Surrogate Mother Requirements and Qualifications

You’ve thought about becoming a surrogate. You’ve done some reading. Now the real question is: do you actually qualify?

Most women who ask that question assume the answer is no before they’ve seen the full list. The truth is, surrogate mother requirements exist to protect you — not to disqualify you.

At Physician’s Surrogacy, every application gets reviewed by board-certified OB/GYNs, not just a coordinator running through a checklist. That means we evaluate candidates the way a physician would: with clinical judgment, not rigid filters alone.

Here’s what we look for, what we screen out, and why each requirement matters.

The Basic Surrogate Mother Requirements

The following are our core eligibility criteria. If you meet all of these, you’re ready to apply.

• Age: Between 20.5 and 40.5 years old
• Pregnancy history: At least one full-term, uncomplicated pregnancy and delivery
• BMI: Under 32 at the time of application; under 34 at embryo transfer
• Lifestyle: Non-smoker, alcohol-free, no recreational drug use
• Mental health: No current use of antidepressants or anti-anxiety medications
• Residency: U.S. citizen or permanent resident in a surrogacy-friendly state
• Pregnancy count: No more than six total pregnancies; no more than three C-sections
• STDs: Free from any sexually transmitted disease that poses risk during pregnancy
• Financial stability: Able to support yourself independent of surrogate compensation

These are the baseline requirements. Below, we explain the reasoning behind each one — and answer the questions we hear most often from applicants.

Age Requirements for Surrogacy

The American Society for Reproductive Medicine (ASRM) recommends a broad age window of 21 to 45 for gestational carriers. At Physician’s Surrogacy, our physicians set a tighter range: 20.5 to 40.5 years old.

The minimum reflects state contract law — most states require women to be at least 21 to enter a legally binding surrogacy agreement.

The upper limit reflects obstetric risk. Maternal age above 40 increases the likelihood of gestational diabetes, preeclampsia, and preterm delivery. Our OB/GYN team sets this threshold based on the same clinical data they use in their own practices.

For a deeper look at how age affects eligibility, see our guide to surrogate age requirements.

Prior Pregnancy Requirement

Every surrogate candidate must have given birth to at least one child and be currently raising that child. This requirement has two purposes.

First, it establishes that your body can carry a pregnancy to term and deliver without major complications. A prior uncomplicated delivery is the strongest predictor of how a future pregnancy will go.

Second, it protects your psychological well-being. In gestational surrogacy, the baby you carry is not biologically related to you — it was created from the intended parents’ or donors’ genetics.

After delivery, the baby goes home with the intended parents. Surrogates who are already parents return home to their own children, which significantly reduces the risk of attachment issues or postpartum depression.

Our post on why surrogates must already be parents explains the psychological reasoning in more detail. All candidates also complete a psychological evaluation to confirm emotional readiness.

BMI Requirements

Our BMI requirement for applicants is under 32. At the time of embryo transfer, the maximum is 34 — a small buffer to account for medication-related weight changes during the preparation cycle.

These thresholds align with ASRM guidance and the standards used by the IVF clinics we partner with. According to data published by the American Society for Reproductive Medicine, higher BMI levels correlate with increased risk of gestational diabetes, hypertension, preeclampsia, and the need for cesarean delivery. A lower BMI at the time of transfer also improves medication response and embryo implantation rates.

If your BMI is close to 32, we can connect you with a nutritionist and review your application individually. Some applicants also ask about GLP-1 medications — such as Ozempic or Wegovy — as a way to reach the BMI threshold.

This is a common question, and the answer depends on timing and medical clearance. Our guide to GLP-1 medications and surrogacy covers what our physicians look for and what you’d need to do before applying.

For a full breakdown of how BMI factors into screening, read our article on BMI requirements for surrogacy.

Mental Health and Medication Requirements

Women currently using antidepressants or anti-anxiety medications are not eligible to apply. This rule is not a judgment — it’s a clinical safeguard.

Pregnancy affects how medications metabolize, and many psychiatric medications carry pregnancy warnings. We cannot ask or expect a candidate to stop taking medication she genuinely needs. If you have a past history of situational depression that has fully resolved without ongoing treatment, that is unlikely to disqualify you. Our physicians review mental health history individually, not categorically.

All candidates complete a psycho-social evaluation with a licensed social worker. Your partner or spouse, if applicable, also participates.

Lifestyle Requirements

Surrogates must be non-smokers living in a non-smoking household, free from recreational drug use, and prepared to abstain from alcohol throughout the process and pregnancy. These are non-negotiable.

Smoking, drugs, and alcohol during pregnancy are directly linked to congenital abnormalities, low birth weight, and preterm delivery — a well-established finding across decades of obstetric research published by the Centers for Disease Control and Prevention.

Pregnancy History: What We Screen For

When you apply, we request records from your previous OB/GYN. Our physicians review your full pregnancy and delivery history to identify any past complications that could increase risk in a surrogacy pregnancy. The following histories may affect eligibility:

• Placental abruption
• Intrauterine growth restriction (IUGR)
• Preeclampsia or eclampsia
• Gestational diabetes requiring medication (insulin or Glyburide)
• Preterm delivery before 36 weeks (where the cause was not avoidable)
• HELLP syndrome
• Complete placenta previa
• Incompetent cervix
• Chronic hypertension requiring medication

Having one of these in your history doesn’t automatically disqualify you. Our OB/GYNs evaluate each case individually — something a standard agency coordinator cannot do.

That physician-level review is one of the primary differences between our agency and others. You can read more about how we screen candidates on our Physician’s Advantage page.

C-Sections

A prior C-section does not automatically disqualify you. Most candidates with one or two previous C-sections are eligible. Three or more places you at the ASRM guideline limit.

If you’ve had three prior C-sections, our physicians will review your records and make an individualized determination.

Surrogacy-Friendly State Requirement

Surrogacy law varies significantly by state. To protect both you and the intended parents, we work only in states where surrogacy contracts are legally enforceable and where pre-birth parentage orders can be obtained. This means both you and the intended parents have legal protection from the start.

States where we do not currently work include Michigan, Louisiana, and Nebraska, which restrict compensated surrogacy by statute. If you’re unsure whether your state qualifies, the fastest way to find out is to submit a short application — it instantly confirms your state eligibility.

How the Screening Process Works

Passing the basic qualifications to be a surrogate gets you into the screening process. Here’s what that involves at Physician’s Surrogacy:

1. Application — A short form covering your personal and pregnancy history. Takes about 10 minutes.
2. Coordinator call — A 30–45 minute phone interview to walk through your history and answer questions.
3. Background check — Criminal and financial screening to confirm a stable home environment.
4. Medical records review — Our OB/GYNs review records from your prior pregnancies and current health history.
5. Physical screening — Arranged near your home. Includes bloodwork, urinalysis, and physical examination.
6. Psychological evaluation — A video interview with a licensed social worker. Your partner participates if applicable.
7. IVF clinic compatibility review — We confirm you meet the specific requirements of the fertility clinic your intended parents work with.

Women who opt for our Medically Cleared Program can match with intended parents within one week. Even those who opt for the traditional route can get matched in less than a month, far faster than the industry average of six to twelve months.

That speed is a direct result of physician-led screening: our OB/GYNs move efficiently because they understand what the data actually means.

What Physician’s Surrogacy Does Differently

Most agencies screen surrogates by running candidates through a requirements checklist.

At Physician’s Surrogacy, board-certified OB/GYNs review every application. Dr. Wade Schwenemann, Dr. Kim Hui, Dr. Brano Cizmar, Dr. Karen Kohatsu, and Dr. Mandhir Suri lead our clinical team — the same type of physicians who manage high-risk pregnancies in hospital settings.

That means we sometimes approve candidates that other agencies’ checklists would reject, and we sometimes catch risks that non-medical screening misses. Both outcomes protect you.

If you’re approved, you know you’ve been cleared by physicians who’ve actually reviewed your records, not just by a coordinator who compared your BMI to a spreadsheet.

Learn more about what surrogates earn once they qualify, and see the full list of common surrogate disqualifications if you have specific concerns.

Not Sure If You Qualify?

The fastest way to find out if you meet surrogate mother requirements is to apply. Our application takes about 10 minutes and immediately flags state eligibility. From there, a coordinator will review your history and let you know where you stand — no guessing or assumptions.

Many women who assumed they didn’t qualify turn out to be strong candidates. Don’t count yourself out before a physician has had the chance to review your history.

See if you qualify — we review every application individually.

Fill Out An Application

FAQs About Surrogate Requirements

Can I be a surrogate with endometriosis?

Endometriosis affects implantation and increases miscarriage risk. It is likely to disqualify you from becoming a gestational surrogate, though severity matters. Our physicians review each case individually.

Can I be a surrogate with PCOS?

Polycystic ovary syndrome (PCOS) increases the risk of gestational diabetes, preeclampsia, and cesarean delivery, which typically disqualifies candidates. Consult your OB/GYN and apply — our team will review your specific history.

Can I be a surrogate after preeclampsia?

Preeclampsia in a previous pregnancy significantly increases the likelihood of recurrence. This does not automatically disqualify you, but it will factor heavily into our physician’s assessment. Severity, timing, and subsequent pregnancies all matter.

Can I be a surrogate if I have HIV or hepatitis B or C?

No. HIV, hepatitis B, and hepatitis C can be transmitted to the baby during pregnancy or delivery. These are hard disqualifications.

Can I be a surrogate if I’ve had gestational diabetes?

Gestational diabetes managed through diet alone is typically not disqualifying. Gestational diabetes that required medication — insulin or Glyburide — raises the risk for a repeat and will be evaluated closely.

Can I be a surrogate if I’ve never been pregnant?

No. Surrogacy requires at least one prior full-term pregnancy and delivery. This is an ASRM requirement, not just an agency preference. It confirms both physical ability and emotional readiness.

Can I be a surrogate if I’m going through menopause?

No. Menopausal women typically fall outside our age range, and pregnancy after menopause carries significant clinical risk.

Can I be a surrogate if I’m breastfeeding?

Breastfeeding suppresses ovulation and makes embryo transfer extremely difficult or impossible. You would need to stop breastfeeding and resume regular menstrual cycles before applying.

Can I be a surrogate with depression?

Women currently on antidepressant medications are not eligible. A past history of situational depression that fully resolved — with no current treatment — is reviewed individually.

How many times can I become a surrogate?

There is no fixed upper limit, but ASRM guidelines cap total pregnancies at five and C-sections at three. Our article on how many times you can be a surrogate covers repeat journey eligibility in full.