Not everyone who wants to become a surrogate receives approval, and that is by design. The disqualifications for surrogacy exist to protect the surrogate first, then the baby and the intended parents. Every requirement traces back to medical safety, emotional readiness, or the legal and financial stability a healthy pregnancy requires.
This article covers every category of disqualification: medical conditions, pregnancy history, age, lifestyle, and background factors. It also addresses common misconceptions about surrogate requirements, such as whether having your tubes tied or a prior C-section will block your application.
Why Surrogacy Disqualifications Exist
Surrogacy disqualifications follow guidelines from the American Society for Reproductive Medicine (ASRM), which set the medical standards that fertility clinics and agencies use. These criteria reflect decades of reproductive research and aim to ensure the safest possible outcome for everyone involved.
A disqualification today does not always mean a permanent one. BMI, tobacco use, and medication history can all change before a candidate applies. The surrogate screening process assesses readiness honestly rather than seeking reasons to exclude good candidates.
Medical Conditions That Can Disqualify You from Being a Surrogate
BMI Outside the Accepted Range
Body mass index ranks among the first factors fertility clinics review. ASRM guidelines recommend a maximum BMI of 30 for surrogate candidates. Many agencies apply a stricter threshold: at Surrogacy by Faith, the limit sits at 29.
An elevated BMI raises the risk of gestational diabetes, preeclampsia, and delivery complications. A BMI that falls too low creates different concerns, including reduced uterine receptivity and nutritional risk during pregnancy. Clinics evaluate BMI alongside the full pregnancy history rather than in isolation.
Uncontrolled Chronic Health Conditions
Several chronic conditions disqualify a candidate outright or require careful case-by-case review. Type 1 diabetes, unmanaged hypertension, and active autoimmune disorders all create elevated risk during pregnancy. Thyroid conditions that remain stable and well-managed may not disqualify a candidate, but they require documentation and close monitoring throughout.
Infectious conditions such as HIV and Hepatitis B or C represent hard disqualifiers. Certain blood-borne infections carry a transmission risk to the baby in utero, according to the Mayo Clinic, which is why fertility clinics treat these as absolute exclusions. PCOS receives individual evaluation: it raises the risk of gestational diabetes and preeclampsia, but the impact varies enough that some candidates with PCOS may still qualify.
History of Serious Pregnancy Complications
Prior pregnancy complications carry significant weight in surrogate eligibility decisions. Conditions such as preeclampsia, placental abruption, and severe postpartum hemorrhage can recur in future pregnancies and pose serious risk to both the surrogate and the baby. Most agencies require that a surrogate’s most recent delivery occurred at 36 weeks or later in a gestational surrogacy arrangement, with an exception for multiples.
Gestational diabetes falls on a continuum. A case that responded to diet alone, resolved completely after delivery, and now shows a normal A1c and fasting glucose may still allow a candidate to qualify. Gestational diabetes that required insulin typically leads to disqualification. Multiple C-sections also receive careful review: most fertility clinics accept up to two prior cesarean deliveries, with three or more assessed individually based on whether past pregnancies were uncomplicated.
Mental Health and Medication History
Active clinical depression, anxiety disorders, or other untreated mental health conditions disqualify a candidate. Surrogacy places real emotional demands on a person, and pregnancy hormones can intensify underlying mental health vulnerabilities. Agencies require that candidates enter the process in a stable, well-supported state.
Current use of antidepressants or anti-anxiety medications disqualifies candidates at most agencies. Many require a minimum of six months free from those medications. Surrogacy by Faith holds a stricter standard: 12 months off antidepressants and anti-anxiety drugs, reflecting a higher threshold for surrogate protection. Every candidate completes a psychological evaluation with a licensed psychologist as part of screening. This conversation exists to confirm genuine readiness, not to find grounds for rejection.
Age and Pregnancy History Requirements
Age Range
Most surrogacy agencies accept candidates between 21 and 40 years old, with some extending the upper limit to 45. Surrogacy by Faith sets the upper limit at 37. The minimum age reflects the emotional maturity and legal standing the role requires. Above 37 at Surrogacy by Faith, the higher risk of pregnancy complications at later reproductive ages guides the decision.
Women under 21 generally do not qualify, regardless of prior birth history. Legal capacity to contract, the ability to give fully informed consent, and the emotional readiness required all factor into why the floor exists where it does.
Prior Pregnancy and Parenting Requirements
Every reputable agency requires a surrogate to have given birth to at least one child and to be actively raising that child. Two reasons support this standard. First, it confirms the candidate’s body has successfully carried and delivered a pregnancy. Second, it shows she understands the emotional reality of pregnancy and parenthood, which reduces the risk of unexpected attachment difficulties after delivery.
Beyond having given birth, timing matters. The most recent delivery must have occurred within the last five years, so the surrogate’s uterine health reflects her current condition. Every step in how to become a surrogate, from application to medical clearance, build directly on this baseline of proven pregnancy history.
Lifestyle and Background Disqualifications
Tobacco, Drug, and Alcohol Use
Active tobacco and nicotine use, including vaping, disqualifies a candidate. Smoking during pregnancy raises the risk of preterm birth, low birth weight, and placental complications. Most agencies set a minimum tobacco-free period of six months before application. Surrogacy by Faith requires 12 months free of tobacco and nicotine products, including e-cigarettes.
Any recreational drug use also disqualifies a candidate, as does alcohol dependency. These standards reflect direct risk factors for fetal development and delivery outcomes. Candidates with a past history of tobacco or drug use who have cleared the required period qualify for review based on their current health status and honesty during screening.
Financial Circumstances and Government Assistance
Surrogacy agencies screen for financial stability because compensation must never serve as the primary motivation for becoming a surrogate. Candidates who rely on cash aid, welfare, public housing, or Section 8 housing assistance do not qualify. Women in financially precarious situations may experience pressure to accept surrogacy as a financial solution, which undermines genuinely free and informed consent.
Nearly all reputable agencies in the United States share this requirement, and it aligns with ASRM ethical guidelines. Surrogate compensation should supplement a stable life, not replace an income that is missing. Other forms of government assistance, such as food benefits, get reviewed individually depending on the agency.
Criminal History
A felony conviction disqualifies a candidate. What is less commonly understood is that this requirement covers all adults living in the household, not only the applicant. Agencies conduct background checks on every adult in the home to confirm the environment is safe throughout the pregnancy.
Misdemeanors typically undergo case-by-case review and do not automatically result in rejection. Honesty during the application matters: undisclosed criminal history that surfaces during the background check creates a more serious problem than transparent disclosure from the start.
Citizenship and Residency
Candidates must hold U.S. citizenship or legal permanent residency. Surrogacy lawsvary significantly by state, and working with fertility clinics and attorneys requires operating within a specific legal framework. The agency must file for a Pre-Birth Order in a surrogacy-friendly state, so residency carries both legal and practical weight.
Things That Do Not Disqualify You from Being a Surrogate
Tubal Ligation (Tubes Tied)
Tubal ligation blocks the fallopian tubes and prevents natural conception, but it does not disqualify a surrogate candidate. IVF and surrogacy work through a laboratory embryo that transfers directly into the uterus, bypassing the fallopian tubes entirely. Tubal ligation has no bearing on a candidate’s ability to carry a gestational pregnancy.
Women who have had their tubes tied and otherwise meet all eligibility criteria can apply without concern on this point. The same principle holds for other forms of permanent contraception that leave uterine function intact.
One Prior C-Section
One C-section typically leaves a uterine scar that fertility clinics consider manageable when the delivery was uncomplicated and recovery proceeded normally. A prior cesarean alone does not close the door to surrogacy.
Most agencies and fertility clinics still accept two prior C-sections, though with closer review of the full obstetric record. Three or more raise enough concern about uterine integrity that many clinics treat this as a disqualifier. A successful embryo transferdepends on a healthy uterine environment, so the clinic’s assessment of the uterine wall drives this decision.
Being a Family Member or Friend of the Intended Parents
Known surrogacy, where a friend or family member carries for someone they know, is fully possible through a surrogacy agency. It follows the same screening and legal process as any other match: medical screening, psychological evaluation, and independent legal representation all apply regardless of the personal relationship.
What to Do If You Have a Concern on Your Record
Certain disqualifications are permanent, such as the absence of a uterus or specific incurable conditions. Many others are not. BMI, tobacco use, and medication history can all change before a candidate applies, and women who did not qualify at one point have gone on to meet the criteria after making the relevant changes.
Complete honesty during the application matters most. The surrogacy process builds on transparency between all parties, and agencies use the information provided to assess readiness. A condition that comes to light in medical records or a background check after concealment creates far more complications than disclosing it upfront.
Candidates unsure about a specific situation, such as a past mental health diagnosis, a complicated delivery, or a question about medication history, can speak with an agency before formally applying. The broader question of can anyone be a surrogate covers the full eligibility picture, including situations that fall into gray areas.
Frequently Asked Questions About Surrogate Disqualifications
Can I Be a Surrogate If I Have Anxiety or Depression?
Not if you currently take medication for it or manage an active, uncontrolled condition. Clinical depression and anxiety disorders disqualify candidates when they require ongoing medication, because most psychiatric drugs carry risks during pregnancy. Beyond medication, surrogacy places real emotional demands on a person, making mental stability genuinely important for the surrogate’s own wellbeing.
A history of depression or anxiety that has fully resolved, with no medication for the required period, may not represent a permanent barrier. Agencies evaluate the nature, duration, and current status of the condition individually. Surrogacy by Faith requires candidates to have been off antidepressants and anti-anxiety medications for at least 12 months.
Can I Be a Surrogate If I Had Gestational Diabetes?
The answer depends on how the condition presented and how the candidate managed it. A case that resolved completely after delivery, responded to diet alone, and now shows a normal A1c and fasting glucose level may not be disqualifying. The fertility clinic reviews the full obstetric history alongside current metabolic markers before making a determination.
Gestational diabetes that required insulin during a prior pregnancy typically leads to disqualification, as it suggests a higher likelihood of recurrence and more complex management during a surrogate pregnancy. Candidates with this history should disclose it fully when they apply to be a surrogate so the clinic can review the case individually.
Can I Be a Surrogate If I Had Preeclampsia?
A history of preeclampsia receives careful review but does not automatically end a candidate’s eligibility. A mild, isolated case in a prior pregnancy carries different weight than a severe or recurring history. Doctors examine the timing of onset, the severity, how the condition was managed, and whether any lasting effects on blood pressure or kidney function remain.
Providing full obstetric records helps candidates with a preeclampsia history move through the review accurately. The fertility clinic makes the final determination based on the medical evidence, with the agency working alongside that process.
Does Government Assistance Affect Eligibility?
Cash aid, welfare, public housing, and Section 8 disqualify candidates at most reputable surrogacy agencies. This standard protects women from entering surrogacy under financial pressure rather than genuine motivation. Surrogate compensation should supplement a stable life, not replace an income that is missing.
Other forms of assistance, such as SNAP benefits, vary by agency. Some treat these as disqualifying; others review them individually. Candidates in this situation benefit from discussing it openly during the initial inquiry rather than waiting for the formal screening stage.
Does Having Your Tubes Tied Disqualify You?
No. Tubal ligation has no effect on eligibility for gestational surrogacy. The IVF medication protocol and embryo transfer take place entirely within the uterus, with no involvement of the fallopian tubes. Many qualified surrogates have had tubal ligation and carry pregnancies without any complication related to it.
How Surrogacy by Faith Screens and Protects Its Surrogates
Surrogacy by Faith follows ASRM guidelines throughout its screening and applies criteria that reflect a genuine commitment to surrogate safety. Screening includes an application review, an upload of OB/GYN records and delivery history through a secure portal, a psychological evaluation over Zoom with a licensed psychologist, and a full medical screening at the IVF clinic covering drug testing, blood work, and sonograms.
Only PGT-A tested embryos transfer, meaning every embryo undergoes chromosomal screening beforehand, protecting the surrogate from carrying a non-viable pregnancy. This standard contributes to a 92% first-transfer success rate compared to a 40 to 60 percent national average. Candidates in California can also review the specific surrogate mother requirements in California for any additional state-level criteria.
The team at Surrogacy by Faith brings direct lived experience to this work. Team members have been surrogates themselves, with eight babies between them. That background shaped the criteria candidates must meet, which means every standard reflects what a healthy, well-supported surrogacy journey genuinely requires.
Ready to Find Out If You Qualify?
Surrogacy by Faith looks for compassionate, qualified women ready to make a real difference for a family. Children and family are a gift, and every surrogate who joins this journey plays a meaningful part in that. If you meet the criteria and want to take the next step, the application takes just a few minutes to start.
If you think you might meet the requirements, fill out the surrogate application to get started.
Intended parents can reach the team through the intended parent application.