The surrogate application process is the series of reviews that runs from your first form to a signed contract, before any embryo transfer. It usually moves through six stages: an initial application, an agency interview and background check, medical screening at a fertility clinic, a psychological evaluation, legal review of the contract, and matching with intended parents. The order can shift between programmes. As a rough estimate, the whole sequence commonly takes 6 to 12 months when nothing needs re-checking, and longer when something does.
You may be reading this privately, before you have said anything to a partner or family. You want to know what you would actually be agreeing to, step by step, before you agree to anything. This page sets that out, including the parts that are slow, uncertain or physically demanding.
Surrogate Compass is an independent platform. We help you understand the process and connect you with agencies. We do not screen, match, contract with or pay surrogates. Agencies, fertility clinics, mental health professionals and attorneys do that, and each makes its own decisions.
Before You Apply: What Agencies and Clinics Look For
Agencies publish their criteria so you can judge whether an application is worth your time. The criteria below are common practice, not national rules. Programmes differ, and a physician makes the final medical call. For more on how each criterion is weighed, see our guide to surrogate qualifications.
- Age. Many agencies accept candidates roughly 21 to 40. Some go up to 42.
- A prior pregnancy and a child in your care. Most programmes look for at least one full-term pregnancy and for you to be parenting a child now. A previous pregnancy gives the clinic evidence of how your body carries. Raising a child also shows that you understand what you would be handing over.
- BMI. This is a medical screening factor, not a fixed national number. A figure in the low 30s is a common reference point. Each fertility clinic sets its own threshold, and some are more flexible than others.
- No nicotine. Programmes commonly require that you have not smoked, vaped or used other nicotine for a set period. That period varies.
- Mental health history. The concern is any history that would affect your ability to carry a pregnancy or relinquish a baby safely. A past diagnosis is not a blanket exclusion. Treatment, stability and timing are all considered.
- Financial stability. You do not need to be well off. Agencies generally look for a household that does not depend on surrogacy payments as its main income. Payments follow a contract schedule and can be paused or changed by medical events. A household that relies on them could be put under strain, and that pressure could shape decisions that ought to be made freely.
- US residency. Your state of residence matters because surrogacy law varies widely between states. Some states are hostile to compensated gestational surrogacy.
Meeting these criteria does not mean you are approved. It means a full application is likely to be worth completing.
Step 1: Completing the Initial Application
The first form is about your history, not your commitment. It typically asks about:
- your personal details and health history
- each pregnancy and birth, including delivery method and any complications
- lifestyle: nicotine, alcohol, medications, travel
- your household, including your partner and the other adults who live with you
Agencies take two common approaches. Some start with a short online pre-screen of a few questions, then send a full application if your answers fit their criteria. Others go straight to a long application. Either way, the agency checks your answers against its own baseline criteria.
How long it takes: many agencies respond within a few business days to a week. This is an estimate, and busy periods take longer.
You commit to nothing by submitting an application. It is a screening step, not acceptance. Some applicants are declined here, usually because an answer falls outside the agency's baseline criteria. Common reasons include age, BMI, recent nicotine use or no prior full-term pregnancy. Another agency or clinic may draw its lines differently.
Step 2: The Agency Interview and Background Review
A coordinator usually calls or schedules a video interview next. The aim is to understand your history and your reasons in more depth than a form allows. Questions commonly cover:
- why you are considering surrogacy
- who would support you at home, practically and emotionally
- what you already understand about the process and its demands
- how your previous pregnancies and deliveries went
Background checks are usually run by a screening company the agency hires. They commonly cover criminal records and child protective services registries, and often financial history as well. Many agencies check every adult in your home, not only you. Certain convictions, particularly violent or child-related offences, commonly lead to a decline. How other records are treated varies by agency. Our page on surrogate background checks goes into the detail.
Home visits are not universal at this stage. Some agencies arrange a home study early, some do it later, and some do not do one at all. References may also be requested.
This interview runs both ways. It is a chance for you to ask the agency how it supports surrogates, how it handles disputes, and how long it has been operating.
Outcome: the agency either moves your application forward or declines it. Agencies usually give a reason when they decline.
Step 3: Medical Screening
Medical screening is carried out by a fertility clinic, usually the intended parents' IVF clinic and its reproductive endocrinologist. The agency does not do it. The clinic makes an independent medical determination, and the agency cannot override it.
It is more involved than a routine check-up. Typical components include:
- Review of your obstetric records. Records from your prior pregnancies and deliveries will be requested from your OB or the hospital.
- A physical exam, often including a transvaginal ultrasound.
- A uterine evaluation. This is often a saline sonogram, in which fluid is passed into the uterus during an ultrasound so the lining and cavity can be seen. Some clinics perform a hysteroscopy, which uses a thin camera inserted through the cervix.
- Bloodwork. This usually includes an infectious disease panel and hormone levels, and sometimes drug screening. Your partner may be asked for infectious disease testing too.
Common reasons a clinic may not clear a candidate include uterine abnormalities, certain infectious disease results, and prior pregnancy complications that the physician judges would create too much risk. None of these is decided by a fixed list. The physician reviews your records as a whole. Our guide to surrogate medical screening covers each test in more detail.
How long it takes: an estimated 2 to 6 weeks to schedule and complete, depending on clinic availability and how quickly your records arrive.
Where it sits: many agencies aim to have medical clearance in place before a match is finalised. In some workflows, a provisional match comes first and the intended parents' clinic screens you afterwards. Ask your agency which order it uses.