Common Disqualifications for Surrogacy: The Complete List

Most women who don’t apply to become a surrogate talk themselves out of it before they’ve even seen the full picture. A past C-section, a slightly elevated BMI, a history of managed depression — they scan a requirements list, find one item that doesn’t fit, and close the tab.

The problem with that: most surrogacy agencies screen candidates using rigid checklists built by coordinators, not physicians. A checkbox says yes or no. A board-certified OB/GYN says “let me look at your specific situation.”

At Physician’s Surrogacy, every application goes to our physician team — not an automated filter. That distinction matters more than most applicants realize.

This guide covers the full list of common disqualifications for surrogacy: what’s a hard stop, what’s a case-by-case evaluation, and what steps you can take if something in your history gives you pause.

Hard Disqualifications for Surrogacy

These conditions disqualify a candidate at any reputable agency. They present medical or legal risks that cannot be safely managed within a surrogacy pregnancy.

• HIV or hepatitis B or C. These infections carry a documented risk of transmission to the baby during pregnancy or delivery. The CDC and ASRM guidelines for third-party reproduction both identify these as disqualifying in gestational carrier arrangements.
• Active substance use disorder. Current use of illegal drugs, misuse of prescription medications, or active alcohol dependency disqualifies a candidate.
• No prior pregnancies. At least one successful full-term delivery is required. Being a parent confirms your body can carry a pregnancy safely and that you understand the physical and emotional demands involved.
• Currently pregnant or recently postpartum. You can apply after full recovery from your most recent delivery — typically six months to a year out.
• Age under 20.5 or over 40.5. Our physicians set this range based on legal contract requirements at the lower end and documented obstetric risk at the upper end. For a full breakdown, see our surrogate age requirements guide.
• Severe, life-threatening pregnancy history. Uterine rupture, eclampsia (distinct from preeclampsia — see below), or a placental abruption requiring emergency hysterectomy are hard disqualifiers due to the high risk of recurrence. The American College of Obstetricians and Gynecologists (ACOG) recognizes these conditions as carrying significant recurrence risk in subsequent pregnancies.
• Active antipsychotic medication use. Active treatment for conditions such as schizophrenia or psychosis is a hard disqualifier. These medications carry known pregnancy risks, and discontinuing them is not a safe option.
• Sexually transmitted infections with transmission risk. Certain sexually transmitted infections (STIs) with documented risk of transmission to the baby during pregnancy are disqualifying.

Soft Disqualifications for Surrogacy: What Gets Evaluated Case-by-Case

These are the conditions where other agencies’ checklists say no — and where our physician review says “let’s take a closer look.” Many women who assume they’re automatically disqualified from surrogacy turn out to be strong candidates.

Prior C-sections

One or two prior C-sections rarely disqualify a candidate. Our physicians evaluate the total number, the recovery history between deliveries, and whether any complications occurred. Three C-sections places you at the ASRM guideline limit and requires careful individual review.

The key factors are uterine integrity and scar tissue — things a physician can assess, and a checklist cannot. Read more about how this is evaluated on our surrogate mother requirements page.

BMI outside the standard range

Our published application threshold is a Body Mass Index (BMI) up to 35. Candidates with a BMI between 35 and 37 may still apply — our team reviews those applications individually and can connect you with nutritional support to help reach a qualifying BMI before proceeding.

A BMI above 35 carries documented increases in gestational diabetes, preeclampsia, and cesarean delivery risk, which is why the threshold exists. The ACOG’s guidance on obesity in pregnancy outlines these risks in detail.

Our full breakdown of BMI requirements for surrogacy explains exactly how this is calculated and what your options are if you’re close to the threshold.

History of preeclampsia

Preeclampsia in a past pregnancy does not automatically disqualify you. Our physicians look at severity, gestational age at onset, resolution after delivery, and whether subsequent pregnancies were uncomplicated.

Mild preeclampsia resolved at full term is evaluated very differently than severe preeclampsia at 28 weeks. This is a clinical judgment call — not a checkbox item. ACOG’s overview of preeclampsia explains how severity and timing factor into recurrence risk assessment.

Gestational diabetes

Gestational diabetes managed through diet alone is typically not disqualifying. Gestational diabetes that required insulin or Glyburide is reviewed more carefully, given the increased likelihood of recurrence and associated risks.

Our physicians look at how it was managed, how the pregnancy resolved, and what your current metabolic health looks like. The CDC’s gestational diabetes overview provides useful context on recurrence patterns that factor into our evaluation.

Depression or anxiety with medication history

Being on antidepressants does not automatically disqualify you. Our physicians evaluate the specific medication, dosage, how long you’ve been stable, and whether the medication is compatible with IVF protocols and pregnancy.

Situational depression that has fully resolved without ongoing treatment is generally not a barrier at all. What we cannot do is ask or expect you to stop medication you genuinely need in order to apply.

Prior preterm delivery

A preterm delivery in your history requires physician review. The key question is causation — was it spontaneous with no identifiable cause, or was there a specific, non-recurring factor? Our OB/GYNs review your delivery records directly, not a summary on a form. The ACOG’s guidance on preterm labor distinguishes between spontaneous and indicated preterm births in ways that directly inform our evaluation.

Use of GLP-1 medications

Women taking GLP-1 medications such as Ozempic or Wegovy to manage BMI are a growing segment of applicants. Eligibility here depends on timing and whether you’ve been cleared off the medication well before embryo transfer. Our GLP-1 medications and surrogacy guide covers what our physicians require and what the timeline looks like.

Lifestyle Factors That Affect Surrogacy Eligibility

These aren’t medical conditions, but they factor into screening at every surrogacy agency.

• Smoking or vaping: Active smoking or vaping disqualifies a candidate. Nicotine use during pregnancy is directly linked to low birth weight, preterm labor, and developmental complications, according to the CDC. Living in a household where others smoke is also assessed.
• Alcohol use during pregnancy: Candidates must commit to full abstinence from alcohol throughout the medical process and pregnancy. According to the CDC, there is no known safe amount of alcohol use during pregnancy.
• Criminal history: Felony convictions — particularly those involving violence, fraud, or child welfare — may disqualify a candidate. Background checks are standard at every reputable agency.
• Financial instability: Candidates should be financially stable enough to support themselves without relying on surrogate compensation. This protects both the surrogate and the intended parents from a situation where financial pressure creates undue influence.
• No support system: Surrogacy requires at least one reliable person — a partner, family member, or close friend — who can provide support during the pregnancy. This is assessed during the psycho-social evaluation.
• Inability to attend appointments: Regular prenatal appointments and occasional travel for medical screening and embryo transfer are part of the process. Reliable transportation and scheduling flexibility are part of what we assess.

Psychological Disqualifications for Surrogacy

The psychological evaluation is one of the most important parts of surrogate screening — and one of the most misunderstood. It’s not designed to catch you out. It’s designed to confirm that you’re genuinely ready for what surrogacy involves.

A licensed social worker conducts a clinical interview with you and, if applicable, your partner. The evaluation covers your mental health history, your motivations for becoming a surrogate, your support system, and your emotional readiness to hand the baby to the intended parents at delivery.

Conditions that typically disqualify a candidate at this stage include:

• Active, unstable mental health conditions that are untreated or recently diagnosed
• A history of severe postpartum depression that was poorly managed
• Significant current life stressors — recent divorce, job loss, or family crisis — that suggest the timing isn’t right
• A support system that is actively opposed to the surrogacy

None of these are permanent disqualifications. “Not right now” is very different from “never.” Many women who apply after resolving a temporary stressor become excellent candidates.

What Physician’s Surrogacy Does Differently

At most agencies, a coordinator reviews your application against a printed checklist. If you don’t check every box, you receive an automated rejection.

Our physician team — Dr. Wade Schwenemann, Dr. Kim Hui, Dr. Brano Cizmar, Dr. Karen Kohatsu, and Dr. Mandhir Suri — reviews every application. They look at the full clinical picture: your specific history, your current health, and whether any flagged item represents an actual risk in your individual case.

If you’ve been turned down by another agency, that rejection was almost certainly a checklist decision, not a clinical one. Our physicians may reach a different conclusion.

How to Address Potential Disqualifications Before You Apply

If something in your history concerns you, here’s what you can do before submitting an application.

• Get your records in order. Agencies and IVF clinics will request records from your prior OB/GYN. Having those ready — especially for any complicated pregnancies — speeds up the physician review and shows you’re taking the process seriously.
• Talk to your doctor. If you have a managed health condition, ask your physician to document your current status and treatment history clearly. A note confirming stable, well-managed blood pressure or a resolved episode of depression carries real weight in our review.
• Address lifestyle factors now. If you’re currently smoking, start a cessation program. If your BMI is close to the limit, connect with a nutritionist before applying. These aren’t reasons to delay indefinitely — but they are factors you can control.
• Apply anyway. The fastest way to know whether you qualify is to submit an application. It takes about 10 minutes, and a coordinator will follow up to walk through your history. Many women who assumed they were disqualified turn out to be strong candidates once a physician has reviewed their records.

Your History Doesn’t Disqualify You — a Physician’s Review Does

A checklist is a blunt instrument. It can’t weigh severity, context, or whether a past complication is relevant to a future pregnancy. Our physician team can — and that distinction changes outcomes for a meaningful number of women who apply to us after being turned away elsewhere.

Our surrogate compensation page covers what you stand to earn once cleared — a fixed-rate package ranging from $55,000 to $75,000+ disclosed in full from day one. If you want to see what the screening process looks like from start to finish, our become a surrogate page walks through every step.

Submit your application — our physicians review every one individually.

Frequently Asked Questions About Surrogacy Disqualifications

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.