Most US surrogacy programmes look for the same core profile. You are roughly 21 to 45 years old. You have carried at least one pregnancy to term and are raising that child. Your BMI falls within a range commonly set somewhere around 19 to 32 or 33. You do not use nicotine, your home is stable and you have a support system. You are not currently relying on public financial assistance, and you are a US citizen or permanent resident. These are common ranges, not national rules. Each agency sets its own policy. A fertility clinic's physician decides medical clearance, a licensed mental health professional assesses psychological readiness, and the law of your state shapes the legal side.
If you are reading this, you are probably still deciding. You may not have told your partner, your family or anyone else yet. That is a sensible place to start, because gestational surrogacy asks a lot. It involves months of screening, a medication protocol, a pregnancy and a delivery, and recovery afterwards, all for a family that is not yours. It usually takes a year or more of your life from first application to postpartum. The requirements exist because of those demands. Knowing them early lets you judge whether this fits your body, your household and your timing before you commit to anything.
Surrogate Compass is an independent educational, qualification and matching platform for women considering becoming a gestational surrogate in the United States. It is not an agency. It explains whether you are likely to meet common criteria, how surrogate compensation is usually structured, what each stage of the process involves and how to compare programmes. It also gives state-by-state context, with the most depth on California. It connects candidates with agencies. Agencies, clinics and attorneys do the screening, matching, contracting and paying. This page is the overview, and each section points you to a more detailed guide where one exists.
On this page
- Why surrogate requirements exist, and who sets them
- Age requirements
- Prior pregnancy and birth requirements
- Health and medical requirements
- Psychological and emotional requirements
- Financial stability requirements
- Lifestyle and living situation requirements
- Legal requirements and residency
- The screening process after you apply
- What can disqualify a surrogate, and what doesn't automatically
- Surrogate requirements in California
- Your rights and protections: what to ask and confirm
- Common myths and misconceptions
- Questions to ask before you apply
- Frequently asked questions
Why Surrogate Requirements Exist, and Who Sets Them
No single authority sets the rules. Three separate layers decide whether you can become a gestational surrogate, and they do not always agree.
Clinical guidance. The American Society for Reproductive Medicine (ASRM) is the main professional body for fertility medicine in the United States. Its Practice Committee publishes recommendations on gestational carriers covering age, medical evaluation and psychological assessment. These are guidelines, not law. Clinics adopt them, adapt them and sometimes go stricter. The American College of Obstetricians and Gynecologists (ACOG) publishes guidance that supports medical screening standards and the ethical framework around a carrier's health.
Agency policy. Each agency writes its own intake criteria. One may accept a BMI of 33 and another may stop at 30. One may want your most recent birth within the last five years and another may not ask. These differences are why a "no" from one programme is not always a "no" everywhere.
State law. Surrogacy law varies widely by state. It governs whether a surrogacy contract is enforceable, how the intended parents' parentage is established, and what the contract has to contain. California has one of the most developed statutory frameworks in the country, built on the Uniform Parentage Act in California Family Code sections 7600 to 7730. Other states have different frameworks, and some jurisdictions are hostile to compensated gestational surrogacy.
The requirements protect three parties. They protect you, because a pregnancy that is medically or emotionally risky for you is a bad arrangement however willing you are. They protect the intended parents' legal standing, because a contract signed without proper counsel or eligibility can be challenged. They also protect the child.
One distinction matters throughout this page. Preliminary eligibility is not qualification. Checking your age, pregnancy history and BMI against common ranges tells you whether you look likely to meet typical criteria. Actual qualification is decided later, by an agency's screening, a clinic's medical evaluation, a mental health professional's assessment and a legal review. For a fuller breakdown of each criterion on its own, see the guide to surrogate qualifications.
Some help sits outside Surrogate Compass. It cannot give you a medical opinion on your records, which is a physician's job. It cannot advise you on a contract, which is your own attorney's job. If you are an intended parent looking for a carrier, this site is not written for you.
Age Requirements for Surrogates
The common range is 21 to 45. ASRM's guidance on gestational carriers recommends surrogates generally fall within that window. In most states this is a professional recommendation, not a legal mandate.
Why 21 is the usual floor. Anyone 18 or older can sign a contract in every US state. Agencies set the floor higher for three reasons. A surrogacy agreement is complex and long, programmes want evidence of emotional maturity, and insurance and clinic policies often assume an adult past the earliest years of independence.
Why the ceiling varies. Many agencies cap age somewhere between 38 and 45. Pregnancy risk rises with age, uterine health changes over time, and clinics weigh this against the outcomes they expect from an embryo transfer. Some agencies set their own ceiling lower, at 38 or 40. Others follow the ASRM upper bound more closely.
What age is measured. Programmes typically care about your age at embryo transfer, not your age when you apply. Screening and matching take months, so a woman who applies at 44 may be past a programme's limit by the time a transfer is scheduled. Ask each programme which date it uses.
California does not set a statutory age ceiling for surrogates beyond general contract capacity. Agencies there still apply their own floors and ceilings, so the practical limits come from programme policy and clinic judgment, not from the Family Code.
Prior Pregnancy and Birth Requirements
This is the criterion women most often misunderstand. Nearly every US programme requires that you have carried at least one pregnancy to term and that you are currently raising at least one child. Treat it as close to universal, and confirm it with any programme you consider.
Why it exists. A previous full-term pregnancy is the best evidence a clinic has that your uterus can sustain one. It also matters for consent. You have been through pregnancy and childbirth, so you know what you would be agreeing to in a way someone who has not cannot.
Why "currently parenting" matters. Most agencies want you to be raising at least one child yourself. This is partly a psychological consideration. A woman whose own family is formed and present in her life is generally seen as better placed to carry a pregnancy for someone else and separate from it at delivery.
C-section history. A prior cesarean is not automatically disqualifying. One or two are often reviewed and accepted. Three or more raise more concern, and some programmes and clinics will not proceed. That depends on how the clinic reads your uterine scar tissue and your delivery records, so there is no national number.
Previous complications. Clinics review preeclampsia, gestational diabetes and preterm labor case by case during medical screening. They look at severity, how each was managed and the risk of recurrence. A history of one does not settle the question either way. A physician reviewing your records decides.
Miscarriage. One or two prior miscarriages are not typically disqualifying on their own. Recurrent pregnancy loss is a different clinical picture and may be.
How recent your last birth was. There is no general requirement to have given birth recently. Some agencies prefer your most recent birth to be within the last five years.
Health and Medical Requirements
Medical requirements are the broadest category, and the one where a physician's judgment matters most. The fertility clinic conducts the medical evaluation, typically the intended parents' clinic, not the agency. The agency coordinates. It does not make the medical determination.
BMI. Most programmes look for a BMI somewhere around 19 to 32 or 33. Some cap at 30 and a few accept up to 34 or 35. BMI usually counts at medical screening, not at application, so you have some time if you are close to a limit. The reasons are clinical: BMI affects medication dosing, anesthesia risk and rates of pregnancy complications. The surrogate BMI requirements guide covers how the number is used and why programmes draw the line differently.
Conditions that raise pregnancy risk. Programmes generally look for no active or recent diagnosis of conditions that significantly increase risk in pregnancy. Examples include uncontrolled diabetes, uncontrolled hypertension and active autoimmune conditions that affect pregnancy. "Controlled" and "uncontrolled" carry real weight here, and the clinic decides which applies to you.
Reproductive health. The clinic examines your uterus, often by sonohysterogram or hysteroscopy, to check for anything that would prevent implantation or complicate a pregnancy.
Infectious disease testing. The screening includes a standard panel: sexually transmitted infections, HIV, and hepatitis B and C. Federal regulation is part of the reason. The FDA's rules on human cells, tissues and cellular and tissue-based products, at 21 CFR Part 1271, set donor eligibility screening and testing for reproductive cells and tissue, including embryos. Clinics also test the carrier under their own protocols and professional guidance. The exact panel is set by the clinic.
Substance use. Programmes generally require no current tobacco or nicotine use, and many want you smoke-free for 6 to 12 months first. They also require no illicit drug use and no heavy drinking. Urine and blood testing are common.
Prescription medications. Some medications are not compatible with an IVF protocol or with pregnancy. This is reviewed at medical screening, not at application. A medication is sometimes changed under a doctor's supervision, but that is a clinical decision. The protocol itself is outlined in the guide to surrogate medication requirements.
Mental health history. It is reviewed in the psychological evaluation, covered in the next section.
The medical evaluation as a whole, including records review, uterine assessment, lab work and how results are communicated, is set out step by step in the surrogate medical screening guide.
Psychological and Emotional Requirements
The psychological evaluation is a real screening step, not a formality. ASRM's guidance recommends psychological evaluation for all gestational carriers. It is usually done by a licensed mental health professional with experience in reproductive psychology.
What it looks at. The evaluator explores:
- why you want to do this
- whether you understand that you will hand the baby to its parents at birth
- who supports you
- how stable your relationship is, if you have one
- how you expect to separate emotionally from the pregnancy
The format is usually one or two sessions plus standardized assessment instruments.
Your partner's role. If you have a partner or spouse, most agencies ask them to take part. Your partner lives with the pregnancy too, and their support or doubts affect how the year goes.
History of depression or anxiety. This is not automatically disqualifying. The evaluator weighs severity, treatment and current stability. Prior trauma and grief history are explored with the same attention to context.
Pregnancy or infant loss. If you have experienced either, expect additional questions. This is not a disqualifier. Evaluators look carefully at how a new pregnancy might affect you.
How the outcome works. A blood panel gives a number. This evaluation ends in a clinical judgment by the professional conducting it, and that judgment can include recommendations as well as a yes or no.
In most agency timelines the psychological evaluation comes after the agency's own screening and before medical screening. The guide to surrogate psychological screening covers the interview, the testing and the possible outcomes in detail.
Financial Stability Requirements
This is not an income test. Programmes are not judging how much you earn. They want to see that you are financially stable and independent of public assistance.
Public assistance. Most agencies require that you are not receiving government financial assistance when you apply. That covers Medicaid (Medi-Cal in California), SNAP, TANF and housing assistance. There are two reasons. The first is ethical and legal: agencies, and the courts that review arrangements, want confidence that financial need is not driving your decision in a way that could look like coercion. The second is insurance: Medicaid and Medi-Cal typically cannot be used to cover a surrogate pregnancy.
Employment. You do not have to be employed. Stay-at-home parents become surrogates. What matters is that your household's finances are stable on their own.
Housing. Some agencies ask for proof of stable housing.
How compensation is framed. Surrogate compensation pays for your time, the physical demands of the medical process and pregnancy, and income you lose along the way. It is not payment for a baby, and that distinction has legal and ethical weight. Contracts commonly set out:
- a base compensation amount
- a monthly allowance for incidental costs
- reimbursements for specific expenses such as travel, lost wages, and childcare during appointments
- the timing of each payment
Every element varies by agency, by state, by whether you have been a surrogate before and by what your contract says. This page does not give dollar figures, because a single number would misrepresent what you personally might be offered. An agency inquiry or consultation is the place to get specifics, preferably in writing and dated.
Insurance in California. California surrogates can face different health insurance considerations from surrogates elsewhere. Your existing policy needs review for surrogacy exclusions. The California section below covers this further.