A surrogate psychological evaluation typically involves an interview and standardized testing with a licensed mental health professional before matching with intended parents. It helps assess your emotional readiness and support system as you prepare for surrogacy.

It’s normal to worry about being judged or disqualified based on your mental health history. The evaluation isn’t a judgment of your parenting abilities, and the right agency will make it a supportive, no-cost part of the screening process.

Connect with a surrogacy professional to learn about psychological screening requirements, discuss your eligibility and find an agency that prioritizes your emotional well-being.

What Happens During a Surrogate Psychological Evaluation?

A surrogate psychological evaluation typically includes an individual interview, standardized testing, a partner interview when applicable and pre-surrogacy counseling. The process may take a few hours, depending on the evaluator and agency requirements.

Pre-Screening Before Matching

Ideally, your psychological evaluation takes place during the surrogate screening process, before you’re matched with intended parents. This helps identify potential concerns early and reduces the risk of delays after matching. During the evaluation, a licensed mental health professional will typically:

• Administer a standardized assessment, such as the MMPI or PAI.
• Discuss your mental health history, motivations and emotional readiness.
• Interview your spouse, partner or another support person, when applicable.
• Provide counseling about the emotional aspects of surrogacy and what to expect.

The Joint Session After Matching

After matching, you and the intended parents may participate in a joint session facilitated by a mental health professional. Your partner may also attend.

This meeting helps everyone establish shared expectations around communication, medical decisions, delivery preferences and contact after birth. It’s an opportunity to discuss important topics together before moving forward with the surrogacy journey.

Why Surrogates Need a Psychological Evaluation

The American Society for Reproductive Medicine (ASRM) recommends a psychosocial consultation for all gestational carrier candidates, with psychological testing when appropriate. This evaluation helps protect your emotional well-being and ensures you understand what surrogacy involves before moving forward.

During the evaluation, a mental health professional assesses whether you:

• Are Making an Informed Decision: You understand the responsibilities of surrogacy and are choosing to participate without pressure from others.
• Have Healthy Coping Skills: You’re emotionally prepared to handle challenges such as failed embryo transfers or unexpected pregnancy complications.
• Have a Reliable Support System: You have people you can depend on throughout pregnancy and postpartum recovery.

The evaluation isn’t a judgment of your parenting abilities or personal worth. It’s an opportunity to assess your readiness, discuss potential concerns and make sure you have the support needed for a healthy surrogacy experience.

What Is the MMPI-2 or PAI Test for Surrogates?

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Personality Assessment Inventory (PAI) are standardized psychological tests used to assess emotional functioning, personality traits and how you respond to stress.

These assessments help mental health professionals evaluate your readiness for surrogacy alongside your personal interview.

• MMPI-2: Includes 567 true-or-false questions and is administered and interpreted by a qualified psychologist.
• PAI: Includes 344 statements that you rate based on how accurately they describe you.

You don’t need to study or prepare specific answers for either test. Both include measures that identify inconsistent responses or attempts to present yourself in an unrealistically positive way.

The best approach is to answer honestly and consistently. Your evaluator isn’t expecting perfection, and your responses are considered alongside your interview and personal history.

Questions You May Be Asked in Your Psychological Evaluation

During your psychological evaluation, you’ll be asked about your personal history, support system and expectations for surrogacy. These questions help the evaluator understand your emotional readiness and identify any areas where you may need additional support. Common topics include:

• Motivations for Surrogacy: Why you want to become a surrogate, including your desire to help a family and earn surrogate compensation. Both are valid motivations.
• Pregnancy and Postpartum History: Your previous pregnancies, deliveries and any physical or emotional challenges during recovery.
• Mental Health History: Past experiences with anxiety, depression, grief or major stress, along with how you manage difficult situations.
• Support System and Childcare: Who you can rely on during pregnancy, medical appointments and postpartum recovery.
• Intended Parent Relationships: Your expectations for communication, involvement and boundaries throughout the journey.
• Talking With Your Children: How you plan to explain surrogacy to your children and prepare them for the experience.
• Medical Decisions: Your views on prenatal testing, pregnancy termination and selective reduction.

You don’t need to rehearse answers before your evaluation. Being honest about your experiences, expectations and concerns helps the evaluator understand your readiness for surrogacy.

Does Your Partner Need a Psychological Evaluation Too?

Yes, if you’re married or have a partner, they’ll typically participate in your psychological evaluation. ASRM guidelines recommend including partners when applicable to assess their understanding of surrogacy and the support they can provide throughout the journey. During the interview, your partner may be asked about:

• Their Support: How they feel about your decision to become a surrogate and their willingness to support you.
• Household Responsibilities: How they’ll help with childcare, appointments and daily responsibilities during pregnancy.
• Intended Parent Involvement: Their comfort level with your relationship and communication with the intended parents.
• Emotional Readiness: Their understanding of the physical and emotional demands of surrogacy.

If you’re single, you can still become a surrogate. The evaluator will typically ask about another reliable support person, such as a family member or close friend, who can help you throughout pregnancy and recovery.

Can Your Mental Health History Disqualify You From Being a Surrogate?

A history of anxiety, depression or another mental health condition doesn’t automatically disqualify you from becoming a surrogate. Evaluators consider your current emotional stability, treatment history and ability to manage the demands of pregnancy. However, certain mental health concerns may affect your eligibility, including:

• Serious Psychiatric Conditions: Active or unmanaged conditions that affect your judgment, daily functioning or ability to make informed decisions.
• Severe Postpartum Mental Health Complications: A history of postpartum psychosis or postpartum depression requiring hospitalization or intensive psychiatric treatment.
• Recent Mental Health Crises: Recent psychiatric hospitalization, suicidal behavior or other serious concerns that may require further evaluation.

Many agencies also require surrogates to be off antidepressants for at least 12 months before beginning the process, although medication policies vary by agency and fertility clinic. Never stop or change prescribed medication solely to qualify for surrogacy without consulting your healthcare provider.

What Happens If You Don’t Pass the Psychological Evaluation?

Not receiving psychological clearance doesn’t necessarily mean you can never become a surrogate. Depending on your evaluation, there are several possible outcomes:

• Full Approval: You’re cleared to continue the screening or matching process.
• Approval With Recommendations: You may need additional counseling or support before moving forward.
• Temporary Deferral: You may be advised to wait and reapply once certain concerns are resolved.
• Not Approved: The evaluator determines that surrogacy isn’t appropriate based on your current circumstances or mental health history.

Evaluation results are typically shared with the agency and fertility clinic, while intended parents may receive confirmation of your clearance status. Detailed personal information is generally kept confidential, subject to your consent and applicable privacy requirements.

If you aren’t approved, another agency or clinic may evaluate your history differently based on its screening requirements, although approval isn’t guaranteed.

Do Experienced Surrogates Need Another Psychological Evaluation?

Experienced surrogates may need another psychological evaluation before beginning a new journey, depending on the agency and fertility clinic’s requirements. Some programs require a full evaluation, while others may only request a mental health check-in. This typically focuses on:

• Previous Surrogacy Experience: How your last journey affected you emotionally and what you learned from the experience.
• Family and Household Support: How your partner, children and other family members handled the previous pregnancy and recovery.
• Current Circumstances: Any significant changes in your mental health, relationships or support system since your last journey.

Even if you’ve successfully completed surrogacy before, this check-in helps ensure you and your family are emotionally prepared for another experience.

How to Prepare for Your Surrogate Psychological Evaluation

Preparing for your psychological evaluation can help ease anxiety and give your evaluator a clearer picture of your emotional readiness for surrogacy. Here are a few steps you can take before your appointment:

• Gather Your Records: Have your mental health history, medication information and previous pregnancy records available to help answer questions accurately.
• Talk With Your Support System: Discuss the responsibilities of surrogacy with your partner, family or other support people so they understand how they can help.
• Consider Your Boundaries and Beliefs: Think about your preferences for communicating with intended parents and your views on termination and selective reduction. These topics will also be important when reviewing your surrogacy contract.
• Arrange Childcare: Plan for someone to watch your children so you can focus on the evaluation without distractions.
• Be Honest: Answer questions openly rather than trying to give the responses you think the evaluator wants to hear.

You don’t need to have every answer figured out beforehand. The goal is to help the evaluator understand your experiences, expectations and readiness for surrogacy.

Find an Agency That Fits Your Health History and Support Needs

Every surrogacy agency enforces its own unique pre-screening timelines, mental health criteria, medication waiting periods and ongoing surrogate support structures. Choosing an agency with experienced screening practices ensures your emotional well-being is actively protected from pre-screening through delivery and beyond.

Connect with a surrogacy professional today to discuss your medical history, learn how different agencies handle psychological screening, and match with an agency that provides the safety, compensation and support you deserve.