How Are Surrogates Screened? Medical, Psychological & Legal Steps

Last reviewed: August 2026. Gestational-carrier screening is designed to reduce medical and psychosocial risks and support informed consent. Requirements vary by fertility clinic, agency and jurisdiction. No agency can guarantee that a candidate “fully qualifies” before the treating fertility clinic completes its own medical evaluation.

Agency prescreening vs. fertility-clinic clearance

Agencies may review applications, pregnancy records and practical eligibility before matching. Some programs do more of this work before a profile is presented; others complete portions after a tentative match. Intended parents should ask exactly which steps have been completed and which remain. Final medical eligibility for embryo transfer belongs to the treating fertility clinic.

1. Pregnancy and medical history

Professional guidance generally expects a gestational carrier to have experienced at least one prior pregnancy and birth. Clinics review obstetric records for complications, delivery history and other factors relevant to a future pregnancy. There is no universal nationwide rule that every candidate must be a U.S. citizen, fall within one exact BMI range or have no more than a fixed number of cesarean deliveries.

2. Current health and medication review

The clinic reviews current conditions, medications, substance use and other health information. A history of preeclampsia, diabetes, mental-health treatment or use of antidepressant or anti-anxiety medication should not be presented online as an automatic universal disqualification. The physician evaluates the specific history, severity, recurrence risk and treatment needs.

3. Medical examination and laboratory testing

Before transfer, the fertility clinic may perform a physical examination, infectious-disease testing, laboratory work and evaluation of the uterus according to its protocol. The exact tests vary. The clinic also considers the risks of medications used to prepare the endometrium and the planned embryo transfer.

4. Psychological evaluation and preparation

A mental-health professional experienced in third-party reproduction may discuss motivation, expectations, support, communication, pregnancy-related decision making, termination or selective-reduction scenarios, relationship stress and postpartum issues. A spouse or partner may also participate where relevant.

5. Background and practical-support review

Agencies may conduct background checks and assess practical support. Home visits and financial reviews are not universal requirements. Financial screening should focus on reducing coercion and understanding the effect of compensation—not on judging whether the carrier is fit to raise the intended parents' child.

6. Legal and insurance review

Screening also includes confirming that the proposed arrangement can proceed under applicable law and that the carrier receives independent legal advice. Health insurance should be reviewed for maternity coverage and surrogacy exclusions before treatment. These are separate from medical clearance.

What intended parents should ask about a profile

• Has the agency obtained and reviewed all prior pregnancy records?
• Has a fertility clinic medically cleared the candidate yet?
• Has psychological evaluation been completed?
• Has insurance been professionally reviewed?
• Has a background check been completed if the program requires one?
• Which screening steps remain after matching?

Bottom line

“Screened surrogate” can mean different things at different organizations. Ask for a precise description of what has been completed rather than assuming a profile is fully cleared. Medical, psychological, legal and insurance reviews each have different purposes and should be performed by the appropriate professionals.

This article provides general educational information and is not medical or legal advice.