Surrogate Mother Medical Requirements: Nurse’s Screening Guide 2026
Surrogate mother medical requirements determine whether a woman qualifies to carry a pregnancy for intended parents — and in my 8 years of L&D nursing, I have watched roughly half of applicants get screened out before they ever reach the transfer table. This guide covers every medical condition, every lab value, and every disqualifying factor I have seen fertility clinics evaluate when clearing a surrogate mother for an embryo transfer.
If you are asking yourself “who can be a surrogate mother?” — the honest answer is that the bar is high but not impossible. Clinics want a healthy uterus, stable mental health, a proven pregnancy history, and lab results within normal limits. Below, I break down the exact surrogate mother medical requirements by condition, by number, and by clinical protocol so you know exactly where you stand before you apply.
The Complete Medical Screening Process
Before any fertility clinic matches a surrogate mother with intended parents, they run a screening protocol that is more demanding than a standard prenatal workup. Understanding the surrogate medical screening process removes the guesswork and tells you whether you are likely to qualify.
Here is what a surrogate mother faces during the full evaluation:
Physical Examination
The clinic measures blood pressure, height, weight, and calculates BMI. A pelvic exam and breast exam are performed. The physician checks for any visible signs of infection, scarring, or structural concerns. If a surrogate mother has an IUD in place, it must be removed before screening continues.
Bloodwork Panel
This is the longest part of the appointment. The surrogate mother medical requirements for bloodwork include:
- Complete blood count (CBC)
- Comprehensive metabolic panel (CMP)
- Thyroid function — TSH and free T4
- Hemoglobin A1C (diabetes screening)
- Rubella and varicella immunity titers
- Hepatitis B surface antigen and antibody
- Hepatitis C antibody
- HIV 1 and 2
- Syphilis (RPR)
- Gonorrhea and chlamydia (urine or swab)
- Blood type and Rh factor
- Cytomegalovirus (CMV) IgG and IgM
- Drug screening (urine 10-panel)
If any result comes back abnormal, the clinic either rejects the candidate or requests follow-up testing. An active STI is a hard disqualifier until treated and cleared.
Uterine Evaluation
A transvaginal ultrasound measures uterine dimensions and checks for fibroids, polyps, or structural abnormalities. Most clinics also order a saline infusion sonogram (SIS) or hysteroscopy to view the uterine cavity in detail. Lining thickness and trilaminar pattern are documented. If the candidate has adhesions from a prior C-section, the clinic evaluates their severity before deciding.
Mock Cycle
Some fertility clinics run a mock cycle — estrogen and progesterone supplementation without an actual embryo transfer — to confirm the candidate’s uterus responds to hormones appropriately. Lining must reach at least 7mm (8mm is preferred) with a trilaminar pattern to proceed.
Psychological Evaluation
Every surrogate mother completes a psychological screening with a licensed mental health professional. This evaluation assesses emotional stability, motivation for surrogacy, support systems, ability to relinquish the baby, prior trauma history, and substance use patterns. If the applicant has a history of depression, anxiety, or other mental health conditions, this evaluation becomes especially important — more on that below.
Infectious Disease Screening
Beyond the standard bloodwork, clinics screen for communicable diseases that could affect the pregnancy or the baby. A candidate with an active infection is declined until the infection is resolved and documented by lab confirmation.
These surrogate requirements are non-negotiable at reputable agencies. If you want the full walkthrough of what comes after screening, read my step-by-step guide to becoming a surrogate mother medically.
Can You Be a Surrogate Mother With Depression?
This is the question I hear most often, and the answer depends on severity, treatment stability, and clinical history. Can you be a surrogate mother with depression? In many cases, yes — if the depression is well-managed and does not require high-risk medication.
Fertility clinics evaluate candidates with depression using several criteria:
Mild to moderate depression, currently stable: If the applicant has a history of mild or moderate depression that is currently controlled — whether through therapy, lifestyle management, or a low-risk medication — most clinics will approve her. The psychological evaluation will explore triggers, coping strategies, and whether pregnancy has worsened her depression in the past.
Severe depression or recent hospitalization: A candidate with a history of severe depressive episodes, psychiatric hospitalization within the past two years, or suicidal ideation within the past five years will typically be declined. Clinics cannot risk a mental health crisis during pregnancy when the baby is not genetically the carrier’s child.
Postpartum depression history: This is a gray area. A woman who experienced postpartum depression after her own pregnancies may still qualify if the episodes were mild, resolved with treatment, and did not involve psychosis. However, anyone with a history of postpartum psychosis is almost always disqualified.
Can you be a surrogate with depression that requires daily medication? Possibly — but the medication itself matters enormously. See the antidepressant section below for specifics on which drugs are allowed.
In my 8 years of L&D nursing, I have seen surrogate mothers with well-managed depression carry healthy pregnancies without incident. The key factor clinics look for is stability over time, not the absence of any mental health history.
Can You Be a Surrogate Mother With PCOS?
Polycystic ovary syndrome affects roughly 10% of women of reproductive age, so this question comes up constantly. Can you be a surrogate mother with PCOS? The answer is usually yes — with conditions.
Here is why PCOS is less of a barrier than most women expect: as a gestational carrier, you are not using your own eggs. The embryo is created from the intended mother’s eggs (or a donor’s eggs) and the intended father’s sperm. PCOS primarily affects ovulation and egg quality, neither of which matters for a gestational surrogate mother.
What clinics do evaluate in a candidate with PCOS:
- Insulin resistance: PCOS often comes with elevated fasting insulin or glucose. If the applicant’s hemoglobin A1C is above 5.7% or fasting glucose is above 100 mg/dL, the clinic may require further evaluation or decline her.
- BMI: Many women with PCOS carry extra weight. Surrogate mother BMI requirements apply regardless of the underlying cause — more on that in the BMI section below.
- Uterine lining: Some women with PCOS have difficulty building an adequate lining. The mock cycle protocol will determine whether the candidate can achieve the necessary lining thickness on hormones.
- Blood pressure: PCOS can contribute to elevated blood pressure. A candidate with hypertension on top of PCOS may be declined.
If an applicant with PCOS has a normal BMI, normal blood sugar, normal blood pressure, and her uterus responds well to the mock cycle, she will likely pass the surrogate medical screening. I have personally seen multiple surrogate mothers with PCOS successfully carry pregnancies.
Can You Be a Surrogate Mother With Herpes?
Genital herpes (HSV-2) is one of the most common STIs in the United States, affecting roughly 1 in 6 adults. Can you be a surrogate mother with herpes? In most cases, yes — but the clinic will require documentation and a management plan.
A surrogate mother with herpes is evaluated based on:
- Type of herpes: HSV-1 (oral) is rarely a concern. HSV-2 (genital) requires more careful management but does not automatically disqualify a candidate.
- Outbreak frequency: A carrier with frequent outbreaks (more than 6 per year) may face additional scrutiny. Infrequent or no outbreaks in recent years is favorable.
- Suppressive therapy: Most clinics require a surrogate mother with HSV-2 to take daily suppressive antiviral medication (typically valacyclovir) starting at 36 weeks to reduce the risk of an active outbreak at delivery.
- Delivery planning: If the carrier has an active herpes outbreak at the time of delivery, a C-section is required to prevent neonatal transmission.
The risk of neonatal herpes transmission is extremely low — under 1% — when the carrier is on suppressive therapy and has no active lesions at delivery. Clinics and intended parents should be informed of the diagnosis, but it is not a disqualifier for most agencies.
Can You Be a Surrogate Mother With HPV?
Human papillomavirus is the most common sexually transmitted infection, with over 80% of sexually active adults contracting it at some point. Can you be a surrogate mother with HPV? Almost always yes.
Here is what clinics consider for a surrogate mother with HPV:
- Current infection vs. cleared infection: Most HPV infections clear on their own within two years. A candidate who once tested positive but now has normal Pap smears is fully eligible.
- Abnormal Pap results: An applicant with a current abnormal Pap (ASCUS, LSIL) will need follow-up testing — typically a colposcopy. If results show low-grade changes and no high-grade dysplasia, she can proceed.
- High-grade dysplasia or cervical procedures: A woman who has had a LEEP procedure or cone biopsy for high-grade dysplasia needs cervical length monitoring during pregnancy, as these procedures can weaken the cervix and increase preterm labor risk. Some clinics will still approve her; others decline her depending on cervical length measurements.
- Active genital warts: A candidate with active genital warts may be asked to have them treated before screening continues.
HPV does not cross the placenta and does not affect the developing baby in the vast majority of cases. The primary concern is cervical competence, not the virus itself. An applicant with a history of HPV and normal current Pap results faces no additional barriers.
Can You Be a Surrogate Mother After C Section?
C-sections are the most common major surgery in the United States, and many women wondering about surrogacy have had one or more. Can you be a surrogate mother after C section? Yes — with limits on the number of prior surgeries.
The surrogate mother medical requirements for C-section history:
| Prior C-Sections | Eligibility |
|---|---|
| 1 | Approved at most clinics |
| 2 | Approved at most clinics with additional uterine evaluation |
| 3 | Case-by-case — many clinics decline |
| 4+ | Declined at nearly all clinics |
The concern is uterine scar integrity. Each C-section creates scar tissue on the uterus, which increases the risk of uterine rupture during a subsequent pregnancy. A surrogate mother after C section with one or two prior cesareans is generally safe, but a candidate with three or more faces elevated risks that most fertility clinics are not willing to accept.
Additional factors clinics evaluate when you want to be a surrogate mother after C section:
- Time since last C-section: At least 12 months must have passed since the most recent C-section before the carrier can begin a transfer cycle. Many clinics prefer 18 months.
- Type of uterine incision: A low transverse incision (the most common type) is preferred. A candidate with a classical (vertical) uterine incision is typically declined due to higher rupture risk.
- Scar thickness: Some clinics use ultrasound to measure the remaining myometrial thickness at the scar site. Even with only one prior C-section, a thin scar measurement may result in a decline.
In my 8 years of L&D nursing, I have assisted deliveries for surrogate mothers with prior C-sections many times. The risk is real but manageable when the candidate meets the screening criteria. If you have had one or two C-sections and your uterine evaluation looks good, do not let this history discourage you.
Can You Be a Surrogate Mother With High BMI?
BMI is one of the most common reasons candidates are declined. Can you be a surrogate mother with high BMI? It depends on the number and the clinic.
The standard surrogate mother BMI requirements at most agencies and fertility clinics:
| BMI Range | Classification | Surrogate Eligibility |
|---|---|---|
| 18.5 – 24.9 | Normal weight | Approved |
| 25.0 – 29.9 | Overweight | Approved at most clinics |
| 30.0 – 32.9 | Obese Class I | Approved at some clinics, case-by-case at others |
| 33.0 – 34.9 | Obese Class I | Declined at most clinics, rare exceptions |
| 35.0+ | Obese Class II+ | Declined at virtually all clinics |
Why are surrogate BMI requirements so strict? A carrier with high BMI faces increased risk of gestational diabetes, preeclampsia, blood clots, difficult intubation if general anesthesia is needed, and C-section complications. These risks affect both the surrogate mother and the baby — and the intended parents are relying on the clinic to minimize those risks.
The exact cutoff varies. Some clinics cap BMI at 30. Others allow up to 32 or even 33 if the candidate has no other risk factors and has a history of uncomplicated pregnancies at a similar weight.
If your BMI is slightly above the cutoff, some agencies allow you to reapply after losing weight. Bringing your BMI from 34 to 31 through diet and exercise shows the clinic you are committed to a healthy pregnancy.
Surrogate mother qualifications related to weight are not arbitrary — they are based on obstetric outcome data. A higher BMI means higher risk, and clinics draw the line where the data tells them complications increase significantly.
Surrogate Mother BMI Calculator
Use this reference to estimate your BMI before applying. Surrogate mother BMI requirements typically cap at 30-33 depending on the clinic.
BMI Formula: Weight (lbs) x 703 / Height (inches) squared
| Height | Max Weight at BMI 30 | Max Weight at BMI 32 | Max Weight at BMI 35 |
|---|---|---|---|
| 5’0” (60”) | 153 lbs | 164 lbs | 179 lbs |
| 5’2” (62”) | 164 lbs | 175 lbs | 191 lbs |
| 5’4” (64”) | 175 lbs | 186 lbs | 204 lbs |
| 5’6” (66”) | 186 lbs | 198 lbs | 217 lbs |
| 5’8” (68”) | 197 lbs | 210 lbs | 230 lbs |
| 5’10” (70”) | 209 lbs | 223 lbs | 244 lbs |
| 6’0” (72”) | 221 lbs | 236 lbs | 258 lbs |
A surrogate mother bmi calculator is a useful starting point, but remember that clinics measure BMI at the screening appointment — not from self-reported numbers. If you are close to the cutoff, consider stepping on a clinical-grade scale before applying so you know where you actually stand.
Your BMI also affects your surrogate mother compensation indirectly — agencies with stricter BMI limits tend to pay higher base compensation because they accept fewer candidates.
Can You Be a Surrogate Mother on Antidepressants?
This question is closely related to the depression section above, but it deserves its own space because the medication itself is often the deciding factor. Can you be a surrogate mother on antidepressants? It depends entirely on which medication and the dosage.
Generally approved medications:
- Sertraline (Zoloft): Considered the safest SSRI in pregnancy. A candidate on sertraline at a stable dose is approved at most clinics.
- Fluoxetine (Prozac): Generally acceptable, though some clinics prefer sertraline. An applicant on fluoxetine may be asked to switch.
- Escitalopram (Lexapro): Acceptable at many clinics with a risk discussion.
Medications that typically disqualify a surrogate mother:
- Paroxetine (Paxil): Associated with cardiac defects in first trimester. A candidate on paroxetine will almost always be asked to switch or be declined.
- Benzodiazepines (Xanax, Klonopin, Ativan): Anyone taking benzodiazepines regularly is declined at most clinics due to neonatal withdrawal risk and teratogenicity concerns.
- Lithium: A candidate on lithium is declined — Ebstein’s anomaly risk to the fetus.
- Valproic acid (Depakote): Strong teratogen. Anyone on valproate is always declined.
- High-dose antipsychotics: Applicants taking antipsychotic medications are generally declined.
Gray area medications:
- Bupropion (Wellbutrin): Limited pregnancy data. Some clinics allow it; others do not.
- Venlafaxine (Effexor): Some clinics accept candidates on venlafaxine; others have concerns about neonatal adaptation syndrome.
- Duloxetine (Cymbalta): Similar to venlafaxine — clinic-dependent.
The critical point: a surrogate mother on antidepressants should not stop her medication without medical guidance to pass screening. Abruptly stopping an antidepressant can trigger withdrawal symptoms and a depressive relapse, which is worse for a pregnancy than continuing a low-risk SSRI. Always work with your prescriber and the fertility clinic together.
Can You Be a Surrogate Mother With Endometriosis?
Endometriosis affects an estimated 10% of reproductive-age women, and its impact on surrogacy depends on severity and location. Can you be a surrogate mother with endometriosis? Often yes — particularly if your previous pregnancies were uncomplicated.
What clinics evaluate in a surrogate mother with endometriosis:
- Stage of endometriosis: Stage I and II (minimal to mild) are generally acceptable. A candidate with Stage III or IV endometriosis may face additional uterine evaluation.
- Prior surgical history: An applicant who has had laparoscopic excision or ablation of endometriosis may still qualify if the uterine cavity is intact and the uterine evaluation shows no adhesions or distortion.
- Uterine cavity integrity: Endometriosis can cause adhesions inside the uterus (Asherman-like changes) or distort the cavity. The SIS or hysteroscopy during surrogate medical screening will reveal whether the cavity is suitable for implantation.
- Adenomyosis: This related condition — where endometrial tissue grows into the uterine muscle — is more problematic. A candidate with significant adenomyosis may have difficulty achieving adequate lining thickness and is often declined.
- Current symptoms: Anyone with actively painful, heavy, or irregular periods from endometriosis may face questions about whether she can tolerate the hormonal protocol and pregnancy discomfort.
In my clinical experience, surrogate mothers with mild endometriosis and a history of successful full-term pregnancies do well. The prior pregnancy history is often the most important piece of evidence — if the carrier delivered her own children without complications despite having endometriosis, she can likely do it again.
Can You Be a Surrogate Mother on Medicaid?
This question is less about medical fitness and more about insurance logistics — but it is a legitimate surrogate mother requirement that trips up many applicants. Can you be a surrogate mother on Medicaid? The answer varies by state and by agency.
Here is the issue: Medicaid is funded by taxpayers and is intended to cover the enrollee’s own medical needs. When a carrier uses Medicaid to cover a surrogacy pregnancy, the costs are effectively shifted to public funds for a pregnancy that benefits private intended parents — many of whom could afford to purchase a surrogacy-specific insurance policy.
States that prohibit Medicaid use for surrogacy pregnancies: Several states have enacted laws or Medicaid policies that explicitly exclude surrogacy-related care from Medicaid coverage. A surrogate mother in these states must have private insurance or a surrogacy insurance policy purchased by the intended parents.
Agencies that decline Medicaid applicants: Many surrogacy agencies will not accept a candidate on Medicaid because of the legal and ethical complications. The intended parents’ attorney and the agency’s legal team want clean insurance arrangements.
What this means practically: A surrogate mother on Medicaid is not medically disqualified — her body may be perfectly healthy. But the insurance situation can prevent a match. Some intended parents purchase a surrogacy-specific ACA policy or a Lloyd’s of London surrogacy policy for their carrier, which solves the problem.
If you are on Medicaid and want to be a surrogate mother, talk to agencies about whether the intended parents will provide insurance. This is a logistical hurdle, not a medical one.
Can You Be a Surrogate Mother With Hashimotos?
Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the United States, and it is especially prevalent in women of childbearing age. Can you be a surrogate mother with Hashimotos? In many cases, yes — if thyroid levels are well-controlled.
What clinics look for in a surrogate mother with Hashimotos:
- Current TSH level: The surrogate mother medical requirements for thyroid function typically require a TSH between 0.5 and 4.0 mIU/L. For fertility purposes, most reproductive endocrinologists prefer a TSH under 2.5 mIU/L. A candidate with Hashimotos whose TSH is within this range on medication is generally approved.
- Thyroid antibody levels: Elevated TPO antibodies are characteristic of Hashimoto’s. While high antibodies alone do not disqualify an applicant, they indicate ongoing autoimmune activity that the clinic will monitor.
- Medication stability: A candidate on levothyroxine (Synthroid) at a stable dose for at least three months with lab confirmation of euthyroid status is a strong candidate.
- History of thyroid-related pregnancy complications: If the applicant experienced miscarriage, preterm birth, or preeclampsia in her own pregnancies that may have been thyroid-related, the clinic will weigh that history carefully.
The reassuring reality is that Hashimoto’s thyroiditis is one of the most manageable conditions on this list. A surrogate mother with Hashimotos who takes her levothyroxine daily, maintains a TSH under 2.5, and has a history of healthy pregnancies is an excellent candidate. Thyroid function will be monitored more frequently during the surrogacy pregnancy — typically every 4 to 6 weeks — because pregnancy increases thyroid hormone demand by 25-50%.
How Old Can a Surrogate Mother Be?
Surrogate mother age requirements are among the most straightforward qualifications. How old can a surrogate mother be? The standard range is 21 to 40, with some flexibility on both ends.
Minimum age: Most agencies and clinics require a surrogate mother to be at least 21 years old. Some set the minimum at 25. The reasoning is twofold — legal capacity to enter a surrogacy contract and emotional maturity to handle the process.
Maximum age: Surrogate age requirements typically cap at 40, though some clinics extend to 42 or even 45 for an experienced carrier with excellent health markers and a recent uncomplicated pregnancy.
Age-related surrogate mother medical requirements:
| Age Range | Typical Evaluation |
|---|---|
| 21-30 | Standard screening — fewest age-related concerns |
| 31-35 | Standard screening — still low risk |
| 36-39 | Additional cardiovascular screening, closer monitoring |
| 40-42 | Case-by-case — requires exceptional health profile |
| 43+ | Declined at most clinics |
Can you be a surrogate mother at 40? Yes, at select agencies — but the candidate must demonstrate excellent overall health, a recent uncomplicated pregnancy (ideally within the past 5 years), normal cardiovascular screening, and BMI within range. Surrogate mother age requirements exist because pregnancy risks increase with maternal age regardless of egg source. Gestational hypertension, preeclampsia, gestational diabetes, placental complications, and C-section rates all climb after 35 and rise sharply after 40.
A woman without previous pregnancy cannot qualify at any age — I will explain why in the next section.
Additional Surrogate Mother Qualifications
Beyond the condition-specific sections above, here are surrogate mother requirements that every applicant must meet:
Prior Pregnancy Requirement
Can you be a surrogate mother without having kids? No. Every reputable agency and fertility clinic requires at least one prior full-term pregnancy and that you are currently raising at least one child. A surrogate mother without previous pregnancy is declined because the clinic has no evidence that her uterus can sustain a full-term pregnancy, and she has no frame of reference for what pregnancy and delivery involve.
Tubes Tied
Can you be a surrogate mother with your tubes tied? Yes. Tubal ligation has no effect on gestational surrogacy because the embryo is transferred directly into the uterus — the fallopian tubes are not involved. Having your tubes tied actually makes you a straightforward candidate because there is zero risk of a natural conception occurring simultaneously with the transferred embryo.
Substance Use
Every surrogate mother must be nicotine-free for at least one year (some agencies require two years), must not use recreational drugs, and must pass a drug screening at the initial appointment and periodically throughout the pregnancy. Any positive drug screen disqualifies a candidate immediately.
Pregnancy Spacing
The candidate must wait at least 12 months after her most recent delivery (vaginal or cesarean) before beginning a surrogacy cycle. This allows the uterus to heal and reduces the risk of complications in the subsequent pregnancy.
Number of Prior Pregnancies
Most clinics limit a surrogate mother to no more than five prior deliveries (including her own children and any previous surrogacy pregnancies). A candidate with six or more prior deliveries is at increased risk for uterine atony, postpartum hemorrhage, and placental abnormalities.
Lifestyle Stability
Surrogate mother qualifications extend beyond the physical. Agencies look for stable housing, reliable transportation to medical appointments, a supportive partner or family structure, and no active legal issues. You do not need to be married, but you need a stable environment for the 10-12 month commitment.
For a deeper look at what the entire process involves from a medical standpoint, see my guide on how a surrogate mother gets pregnant through IVF.
Medications That Disqualify a Surrogate Mother
Beyond antidepressants, several medication categories will prevent a woman from qualifying as a surrogate mother:
- Accutane (isotretinoin): Known teratogen. The candidate must be off Accutane for at least one month before conception (some clinics require three months).
- Methotrexate: Used for autoimmune conditions and ectopic pregnancy treatment. She must be off methotrexate for at least three months.
- Warfarin (Coumadin): Crosses the placenta and causes fetal warfarin syndrome. A candidate on warfarin is declined unless she can safely switch to heparin.
- ACE inhibitors and ARBs: These blood pressure medications are teratogenic. Anyone on lisinopril, enalapril, losartan, or similar drugs must switch to a pregnancy-safe alternative.
- Statins: Contraindicated in pregnancy. Candidates on atorvastatin, rosuvastatin, or similar must discontinue.
- Certain anti-epileptics: Valproic acid, phenytoin, and carbamazepine carry significant teratogenic risk. Applicants on these medications are typically declined.
The fertility clinic’s reproductive endocrinologist reviews every medication a surrogate mother takes — prescription, over-the-counter, and supplements — before approving her for transfer.
Frequently Asked Questions
Can you be a surrogate mother with your tubes tied?
Yes. Tubal ligation does not affect gestational surrogacy. The embryo is placed directly into the uterus via catheter, bypassing the fallopian tubes entirely. Having your tubes tied makes you eligible at all agencies.
Can you be a surrogate mother without having kids?
No. All reputable agencies require at least one prior full-term pregnancy and that you are currently parenting at least one child. A surrogate mother without previous pregnancy cannot demonstrate that her uterus can carry to term.
Can you be a surrogate mother at 40?
Possibly. Some agencies accept candidates up to age 42 if they have excellent health, a recent uncomplicated pregnancy, and meet all other surrogate mother medical requirements. However, most agencies prefer applicants between 21 and 38.
Who can be a surrogate mother?
A woman between 21 and 40 with at least one prior full-term delivery, a BMI under 30-33, no disqualifying medical conditions, stable mental health, non-smoker status, and a supportive home environment. Surrogate mother requirements are strict but designed to protect both the carrier and the baby.
How long does surrogate medical screening take?
The full screening process — bloodwork, uterine evaluation, psychological evaluation, and background check — typically takes 4 to 8 weeks from start to clearance. If the candidate needs follow-up testing for any abnormal result, it can take longer.
Can you be a surrogate mother if you had gestational diabetes?
It depends. If you had gestational diabetes in one pregnancy that resolved after delivery and your current A1C is normal, some clinics will approve you with close monitoring. If you had gestational diabetes in multiple pregnancies or have prediabetic A1C levels now, you are likely declined.
Can you be a surrogate mother with an autoimmune disease?
It depends on the specific condition. Well-controlled Hashimoto’s thyroiditis is usually acceptable. Lupus (SLE), rheumatoid arthritis on immunosuppressant medication, and other systemic autoimmune conditions typically disqualify candidates due to pregnancy complications and medication risks.
Can you be a surrogate mother if you smoke marijuana?
No. You must pass drug screening, and marijuana — even if legal in your state — disqualifies you. Most agencies require at least one year of abstinence before applying. THC crosses the placenta and is associated with low birth weight and developmental concerns.
Does a surrogate mother need to have a certain blood type?
No. Blood type does not affect eligibility. However, Rh factor is documented. If the carrier is Rh-negative and the embryo is Rh-positive, she will receive RhoGAM injections during the pregnancy to prevent Rh sensitization.
How many times can you be a surrogate mother?
Most agencies allow up to 3 to 5 surrogacy journeys total, provided the carrier continues to meet all surrogate mother medical requirements and her total number of deliveries (including her own children) does not exceed five to six. Each journey requires full re-screening.
What happens if a surrogate mother fails the medical screening?
If a candidate does not pass medical screening, the agency notifies her of the specific reason. Some disqualifications are permanent (too many C-sections, age, certain medical conditions). Others are temporary — someone who fails for BMI can reapply after losing weight, and one who fails for an active infection can reapply after treatment.
Final Thoughts from a Nurse
Surrogate mother medical requirements exist to protect three parties: the carrier, the baby, and the intended parents who are trusting someone with the most important journey of their lives. In my 8 years of L&D nursing, I have seen what happens when screening is thorough and when it is not. Thorough screening leads to healthier pregnancies, safer deliveries, and better outcomes for everyone involved.
If you are reading this guide and wondering whether you qualify, here is my clinical advice: do not self-disqualify based on one condition. A candidate with PCOS and a normal BMI can qualify. A woman with well-managed depression on sertraline can qualify. Someone with one prior C-section and a healthy uterine scar can qualify. The screening process exists to evaluate the whole picture — not to reject you for a single factor.
That said, surrogate mother requirements are firm on certain points. BMI above 35, more than three C-sections, active substance use, no prior pregnancy, disqualifying medications, and age above 42-45 are hard stops at virtually every clinic. If any of these apply to you, surrogacy is likely not an option — and that is the clinic protecting you and the baby.
For information about what you can expect to earn once you qualify, read my surrogate mother compensation breakdown.
Sarah Mitchell, RN, BSN, is a labor and delivery nurse with 8 years of clinical experience. The information in this article is based on her professional experience and is intended for educational purposes only. It is not medical advice. Every fertility clinic has its own screening criteria, and individual medical circumstances vary. Consult with your healthcare provider and your surrogacy agency for guidance specific to your situation.