Surrogate Mother Requirements & Qualifications in the U.S. (2026)

Last reviewed: August 2026. Surrogate requirements are designed to protect the health and well-being of the gestational carrier, the pregnancy and everyone involved in the journey. There is no single nationwide checklist that every U.S. agency and fertility clinic uses, so eligibility can vary by program and individual medical history.

Professional guidance from the American Society for Reproductive Medicine (ASRM) provides a useful framework, while fertility clinics make the final medical determination and agencies may apply additional program criteria.

What are the basic requirements to become a surrogate?

Common starting criteria for gestational carriers include having previously delivered at least one child, being medically suitable for another pregnancy, completing psychological evaluation and having a stable environment and support system for the journey. Candidates must also be able to give informed consent and participate voluntarily.

ASRM guidance generally prefers gestational-carrier candidates to be legal adults who are at least 21 years old and ideally under 45, although individual circumstances can require additional medical consideration. A program's age limits may be narrower.

Is there a BMI requirement for surrogacy?

There is no single universal BMI cutoff for all surrogacy programs. Fertility clinics and agencies may use BMI ranges as part of medical eligibility because body weight can be relevant to pregnancy and treatment risk, but the cutoff varies. A candidate should confirm the specific clinic or program criteria rather than relying on one online number.

What pregnancy history is required?

A gestational-carrier candidate is generally expected to have had at least one prior pregnancy resulting in a live birth and to have a pregnancy history that the fertility clinic considers appropriate for another pregnancy. Medical records are reviewed for factors such as previous pregnancy complications, deliveries and C-sections.

A past medical condition does not always create an automatic universal disqualification. The nature, severity, recurrence risk and current health of the candidate matter, and the fertility clinic should make the medical-clearance decision.

What does medical screening include?

Medical screening commonly includes review of prior obstetric and medical records, a physical evaluation and laboratory testing appropriate to assisted reproduction and pregnancy. The exact testing protocol is determined by the fertility clinic and can vary based on medical history and current professional guidance.

What psychological screening is required?

Psychological evaluation is an important part of gestational-carrier screening. It helps assess informed consent, expectations, coping resources, support, communication and the emotional implications of the arrangement. A qualified mental-health professional experienced in third-party reproduction should conduct the evaluation according to the program's protocol and applicable professional guidance.

Do surrogates need to be financially stable?

Programs may consider financial stability to help ensure that a candidate is entering the arrangement voluntarily and is not being subjected to inappropriate financial pressure. However, receiving government assistance is not a universal automatic disqualification across all U.S. surrogacy programs. Eligibility depends on the specific program, the type of benefit, applicable rules and the candidate's overall circumstances.

Do surrogates need a spouse or partner?

No universal rule requires a surrogate to be married or partnered. Programs do, however, commonly assess whether she has a reliable support system for appointments, treatment, pregnancy, delivery and recovery. When a spouse or partner is involved, that person may also participate in counseling, screening or legal discussions depending on the program and circumstances.

Are smoking, drugs or medications automatic disqualifiers?

Smoking, substance use and certain medications can affect eligibility, but medication use should not be treated as a blanket disqualification without medical review. Candidates should disclose prescription medications, supplements, nicotine, cannabis and other substance use honestly so the appropriate medical professionals can assess safety and program eligibility.

Who makes the final decision?

Screening is usually a coordinated process. An agency or program may determine whether a candidate meets its initial criteria, a mental-health professional evaluates psychological readiness, and the fertility clinic determines medical suitability for treatment and pregnancy. Legal clearance is a separate step handled with qualified attorneys.

What should intended parents ask about screening?

• Which criteria are agency policies and which are fertility-clinic requirements?
• Has the candidate's pregnancy and delivery history been reviewed?
• Who provides final medical clearance?
• Who conducts the psychological evaluation?
• At what stage are medical, psychological and legal clearances completed?
• How is private medical information handled and shared?

For more detail on the application process, see our guide on how to become a surrogate. Intended parents can also browse available surrogate profiles and compare potential matches. You can also review our guide to factors that can affect surrogate eligibility.

This article provides general educational information and is not medical or legal advice. Requirements vary by fertility clinic, agency, jurisdiction and individual circumstances.