SURROGATE SCREENING PROCESS: TESTS, TIMELINES, AND APPROVAL TIPS

If you are thinking of becoming a surrogate, understanding what happens during the screening process can help you decide whether to move forward. The process takes a close look at your health, pregnancy history, emotional readiness, and lifestyle. At Growing Generations, it determines whether you meet the medical and psychological criteria to be cleared to carry. Knowing what to expect helps you determine whether becoming  a surrogate is the right path for you.

What Is Surrogate Screening?

Surrogate screening is a structured evaluation that helps determine whether you are physically and emotionally prepared to become a surrogate. It often begins with an application and medical record review before progressing to psychological evaluation and other assessments, then clinic appointments and laboratory testing. This may also include a review of your lifestyle, financial stability, criminal history, insurance options, and your overall support system.

Screening requirements vary depending on the agency and the medical protocols. Although the process may feel extensive, the goal remains the same: to support a safe and successful surrogacy outcome for both you, the intended parents, and the baby.

Why Medical Screening Matters in Surrogacy

Pregnancy and fertility treatment place real demands on your body. Medical screening helps determine whether your health, pregnancy history, and current circumstances support a safe pregnancy. Even if you have carried a child before, a surrogate pregnancy begins through IVF and may involve medications, monitoring appointments, travel, and an embryo transfer.

A Maternal-Fetal Medicine specialist reviews your records and test results to identify factors that could affect treatment, pregnancy, or delivery, followed by the IVF clinic. The medical review also helps the fertility clinic and intended parents make informed decisions before treatment begins. It allows the clinic to explain the IVF protocol, possible risks, appointment expectations, and any precautions that may apply to you. The American Society of Reproductive Medicine recommends that prospective surrogates receive counseling about uterine preparation, embryo transfer, and hormone support before moving forward.

Screening also establishes expectations before matching and treatment. You should understand the medical commitment, responsibilities, and decisions that may arise during pregnancy.

Eligibility and Preliminary Surrogate Requirements

Before formal medical screening begins, Growing Generations completes an initial eligibility review. Meeting an agency’s preliminary surrogate requirements does not guarantee medical clearance. At Growing Generations, potential surrogates need to meet our minimum requirements before undergoing our extensive screening process.

Age Requirements

According to ASRM guidelines, agencies usually recommend surrogates between the ages of 21 and 45. Age ranges between agencies may vary. Some may use narrower age ranges. Growing Generations, for example, requires surrogates to be between 21-38 years old.

Previous Healthy Pregnancy History

You need to have completed at least one healthy pregnancy and delivery before becoming a surrogate. Your care team will review those records to better understand how your body responded to pregnancy, labor, and recovery. 

Limited Pregnancy and C-Section History

Your agency reviews your total number of deliveries, Cesarean sections, and any previous pregnancy complications. Previous complications may influence your eligibility. ASRM recommends no more than five prior deliveries or three Cesarean deliveries. Growing Generations uses a stricter standard: no more than five deliveries and two Cesarean sections at the time of application. 

BMI and General Health Requirements

Surrogacy agencies review your BMI, blood pressure, medications, health conditions, and other factors that may affect fertility treatment or pregnancy. We currently require a BMI below 32, although other programs may use different limits.

Non-Smoking and Substance-Free Requirements

Smoking, recreational drug use, and other restricted substances may affect your eligibility. Surrogacy agencies require you to avoid tobacco and secondhand smoke before applying and include substance testing during screening.

Financial Stability Requirements

Growing Generations works with women who are financially stable, whether through their own employment or a partner's, and are not pursuing surrogacy out of financial need. 88% of our surrogates are working professionals, though personal employment isn't a requirement. This ensures that you can make decisions based on your health and readiness rather than immediate financial pressure.

Background and Legal Requirements

Growing Generations conducts criminal background checks on you and your partner, if applicable, and reviews legal factors that could affect your eligibility. This includes your citizenship status, state of residence and eligibility under local surrogacy laws. Legal requirements may vary depending on your location.

Emotional Readiness Requirements

Your agency will consider your motivations, coping skills, expectations, and emotional support early in the screening process. A qualified counselor will evaluate your, and your partner's if applicable, emotional readiness as a surrogate. Growing Generations also draws on a proprietary screening, support, and monitoring process developed by Dr. Kim Bergman to support you throughout the process.

Partner and Family Support Considerations

Your decision to become a surrogate will affect your household. It is recommended to have a stable home environment and adequate support. Your family does not need to understand every medical detail. However, the people closest to you should respect your decision and understand how they may need to support you. A reliable support system can make your surrogacy experience feel more manageable, and is required — without one, you will not be able to move forward as a surrogate.

Surrogate Medical Screening Timeline

Surrogate screening does not happen during one appointment. You will move through several stages, and each stage may involve different professionals.

Initial qualification: You begin by answering questions about your age, pregnancy history, health, location, lifestyle, and other basic requirements.

Application and consultation: If you meet the initial criteria, you complete a detailed application and speak with a Surrogate Specialist. This conversation gives you an overview of the process and time to ask questions.

Medical record review: Growing Generations orders your prenatal and delivery records and pap results. A Maternal-Fetal Medicine specialist then reviews them and speaks with you directly, using records from previous pregnancies, deliveries, surgeries, and other relevant medical care. 

Psychological and personal screening: Background, financial, and lifestyle reviews happen first. You, and your partner if applicable, then complete a psychological evaluation.

Medical examination: Clinic staff, which may include a nurse or reproductive endocrinologist, reviews your records and completes the required medical evaluation. Your appointment may include a physical exam, pelvic exam, blood draw, urine testing, and uterine cavity evaluation.

Follow-up and clearance: Your agency reviews your results and may request additional records, repeat testing, treatment, or specialist clearance. 

Timelines vary based on clinical processes, agency protocols, and individual circumstances. Record delays, appointment availability, or follow-up testing may be some factors that affect it.

Tips to Improve Your Chances of Screening Approval

Medical clearance cannot be guaranteed. You can support the process by being honest, prepared, and informed. Here are some helpful tips for improving your chances of approval:

Care for your health. Follow healthy daily habits, attend routine medical appointments, and take prescriptions as directed. Ask your healthcare provider before changing a medication or supplement.

Gather records early. Make a list of your obstetricians, delivery hospitals, surgeries, pregnancies, and postpartum care. Complete authorization forms promptly so the agency can receive your records.

Follow clinic instructions. Read appointment details carefully. Some tests may require fasting, a full bladder, specific menstrual cycle timing, or temporary activity restrictions. When in doubt, ask your clinic questions.

Communicate openly. Share accurate information about your medical history, mental health, medications, substance use, pregnancy experiences, and current stressors. Complete information allows your team to make a safe decision; non-disclosure of information can delay or affect your ability to move forward.

Keep the full review in perspective. Approval depends on several medical, psychological, lifestyle, and program-specific factors. One result may require follow-up without determining the final outcome.

The goal is not to appear perfect but to give your care team a clear and honest picture of your readiness.

Common Reasons for Disqualification

Screening decisions are based on medical and program criteria, not on you as a candidate. Your application may be declined because of certain factors such as:

• Age outside of 21 to 38

• Body Mass Index (BMI) Above 32

• Delivery History

• Pregnancy History

• Cervical Condition

• Use of Tobacco, Recreational Drugs, or Heavy Alcohol

• Well-being Concerns

• Financial or Housing Instability

• State of Residency

• Criminal History (surrogate or partner)

Requirements vary between agencies, so one decision may not apply everywhere. Your care team should explain the reason clearly and let you know whether additional records, treatment, or more time could change your eligibility. In some cases, we may also be able to refer you to another agency.

FAQs

How long does surrogate screening take?

The full process may take several weeks or months, depending on record collection, appointments, testing, and follow-up needs.

What tests are included in the medical screening process?

Screening may include a physical and pelvic exam, bloodwork, infectious disease testing, drug screening, immunity testing, and a uterine evaluation. Your clinic may request additional tests based on your health history and IVF protocol.

Can someone fail surrogate screening?

Yes. You may be denied approval based on medical history, pregnancy complications, test results, lifestyle factors, emotional readiness, or program requirements. Some decisions are temporary, so ask whether treatment, additional records, or more recovery time could allow you to reapply.

What happens after medical screening approval?

After you clear your medical screening, you move forward with matching, typically within one to three months.

Growing Generations accepts surrogates from the top 2% of applicants overall. Of those who reach in-person medical review, 98% pass. Learn more about becoming a surrogate and take the first step toward helping someone on their path to parenthood.

Sources

American Society for Reproductive Medicine Ethics Committee. “Consideration of the Gestational Carrier: An Ethics Committee Opinion.” American Society for Reproductive Medicine, 2023.