Surrogates

Surrogate Health Requirements: What You Need to Know

Every surrogate must meet certain health requirements to make sure she can safely carry a child without increased risk to herself or the baby.

When you become a gestational surrogate, a couple is placing their hopes of becoming biological parents with you and your ability to carry a child. They’ll invest a great deal of time, money and their emotions into their surrogacy journey — which is why it’s so important that you can give them their best chance at having a biological child.

One of the most important parts of making sure you’re suitable to carry a child as a surrogate is meeting the health requirements to be a surrogate mother. No matter which agency or professional you work with to become a surrogate, you will be required to meet certain health and lifestyle standards to ensure that you are fit enough to not only go through fertility treatments and medical preparation for the pregnancy, but also to carry a healthy child to term with no complications.

Surrogacy requirements, including surrogate health requirements, vary from agency to agency and clinic to clinic, but most surrogacy agencies require some sort of screening before you can become a surrogate. These screenings may include:

  • Initial application: Typically completed first, these are basic information forms about you, your desire to become a surrogate and your history with pregnancies and/or surrogacy.
  • Background screening: Surrogacy agencies will usually conduct federal and state background criminal checks, as well as financial screenings to make sure you can effectively provide for yourself without being dependent on surrogate compensation. Because you will be trusted with a couple’s chance to become biological parents, these screenings are necessary to not only put them at ease but also to make sure that you’re fit to be a surrogate.
  • Psychosocial screening: A social worker from your surrogacy agency may interview you and your partner, if applicable, in-person or in your home to evaluate your mental state and whether you’re emotionally ready to become a surrogate. They may address the emotions you’re feeling now, what you may feel during the pregnancy and how you’ll feel after you give birth to the baby. It’s important that you’re prepared for these emotions and that you’re choosing to become a surrogate for the right reasons.
  • Health screening: You will need to visit a fertility specialist to make sure you are physically fit to be pregnant. This will involve a screening of your personal and sexual history, lab testing of your blood and urine and an overall examination by your doctor to make sure you’re ready for fertility treatments and pregnancy.

In addition to these requirements to be a surrogate mother, you will also have to agree to abstain from alcohol, drugs and smoking during your pregnancy to give the unborn child the best chance at a healthy pregnancy and birth. Other qualifications to be a surrogate will vary by agency, but many agencies require you to have already given birth to a child, have the support of your spouse and not be on public assistance, in addition to other criteria.

In regards to health requirements to be a surrogate mother, there are some common questions that potential surrogates have when they’re considering surrogacy. Your doctor can give you more accurate information about your own health situation and whether it will impact your ability to be a surrogate. The intended parents also have the right to decide what kind of health conditions they’re comfortable with in a surrogate, which may impact your wait to be matched with a family.

Again, requirements vary by agency and fertility clinics, but here are the generally accepted answers to questions about whether your health situation will prevent you from being a surrogate.

How old can a surrogate be? Why is there an age limit to being a surrogate?

Generally, if you want to be a gestational surrogate, you must be between the ages of 21–40. Just like with any pregnancy, an older age makes health complications and risks more likely, which is why many agencies and IVF clinics set an age limit for surrogate parents.

Can you be a surrogate after having your tubes tied?

You can still become a surrogate mother after a tubal ligation, or “having your tubes tied.” Because a gestational surrogacy involves the eggs of the intended mother or a donor, not your own, a tubal ligation (which halts ovulation) will not prevent a successful embryo implantation in your uterus. In fact, a surrogacy after a tubal ligation ensures that you will not become pregnant with your own child during the fertility process.

Can I be a surrogate if I have HPV?

In most cases, HPV will not affect a developing baby during pregnancy. HPV is the most common type of STI in the U.S. and most commonly results in genital warts. If you have an outbreak of warts close to your due date, you will likely have to have a cesarean-section performed to prevent the transmission of HPV to the child.

Can you be a surrogate mother with herpes?

Like HPV, it’s rare for a baby to be born with birth defects because of a surrogate mother with herpes. However, you may need to have a cesarean-section if you have an outbreak close to your due date.

Can I be a HIV-positive surrogate mother?

Because HIV can be spread to a baby through pregnancy or while giving birth, you cannot be a surrogate mother if you’ve tested positive for HIV.

Can you be a surrogate after preeclampsia?

Preeclampsia is a condition that can cause high blood pressure, kidney damage and other problems that can be very dangerous to both you and the baby you’re carrying — even life-threatening. If you’ve had preeclampsia in a previous pregnancy, you’re more likely to develop it again in later pregnancies, which is why preeclampsia will likely disqualify you from becoming a surrogate. Your doctor can give you more information about your specific case.

Can you be a surrogate after ablation?

Pregnancy is not likely to occur after ablation, as it destroys a thin layer of the lining of the uterus and makes implantation of an embryo more difficult. Even if you do become pregnant after ablation, you have an increased risk of miscarriage and other pregnancy conditions. Many fertility clinics and surrogacy agencies will disqualify you from being a surrogate if you’ve experienced ablation.

Can I still pursue surrogacy with endometriosis?

Endometriosis can make it more difficult for you to become pregnant and may increase your risk of miscarriage. It’s best to talk with your doctor about whether the severity of your condition could affect your ability to successfully carry a child.

Are there restrictions on being a surrogate with PCOS (polycystic ovarian syndrome)?

Although PCOS mainly affects your ability to become pregnant by affecting your ovulation, it can also affect a gestational surrogate pregnancy. Women with PCOS are more likely to experience gestational diabetes, preeclampsia and endometrial cancer; require a cesarean-section; and give birth to a preterm baby. While only your doctor can tell you whether your PCOS will affect your ability to carry a child, it’s highly unlikely that you can be a surrogate.

Can a female with adenomyosis be a surrogate?

Adenomyosis is a condition where endometrial tissue begins to grow into the muscle layers of the uterus. This can affect the implantation of an embryo inside your uterus, although it may be treated by a fertility specialist with hormone treatments. Talk to your doctor about whether your adenomyosis will affect your ability to successfully carry a pregnancy.

Can a menopausal woman be a surrogate?

Many women who are menopausal are over the age of 40, which is older than many agencies allow for surrogates. Becoming pregnant after menopause can cause many risks to you and the child due to the fact that menopause is your body’s way of stopping any future pregnancies. It’s highly unlikely that you’ll be able to successfully be a surrogate mother after menopause.

What pregnancy conditions disqualify me from surrogacy?

While agencies and fertility clinics may allow different pregnancy-related conditions in their surrogates, your previous pregnancies should have been generally healthy and free of complications for you to be a successful surrogate. Possible conditions that could affect your surrogacy are preterm labor, miscarriage, placenta previa and other issues that need medical intervention. You should talk to your doctor about whether your previous pregnancy conditions could disqualify you from surrogacy.

If I just had a child, how long do I have to wait to become a surrogate?

Generally, fertility clinics will not work with surrogate mothers until three months after a vaginal delivery or six months after a cesarean-section. Different surrogacy agencies, however, may require you wait longer before you can become a surrogate for them.

I’m breastfeeding; can I be a surrogate?

Breastfeeding naturally delays a woman’s return to fertility by causing a lack of ovulation and periods. If you’re trying to get pregnant and be a surrogate, this can cause serious problems with implantation of an embryo. Therefore, to become a surrogate, you will have to stop breastfeeding and resume your regular menstrual cycle for a more successful IVF process. You may be able to keep breastfeeding during your application and initial screening process for surrogacy.

Can I be a surrogate if I’ve never been pregnant?

Most agencies require that you’ve already carried at least one pregnancy successfully to term before you can become a surrogate mother. A surrogate without a previous pregnancy comes with many unknowns: Can she carry a pregnancy to term? Are there underlying conditions she isn’t aware of? Can she even become pregnant?

Not only does a surrogate mother who has never been pregnant raise medical concerns, but if you’ve never had children or been pregnant, the situation will be confusing and maybe even scary for you. All surrogates need to know what to expect ahead of time — both physically and emotionally — which is why almost all agencies require you to have been pregnant before becoming a surrogate.

How many times can you be a surrogate?

There are many factors taken into consideration to determine how many surrogacies is too many, and the decision will be entirely up to the surrogacy agency you’re working with, your doctor and your fertility clinic.

Is there a weight requirement to be a surrogate?

Many agencies and fertility clinics abide by the BMI standard, which determines whether your weight is heathy for your height. The required BMI to be a surrogate will vary by agency, but it usually will fall within the healthy range of 19–33.

A healthy weight of a surrogate can help ensure a successful conception and reduce the risk of pregnancy complication. You can calculate your BMI here. You can also see your doctor for more information about your personal BMI.

Can someone with a history of mental illness be a surrogate?

Again, individual agency requirements on this will vary. As a surrogate mother, you will need to be able to schedule and attend appointments, take medication at the correct time and legally consent to your surrogacy agreement. If you have a mental illness that may impact your ability to do so, you may be disqualified from being a surrogate mother.

Being a surrogate can be an emotional process, so you also have to be stable enough to cope with those emotions during the pregnancy and after the baby is born. Most agencies will also require you to cease anti-depressants or other medicine for mental illness for a certain time before you can become a surrogate.

Can someone with sickle cell be a surrogate?

If you have sickle cell disease as a surrogate, you are more likely to have health complications during your pregnancy, including miscarriage, premature birth and a low birth weight. In most cases, having sickle cell will make becoming pregnant too dangerous for the child that you’re carrying and will prevent you from becoming a surrogate.

Can you be a surrogate with diabetes?

If you have Type 1 or Type 2 diabetes, it may be more difficult to control your blood glucose levels during pregnancy. While it is possible to have a healthy pregnancy with diabetes, many agencies will choose to disqualify you from becoming a surrogate because of the possible health risks to you and the child that you carry.

Like other pregnancies, a surrogate pregnancy comes with the risk of developing gestational diabetes — diabetes that lasts for the length of the pregnancy until the child is born. This not only poses a risk to you as the pregnant woman but can also affect the growth rate of the baby. If you have a history of gestational diabetes, it may not immediately disqualify you from being a surrogate, but you’ll need to speak to your doctor and fertility clinic to determine the possible effects of your individual situation.

These are the general answers to questions you may have about surrogate health requirements, but it’s highly recommended that you speak with your surrogacy agency, your personal doctor and your fertility clinic about any health conditions you have and how they may affect your ability to carry a healthy pregnancy to term. Remember, requirements for surrogacy vary from agency to agency, and your application process will help determine whether you are physically and mentally fit to become a surrogate mother.

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