What Actually Disqualifies You from Being a Surrogate (And What Doesn’t)
What actually disqualifies you from being a surrogate?
It’s easy to rule yourself out before a clinician has looked at your history. A past C-section, a slightly elevated body mass index (BMI) or a history of depression can look like a dealbreaker on a checklist.
This guide explains what Physician’s Surrogacy requires, what rules an applicant out and what matters in pregnancy for common health conditions.
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A past C-section, depression, PCOS or another health condition raises specific questions in pregnancy. This guide explains each one, along with the baseline requirements Physician’s Surrogacy applies.
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Physician’s Surrogacy accepts applicants aged 20.5 to 38.5. Applicants with a BMI up to 37 are welcome to apply.
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At Physician’s Surrogacy, practicing OB/GYNs design the screening protocol and review applicants’ medical histories.
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The Baseline Requirements Every Surrogate Must Meet
Physician’s Surrogacy has these baseline requirements.
- Age: 20.5 to 38.5. Applicants outside this range aren’t eligible. Risks such as gestational hypertension and preterm delivery rise with age.
- Prior pregnancy and parenting. You must have had at least one full-term, uncomplicated pregnancy and delivery, and be raising at least one child of your own. Fertility clinics rely on that history to assess how your body handles pregnancy, which is why a prior pregnancy is required for surrogacy.
- BMI: applicants with a BMI up to 37 are welcome to apply.
- Residency: U.S. citizen or permanent resident living in an eligible state.
- Lifestyle: non-smoker who doesn’t use recreational drugs.
Hard Disqualifications: What Rules You Out at Physician’s Surrogacy
Physician’s Surrogacy can’t accept applicants who are outside the age range, haven’t had a prior full-term, uncomplicated pregnancy and delivery, aren’t raising a child of their own, smoke or use recreational drugs, currently take antidepressant or anti-anxiety medication, have a felony conviction, or rely on government assistance as their household’s main income.
Health Conditions and Surrogate Eligibility
For each condition below, here’s what matters in pregnancy and why.
1. C-Section History
Each cesarean leaves a scar on the uterus, and the risk of placenta accreta, where the placenta grows too deeply into the uterine wall, rises with each one. That’s the main medical concern behind surrogacy after a C-section.
2. Depression and Antidepressant History
Physician’s Surrogacy doesn’t accept applicants who are currently taking antidepressant or anti-anxiety medication. The psychological evaluation looks at your current wellbeing and support, not only your records, which matters if you have a history of depression.
3. Anxiety Disorder History
The psychological evaluation looks at your current wellbeing, your support system and your readiness for the emotional side of surrogacy. It helps to think through whether you’re emotionally ready for surrogacy before you apply.
4. ADHD and ADHD Medication
Some ADHD medications have limited safety data in pregnancy. Any change to your medication is a decision for your prescribing doctor, not a step to qualify.
5. HPV
HPV is the most common sexually transmitted infection in the U.S. What matters most in pregnancy is current cervical health, and procedures such as a loop electrosurgical excision procedure (LEEP) or a cone biopsy can affect the cervix. That’s why cervical history is the focus when people ask about being a surrogate with HPV.
6. Herpes (HSV-1 and HSV-2)
Genital herpes, from either HSV-1 or HSV-2, matters in pregnancy because the virus can pass to the baby at delivery. That’s why full disclosure matters if you’re considering becoming a surrogate with herpes.
7. PCOS (Polycystic Ovary Syndrome)
Gestational surrogacy uses the intended parents’ embryo, so PCOS’s effect on ovulation isn’t the concern. PCOS is linked to higher rates of gestational diabetes and preeclampsia, so your past pregnancies are relevant.
8. Endometriosis
Endometriosis ranges widely in severity. Because the embryo is transferred into the uterus, what matters most with endometriosis and surrogacy is the health of the uterus and its lining.
9. Uterine Fibroids
Fibroids are common, and location matters: fibroids inside the uterine cavity (submucosal) can interfere with implantation, while those in the wall or on the outside of the uterus are less likely to.
10. Preeclampsia History
Severity and timing matter: a mild episode at full term carries a different recurrence risk than severe preeclampsia early in pregnancy or HELLP syndrome (a severe form that affects the liver and blood clotting), as ACOG’s preeclampsia guidance explains.
11. Gestational Diabetes History
Gestational diabetes is more likely to return in a later pregnancy, so how it was managed and whether it recurred are relevant.
12. Thyroid Disorders (Hypothyroidism and Hyperthyroidism)
Unmanaged thyroid disease is linked to preterm delivery and high blood pressure in pregnancy, which is why stable thyroid levels matter.
13. Autoimmune Conditions (Lupus, Rheumatoid Arthritis, Hashimoto’s)
Autoimmune conditions vary widely. Whether the condition is active and whether your medications are safe in pregnancy both matter.
14. Chronic Hypertension
Chronic high blood pressure raises the risk of preeclampsia, growth restriction and placental abruption, so how well it’s controlled matters.
15. Prior Preterm Delivery
The cause matters: spontaneous preterm labor is assessed differently from an early delivery prompted by a specific medical reason, as ACOG guidance explains.
16. Multiple Miscarriages
ASRM defines recurrent pregnancy loss as two or more spontaneous pregnancy losses, not counting ectopic or molar pregnancies. Physicians look for an identifiable cause.
17. Blood Clotting Disorders (Thrombophilia)
Blood-clotting disorders include inherited conditions such as Factor V Leiden and acquired conditions such as antiphospholipid syndrome. They can raise the risk of complications in pregnancy, especially if a past pregnancy involved clotting problems.
18. GLP-1 Medications (Ozempic, Wegovy, Mounjaro)
If you take a GLP-1 medication, tell the screening team. Stopping times differ by drug; semaglutide’s labeling, for example, advises stopping at least two months before a planned pregnancy. Your prescribing doctor advises on the medication itself, and the fertility team sets its own requirements before transfer.
19. Tubal Ligation (Tubes Tied)
If you’ve had your tubes tied, embryo transfer isn’t affected: the embryo is placed directly into the uterus, so the fallopian tubes aren’t involved.
20. Tattoos and Recent Piercings
Recent tattoos and piercings carry a small risk of bloodborne infection, so be ready to share when you had them.
The Physician’s Difference
Physician-Designed Screening
At Physician’s Surrogacy, practicing OB/GYNs design the screening protocol, review applicants’ medical histories and consult with your delivering OB during the pregnancy. That’s the core of our physician-led approach to surrogacy.
About 8% of more than 10,000 applicants a year pass our physician-designed screening.
Our preterm delivery rate was 50% lower than the U.S. national average (PS data, 2022).
Qualifying candidates can complete medical clearance before matching through our Medically Cleared Program. Participation requires working exclusively with PS’s partner clinic.
Lifestyle Factors That Affect Eligibility
These aren’t medical conditions, but they affect eligibility too, and some can change before you apply.
- Smoking or vaping. The CDC links nicotine use in pregnancy to preterm birth, low birth weight and placental complications.
- Alcohol. Per CDC guidance, there is no known safe level of alcohol during pregnancy.
- Criminal history. Applicants must pass a standard background check. Felony convictions are disqualifying.
- Financial stability. Candidates must be financially stable without depending on surrogate compensation for basic living expenses, and not relying on government assistance as the household’s main income.
- Support system. A reliable support person matters throughout surrogacy, and the psychological evaluation looks at your support system.
Psychological Disqualifications: What the Evaluation Actually Looks For
The psychological evaluation isn’t designed to catch you out. It’s designed to confirm you’re prepared for what surrogacy involves.
A licensed psychologist conducts a clinical interview with you and, if applicable, your partner. The evaluation covers your mental health history, motivations, support system and emotional readiness to hand the baby to the intended parents at delivery.
The evaluation can show that now isn’t the right time, for example during a major life change. Timing can change, and you can apply again later, though that doesn’t guarantee acceptance.
What to Do If Something in Your History Concerns You
- Keep your records handy. If you have records from past pregnancies, keep them handy. The team will tell you what’s needed after you apply.
- Talk to your doctor first. If you have a managed condition, ask your physician to document your current status clearly.
- Address what you can. If you’re currently smoking, start a cessation program. If your BMI is near the limit, connect with a nutritionist.
- Apply and disclose fully. The fastest way to know if you qualify is to apply. Leaving information out doesn’t help: your records contain what they contain, and honest disclosure is always the right call.
What Disqualifies You from Being a Surrogate, and What Doesn’t
A checklist can’t weigh severity, context or whether a past complication is relevant to a future pregnancy. That takes clinical judgment.
Clinical judgment works alongside the requirements every surrogate must meet [link only after C2 is fixed], and it continues through each step of the surrogate screening process after you apply.
Surrogacy sits at the intersection of medical science and one of the most generous decisions a person can make. The women who pursue it deserve a process that takes their health seriously from the first contact.
Questions about your medical history are answered when your history is reviewed, not by more research.
Physician’s Surrogacy is the only physician-led surrogacy program in the U.S. managed by practicing OB/GYNs.
First-time compensation starts at $60,000 to $75,000+, depending on your state, and a $1,250 bonus is paid when you complete pre-screening, before matching.
Frequently Asked Questions About Surrogate Disqualifications
What automatically disqualifies you from being a surrogate? +
Physician’s Surrogacy can’t accept applicants who are outside the age range, haven’t had a prior full-term, uncomplicated pregnancy and delivery, aren’t raising a child of their own, smoke or use recreational drugs, currently take antidepressant or anti-anxiety medication, have a felony conviction, or rely on government assistance as their household’s main income.
Can I reapply after being disqualified from surrogacy? +
Some reasons are about timing, such as BMI or a recent life stressor, and you can apply again once things change. A new application doesn’t guarantee acceptance.
Julianna Nikolic
Chief Strategy Officer Julianna Nikolic leads strategic initiatives, focusing on growth, innovation, and patient-centered solutions in the reproductive sciences sector. With 26+ years of management experience and a strong entrepreneurial background, she brings deep expertise to advancing reproductive healthcare.
