There are a lot of questions that come with becoming a surrogate, but one of the big ones is pretty simple: is there anything that could stop me from qualifying?
Maybe you’ve had a couple of C-sections. Maybe you take medication, have a history of anxiety or your BMI is a little higher than the numbers you’ve seen online. (And there are a lot of numbers and opinions online.)
The slightly frustrating answer is that there isn’t one universal list of surrogate disqualifiers.
Some things can mean surrogacy isn’t recommended, particularly if another pregnancy could put your health at risk. Others might just need a closer look by the IVF clinic. And some of the things you may have heard automatically disqualify you? Not necessarily.
So, rather than trying to piece it together from a dozen different answers, here are 14 of the most common things that can affect whether you qualify to become a surrogate, and what they actually mean.
What can disqualify you from being a surrogate? The quick answer
Some of the most common surrogate disqualifiers and eligibility considerations include:
- Never having previously carried a healthy pregnancy to term
- Certain serious pregnancy or delivery complications
- Multiple previous C-sections or births
- Being outside the accepted surrogate age range
- Certain medical conditions that could make another pregnancy unsafe
- A BMI outside your IVF clinic’s accepted range
- Smoking, nicotine or recreational drug use
- Certain medications
- Some significant or unresolved mental health conditions
- Having recently given birth or still breastfeeding
- Having had a hysterectomy
- Certain active infections identified during screening
- Not having enough practical, emotional or financial stability for the journey
- Not receiving the required medical or psychological clearance
It looks like a long list, we know. But there’s an important distinction here: a consideration isn’t always a disqualification.
Some things might mean not ever. Quite a few simply mean not right now. And others need an individual assessment before anyone can really give you an answer.
Let’s unpack them properly.
1. You’ve never had a previous pregnancy
Having never carried a previous pregnancy is one of the more straightforward surrogate disqualifiers.
Before becoming a gestational surrogate, you need to have carried and delivered a baby yourself. Ideally, your previous pregnancy and delivery will also have been uncomplicated.
There’s a practical reason for this. Until you’ve experienced pregnancy, there’s no medical history showing how your body responds to it.
The American Society for Reproductive Medicine (ASRM) recommends that a gestational carrier has previously had at least one term, uncomplicated pregnancy.
If you’re looking for the positive side of the checklist, our guide to surrogate requirements and eligibility goes through what clinics generally look for when assessing a potential surrogate.
2. You’ve experienced complications during a previous pregnancy
Certain previous pregnancy complications can affect whether you’re medically cleared to become a surrogate.
This is where things become less black and white.
Having experienced a complication during pregnancy doesn’t necessarily mean you can’t become a surrogate. What happened, how serious it was and whether it could increase the risks of another pregnancy all matter.
Your pregnancy and delivery records will be reviewed by the IVF clinic as part of the screening process. If something needs a closer look, the medical team may request additional information or assessment.
The important thing? Be open about your medical history from the beginning.
Surrogacy involves a lot of moving parts, and nobody benefits from surprises halfway through the process.
You can read more about what happens during the surrogate application and screening process.
3. You’ve had multiple C-sections
Having had a C-section does not automatically rule you out of becoming a surrogate.
The number of previous C-sections is more relevant.
ASRM recommends that gestational carriers ideally have no more than three previous cesarean deliveries, and no more than five previous deliveries in total.
Your individual pregnancy history still matters because two women with exactly the same number of births can have very different medical histories.
Had one or two C-sections and wondering where you stand? This is a conversation worth having rather than assuming the answer is no.
4. You’re outside the recommended age range
Age requirements for surrogates vary between IVF clinics, but in practice you’ll commonly see an upper age limit of around 40.
ASRM’s broader recommendation is that gestational carriers are preferably between 21 and 45 years old, while many clinics use a younger upper age limit.
There’s also the timeline to think about. Applying to become a surrogate at 39 doesn’t mean you’ll be pregnant at 39. Screening, matching, legal agreements, medical clearance and preparing for an embryo transfer all take time.
That’s why agencies may prefer women to begin the process around 38 or 39 when the IVF clinic requires a surrogate to be under 40 by the time treatment begins.
Close to the upper age range? It’s worth having the conversation with the agency. Age is only one part of your medical history, and ultimately the IVF clinic will determine whether you meet its requirements.
5. You have a medical condition that could make pregnancy unsafe
Certain medical conditions can prevent you from being medically cleared as a surrogate.
This one really comes down to safety.
Surrogacy involves IVF treatment, pregnancy and delivery, so the medical team needs to be confident that carrying another pregnancy is considered safe for you.
Certain cardiovascular, autoimmune, reproductive or other significant health conditions may require further investigation or mean that another pregnancy isn’t medically recommended.
This is also why Googling your diagnosis followed by “can I be a surrogate?” can only get you so far. Your medical history needs to be considered as a whole.
6. Your BMI falls outside an IVF clinic’s requirements
BMI requirements for surrogates vary between IVF clinics, but a BMI of around 19 to 30–32 is a common range, with some clinics accepting a BMI up to 35.
And, ah, BMI. This is probably one of the most confusing parts of researching surrogate eligibility online.
There isn’t one universal BMI cutoff for gestational surrogates, and ASRM doesn’t specify a particular number. That’s why you might see 30 on one website, 32 on another and 35 somewhere else. (Remember all those numbers and opinions we mentioned?)
The final requirement comes down to the IVF clinic and its medical protocols, alongside your broader health and pregnancy history.
So if your BMI is 31 and you’ve read somewhere that it must be below 30, don’t immediately assume that’s the end of the conversation. Ask. The clinic you’re ultimately working with may have different requirements.
7. You currently smoke, vape or use recreational drugs
Current smoking, nicotine and recreational drug use can affect whether you’re cleared to become a surrogate.
There’s good reason for this. Smoking and nicotine exposure can affect pregnancy and fetal health, so naturally they’re going to come up during screening.
The CDC’s guidance on smoking and reproductive health notes that smoking during pregnancy increases the risk of a number of pregnancy complications.
Your lifestyle and health history will be discussed during screening alongside other factors that could affect pregnancy.
And yes, second-hand smoke can matter too.
8. You take certain medications
Taking medication does not automatically disqualify you from becoming a surrogate.
It depends on what you’re taking, why you’re taking it and whether it’s considered compatible with IVF treatment and pregnancy.
Some medications may be perfectly manageable. Others may need further review by the appropriate medical professionals.
One very important aside: never stop taking prescribed medication because you think it will improve your chances of qualifying as a surrogate. That’s a conversation for your treating doctor and the IVF clinic.
9. You have a history of anxiety, depression or another mental health condition
A history of anxiety, depression or another mental health condition doesn’t automatically rule out surrogacy.
Another area where a little nuance goes a long way.
Mental health is considered as part of psychological screening because surrogacy can be emotionally demanding as well as physically demanding. Your current wellbeing, treatment history, medications and previous experiences will all form part of that conversation.
The goal isn’t to find someone with a perfectly blank mental health history. It’s to make sure you’re in a good place to take on the emotional demands of the journey.
Again, this is about having an open conversation, not trying to present a perfect version of yourself.
10. You’ve recently given birth or you’re still breastfeeding
Recently having a baby or currently breastfeeding may mean you need to wait before beginning a surrogacy journey.
And this is a good example of not now being very different from not ever.
Your body needs time to recover from pregnancy and birth before another pregnancy begins, and IVF clinics can have their own requirements around how long you need to wait after delivery and after breastfeeding has finished.
So if you have a six-month-old at home and are already thinking about becoming a surrogate, that doesn’t necessarily mean you can’t do it. It may simply mean the timing isn’t quite right yet.
Speak with the agency about when it makes sense to start the process, particularly because screening and matching themselves take time.
11. You’ve had a hysterectomy
A hysterectomy prevents someone from carrying a pregnancy as a gestational surrogate because the uterus is required for an embryo to implant and a pregnancy to develop.
This one is much more straightforward.
If you’ve had your uterus removed, you won’t be able to carry a pregnancy as a surrogate, even if you still have your ovaries.
It’s worth making that distinction because having your tubes tied is completely different. A gestational surrogate becomes pregnant through IVF and embryo transfer, so the fallopian tubes aren’t needed for conception.
We answer a few more of those “but what if I’ve had…?” questions in our surrogacy FAQs.
12. An infection is identified during screening
Certain active infections can temporarily prevent someone from being medically cleared as a gestational surrogate.
Infectious disease screening is a standard part of the medical process, and ASRM recommends screening gestational carriers for sexually transmitted and other infections that could affect the surrogate, pregnancy or baby.
This doesn’t necessarily mean a positive result is a permanent disqualification.
For example, ASRM guidance states that some infections should be treated and successfully cleared before someone is reconsidered as a gestational carrier.
In other words, this can be another not right now rather than not ever situation.
13. You don’t currently have enough stability or support around you
Having adequate practical and emotional support is an important part of being considered for surrogacy.
You might be the one becoming a surrogate, but you won’t exactly be doing it alone.
There are appointments. IVF medications. Pregnancy. Potentially some very tired days. Delivery. Recovery.
If you have a partner and children, they’ll experience parts of the journey too.
That’s why clinics and surrogacy professionals look at the support you have around you and your broader circumstances. It isn’t about having a picture-perfect home life. (Whose is?) It’s about knowing you have the stability and support to take on another pregnancy and everything that comes with it.
Financial circumstances can also form part of the broader screening process. Surrogacy shouldn’t put someone in a position where they feel financially pressured to continue with a journey that isn’t right for them.
14. You don’t receive medical or psychological clearance
Ultimately, becoming a gestational surrogate requires medical and psychological clearance.
Meeting the initial requirements is only the beginning.
Potential surrogates undergo screening before moving forward with a journey. This can include reviewing previous pregnancy records, medical testing, medications, infectious disease screening, psychological evaluation and conversations about the realities of surrogacy.
It might sound like a lot.
But the purpose isn’t to find a mythical “perfect” candidate. It’s to make sure another pregnancy and a surrogacy journey are appropriate for you.
And that’s something everyone should want to know before getting started.
What about where I live?
Where you live can affect whether and how a surrogacy journey can legally proceed.
Surrogacy law in the United States is largely determined at state level, which means the legal framework isn’t identical everywhere. Laws also change, which is exactly why we don’t think a quick list of “good states and bad states” is particularly helpful.
You can explore our guide to surrogacy laws across the United States for more detail, but your individual circumstances should ultimately be reviewed by an experienced surrogacy attorney.
Does being disqualified mean you can never become a surrogate?
No. Being unable to qualify right now doesn’t necessarily mean you can never become a surrogate.
Some medical circumstances may mean another pregnancy simply isn’t considered safe.
But other eligibility issues can be temporary or require further assessment.
Perhaps you’ve only recently given birth. Maybe you’re still breastfeeding or taking a temporary medication. Your BMI might fall outside one clinic’s guidelines. An infection might need to be treated. Or something in your medical history simply needs to be reviewed before anyone can give you an answer.
Not now and not ever are two very different things.
So if you’re interested in becoming a surrogate but there’s something in your history you’re worried about, have the conversation.
What if I’m not sure whether I qualify to be a surrogate?
You don’t need to arrive with all the answers. Actually, that’s part of what the screening process is for.
Be honest about your pregnancy history, physical and mental health, medications and what’s happening in your life. Ask questions. If there’s something you’re worried might affect your eligibility, bring it up.
The best surrogacy journeys begin with everyone understanding what to expect and feeling comfortable enough to talk openly when something isn’t clear.
If you’re still at the could I actually do this? stage, you can complete our surrogate eligibility questionnaire and take it from there.
FAQs: What disqualifies you from being a surrogate?
What automatically disqualifies you from being a surrogate?
There isn’t one universal list of automatic surrogate disqualifiers that applies to every IVF clinic and every woman. Never having previously carried a pregnancy, not having a uterus, certain medical conditions that make pregnancy unsafe, current smoking or drug use, and being unable to receive medical or psychological clearance are among the circumstances that can prevent someone from proceeding. Other factors need individual assessment.
Can you be a surrogate if you’ve had a C-section?
Yes. Having had a C-section doesn’t automatically disqualify you from becoming a surrogate. The number of previous C-sections and your individual pregnancy history will be considered. ASRM recommends that gestational carriers ideally have no more than three previous cesarean deliveries.
What BMI do you need to be a surrogate?
A BMI of around 19 to 30–32 is common for gestational surrogates, although some IVF clinics accept a BMI up to 35. There is no single universal BMI cutoff, so the requirement will depend on the IVF clinic involved in your journey.
Can you be a surrogate at 40?
Possibly. ASRM recommends gestational carriers are preferably between 21 and 45, but many IVF clinics use an upper age limit around 40. Because screening and matching take time, it’s worth speaking with an agency earlier if you’re approaching the clinic’s upper age range.
Can you be a surrogate if you have anxiety or depression?
Potentially, yes. A history of anxiety or depression doesn’t automatically rule out surrogacy. Your current wellbeing, mental health history, treatment and medications will be considered during psychological and medical screening.
Can you be a surrogate if you take medication?
It depends on the medication and your individual circumstances. Some medications may be compatible with surrogacy, while others require further medical review. Never stop prescribed medication in an attempt to qualify without first speaking with your doctor.
Can you be a surrogate if you’re breastfeeding?
You may need to wait. IVF clinics can have requirements around breastfeeding and how long you need to wait after giving birth before beginning treatment. This is often a timing issue rather than something that permanently prevents you from becoming a surrogate.
Can you be a surrogate if you’ve never been pregnant?
Generally, no. Gestational surrogates are expected to have previously experienced at least one term pregnancy and delivery. This gives the medical team important information about how your body has responded to pregnancy in the past.
Can you be a surrogate if your tubes are tied?
Yes. Having your tubes tied doesn’t generally prevent you from becoming a gestational surrogate. Gestational surrogacy uses IVF and embryo transfer, so conception doesn’t rely on your fallopian tubes.
A note about surrogate requirements
Surrogate eligibility and medical requirements can vary between IVF clinics and individual circumstances. NewGen Families works with and follows the requirements and medical guidance of the IVF clinic involved in each journey.
That’s why open, honest and transparent conversations are so important. If there’s something in your medical or pregnancy history you’re unsure about, bring it up. It’s always better for everyone to understand what to expect from the beginning and throughout the journey.
This article provides general information about surrogate eligibility in the United States and isn’t a substitute for individual medical or legal advice.
