California Surrogate Screening: What the Process Actually Involves

California surrogate screening has four separate tracks. A fertility clinic runs the medical evaluation. A licensed mental health professional runs the psychological evaluation. An agency runs background and household checks. Then independent attorneys review the contract. Each track has its own decision-maker, and the criteria vary between programmes. From application to clearance for an embryo transfer commonly takes three to six months.

You may be reading this before you have told anyone. That makes sense. Screening asks a lot: your medical records, your mental health history, your household, and a year or more of your time. It helps to know what each step looks at, and why, before you decide whether to apply.

Surrogate Compass is an independent platform for women considering gestational surrogacy. It explains eligibility, compensation, the process and how to choose a programme, and it connects candidates with agencies. It does not screen, match, contract with or pay anyone. Agencies, clinics and attorneys do that.

What Surrogate Screening Is and Why It Exists

Screening is not one test or one interview. It is a series of evaluations run by different professionals, and you move through them over several months.

No single party sets the standard. The rules come from four sources. The American Society for Reproductive Medicine (ASRM) publishes professional guidance. The fertility clinic sets its own medical protocol. The agency sets its own application policies. Legal counsel handles the contract. California law does not set out a medical or psychological screening checklist. Clinics and agencies in California generally work from ASRM practice guidance instead.

This page is about gestational surrogacy. In gestational surrogacy the embryo is created from the intended parents' or donors' egg and sperm, so you have no genetic link to the child. Traditional surrogacy uses the surrogate's own egg. California courts and agencies treat the two very differently, and most programmes work only with gestational arrangements.

The standards protect several people at once. They protect your health, because the clinic is checking whether a pregnancy is likely to be safe for you. They protect the intended parents, who are making a large financial and emotional commitment. They also protect the legal integrity of the arrangement, so the child's parentage is clear at birth.

The Medical Screening Component

The fertility clinic does the medical screening, not the agency. A reproductive endocrinologist reviews your records and examines you. Some clinics accept a surrogate the agency has already approved and some decline her, so agency approval does not guarantee medical clearance. The surrogate medical screening page walks through the appointment in more detail.

Uterine evaluation. The clinic checks the inside of your uterus, usually with a hysteroscopy or a sonohysterogram. It is looking for polyps, fibroids, scarring or other changes that could affect implantation or pregnancy.

Infectious disease panel. The federal rules in 21 CFR Part 1271 set communicable disease testing requirements for donors of human cells and tissue. Fertility clinics build their panel on that framework. It covers HIV, hepatitis B, hepatitis C, syphilis, gonorrhea and chlamydia. These are federal rules, not a California-specific requirement. If you have a partner, the clinic usually tests your partner as well.

General bloodwork. The clinic usually runs a complete blood count, a metabolic panel and thyroid function tests.

BMI. Many clinics look for a BMI somewhere in a range commonly cited as 19 to 33. Some clinics are stricter and some go higher. A candidate outside a clinic's range may be declined at that clinic's discretion.

Obstetric history. The clinic wants to see prior deliveries without major complications. Those deliveries can be vaginal or cesarean. Preterm labor, placenta previa and other significant complications get close attention. A physician reads your records in context. The clinic does not apply a single list.

Nicotine and substances. Expect testing for nicotine and drugs.

The clinic issues medical clearance. No one else can.

The Psychological Evaluation

A licensed mental health professional conducts this evaluation. That may be a psychologist, an LMFT or an LCSW, usually one with experience in third-party reproduction. ASRM recommends psychological evaluation for all gestational carriers. That recommendation is professional guidance, not a California statute.

The evaluation usually combines a clinical interview with a standardised test such as the MMPI-2 or the PAI. The evaluator looks at:

• why you want to do this
• whether you understand that the baby goes home with the intended parents
• who supports you day to day
• your mental health treatment history
• how stable your relationship is

A past history of depression or anxiety does not automatically rule you out. Evaluators look at how you are doing now, what treatment you have had, and how stable you have been.

If you are partnered, your spouse or partner is usually part of the evaluation. The evaluator writes a report, and the clinic and agency review it. You do not control whether that report is shared with them. The surrogate psychological screening page covers the testing in more depth.

This evaluation is separate from ongoing counselling. Many programmes require counselling, or strongly encourage it, during the pregnancy. Ask each programme what it offers and who pays for it.

Background and Home Study Checks

Criminal records. Agencies run a criminal background check on you and on every adult in your household. Felony convictions, especially for violence, child abuse or drug offences, are typically disqualifying. Some misdemeanours are reviewed case by case, depending on what the offence was and how long ago it happened. The surrogate background checks page explains what records are searched.

Your living situation. Not every agency does a formal home study. Most do review your housing, who lives with you, and how stable things are. California does not require an adoption-style home study for gestational surrogacy. Any home review comes from the agency's own policy.

Finances. Many agencies decline candidates who currently receive means-tested public assistance, such as Medi-Cal or SNAP. This is agency policy, not California law. The concern is that surrogacy compensation could affect your eligibility for those benefits. Policies differ between programmes, so ask each programme directly.

Legal Screening and the Surrogacy Contract

California Family Code § 7960 et seq. is the statutory framework for gestational surrogacy agreements. It requires a written agreement. It also requires that you and the intended parents each have independent legal representation before the agreement is signed. You cannot use the intended parents' attorney.

The intended parents' attorney usually drafts the contract. Your own attorney reviews it for you and negotiates on your behalf. The contract sets out several things:

• your compensation and allowances, which vary by programme
• what is reimbursed
• how insurance is handled
• what happens if complications arise

Each of these is negotiated. Your attorney is the person to explain what your specific draft says.

Legal screening is not designed to disqualify you. Its job is to make sure you give informed consent and that the agreement can be enforced.

The agreement also matters for parentage. A pre-birth order is a court order, obtained before delivery, that places the intended parents on the birth certificate. A valid, fully signed surrogacy agreement is a prerequisite for seeking one. California is widely regarded as one of the more established states for gestational surrogacy, because its Family Code addresses these agreements directly. Pre-birth orders are commonly sought there for married and unmarried intended parents, including same-sex couples. Your attorney can confirm how this applies to your arrangement.

Legal clearance is separate from medical and psychological clearance. All three must be complete before a transfer cycle begins.

Agency Screening vs. Clinic Screening: Who Decides What

The agency handles your application, background check, home and financial review, and initial interview. If you pass, it may give a preliminary approval to move toward matching. That approval is not medical clearance.

The clinic handles the medical evaluation, infectious disease testing and uterine assessment. It issues medical clearance.

The psychological evaluation is often arranged by the agency. An independent professional conducts it, and the clinic reviews the report.

Legal review comes after medical and psychological clearance and before transfer.

Because these are separate tracks, you can pass agency screening and still be declined by a clinic. The reverse can also happen. The intended parents may also have their own preferences that affect matching, apart from any formal criteria.

Many California agencies work with several fertility clinics, and those clinics may set different criteria. So the same applicant can meet one clinic's standards and not another's. The surrogate qualifications page sets out the common ranges and how much they vary.

Common Reasons Applications Are Declined

The most common reasons are below. None of them is a universal rule. Each one is a judgment made by a particular programme or physician.

Medical findings: - a uterine abnormality found during hysteroscopy or sonohysterogram - a BMI outside that clinic's range - no prior live birth, or no prior pregnancy without significant complications - active nicotine use (most clinics require you to have stopped for a set period before transfer) - certain medications, particularly antidepressants or antipsychotics, which may trigger extra review or may be disqualifying at some clinics

Agency findings: - financial instability, or current receipt of means-tested benefits - criminal history involving violence, child welfare or controlled substances - a partner who declines to take part in screening (most agencies will not proceed without the partner)

Psychological findings: - unresolved grief - ambivalence about handing over the baby - too little support at home

A decline at one agency or clinic is not a decline everywhere. Criteria differ, and some women who are declined by one programme are accepted by another.

How Long Screening Takes in California

Here is how long each step typically takes:

Scheduling the medical appointment depends on the clinic's availability. Clinics in major metro areas such as Los Angeles, the San Francisco Bay Area and San Diego may be able to schedule sooner than clinics in less populated parts of California.

The steps do not all run at the same time. Medical clearance usually comes before the contract is signed. From application to transfer clearance, the process commonly takes three to six months, but individual timelines vary a great deal. The surrogate application process page shows how screening fits into the full sequence.

What ASRM Guidelines Say About Gestational Carrier Screening

ASRM guidance is the professional standard. It is not law. The criteria clinics most often draw from it are:

• an age range typically given as 21 to 45, though many clinics set a narrower range
• at least one prior live birth
• having completed your own childbearing
• a psychological evaluation
• a medical evaluation, including a uterine assessment and infectious disease testing

ASRM also recommends independent legal counsel for gestational carriers. That matches what the California Family Code requires.

California clinics are not legally required to follow ASRM. In practice, accreditation and professional norms mean clinics generally work from it. ASRM revises its guidance from time to time, so the current version on asrm.org is the one to rely on.

Keep the two sources of authority separate. ASRM shapes the medical and psychological criteria. California law governs the contract and parentage.

Screening When Working Without an Agency

Some surrogates and intended parents go ahead without a full-service agency. This is often called independent or identified surrogacy. It usually happens when the people already know each other.

Without an agency, the parties have to organise every part of screening themselves:

• medical screening through a fertility clinic
• the psychological evaluation
• separate attorneys for each side

California law still requires independent legal counsel for both sides, whether or not an agency is involved. The parties also take on the scheduling, choosing and checking providers, and making sure every step is actually done.

Independent arrangements are permitted in California, but they carry more coordination risk. A missed screening step can delay the process or cause problems when the pre-birth order is sought. Some California fertility clinics will not work with independent arrangements and require an agency to be involved. That is clinic policy, not a legal requirement.

Next Step: A Free Eligibility Review

If you want a clearer read on your own situation, Surrogate Compass offers a free eligibility review with no obligation. The review looks at your age, your pregnancy and delivery history, your BMI and household situation, and the other criteria programmes commonly use. It shows whether your situation looks likely to meet those common criteria. It is not approval. Agencies and clinics run their own screening, and a physician decides on medical clearance.

What a surrogate may be entitled to varies by programme and by the specific terms negotiated, so the surrogacy agreement and independent legal counsel are the right places to confirm those details.

When you are ready, contact Surrogate Compass to request your free eligibility review. There is no deadline, and you can come back whenever it suits you.