRM) sets the standard medical requirements for surrogates. Fertility clinics and surrogacy agencies, including Pathways to Parenthood, follow these guidelines during the evaluation of surrogate candidates and may add additional qualifications depending on the needs of intended parents, or the fertility clinics they partner with.

The surrogacy requirements listed below are not all inclusive. They cover most of the health and lifestyle criteria that need to be met to begin the surrogacy process. If you are unsure whether you qualify based on these requirements, Pathways To Parenthood surrogacy specialists can answer any questions you may have. Contact us today about your next steps in the surrogacy process.

Medical Requirements for Surrogates

To qualify as a surrogate, you must meet certain health and medical criteria:

• Age: Between 22 and 39 years old
• A qualified candidate must have had at least one successful pregnancy and delivery with no major complications
• You must have a healthy body mass index (BMI) between 18–33
• No current sexually transmitted disease (STD) diagnosis
• You must be in both good physical and mental health
• You must not have any medical conditions that pregnancy could worsen
• You must not have had a tattoos or new piercing within the last six months

These requirements help ensure that both you and the baby remain healthy throughout the pregnancy. 

Lifestyle Requirements for Surrogates

In addition to medical qualifications, surrogate candidates must meet lifestyle criteria that demonstrate stability and support:

• Must be a U.S. citizen or permanent resident
• Hold a valid driver’s license and have reliable transportation
• Be a non-smoker with no exposure to secondhand smoke
• Must not use any illegal drugs
• Live in a stable, supportive home environment
• Have healthy coping strategies for life’s stressors
• You (or your partner) must not have a felony criminal history
• Not dependent on public assistance or government aid

The Screening and Evaluation Process

After the surrogacy matching process is completed, a full medical evaluation will be done by the fertility clinic your intended parents are working with. The medical evaluation includes:

• Physical examination (uterine and pelvic assessment)
• Bloodwork for hormones, infectious diseases, and general health
• Urine drug and nicotine screening

Ultimately, it will be up to the fertility clinic to assess all of the necessary surrogacy requirements and make the final determination as to whether it is medically advisable for you to be pregnant as a surrogate. There are times a particular situation will allow for an exception depending on specific surrogate circumstances.

The surrogacy requirements and medical evaluation are important because they ensure that you and the baby you carry are healthy throughout the surrogacy pregnancy and delivery.  Although there are always risks during pregnancy, these requirements and evaluation greatly reduce the likelihood that certain complications and outcomes will occur.  Your safety and well-being, as well as the baby you will carry, are the most important aspects of the entire surrogacy process.

If you have questions about the requirements to become a surrogate and wonder about your personal situation and if you qualify, our surrogacy specialists are ready to answers your questions so you know your next steps. Please contact us with any questions you may have, and we will be in touch within 24 hours with answers.

What If You Don’t Qualify for Surrogacy?

We understand that it is incredibly difficult and disappointing to learn that you may not quality for surrogacy. Disqualifying a woman who desires to be a surrogate mother is not an easy decision and certainly not one we take lightly. At Pathways to Parenthood, we consider surrogates on a case-by-case basis, and always take the time to understand your personal health history and life situation before making any decisions. Unlike some agencies that automatically deny candidates without knowing the specifics, we believe every woman deserves a thoughtful review of her individual circumstances.

We believe you are worth our time and make the extra effort to learn about you — this includes your health history and personal life situation, and we look forward to hearing from you!

Why Choose Pathways to Parenthood?

Pathways to Parenthood works with surrogate candidates nationwide, with a special focus on the Midwest, including Kansas, Missouri, Oklahoma, Ohio, Kentucky, Illinois, Indiana, and Colorado. Based in Overland Park, Kansas (Kansas City area), our central location allows us to serve both surrogates and intended parents across the country.

We have families waiting to be matched with women like you who are ready to take this life-changing step. Our surrogacy specialists are here to guide you every step of the way.

Contact Pathways to Parenthood today to learn if you qualify to become a surrogate and begin your journey.