The Surrogate Medical Clearance Appointment [Guide for Intended Parents]

After you have found a potential match, this medical clearance appointment is the final check before you move forward. It is a thorough evaluation to ensure the woman you are working with is ready to carry a pregnancy.

The following guide covers what happens during this full-day visit, the specific tests involved and how the results determine your next steps. If you want to learn what comes next in your surrogacy journey, you can learn more about the medical process.

What Happens at the Surrogate Medical Screening Appointment?

The medical screening is typically a full-day appointment at your fertility clinic. It is usually conducted by a reproductive endocrinologist (RE) to ensure your surrogate is prepared for the embryo transfer.

Here’s what screenings are done for surrogates during this visit:

Why the Medical Screening Appointment Is So Important

The medical screening appointment confirms that the surrogate is ready for embryo transfer and that her overall health supports a safe pregnancy.

This step protects both the surrogate and your embryos by identifying any issues before medications begin. It also allows the reproductive endocrinologist to establish a transfer plan based on her hormone responsiveness and medical history.

To improve the chances that surrogates will qualify, reputable agencies conduct pre-screening before you match. They’ll review pregnancy and delivery records, evaluate overall health and complete a psychological evaluation. When it comes time for the medical clearance appointment, you can be confident that your journey will keep moving forward.

Here are three agencies that pre-screen prospective surrogates:

• American Surrogacy
• Stronger Together Surrogacy
• Growing Generations

What Medical Tests Are Required During Surrogate Medical Screening?

Exact requirements may vary by fertility clinic and reproductive endocrinologist, but there are several standard tests.

Bloodwork and Infectious Disease Screening

The fertility clinic will test for infectious diseases, including HIV, Hepatitis B and C and syphilis. They also check for rubella immunity and blood type.

Beyond these basics, the RE looks at hormone levels to make sure the surrogate’s system can support a pregnancy once the medication protocol begins.

Uterine Evaluation: Saline Sonogram vs. HSG

Doctors may use several tests to ensure the uterus is healthy and free of anything that could interfere with a successful pregnancy.

The most common tool is a saline sonogram (SIS). During this procedure, sterile saline is placed into the uterus while an ultrasound is performed. This allows the doctor to see the shape of the uterine cavity and check for polyps, fibroids or scar tissue.

An RE may also use a hysterosalpingogram (HSG). This test uses dye and X-rays to evaluate the shape of the uterine cavity and determine whether the fallopian tubes are open.

For a gestational surrogate, the tubes do not play a role because the embryo is placed directly into the uterus through IVF. Because of this, the saline sonogram is usually the preferred method.

If the doctor sees something unusual, they may perform a hysteroscopy — a procedure that uses a tiny camera to look inside the uterus more closely.

Is a Mock Transfer Necessary for Surrogacy?

Many clinics perform a mock embryo transfer during the screening. This isn’t a full mock cycle for surrogacy (which involves a trial run of hormones), but rather a preliminary run of the transfer itself.

During this procedure, the doctor inserts a thin catheter to map the best route to the uterus. It helps them find any physical hurdles before the actual transfer day.

How Long Does Medical Clearance Take?

The timeline for medical clearance depends on the fertility clinic. Typically, a clinic takes a week or two to review medical records before the appointment. The screening itself takes one full day.

After the appointment, it can take a week to get the final results back from the lab. You might see a delay if a test is inconclusive or if the doctor wants a follow-up for something minor.

When you work with an agency, these timelines are often smoother. Experienced surrogacy agencies organize and review surrogate medical records during the pre-screening process. By the time the medical clearance appointment is scheduled, they have already gathered the documentation your fertility clinic needs.

Can Intended Parents Attend the Medical Clearance Appointment?

Whether you attend is up to you and your surrogate. Some parents go to offer support, while others join via video call for the wrap-up at the end of the day.

If you can’t be there, or if your surrogate prefers privacy during the physical exams, you can still show support. A thoughtful text or a small gift like her favorite snack is a great way to stay connected.

What Intended Parents Should Do Before the Appointment

Before your surrogate attends the medical screening appointment, you should confirm a few things:

• Ask about clinic protocols. Does the fertility clinic require a full mock cycle, or will the process begin with a one-day screening appointment? Understanding the clinic’s process helps you plan the next steps.
• Review insurance and financial coverage. Make sure screening costs are accounted for in your surrogacy budget so there are no surprises when the clinic schedules testing.
• Double-check pre-screening results. The best agencies review your surrogate’s pregnancy and delivery records in advance to ensure there are no obvious red flags before the clinic appointment.

Taking these steps ahead of time helps the medical screening appointment run smoothly and reduces the chance of delays.

What Could Disqualify a Surrogate at Medical Clearance?

Many surrogate candidates who reach medical screening move forward without issues, but sometimes the doctor may decide it’s not safe to proceed. When that happens, it’s usually related to uterine concerns, hormone irregularities or unresolved infections. For example, uterine scarring could make it difficult for an embryo to implant.

It’s important to remember that a “no” isn’t always the end. Some issues, such as a small uterine polyp or low iron levels, can often be treated before moving forward. However, if a doctor identifies a chronic condition or structural concern that could affect pregnancy, they may decide a candidate is not the right fit for surrogacy.

Experienced agencies help reduce the likelihood of surprises at this stage. By reviewing medical records and pregnancy history early in the process, they can often identify potential concerns before you spend time and money on medical clearance.

What Happens if a Surrogate Doesn’t Pass Medical Clearance?

If a candidate doesn’t pass the surrogate medical screening process, the match usually ends. This is a hard moment because it means resetting your timeline and finding a new surrogate.

If you are doing this on your own, a failed screening can mean losing time and money. This is why many parents work with agencies that offer protection for these specific situations.

How Agencies With Financial Protection Reduce Risk

To help with the stress of a failed screening, surrogacy agencies like American Surrogacy offer risk-sharing programs. These can include:

What Happens After Medical Clearance?

Once the doctor gives the official “yes,” you have passed the final medical hurdle.

The clinic will send a clearance letter to your agency and lawyer, starting the legal contract phase. Drafting, negotiating and signing a surrogacy agreement typically takes one to two months.

Once the contracts are signed, the surrogate can begin taking medications to get ready for the embryo transfer.

Have Questions About Medical Clearance or Rematching? We Can Help

Whether you are just starting your search or you are dealing with a failed screening right now, having a surrogacy professional on your side makes a difference.

We can help you connect with a reputable surrogacy agency that conducts pre-screening and offers financial protection. Fill out our contact form for more information.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice, diagnosis or treatment. Always seek the advice of a licensed healthcare provider with any questions you may have regarding a medical condition or procedure.