Surrogate qualifications usually cover six areas: age, a prior full-term pregnancy, physical health, mental health, financial stability and home life. Most programmes look for women roughly 21 to 45 who have given birth and are raising a child, with a BMI somewhere in the 19 to 32 range. Standards differ between agencies and clinics, and a physician reviewing your records makes the medical decision.
Many women start here quietly. They have not told a partner or a friend yet, and they want to know whether the idea is realistic before they spend more time or feeling on it. That is a sensible order to do things in. This page lays out what screening looks at and why, so you can see which parts are firm, which parts vary, and which parts only a doctor can answer.
Surrogate Compass is an independent platform for women considering gestational surrogacy in the US. We explain eligibility, pay and process from the surrogate's side and connect candidates with agencies. We do not screen, match, contract with or pay anyone. Agencies and clinics do that, and their decisions are the ones that count.
Why Surrogate Qualifications Exist, and Who Sets Them
Three groups shape the criteria you will meet.
The first is the American Society for Reproductive Medicine (ASRM). It publishes clinical guidance for gestational carriers that most US fertility clinics follow. That guidance is the closest thing to a national standard, but it is a set of professional recommendations, not federal law.
The second is the agency. Agencies often add their own criteria on top of the ASRM baseline: a lower age ceiling, a tighter BMI range, rules about public assistance or household smoking. Two agencies can look at the same woman and reach different preliminary answers.
The third is the fertility clinic that performs the medical screening and the embryo transfer. Its physician makes the final call on whether your body is medically suitable. An agency cannot override that decision.
The reasons behind the rules are mostly about your health. Pregnancy places real demands on the body, and IVF adds medications and procedures on top. Criteria that look like gatekeeping are usually an attempt to screen out situations where carrying a pregnancy would put you at higher risk. Some criteria also protect the legal soundness of the arrangement, so that everyone's rights are clear before a transfer happens.
Location matters for the legal side, not the medical one. California, where this site goes deepest, has a statute that specifically governs gestational surrogacy contracts. That legal structure does not change the medical baseline. A clinic in California applies the same health considerations as a clinic anywhere else.
One distinction runs through everything below. Meeting an agency's checklist is preliminary eligibility. It is not qualification. Medical and psychological screening come later, are carried out by independent professionals, and can reach a different conclusion.
Age and Prior Pregnancy Requirements
ASRM guidance recommends that gestational carriers be between 21 and 45. Many agencies set a lower upper limit, commonly 40 or 42. Some clinics look more closely at candidates near the top of their range. The lower limit reflects maturity and informed consent as much as biology.
A prior pregnancy carried to term with a live birth is one of the most consistent requirements across programmes, and ASRM guidance supports it. It does two jobs. Medically, it shows that your uterus has carried a pregnancy to term. Personally, it means you know what pregnancy, labour and the weeks afterwards actually feel like.
That second reason is the one most programmes treat as non-negotiable. A woman who has never given birth cannot fully anticipate the physical demands, or what it is like to hand over a baby she carried. Because of that, programmes do not accept women who have not yet had a child of their own. This is treated as a medical and ethical standard rather than a preference, and it is rare to find an exception.
Most agencies also want you to be currently parenting at least one child. That child does not need to be in your sole custody. The point is that you have lived through pregnancy, birth and early parenting, not to audit your family arrangements.
Physical Health and Medical Screening
The medical evaluation is the most detailed part of qualification and usually the most decisive. Here is what it commonly covers.
BMI. Most clinics look for a BMI between about 19 and 32, and some extend to 33 or 34. A few cap at 30. The threshold is clinical, not aesthetic: BMI affects how IVF medications work, the chance of a successful transfer and the risk of complications such as gestational diabetes and high blood pressure. Our page on surrogate BMI requirements explains the ranges in more detail.
Chronic conditions. Conditions that could complicate pregnancy are reviewed closely. Examples include uncontrolled diabetes, hypertension, autoimmune disorders and clotting disorders. The word "uncontrolled" matters. How well a condition is managed, and what your specialist's records show, is part of what the clinic weighs.
Uterine health. The clinic examines your uterine cavity, usually with a saline sonogram or a hysteroscopy, to confirm it is structurally suitable for embryo transfer.
Infectious disease testing. You will have a panel for sexually transmitted infections and other communicable diseases. Federal FDA rules on human cells and tissues, set out in 21 CFR Part 1271, govern infectious disease screening in third-party reproduction, which is why this testing is standardised rather than optional.
Nicotine. Most agencies require a nicotine-free period, commonly 6 to 12 months. Vaping and other nicotine products are treated the same as cigarettes.
Medications. Some medications are incompatible with IVF protocols or pregnancy. Whether yours is one of them, and whether a safe alternative exists, is a question for the clinic and your own prescriber. Stopping a medication on your own to become eligible is not something a clinic expects or wants.
Prior C-sections. Many clinics set a limit, often two or three cesarean deliveries, because of scar tissue and the risk it poses in a later pregnancy. How the scar has healed and how close together the births were also count.
Prior complications. Preeclampsia, gestational diabetes and preterm labour in a previous pregnancy do not automatically disqualify you. They are reviewed case by case. A clinic typically looks at how severe the complication was, when it appeared, how it was treated and how your later pregnancies went. The answer depends on a physician reading your records.
The medical screening page walks through the appointments, tests and timing.