Surrogacy is a deeply meaningful journey that requires care, commitment and preparation. Whether you are someone considering becoming a surrogate or an intended parent hoping to understand the process, it’s essential to know what makes someone eligible for this role.
There are specific medical, legal, emotional, and lifestyle criteria that help ensure a safe and successful experience for everyone involved. In this guide, you will find a clear and detailed overview of the requirements to become a surrogate, why they matter, and how they support a healthy and respectful surrogacy journey for all parties.
General Requirements to Become a Surrogate
Age Requirements
To become a surrogate, you must be between 21 and 40 years old for most agencies. Some fertility clinics and surrogacy agencies, like Surrogacy by Faith, may set a preferred upper limit at 37, based on medical best practices and insurance considerations.
Age plays a major role in reproductive health. It influences how your body responds to hormone treatments, how easily an embryo implants, and the overall safety of the pregnancy. Most programs avoid accepting candidates under 21 or over 40 due to increased medical risks, such as gestational diabetes, hypertension, or miscarriage.
Most agencies follow general medical guidelines on how old a surrogate has to be. While some flexibility may exist, all age-related decisions are made with the health and safety of both the surrogate and the baby in mind.
Previous Pregnancy and Delivery
A key requirement for becoming a surrogate is having previously completed at least one healthy, full-term pregnancy. This is not only a medical consideration but also an emotional one. It ensures that the person carrying the baby has already experienced pregnancy and childbirth, understands the process, and has demonstrated that their body can safely support a developing fetus.
Most agencies and fertility clinics will require documentation of this prior pregnancy, including medical records confirming:
- A full-term birth, typically after 37 weeks
- No major complications during pregnancy or delivery
- A healthy recovery after childbirth
Certain past complications may lead to ineligibility, depending on their severity and recurrence. These can include:
- Severe preeclampsia or toxemia
- Uncontrolled gestational diabetes
- Placental abruption or placenta previa
- Postpartum hemorrhage
- Preterm labor without a medical reason
- Stillbirth, especially if it occurred recently and without a clear medical explanation
Having had a cesarean section does not automatically prevent someone from becoming a surrogate. In many cases, one or two past C-sections are acceptable if the surgeries and recoveries were smooth. However, when there is a history of multiple C-sections or if uterine scarring is present, further medical evaluation may be necessary to ensure the uterus is strong enough to carry another pregnancy safely.
This requirement helps confirm that the potential surrogate is physically prepared and emotionally familiar with pregnancy, which supports a more stable and secure surrogacy experience for everyone involved.
Legal Status in the United States
To become a surrogate in the United States, the candidate must be either a U.S. citizen or a legal permanent resident. This requirement is essential not only for protecting the intended parents but also for protecting the surrogate herself.
Surrogacy involves legal agreements that outline everyone’s rights and responsibilities. These surrogacy contracts make sure that the intended parents will assume full parental rights after birth, and they also protect the surrogate. They guarantee her access to proper medical care and ensure that she receives the compensation that was agreed upon. For these contracts to be valid and enforceable, the surrogate needs to have legal standing under U.S. law.
Legal status also makes it possible to navigate things like health insurance, medical appointments, and any necessary legal filings during the process. Without the right documentation, these steps can become complicated or even impossible to complete correctly.
That’s why individuals who are undocumented or living in the U.S. on a temporary visa are generally not eligible to become surrogates.
Health and Medical Requirements
General Physical Health
A potential surrogate must be in good overall health, with no chronic medical conditions that could pose a risk during pregnancy. Conditions such as uncontrolled diabetes, high blood pressure, epilepsy, or autoimmune disorders like lupus may result in disqualification unless a doctor confirms they are fully managed and stable.
Fertility clinics also look at overall fitness, cardiovascular health, and whether the body is likely to respond well to hormone therapy used during the IVF process. The candidate will be asked to complete a physical examination and provide detailed medical history.
BMI Guidelines
Most clinics require that a surrogate’s Body Mass Index (BMI) fall between 19 and 32. Some may accept up to 34, depending on their protocols and the surrogate’s overall health profile.
Maintaining a BMI within this range is important for several reasons. It helps ensure that the body responds effectively to fertility medications, reduces the risk of complications such as gestational diabetes or preeclampsia, and supports a healthier pregnancy overall.
Some agencies provide detailed explanations of BMI requirements for surrogacy, including how this metric affects eligibility and what to expect during medical screening.
If a candidate’s BMI is slightly above the accepted limit, she may be advised to lower it before reapplying. This requirement is based on safety and medical outcomes, not appearance.
Reproductive Screening
Before being approved, a surrogate must undergo a full reproductive health screening. This includes a transvaginal ultrasound to assess the condition of the uterus and look for any abnormalities that might interfere with pregnancy. In some cases, additional tests such as hysteroscopy may be recommended to provide a clearer view of the uterine cavity and ensure that it is healthy and free of polyps, fibroids, or scar tissue.
Blood tests are also required to check hormone levels, hemoglobin, immunity to diseases like rubella and chickenpox, and overall health markers. A pap smear may be needed, depending on the medical history. In some cases, additional screenings such as infectious disease testing or genetic carrier screening may be performed.
All results are reviewed by a fertility specialist to confirm that the surrogate is medically ready to carry a child safely.
Lifestyle and Personal Stability
Drug-Free and Smoke-Free Living
A surrogate must not smoke, use recreational drugs, or abuse alcohol. Most agencies require that the candidate has not used tobacco or nicotine products for at least 12 months prior to applying. Drug and nicotine screenings may be done throughout the process to ensure ongoing compliance.
Alcohol must be completely avoided during the medical preparation and throughout the pregnancy. Any history of substance abuse will be reviewed carefully, and in most cases, it will disqualify the candidate unless it is well in the past and has been fully resolved with professional treatment.
Financial Independence
The surrogate must not be receiving income-based government assistance such as Medicaid, SNAP, or other public aid programs. This requirement is in place to ensure that the decision to become a surrogate is not driven by financial pressure and that the candidate is already able to support herself and her household.
Compensation is a meaningful part of the surrogacy journey, but it is not intended to replace income or serve as emergency support. Intended parents need to know that the person carrying their child is financially stable and entering into the agreement from a place of strength and balance.
Stable Living Environment
A safe and stable home is essential for the well-being of the surrogate and the baby she carries. Agencies and clinics look for indicators that the candidate has reliable housing, emotional security, and a calm environment where she can follow medical instructions, attend appointments, and rest when needed.
Having a support system is also important. Whether it comes from a partner, close family, or trusted friends, that network helps ensure the surrogate feels encouraged and cared for during the process. Living in a chaotic or unsafe environment may lead to disqualification, not as a judgment, but as a precaution to protect the entire journey.
Psychological and Emotional Evaluation
Psychological Screening Process
Before being matched with intended parents, every surrogate candidate must complete a psychological evaluation. This step is conducted by a licensed mental health professional and is a standard part of the process at all reputable agencies and clinics.
The evaluation covers a range of topics, including the surrogate’s motivations, her understanding of the emotional and physical demands of the journey, her ability to set boundaries, and her emotional resilience. It may also explore her relationships, personal history, and any prior mental health conditions.
This screening is not designed to exclude someone unnecessarily. Its purpose is to ensure that the surrogate is fully prepared to carry a child for another family and can do so with clarity, stability, and emotional balance.
Emotional Readiness and Support System
Beyond the formal screening, emotional readiness is a core element of what makes a surrogate eligible. Carrying a child for someone else can be deeply meaningful, but it can also be complex and emotionally demanding. Agencies look for candidates who are mentally strong, emotionally mature, and aware of the unique aspects of this role.
It is also important that the surrogate has a reliable support system. If she is in a relationship, her partner’s understanding and approval may be required. Support from family and friends can also make a real difference, especially during the later stages of pregnancy and post-birth recovery.
Surrogates who are currently under treatment for serious mental health conditions, or who have recent histories of emotional instability, are generally not eligible. In some cases, failing the psychological evaluation for surrogacy may not mean permanent disqualification, but it will delay the process until the person is emotionally ready to continue.
Disqualifying Criteria for Surrogacy
Medical Conditions
Certain medical issues may make a candidate ineligible to become a surrogate. These include chronic conditions that are not well managed, such as uncontrolled diabetes, epilepsy, severe asthma, or hypertension. Autoimmune diseases like lupus, as well as serious heart, kidney, or liver problems, are also considered high-risk for pregnancy and may lead to disqualification.
Complications in past pregnancies can also raise concerns. These include multiple miscarriages, preeclampsia, placental abnormalities, or premature labor that occurred without medical cause. A uterine abnormality, if detected during screening, may also prevent the candidate from being approved.
Mental Health and Psychological History
Emotional stability is essential for a safe and positive surrogacy journey. Candidates with a history of untreated depression, anxiety disorders, bipolar disorder, schizophrenia, or any other major psychiatric condition are usually not eligible. A past diagnosis does not always lead to automatic disqualification, but it will require a detailed evaluation, especially if the condition has been recent or untreated.
If a candidate has been recently hospitalized for mental health reasons or is currently on certain medications that affect emotional regulation, she may be asked to wait or explore other ways to support families.
Legal and Background Issues
All candidates must pass a background check as part of the screening process. A history of criminal offenses, unresolved custody disputes, or legal instability may result in disqualification. These checks are in place to ensure the safety of the child, the intended parents, and the surrogate herself.
In some states, additional legal criteria may apply, especially regarding marital status, previous convictions, or family law matters.
Substance Use History
Candidates who have a history of substance abuse, including alcohol, recreational drugs, or prescription drug misuse, will generally not be accepted. If the history is distant and recovery is well-documented and stable, some exceptions may be considered on a case-by-case basis, but this is rare.
Ongoing use of tobacco, nicotine products, or vaping also results in disqualification, as these substances can affect pregnancy outcomes and the baby’s health.
Situations That May Require Temporary Ineligibility
Some conditions or circumstances do not permanently disqualify a candidate, but may require her to pause the process. This can include recovering from a recent C-section, adjusting medication, or waiting for test results. In some cases, candidates may be allowed to reapply after the issue is resolved or after a recommended waiting period.
Medical, psychological, and lifestyle factors are all considered when reviewing a candidate, based on clearly defined surrogacy disqualification criteria used across most agencies.
Frequently Asked Questions About Surrogate Qualifications
Do surrogacy requirements vary by state?
Most medical and psychological qualifications are consistent across the U.S., but the legal ability to act as a surrogate depends on state law. Some states do not allow compensated surrogacy or require additional legal steps, which may affect whether a candidate can proceed even if she meets all the other criteria.
What are the legal considerations to become a surrogate?
A legal contract must be signed between the surrogate and the intended parents before any medical steps begin. This agreement outlines rights, responsibilities, and protections for everyone involved. Legal eligibility also requires that the surrogate be a U.S. citizen or legal permanent resident.
What are the different types of screenings a surrogate must complete?
Every candidate must go through a series of screenings, including medical evaluations, psychological assessments, and background checks. These screenings ensure the surrogate is physically healthy, emotionally ready, and living in a safe, stable environment.
Can someone become a surrogate after a C-section?
Yes, a prior C-section does not automatically disqualify a candidate. If the recovery was smooth and there are no complications with the uterus, most clinics will approve it. Multiple C-sections may require additional review.
What happens if someone doesn’t pass the psychological evaluation?
If a candidate fails the psychological evaluation and does not meet the psychological criteria for surrogacy, the agency or clinic may recommend postponing the process. In some cases, it is possible to reapply after addressing the underlying concerns.
Does a surrogate need to have a certain BMI?
Yes, most clinics follow specific BMI requirements for surrogacy, usually between 19 and 32. This range supports better response to fertility treatments and a safer pregnancy.
Become a Surrogate with Surrogacy by Faith
Surrogacy by Faith is a values-based agency that offers more than guidance. It provides a supportive and respectful environment for every woman who chooses to carry a child for someone else. The agency operates from a pro-life perspective and works exclusively with intended parents who share a commitment to protecting life throughout the journey.
What sets Surrogacy by Faith apart is that its team includes women who have been surrogates themselves. Their lived experience allows them to offer real support, grounded in understanding and compassion.
The agency offers generous compensation through clear, transparent agreements. But beyond financial considerations, it is the emotional and ethical framework that makes the experience meaningful. From medical coordination to legal guidance and personal support, everything is done with care and respect.
For intended parents considering surrogacy, the best way to start the journey is by exploring the intended parent application process. Women interested in becoming surrogates can learn more about the steps involved by reviewing the surrogate mother application process.