How to Become a Surrogate

Most agencies require surrogates to be between 21 and 40 years old, though some set the upper limit at 38. Age requirements exist because pregnancy risks increase with age, and fertility clinics and intended parents generally prefer surrogates in their 20s or early 30s. First-time surrogates are typically preferred to be under 35.

This is the single most important surrogate requirement: you must have previously given birth to at least one child whom you are currently raising. This requirement exists for two reasons:

• Proven fertility: A prior birth demonstrates that you can carry a pregnancy to term
• Informed decision-making: You understand the physical and emotional reality of pregnancy and childbirth, including the bond that forms, before agreeing to carry for someone else

The requirement that you are currently raising your own child(ren) is a psychological safeguard — agencies want to ensure you have a stable family situation and a clear distinction between your own children and the child you'd be carrying for intended parents.

Agencies and fertility clinics will review your obstetric history in detail. Generally favorable: uncomplicated vaginal deliveries, healthy full-term pregnancies. Complicating factors that require further review include:

• C-sections: 1–2 prior C-sections is often acceptable. Three or more C-sections is typically disqualifying due to uterine scar tissue risks.
• Gestational diabetes: History of GD is often disqualifying or requires additional medical clearance.
• Preeclampsia: Severity-dependent. Mild cases may be acceptable; severe preeclampsia history is often disqualifying.
• Premature birth: Depending on cause and gestational age, may affect eligibility.

A BMI under 32 is required by most agencies and fertility clinics. Higher BMI is associated with increased pregnancy complications (gestational diabetes, preeclampsia, C-section rates) and anesthesia risks. Some clinics set the limit at 30; a few are willing to work with surrogates up to BMI 34 in certain circumstances.

Most agencies require that surrogates not be currently receiving government financial assistance (SNAP, Medicaid, SSI, housing assistance, etc.). This requirement exists to ensure that financial need is not the sole motivating factor for surrogacy, protecting both the surrogate and intended parents from potential legal complications.

This does not mean you need to be wealthy. Many surrogates are middle-income working individuals and families. Being employed or having stable household income is typically sufficient.

If you are married or in a long-term relationship, most agencies require that your partner be fully supportive of your decision to become a surrogate. Partners are typically included in the psychological evaluation and must sign a legal acknowledgment. An unsupportive partner is a red flag for agencies, as the surrogacy process significantly impacts household life over 18–24 months.

Single women can and do become surrogates — partner support requirements only apply if you have a partner.

All surrogacy agencies require surrogates to be completely free of tobacco, nicotine, and recreational drugs. This is non-negotiable and is verified through toxicology screening during the medical evaluation. Some agencies also require that no one in your household smokes.

A thorough psychological evaluation is required for all surrogates (and their partners). The evaluation covers motivation for surrogacy, understanding of the process, coping strategies, ability to bond with and then relinquish the baby, and overall psychological stability. This is not a pass/fail test in most cases — it's a conversation designed to prepare you for the emotional aspects of the journey.