Intended Parents

Surrogate Medical Screening: How Intended Parents Are Protected

Before the embryo transfer, surrogates must complete medical screening. This process confirms that they meet established health standards and helps reduce medical risk.

Below, we break down what surrogate medical screening involves, what clinics look for and why some candidates may not move forward. If you would like to begin the process of finding a qualified surrogate, you can complete our form to connect with a surrogacy professional.

What Is the Surrogate Medical Screening Process?

Surrogate medical screening is the process a fertility clinic uses to confirm that a woman meets the health requirements to be a surrogate. It takes place after you match and before any legal contracts are finalized.

The clinical screening typically includes:

After you match with a surrogate, your fertility clinic reviews her medical records. The reproductive endocrinologist must approve her history before scheduling an in-person exam.

This visit takes place at your clinic and includes a physical exam, bloodwork and uterine imaging.

Once the lab results come back after the appointment, your fertility clinic issues a formal letter of medical clearance. At that point, you can move to the legal contract phase.

Before the fertility clinic’s surrogate medical screening process, reputable agencies conduct their own pre-screening. This earlier review includes collecting medical records and confirming baseline requirements such as age, BMI and a history of uncomplicated pregnancies.

What Medical Tests Do Surrogates Go Through?

Surrogate medical screening includes a review of a surrogate’s prior pregnancies and an evaluation of current reproductive health. Testing is conducted by your fertility clinic’s medical team, and your reproductive endocrinologist makes the final decision on medical clearance.

Pregnancy and Delivery History Review

The best indicator of a future healthy pregnancy is a history of successful births.

Your fertility clinic will review OB-GYN records from each of the surrogate’s prior pregnancies. They are looking for full-term deliveries without complications like preeclampsia, gestational diabetes or placental abruption.

If she has had too many vaginal births (five) or C-sections (three), she may be disqualified to ensure her safety and the safety of the baby.

Infectious Disease Testing

Your fertility clinic will conduct FDA-required infectious disease screening to ensure safety and prevent transmission. Testing typically includes HIV, Hepatitis B and C, syphilis and other sexually transmitted infections. If your surrogate has a partner, they may also be tested.

Uterine and Reproductive Health Evaluation

The clinic must confirm the surrogate is physically ready for embryo transfer. This may involve:

Saline Infusion Sonohysterography (SIS): This is a specialized ultrasound that uses sterile saline to expand the uterine cavity, allowing the doctor to check for polyps, fibroids or scarring that could interfere with implantation.
Hysterosalpingogram (HSG): This is an X-ray that confirms the shape of the uterine cavity is normal.
Hysteroscopy: If imaging raises concerns, a doctor may use a small camera to directly examine the uterine lining.
Hormone Testing: Blood tests check thyroid levels, prolactin and other markers.

How the Best Agencies Vet Surrogates Before Matching

Reputable surrogacy agencies pre-screen surrogates before you’re introduced to a potential match. Here’s how surrogates are screened at this early stage:

Medical Record Collection and Review
Agencies obtain prior OB-GYN and delivery records to confirm a history of healthy, uncomplicated pregnancies and basic eligibility requirements.
Psychological Evaluation
A licensed mental health professional evaluates the surrogate’s emotional readiness, support system and understanding of the responsibilities involved in surrogacy.

In an independent search, these steps often occur after you’ve already invested time and money in a match. If your surrogate isn’t cleared by your fertility clinic, you’d have to start over.

Working with a surrogacy agency that completes pre-screening improves your chances of matching with a qualified surrogate. What’s more, some agencies, including American Surrogacy, offer financial protection if a candidate does not pass clinic-level medical screening.

Psychological Screening and Emotional Readiness

As part of the best agencies’ pre-screening processes, surrogates complete a psychological evaluation with a licensed mental health professional. It assesses their support systems, motivations for pursuing surrogacy and understanding of their responsibilities. This is about protecting everyone — the surrogate, baby and intended parents.

Why Might My Surrogate Be Disqualified During Screening?

Here’s what could disqualify someone from being a surrogate:

BMI and Health Markers: Most clinics require a BMI under 30 to 35. Higher BMIs are statistically linked to higher risks of gestational diabetes and preeclampsia.
Substance Use: Any use of tobacco, nicotine (including vaping) or illegal substances is an automatic disqualification.
Mental Health: If a candidate lacks a stable living environment or doesn’t have a reliable support person to help her during the pregnancy, the clinic may deny clearance for her own well-being.
Medication: Certain medications for chronic conditions may not be safe during pregnancy.

If a surrogate is disqualified, it isn’t a failure on her part. Rather, it’s the surrogacy medical screening process working as it should to protect you and the future child.

Why Thorough Pre-Screening Matters for Your Peace of Mind

Thorough pre-screening reduces the likelihood that a surrogate will be disqualified during clinic-level medical screening. By reviewing medical records and confirming basic eligibility before matching, surrogacy agencies identify potential issues earlier in the process.

Pre-screening does not replace fertility clinic testing. Final medical clearance is still determined by your reproductive endocrinologist. However, verifying records upfront helps limit avoidable delays, repeat matching and unnecessary expense if a candidate does not meet clinic standards.

Get Clarity on Surrogate Screening — Speak With a Professional

If you’re preparing to move forward with a match, understanding how surrogate medical screening works is essential. You should know what your fertility clinic will require, how records are verified and what could delay medical clearance.

If you’d like to discuss screening requirements or find a qualified surrogate, fill out our contact form. We’ll help you connect with a reputable surrogacy professional to review your options.

Frequently Asked Questions About Surrogate Screening

What if My Surrogate Lives in a Different State Than My Fertility Clinic?
This is very common. If you work with a reputable agency, they will coordinate your surrogate’s travel and lodging so you can continue with your fertility clinic. This is typically covered by your matching fee.
How Long Does Surrogate Medical Screening Take?
Agency pre-screening typically happens before a surrogate is introduced as a potential match. Once you match, clinic-level medical screening usually takes about three weeks. This includes record review, the in-person medical appointment and final lab results.
Are Repeat Surrogates Screened Again?
Yes. A woman’s health can change between pregnancies. She must be re-evaluated to ensure she is qualified to carry a baby for another family.
Can a Surrogate Fail Screening After Matching?
Yes. However, the likelihood is significantly lower when working with an agency that follows ASRM guidelines and has a thorough pre-screening process.
Who Pays for the Medical Evaluation?
Intended parents pay for the clinical screening. This is why agency pre-screening is vital; it limits spending on candidates who may not qualify.

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.