What Happens During the Surrogate Screening Process?

The surrogate screening process helps determine whether an applicant is medically, emotionally, and practically prepared to become a gestational surrogate.

Screening does not happen in one appointment. It usually begins with an application and continues through pregnancy-record review, interviews, psychological evaluation, background checks, medical testing, and fertility clinic clearance.

Each part serves a purpose. The agency needs to understand the applicant’s pregnancy history and daily circumstances. The fertility clinic needs to determine whether she meets its medical standards. The applicant also needs enough information to decide whether the commitment fits her health, family, work, and responsibilities.

Meeting the starting requirements does not guarantee approval. It means the application may continue into more detailed review.

Why Are Gestational Surrogates Screened?

A gestational surrogate agrees to fertility medications, medical appointments, an embryo transfer, pregnancy, delivery, and ongoing communication with intended parents and professionals.

The commitment affects more than her medical care. It also affects her schedule, children, household, work, transportation, relationships, and support system.

Screening helps assess whether those responsibilities are realistic for the applicant. It also gives the applicant time to understand what participation will require before matching or treatment begins.

For intended parents, screening provides information about the prospective surrogate’s pregnancy history, health qualifications, support, reliability, and readiness.

For the surrogate, it helps identify medical or practical concerns before she becomes financially or emotionally invested in a match.

Screening is not just a formality. It protects the surrogate, intended parents, pregnancy, and working relationship.

The Surrogate Screening Process Begins With an Application

The first step is usually a surrogate application.

At Global Surrogacy Services, the application collects information from surrogate applicants about contact details, location, pregnancy history, health, lifestyle, citizenship or legal status, transportation, mental health, substance use, support, and willingness to complete the requirements of a fertility clinic.

Applicants may also answer questions about previous C-sections, gestational diabetes, pregnancy-induced hypertension, preeclampsia, medications, smoking, whether they are tobacco free, drug use, criminal history, and prior fertility or surrogate experience.

The application is an initial review, not a final medical decision.

An applicant should answer every question honestly. Leaving out a health condition, pregnancy complication, medication, or lifestyle concern does not help the process continue faster. Missing information can delay records review or cause a match to end later.

Applying starts the review. It does not guarantee approval or obligate the applicant to continue.

What Basic Qualifications Does the Agency Review?

Before requesting extensive records or scheduling evaluations, the agency reviews whether surrogate candidates appear to meet the starting requirements against the agency’s own requirements, which often include proven fertility and a healthy body mass index bmi.

The review commonly covers:

• Age and location
• Prior pregnancy and delivery
• Whether she is currently raising a child
• General health and Body Mass Index (BMI), with many programs requiring a BMI below 35
• Smoking, vaping, and recreational drug use
• Housing stability
• Reliable transportation
• Support from a spouse, partner, family member, or other trusted person
• Criminal history
• Mental health history
• Ability to attend appointments and follow clinic instructions

Global Surrogacy Services also considers whether an applicant understands the practical commitment involved. A healthy pregnancy history matters, but it is not the only consideration. A BMI above 35 is associated with higher pregnancy risks, so it does not automatically disqualify every applicant but may require closer review.

A prospective surrogate also needs time, transportation, dependable communication, and support at home. She must be prepared to complete medical testing, take prescribed fertility medications, attend appointments, and communicate openly when something changes.

Applicants should review the current surrogate requirements before applying. Exact standards can change based on agency policy, fertility clinic requirements, medical history, and case-specific review.

Pregnancy and Delivery Records Are a Major Part of Screening

Prior pregnancy history and obstetric history are two of the most important parts of gestational surrogate screening.

An applicant generally needs to have completed a prior pregnancy and delivery. This gives medical professionals actual records to review rather than asking them to predict how her body may respond to pregnancy for the first time.

The agency or fertility clinic may request records as part of a medical records review, with prenatal and delivery records central to that process:

• Prenatal care
• Labor and delivery
• Hospital admission
• C-section or other procedures
• Postpartum care
• Treatment for pregnancy complications
• Previous fertility or surrogate cycles

Medical professionals may review whether the applicant’s previous pregnancies, the last pregnancy, or other medical conditions suggest elevated risk for a future surrogate pregnancy, including severe preeclampsia, significant gestational diabetes, preterm delivery, recurrent miscarriage, or complications related to prior C-sections.

A prior complication does not always produce an immediate answer. The severity, treatment, timing, recurrence risk, and current health all matter. The fertility clinic reviews the records and determines whether additional testing or specialist input is needed.

The agency should not diagnose the applicant or decide whether a medical condition is safe for pregnancy. That decision belongs with qualified medical professionals.

What Happens During the Surrogate Interview?

After the initial application review, the agency may schedule a phone, video, or in-person interview.

The interview allows the agency to learn more than a form can show and to place the applicant within the broader surrogacy process. It also helps the agency decide whether screening should continue and gives the applicant time to ask questions before more review begins.

Topics may include:

• Why she is considering surrogacy
• Her previous pregnancy experiences
• Her household and support system
• Her work and childcare responsibilities
• Transportation to appointments
• Communication preferences
• Her understanding of IVF medications and embryo transfer
• How her family feels about surrogacy
• What she expects from intended parents
• How she handles stress or changes in plans
• Whether travel could be required
• What she understands about screening, matching, pregnancy, and recovery

The agency may also request personal references from family and friends, including someone from the immediate family when appropriate, and contact them to evaluate the applicant’s stability and support.

The agency is not looking for a rehearsed answer about wanting to help a family. It needs an honest understanding of the applicant’s motivations, concerns, responsibilities, and expectations.

A prospective surrogate should use the interview to evaluate the agency, too. She can ask who will support her, how communication works, what expenses are reimbursed, how the matching process is handled, and what happens when a match or transfer does not continue. This conversation also helps prepare both sides for the steps that follow in screening and placement.

Why Does the Support System Matter?

Pregnancy does not happen outside of normal life.

A surrogate may still need to manage work, parenting, household responsibilities, transportation, appointments, medication schedules, and unexpected medical instructions. Some procedures or pregnancy complications could temporarily affect what she is able to do.

A strong support system may include a spouse, partner, relative, friend, or another trusted person who understands the commitment.

The agency may ask:

• Who can help with childcare during appointments?
• Who can provide transportation if needed?
• Does the person at home understand the surrogacy arrangement?
• Who can assist if the clinic requires travel?
• Is someone available if the surrogate needs rest or has activity restrictions?
• Does the household support the medical and communication requirements?

A Primary Support Person plays an important role because that person may need to help with appointments, childcare, transportation, or recovery needs.

Support does not mean the surrogate loses independence. It means she has people available when pregnancy, treatment, or scheduling places additional demands on her household.

Global Surrogacy Services may also review the home and daily environment to confirm that the applicant has stable living conditions and practical support. The agency is also looking at how the applicant’s support network affects the surrogate’s ability to manage the demands of the surrogacy journey and maintain a smooth experience.

What Does the Psychological Evaluation Cover?

Psychological screening is a standard part of the surrogate review process.

The evaluation does not assume that an applicant has a mental health condition. It gives a licensed mental health professional an opportunity to complete psychological screening and psychological assessment of emotional readiness, expectations, coping skills, support, and understanding of the arrangement.

This psychological assessment often includes a structured interview conducted by the licensed mental health professional.

The discussion may cover:

• Motivation for becoming a surrogate
• Previous pregnancy and birth experiences
• Feelings about carrying a child for intended parents
• Expectations about communication and the relationship
• Emotional responses to embryo transfer outcomes
• Thoughts about pregnancy loss or medical complications
• Feelings about delivery and separation after birth
• Family and partner support
• Mental health and treatment history
• Stress management
• Boundaries and decision-making
• Expectations after delivery

Some evaluations also use the Personality Assessment Inventory as part of screening.

A history of counseling or mental health treatment does not explain a person’s current readiness by itself. The evaluator will consider the condition, treatment, stability, medications, support, and professional recommendations.

Untreated or significant current mental health concerns may prevent or pause an application. The purpose is not to punish someone for seeking treatment. It is to determine whether the demands of fertility treatment, pregnancy, communication, and delivery are appropriate at that time so applicants can feel confident about whether to pursue surrogacy.

What Is Included in the Surrogate Background Review?

A surrogate background check helps the agency identify concerns that could affect safety, reliability, legal planning, or the stability of the arrangement.

The review may include county, state, and federal criminal records. A spouse or partner living in the home may also need to participate.

The application and interview may ask about:

• Criminal convictions
• Violence or abuse
• Child endangerment
• Substance-related history
• Current legal matters
• Household safety
• Driving and transportation
• Previous involvement with another surrogacy arrangement

Not every historical issue has the same significance. The agency reviews what occurred, when it occurred, and whether it affects the current application.

Applicants should disclose relevant history early. Finding an undisclosed issue during a later background review can delay or end the application.

What Lifestyle Factors Are Reviewed?

The screening process also considers whether the applicant’s daily circumstances support a healthy and dependable arrangement.

Lifestyle review may cover:

• Smoking or vaping
• Recreational drug use
• Alcohol or substance-use history
• Prescription medications
• Housing stability
• Reliable transportation
• Ability to attend appointments
• Financial circumstances
• Support at home
• Willingness to follow clinic protocols

Global Surrogacy Services identifies smoking, vaping nicotine, drug use, unstable housing, insufficient support, lack of reliable transportation, and certain criminal or substance-use histories among concerns that could disqualify an applicant.

Applicants should not assume that one question automatically disqualifies them unless the agency has said so. Some circumstances require additional information rather than a simple yes-or-no decision.

For example, not every form of government assistance receives the same treatment. An applicant with questions about financial eligibility should speak with the agency rather than leaving out information or deciding not to apply based on an assumption.

What Happens During Medical Screening?

Agency review and fertility clinic clearance are separate stages.

The agency may determine that an applicant appears to meet its starting requirements. The fertility clinic then conducts its own surrogate medical screening, including a separate medical evaluation by the medical team, before approving her for embryo transfer.

Medical screening may include:

• Review of pregnancy and delivery records
• Review of general medical history
• Physical examination
• Blood and urine testing
• Testing for infectious diseases, following FDA and ASRM requirements
• Drug and nicotine testing
• Uterine evaluation
• Review of current medications
• Assessment of previous surgeries or C-sections
• Additional testing requested by the fertility clinic

The clinic may also request records or evaluations that the agency did not require during the initial review. It also reviews whether the surrogate’s current health insurance covers surrogate pregnancies.

Medical clearance belongs to the fertility clinic. An agency cannot guarantee that an applicant will receive approval simply because she passed the preliminary screening.

That distinction is important for both the surrogate and intended parents. A profile can be reviewed and a potential match can feel comfortable, but clinic approval is meant to leave no stone unturned before treatment proceeds, and final medical clearance is typically confirmed again immediately before embryo transfer.

What Medical Issues May Affect Surrogate Eligibility?

Certain medical and reproductive concerns affecting prospective gestational carriers may prevent an application from continuing or require additional review.

GSS screening materials identify concerns such as:

• No prior full-term pregnancy
• Severe pregnancy complications
• Preterm labor or delivery
• Gestational diabetes requiring significant treatment
• Multiple prior C-sections
• Recurrent miscarriage
• Previous surrogate complications
• Abnormal uterine evaluations
• Uncontrolled diabetes
• Heart disease
• Serious hypertension
• Certain autoimmune disorders
• Untreated sexually transmitted infections
• Medications considered unsafe during pregnancy

These are review categories, not instructions for applicants to diagnose themselves. Some issues do not automatically disqualify an applicant, but instead require case-by-case review based on medical records, current health, treatment history, and the fertility clinic’s standards.

An applicant should disclose her history and allow the agency and medical professionals to review it.

Can Someone Pass Agency Screening but Not Receive Clinic Clearance?

Yes.

Agency screening determines whether the applicant appears to meet the agency’s qualifications and is prepared to continue. Clinic screening determines whether the fertility specialist considers her medically eligible for a particular case and treatment plan.

A clinic may identify a concern that was not apparent during the initial application. It may also apply different standards based on medical history, embryo-transfer protocol, current test results, or its own policies.

This is one reason the journey begins only after multiple reviews continue beyond initial agency approval.

Mutual interest is important, but it is not final approval. Additional medical, psychological, legal, background, and insurance review may still be required before the match becomes official, with legal clearance including contracts that define roles and responsibilities. This stage helps create a strong foundation before legal clearance and treatment move forward.

How Long Does Surrogate Screening Take?

There is no single timeline for a thorough screening process.

The process depends on:

• How quickly the application is completed
• Whether the applicant meets the starting requirements
• How long it takes to obtain pregnancy and delivery records
• Interview scheduling
• Psychological evaluation availability
• Background-check processing
• Fertility clinic availability
• Required medical testing
• Whether additional records or specialist input are needed
• Insurance review
• Whether screening happens before or after a potential match

In some early-stage cases, the surrogate screening process may move in about 1–3 weeks, but complete screening more often takes several weeks to months once records, evaluations, and clinic review are included.

Applicants can reduce avoidable delays by completing forms accurately, responding to the agency, providing provider information, attending scheduled appointments, and disclosing relevant medical or personal history early.

The goal should not be to finish screening as quickly as possible. The goal is to complete it with accurate information. Only a small percentage of applicants complete the full process, with some programs reporting that fewer than 8% pass screening.

What Happens After a Surrogate Passes Screening?

Screening does not lead directly to an embryo transfer.

Depending on which parts have already been completed, the next stages may include:

• Creating or completing the surrogate profile
• Reviewing a potential intended-parent match
• Meeting the intended parents
• Confirming mutual interest
• Completing fertility clinic clearance
• Finishing psychological or background requirements
• Reviewing insurance
• Receiving independent legal representation
• Finalizing the legal agreement
• Funding escrow
• Beginning the fertility clinic’s medication and transfer plan

The order may differ by case.

Not every potential match continues. The timing may change, medical clearance may identify a concern, or the surrogate or intended parents may decide that the fit does not work after speaking.

That is not a failure of screening. It is part of making sure a match does not continue without the required medical approval, practical alignment, and mutual comfort.

What Should Applicants Ask Before Screening Begins?

A prospective surrogate should understand what she is agreeing to before scheduling medical or psychological evaluations.

Useful questions include:

• What are the current starting requirements?
• Which pregnancy records will I need?
• Who pays for screening appointments?
• Will my spouse or partner need to participate?
• What does the psychological evaluation involve?
• Which background checks are required?
• When does fertility clinic screening occur?
• Will I review intended-parent information before agreeing to a match?
• Who will explain compensation and reimbursements?
• Who will serve as my case manager?
• What happens if the clinic does not clear me?
• How will my personal and medical information be used?

A dependable agency should answer these questions directly and explain which decisions belong with the agency, fertility clinic, mental health professional, or attorney.

Apply to Become a Surrogate With Global Surrogacy Services

The surrogate screening process asks for detailed information because gestational surrogacy involves a serious commitment.

Global Surrogacy Services reviews each applicant’s pregnancy history, health, support, lifestyle, and readiness before determining whether the next screening stage makes sense. The fertility clinic and other professionals then complete their own evaluations before medical treatment begins.

Not every applicant will qualify. That is not a judgment of her character or willingness to help another family. It means the medical or practical requirements do not align at this time.

Women who appear to meet the starting requirements can submit a surrogate application for review by Global Surrogacy Services.