Is Surrogacy Safe for Women? A Medical Perspective

Last reviewed: August 2026. Gestational surrogacy can be carried out with extensive medical, psychological and legal safeguards, but it is not risk-free. A gestational carrier faces the risks associated with pregnancy and delivery as well as treatment related to embryo transfer. Screening and careful care can reduce some risks; they cannot eliminate them.

What medical risks does a surrogate face?

Gestational carriers can experience complications that occur in pregnancy generally, including gestational diabetes, hypertensive disorders such as preeclampsia, hemorrhage, infection, C-section and other pregnancy or postpartum complications. Individual risk depends on medical and obstetric history, age, the pregnancy itself and other factors.

How does screening help?

Before treatment, programs typically review a candidate’s prior pregnancies and medical records and arrange medical and psychological evaluation. The fertility clinic determines whether the candidate is medically appropriate for treatment. Screening is intended to identify relevant risks and support informed decision-making; passing screening does not guarantee an uncomplicated pregnancy.

Does PGT-A make surrogacy safer?

PGT-A (preimplantation genetic testing for aneuploidy) can provide information about the chromosome number of biopsied embryos and may be useful in selected IVF situations. It should not be described as a universal safety test for surrogacy or as something proven to reduce miscarriage for every IVF patient. ASRM’s 2024 committee opinion states that the value of routine PGT-A screening for all IVF patients has not been demonstrated.

Genetic carrier screening is a different type of testing. It can help identify certain inherited-disease risks associated with the genetic contributors, but it does not make a pregnancy free of genetic or obstetric risk.

Why does single-embryo transfer matter?

Multiple pregnancy increases risk for the gestational carrier and babies. ASRM strongly recommends single-embryo transfer in gestational-carrier cycles to reduce the risk associated with multiple gestation. Even after transfer of one embryo, identical twins can occasionally occur.

Who controls the surrogate’s medical decisions?

The gestational carrier does. ASRM states that carriers are the sole source of consent regarding their medical care from embryo transfer through prenatal care, labor, delivery and aftercare. Contracts and intended-parent preferences should not override a carrier’s bodily autonomy or her right to make informed medical decisions.

What about emotional and psychological health?

Psychological screening and access to counseling are important safeguards. A carrier should understand the emotional and social implications of the arrangement, have appropriate support and be able to participate without coercion. ASRM recommends psychological evaluation before participation and access to counseling during and after the journey.

What safeguards should a surrogate look for?

• Independent medical evaluation and fertility-clinic clearance
• Review of prior pregnancy and delivery records
• Psychological evaluation and access to counseling
• Independent legal counsel
• Clear insurance and medical-expense planning
• A treatment plan that prioritizes singleton pregnancy
• Respect for the carrier’s authority over her own medical care
• Appropriate prenatal and postpartum care

So, is surrogacy safe for women?

A better answer than simply “yes” or “no” is that gestational surrogacy involves real medical and psychological risks that should be understood before consent. Careful candidate selection, professional screening, single-embryo transfer, appropriate medical care, counseling and independent legal advice can help manage risk, but no program can promise a risk-free pregnancy.

Women considering becoming gestational carriers should discuss their individual health history and risks directly with qualified medical professionals rather than relying on general online eligibility rules.

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