Medical complications during a previous pregnancy, chronic health conditions, certain medications, a BMI outside clinic limits, untreated mental health disorders, substance use and felony convictions represent the core factors that determine what disqualifies you from being a surrogate.

Because federal laws do not regulate surrogacy in the United States, qualification standards vary between surrogacy agencies and fertility clinics.

An agency establishes preliminary acceptance criteria, but the intended parents’ reproductive endocrinologist makes the final medical determination for embryo transfer.

Understanding why surrogacy agencies have strict eligibility requirements shows that clinical protocols prioritize maternal safety over administrative barriers.

Thorough pre-screening identifies health or legal risks before anyone spends months planning a match. A professional review confirms whether your personal health history meets current guidelines so you can move forward with confidence.

Undergoing an individualized surrogate eligibility assessment helps determine if you qualify before you invest significant time or emotional energy.

Standard Agency Requirements for Surrogates

The American Society for Reproductive Medicine (ASRM) establishes standard medical and ethical recommendations for surrogacy in the United States.

In the absence of federal surrogacy laws, reputable agencies follow ASRM gestational carrier guidelines to build their baseline qualifying requirements.

Evaluating surrogate medical screening vs. agency pre-screening clarifies how agencies audit initial records before fertility doctors perform clinical exams.

While specific rules vary by agency, standard preliminary requirements generally include:

• Between 21 and 40 years of age
• At least one prior uncomplicated pregnancy and delivery
• No major complications during previous pregnancies
• No felony convictions
• Currently raising at least one child in your home
• A body mass index (BMI) between 19 and 35
• No smoking, nicotine products or illicit drug use

Many applicants ask whether they can be a surrogate with a high BMI, which depends on clinic weight thresholds designed to minimize maternal risks.

A BMI outside the 19 to 35 range increases the likelihood of gestational diabetes, preeclampsia and delivery complications.

What Automatically Disqualifies You From Being a Surrogate?

Having a felony record, never having delivered a child, not raising your own child, having more than five births or three C-sections and carrying specific infectious diseases automatically disqualify you from being a surrogate.

Surrogacy professionals follow safety protocols established by ASRM surrogate recommendations and federal tissue donation standards under federal donor screening regulations.

Clinical guidelines detail automatic disqualifications for surrogacy to protect prospective carriers and embryos from preventable physical dangers.

Hard disqualifications include:

• A felony conviction on a background check for you or any adult living in your household
• No prior successful pregnancy carried to term without major complications
• Not currently raising your own child in your home
• More than three C-sections or more than five total deliveries
• A positive test result for HIV, hepatitis B or hepatitis C

These baseline exclusions are standard across reputable programs because they involve direct legal liabilities and major obstetric hazards.

Health Conditions That May Disqualify You From Being a Surrogate

Chronic illnesses, reproductive disorders and past delivery complications are common medical concerns, but many diagnoses are not automatic barriers.

Reviewing common medical conditions that disqualify you from surrogacy helps set realistic expectations before you submit an application.

A fertility clinic evaluates disease severity, recent treatments and potential pregnancy complications. Medical teams audit your records to identify medical conditions disqualifying surrogates that could put you or the pregnancy at risk.

Instead of relying on a generalized checklist, reproductive endocrinologists review your medical records individually to assess overall physical safety.

Endometriosis

Endometriosis does not automatically disqualify you, but its location and severity determine whether you can safely carry an embryo transfer.

Fertility specialists review records when evaluating endometriosis in surrogacy because endometrial tissue outside the uterus can cause severe pelvic inflammation or impair uterine receptivity.

A physician will review past operative notes to see if the condition distorted pelvic anatomy or affected prior pregnancies.

Mild cases that required minimal surgical intervention and caused no obstetric complications often pass screening, while extensive disease or uterine scarring will prevent medical clearance.

PCOS

Polycystic ovary syndrome (PCOS) rarely disqualifies you on its own because surrogates do not provide their own eggs.

Doctors review surrogacy with a PCOS diagnosis because the condition frequently presents with metabolic issues like insulin resistance, elevated BMI and hypertension.

These related conditions can increase pregnancy risks even when ovarian function is not a factor.

If your blood pressure and blood sugar are well-managed and your past pregnancies were healthy, you can still qualify.

Depression or Anxiety

A history of depression or anxiety will disqualify you if you have active symptoms, recent psychiatric hospitalizations or rely on medications unsafe for pregnancy.

Applicants frequently ask whether they can be a surrogate if taking antidepressants or other prescription medication, and reproductive endocrinologists evaluate each prescription individually.

Mental health clinicians assess candidates during screening depression and anxiety because fertility medications and pregnancy hormones create substantial emotional demands.

Women who have maintained stability on a pregnancy-safe medication for at least six to twelve months and pass a psychological evaluation can often move forward.

ADHD

An ADHD diagnosis does not disqualify you from becoming a surrogate, but the prescription medications used to manage it require careful medical evaluation.

Fertility doctors evaluate taking ADHD medication during surrogacy because most stimulant prescriptions are not cleared for pregnancy and must be discontinued before embryo transfer.

If you can safely manage daily life without stimulants, your application can proceed.

Screening also assesses whether pausing medication affects your ability to follow strict injection schedules, track appointments and maintain regular communication.

HPV

Having HPV only disqualifies you if you have an active abnormal Pap smear, untreated cervical lesions or compromised cervical tissue.

A fertility clinic assesses HPV and cervical health guidelines because prior procedures like a LEEP or cone biopsy can shorten or weaken the cervix.

Medical teams review past pathology reports to confirm structural stability.

If your Pap smear is clear and your cervix shows adequate length on an ultrasound, HPV will not prevent your approval.

Thyroid Disorders

Having a thyroid disorder will disqualify you if your hormone levels are fluctuating or uncontrolled.

Reproductive endocrinologists evaluate thyroid disease surrogate requirements because maternal thyroid levels regulate fetal brain development, while unmanaged disease raises miscarriage risks.

Doctors verify that thyroid function is steady before starting an IVF cycle.

If you take a stable dose of medication like levothyroxine and maintain normal thyroid-stimulating hormone (TSH) levels for several consecutive months, you can qualify.

Preeclampsia

A previous history of preeclampsia frequently disqualifies you from being a surrogate because the condition carries a high risk of recurring in future pregnancies.

Prospective carriers often ask whether they canbe a surrogate if they had gestational diabetes or preeclampsia, and doctors evaluate the severity and timing of past occurrences.

Medical teams review records of a preeclampsia history in prospective surrogates to determine when the condition developed, whether it caused premature delivery and whether it progressed to organ damage or HELLP syndrome.

While a mild case occurring right at delivery might receive secondary review at select clinics, early-onset or severe preeclampsia is an absolute medical disqualifier.

Herpes (HSV-1 and HSV-2)

Neither oral herpes (HSV-1) nor genital herpes (HSV-2) will automatically disqualify you from becoming a surrogate.

Doctors follow genital herpes surrogate screening guidelines because active lesions during labor can transmit the virus to the baby, creating severe newborn complications.

Oral herpes is very common and presents minimal pregnancy risk.

Taking suppressive antiviral medication in late pregnancy and delivering by cesarean section if an active outbreak occurs near delivery keeps both you and the baby safe.

C-Section History

Having more than three cesarean deliveries will disqualify you, but having one or two past C-sections does not end your eligibility.

Medical teams examine surrogate eligibility after C-sections because surgical scarring increases the risks of uterine rupture, blood loss and placental implantation disorders like placenta accreta.

Doctors review your operative reports to inspect uterine wall healing and incision types.

Most agencies and clinics accept candidates with up to three prior C-sections, while more conservative fertility clinics cap eligibility at two.

Gestational Diabetes

A history of gestational diabetes can disqualify you if your condition required insulin or caused complications during a previous pregnancy.

Physicians examine gestational diabetes surrogate health requirements because unmanaged blood sugar can lead to fetal macrosomia, birth injuries, preeclampsia and recurring gestational diabetes.

They verify how blood glucose was controlled in past pregnancies.

If your prior case was managed through diet alone and your blood sugar normalized immediately after birth, many agencies will accept your application.

Autoimmune Conditions

Active autoimmune conditions like lupus, rheumatoid arthritis, multiple sclerosis or Crohn’s disease will generally disqualify you from becoming a surrogate.

Autoimmune conditions can flare unpredictably during pregnancy, and the immunosuppressive medications used to manage them often cross the placenta and affect fetal development.

A clinic will review whether past pregnancies triggered serious medical complications.

If your condition is mild, requires no teratogenic medication and has remained in complete remission for years, a fertility clinic may evaluate your medical records individually.

Multiple Miscarriages

Experiencing two or more miscarriages can disqualify you or pause your screening until doctors investigate the underlying cause.

Fertility doctors evaluate surrogacy clearance after miscarriages because recurrent pregnancy loss can point to uterine anomalies, hormonal imbalances or blood clotting disorders.

While a single early loss followed by a full-term birth is common, multiple losses require thorough diagnostic evaluation.

If medical testing identified a treatable cause that was resolved and you went on to have an uncomplicated full-term birth, you may still qualify.

How Surrogacy Agencies Screen Prospective Surrogates

Reputable surrogacy agencies use a structured, multi-step screening sequence to identify potential health, lifestyle or legal concerns before matching occurs.

Undergoing the professional surrogate screening sequence protects prospective surrogates from avoidable health risks and confirms legal compliance.

Completing the surrogate screening process and requirements confirms that every candidate can safely carry a pregnancy before legal contracts are drafted.

The standard screening sequence includes:

1. Initial application reviewing your age, BMI, parenting history and basic health factors
2. Medical-record retrieval auditing all previous prenatal charts, labor summaries and operative reports
3. Criminal background reviews completed for you and all adult household members
4. Psychological evaluation by a licensed mental health clinician assessing emotional readiness and support systems
5. Insurance audit confirming whether your policy covers a surrogate pregnancy
6. Fertility clinic clearance conducting infectious disease panels, drug tests and a uterine exam

Completing these steps in order confirms that every party is medically, legally and emotionally prepared before moving forward into an embryo transfer.

What If You Don’t Qualify to Be a Surrogate?

A disqualification does not always mean your opportunity to become a surrogate is permanently closed, because several eligibility factors can be resolved over time.

Candidates often ask what happens if they fail surrogate screening, and the result depends on whether the disqualifying issue is temporary or permanent.

If your application was paused for an elevated BMI, a recent delivery, an unreviewed medication or an abnormal Pap smear, you can often address the concern with your physician and reapply once you meet agency criteria.

Permanent medical issues, such as severe uterine scarring or previous preeclampsia, cannot be overturned because your long-term health remains the top priority.

For women facing permanent disqualification, referral programs offer another way to support intended parents.

American Surrogacy’s referral program, for example, allows you to connect eligible friends or family members to an agency, helping families grow while earning financial compensation for each qualified referral.

Referring a qualified surrogate allows you to make a meaningful difference for intended parents even if carrying a pregnancy yourself is not medically advisable.

Find Out Whether You Meet Surrogate Requirements

You do not have to guess whether your health history or previous pregnancy complication disqualifies you based on an online checklist alone.

Many applicants wonder whether they can still be a surrogate if they do not meet one requirement, and speaking directly with a coordinator provides a definitive answer.

Look for an organization that provides upfront screening criteria, independent legal protections and full transparency about their clinical clearance process.

Getting clear answers from the start helps you understand your options and take the right next steps for you and your family.

By contacting an experienced surrogacy professional, you receive an individualized eligibility review based on your actual medical records and clinical guidelines.