The Medical Process

All You Need to Know About Surrogate Health Requirements

Every woman considering surrogacy must meet certain health requirements to be a surrogate mother. These requirements are important in ensuring not only your safety as a prospective surrogate but also the safety of the intended parents, their embryos and their eventual baby.

Before you become a surrogate, you’ll need to work with a surrogacy professional — like an agency or a surrogacy clinic — to determine whether you meet the necessary surrogate health requirements. Usually, this is completed through several different kinds of screening, including:

Only after you have completed all of these screenings and your surrogacy specialist approves you for the surrogacy process can you start the medical process of surrogacy with your intended parents.

The Health Requirements for Surrogacy

But, what exactly are the health requirements to be a surrogate mother that professionals are looking for when they complete these screenings?

As mentioned, the main purpose of a surrogate medical screening is to make sure you are healthy enough to carry a child for intended parents. The physical challenges of surrogacy (not to mention pregnancy) can be demanding and, to prevent any delays or disappointment in your or your intended parents’ surrogacy process, it’s crucial that you are medically approved for the process before you begin.

Each surrogacy professional sets slightly different surrogate health requirements, but most use the basic guidelines provided by the American Society for Reproductive Medicine. These guidelines include:

Again, because professionals’ health requirements to be a surrogate mother may vary, speak with an appropriate professional to determine if you can be medically approved for their particular program.

Frequently Asked Questions About Health Requirements to Be a Surrogate

Many times, whether a woman meets surrogate health requirements will depend on her personal medical background. Some surrogacy professionals may set additional medical standards, while others may make exceptions for individual circumstances.

If you’re wondering about the health requirements to be a surrogate, you may also have personal questions about how your health conditions may impact your ability to be a surrogate. As always, a surrogacy or medical professional can best answer these questions, but we’ve listed a few of the most common ones below:

1. What are the age requirements for surrogacy?

The desire to help someone else become a family is not one that is limited by age. Women start having dreams of being a surrogate in their childhood, while others may not think about this path until after they have completed their own family. However, a desire to be a gestational carrier is not enough to qualify a surrogate candidate; a woman must also meet surrogate mother age requirements.

Many agencies set their own surrogate age requirements, but many follow the guidelines of the ASRM: A surrogate must be at least 21 and younger than 40 years old to pursue this path. These surrogate mother age requirements are designed to ensure a woman is at her healthiest age for pregnancy when starting the surrogacy process, as well as providing for the requirement that she must have already been pregnant once before she can be a surrogate (more on that below).

2. How old is too old to be a surrogate mother?

As you’ve researched the surrogacy process, you’ve probably come across stories of women carrying their own grandchildren through gestational surrogacy. Many of these women are over 40 years old — so why do so many agencies set a strict surrogate mother age limit at this age?

It all has to do with biology. A menopausal or postmenopausal woman (typically, women over 40) will have a much harder time getting pregnant than a woman who is in her 20s or 30s. Even if she were to get pregnant, an older woman would have a riskier pregnancy.

Remember, intended parents want a surrogate who gives them the best chance at a healthy and successful pregnancy. A woman who is older than 40 cannot do that. Therefore, surrogacy professionals set a surrogate age limit to protect all parties involved.

If you are asking, “Am I too old to be a surrogate mother?” we encourage you to call a surrogacy agency or a fertility clinic for more information.

3. Can I be a teen surrogate?

Young women frequently ask, “I’m officially an adult. Why can’t I be an 18-year-old surrogate mother?”

Teen surrogacy is a very dangerous business, and you’ll be hard-pressed to find a surrogacy professional who will help you be a surrogate at 18, 19 or even 20. Surrogacy is a big commitment to make, and many teenagers simply aren’t ready for the physical and emotional challenges of this journey. And, of course, remember that all surrogates must have carried one pregnancy successful to term and be raising a child on their own. The vast majority of teenagers cannot meet those surrogate health requirements.

Most professionals will require a surrogate mother minimum age of 21. If you have dreams of being a teen surrogate, remember that these professionals will still be happy to accept you in a few more years, as long as you meet all the necessary requirements.

4. Can you be a surrogate without having given birth?

There are many women out there with perfectly healthy reproductive organs that are either not ready to have or are uninterested in having biological children. But, they still want to use their abilities for good, so they ask, “Can you be a surrogate mother without a previous pregnancy?”

Unfortunately, the answer is no. A woman pursuing surrogacy without a previous pregnancy will be disqualified from the surrogacy process.

It’s important that you have proven you can carry a pregnancy to term safely before you become a surrogate — for your own well-being and to ensure the intended parents’ embryos are placed in the uterus of the woman who gives them the best chance at a successful pregnancy. If you become a surrogate with no previous pregnancy, you put yourself and the intended parents at risk. You have no idea how your body will react to pregnancy (emotionally and physically), and the intended parents have no guarantee that you can safely deliver their baby to term.

This is absolutely a “no exceptions” situation. You cannot be a surrogate if you’ve never given birth.

5. Can a woman in menopause be a surrogate?

As mentioned, surrogacy professionals only work with women who offer the best chances of a successful pregnancy. Because menopause comes with effects that stop future pregnancies, being a surrogate mother after menopause is a very risky and difficult process. This is why many professionals set age restrictions for surrogacy at 40, before most women experience menopause.

However, there are many stories out there about surrogate mothers in menopause successfully bringing a baby into the world. It may make you wonder whether it’s really a path for you. Keep in mind that these situations are often independent surrogacies with family member or friends. A surrogate still has to undergo medical screening at a clinic to ensure she is physically prepared to be a surrogate.

For more information on whether you can be a surrogate after menopause, please contact your local fertility clinic.

6. Can I be a surrogate after tubal ligation?

Yes! It is certainly possible to be a gestational surrogate mother after tubal ligation. In fact, some professionals will even prefer it.

Tubal ligation is a medical process that halts ovulation and prevents women from becoming pregnant. This is an ideal situation for a gestational carrier, as being a surrogate with a tubal ligation will prevent you from becoming pregnant with your own egg during your fertility medication protocol and embryo transfer process. It also means you have completed your own family, which is an emotional advantage. Being a surrogate can put your reproductive ability at risk but, if you are done having children, that risk shouldn’t concern you.

While you can be a surrogate after tubal ligation, remember that you will still need to meet all the other health requirements to be a surrogate, too.

  1. How many times can you be a surrogate?

How many times a woman can be a surrogate will likely depend upon her personal health and pregnancy history. If having another child will put a prospective surrogate at risk, she will likely be disqualified from the process.

Each surrogacy professional has a different rule when it comes to the number of times you can be a surrogate. Contact one today to learn more.

  1. I’m breastfeeding; can I be a surrogate?

Surrogacy professionals will require prospective surrogates to have stopped breastfeeding before they begin the medical process of surrogacy, as breastfeeding causes a natural delay in your return to fertility. However, you can likely begin the initial surrogacy application process while you are still breastfeeding, as long as you have plans to stop before you begin the medical procedures.

9. Can I be an HIV-positive surrogate mother?

HIV can transfer to a baby during pregnancy, which is why you cannot have HIV and become a surrogate.

10. Can I be a surrogate if I have HPV?

HPV is the most common type of STD in the U.S. and, in most cases, the disease will not affect a developing baby. However, if you have an outbreak of genital warts close to your due date, you may be scheduled for a cesarean-section to prevent the transmission of HPV to the baby.

11. Can you be a surrogate mother with herpes?

Similarly, herpes rarely affects a baby born from a woman who has the disease, so someone with herpes can be a surrogate, if she meets all the other requirements. Again, if you have an outbreak before your due date, you may need to have a C-section instead of a vaginal birth.

12. Is being a surrogate with PCOS (polycystic ovarian syndrome) possible?

Although PCOS mainly affects a woman’s ability to ovulate, it can still cause risks in a gestational surrogacy. For example, women with this condition are more likely to develop gestational diabetes, preeclampsia and other pregnancy complications. Speak with your fertility specialist and doctor to determine if your PCOS diagnosis may affect your ability to be a surrogate.

13. Can a female with adenomyosis be a surrogate?

Adenomyosis is a condition that causes endometrial tissue to grow into the muscle layers of the uterus, which can make the implantation of an embryo very difficult. Your doctor can best determine if your condition can be treated successfully so you can be a surrogate.

14. Can I pursue surrogacy with endometriosis?

Endometriosis is another reproductive disorder that can make it difficult for you to become pregnant and may increase your risk of miscarriage. Your doctor can best determine the severity of your condition and whether it will affect your ability to become a surrogate.

15. Can you be a surrogate after ablation?

Ablation often destroys a thin layer of the lining of the uterus, which makes future implantations of embryos very difficult. Most surrogacy professionals will disqualify you from being a surrogate if you’ve experienced ablation because of the risks it will bring to your pregnancy.

16. What pregnancy conditions disqualify you from surrogacy?

Most surrogacy professionals will look for prospective surrogates who have had no or minimal complications in their previous pregnancies. It’s always a good idea to speak with your doctor about your pregnancy history to determine whether past complications will affect your ability to be a surrogate. Remember, intended parents want a surrogate with the best chance of a successful pregnancy, which certain pregnancy complications will make difficult or near impossible.

17. Can someone with sickle cell be a surrogate?

Sickle cell can cause health complications during pregnancy, such as miscarriage, premature birth and a low birth rate. Therefore, this condition means it is too dangerous to pursue surrogacy — both for you as a surrogate and the baby you’ll carry.

18. Can you be a surrogate with diabetes?

Diabetes makes it difficult for people to control their blood glucose levels and, during pregnancy, this can be incredibly dangerous. If you have Type 1 or Type 2 diabetes, you will often be disqualified from being a surrogate.

Like any other pregnancy, a surrogate pregnancy comes with the risk of developing gestational diabetes — which lasts until the baby is born. If you have a history of gestational diabetes in earlier pregnancies, speak with your surrogacy professional and your doctor to see if pursuing surrogacy will be safe for you.

19. What are the BMI requirements for surrogacy?

Part of being a healthy surrogate is meeting surrogate mother weight requirements. While your weight will always be evaluated by a medical professional during your initial screening, surrogacy professional often set a required BMI to be a surrogate early on. That way, you can know before applying whether you will be eligible.

Every professional has a different standard for what’s the best BMI for a surrogate, but many adhere to the recommendations of the ASRM: a BMI between 19 and 32. It’s for a reason; any woman who is underweight or obese will have a riskier pregnancy that a woman at a healthy weight.

If you’re asking, “Am I too fat to be a surrogate?” we encourage you to speak with a surrogacy professional or fertility clinic. BMI can be a misleading measurement of health, so an in-person exam can sometimes be the best determination of whether your weight is healthy enough for pregnancy.

20. Can you be a surrogate if you’re on antidepressants?

Every woman who wishes to become a surrogate must pass certain psychosocial screenings to ensure she is mentally prepared for the emotional challenges of surrogacy. Either during this screening or before, your surrogacy professional will ask you about your history of mental illness, including any medication you might be taking.

Simply put, you cannot be a surrogate if you’re on antidepressants during the pregnancy. You must stop taking antidepressant or antianxiety medication 12 months before applying to be a surrogate.

Now, if you’re asking, “Can I be a surrogate with a history of depression?” the answer is a bit different.

If your illness has been treated and is manageable, it likely won’t affect your ability to be a surrogate. However, if your condition will prevent you from properly scheduling and attending appointments, taking medication at the correct time and legally consenting to your surrogacy agreement, it will likely prevent you from pursuing surrogacy.

Because your personal mental health situation is always unique, speak with a surrogacy professional for more information.

Understanding and meeting the necessary health requirements to be a surrogate mother is an important part of your surrogacy journey. Only once you have done so can you safely carry a baby for intended parents and help their family dreams come true.

If you have a question that wasn’t answered here, or you want to learn more about surrogate health requirements, contact an appropriate surrogacy agency or surrogacy clinic today.

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