Hatch Fertility Blog

13 Disqualifying Factors for Becoming a Surrogate in 2024

Hatch Fertility
Written by Hatch Fertility
02/29/2024

Gestational surrogacy is a transformative journey for everyone involved. Helping another family achieve their dreams of becoming a parent and becoming a parent are both deeply profound and rewarding experiences.

Surrogacy qualifications and requirements are determined by multiple stakeholders, from your surrogacy agency to the IVF clinic and your State’s legislation. 

If you’re considering gestational surrogacy, review the following surrogacy disqualifications and ask yourself if you’re prepared, physically and mentally, to embark on this exciting journey. 

Medical Disqualifications for Gestational Surrogacy

Below are medical conditions that can prevent people from becoming gestational surrogates. 

1. Polycystic Ovary Syndrome (PCOS) 

Those who suffer from PCOS have a higher chance of developing Gestational Diabetes, Endometrial Cancer, and Preeclampsia. Additionally, women who suffer from PCOS are known to produce a significant amount of the male hormone Androgen. Because of this, one may exhibit symptoms such as missed or irregular periods, body hair, weight gain, and acne. 

Androgen also prevents the female reproductive system from releasing a healthy egg from the ovary into the fallopian tubes, making it harder to conceive a child. We service gestational surrogacy, so the surrogate does not share a genetic connection with the child the carry, though successfully carrying the pregnancy is what everyone involved is hoping for.

2. Preeclampsia

Preeclampsia is a medical condition that presents symptoms such as high blood pressure, protein in the urine, and kidney damage. These health issues typically make carrying a pregnancy to term dangerous for both the gestational carrier and the baby. 

At worst, preeclampsia can affect a gestational carrier’s kidneys and liver, cause neurological symptoms, compromise blood flow from the placenta to the baby, or escalate to eclampsia. Discovering preeclampsia during pregnancy may necessitate inducing labor before the due date or even before viability if pre-eclampsia occurs early in pregnancy- which can be extremely difficult for surrogates and intended parents pursuing gestational surrogacy. 

3. Unhealthy BMI

Being a little overweight won’t prevent you from becoming a surrogate, especially if you've had previous pregnancies at a similar weight without complications. However, women classified as morbidly obese or with a BMI over 32 will have to lose weight to qualify because there are medical complications associated with being over or underweight. 

Women need to maintain a normal BMI to qualify as surrogates. Most agencies don't have a minimum weight requirement, but the lower end typically stays above 19 because this can impact menstrual cycles and pregnancy and lead to premature birth. However, a pre-pregnancy BMI over 32 can lead to an increased risk of complications in pregnancy.

At Hatch, potential surrogates should have a BMI no higher than 32.

4. Gestational Diabetes 

Due to medical risk factors associated with diabetes, women experiencing Type 1 Diabetes cannot become surrogates. As this is a lifelong disease that affects the control of your blood sugar, you’ll experience hormonal-related glucose intolerance during the prenatal period of your gestational surrogacy. 

Some women who do not have pre-existing diabetes outside of pregnancy may experience gestational diabetes, and a surrogate candidate is disqualified. Sometimes women experience gestational diabetes that does not recur in future pregnancies, and it is well managed with diet alone. In this case, the surrogate may still be a good candidate if she has a recent normal A1c and fasting glucose test. 

Risk factors associated with gestational diabetes include: 

  • Future Diabetes in Mother and Child 
  • Excessive weight in infant 
  • Premature delivery
  • Low blood sugar in baby 
  • Preeclampsia in mother
  • Respiratory distress syndrome in Baby

Because of the risks gestational diabetes poses to pregnancy, surrogacy agencies don’t accept women with gestational diabetes requiring the use of insulin or similar medications

5. Endometriosis 

Endometriosis occurs when the tissue lining a woman’s uterus grows outside the womb, including the ovaries, fallopian tube, cervix, bladder, and even the tissue that holds the uterus in place. Endometriosis makes it harder to conceive and can cause infertility--still, women with endometriosis can undergo surgery to remove these growths. Endometriosis is a disqualifier for surrogates, where it is of the utmost importance that medical conditions haven’t compromised their fertility. 

endometriosis diagram for surrogacy disqualifications

Source: News Medical

6. Multiple C-Sections

Although one C-section may not disqualify you from becoming a surrogate, multiple C-sections will. Most clinics only accept surrogates with no more than two previous C-sections; some will get candidates with three C-sections if the pregnancies are uncomplicated and they pass a mock cycle. However, the exact number of C-sections you can have hasn't been established yet

At Hatch Fertility, prospective surrogates with three C-Sections must have less than five total deliveries and pass a mock cycle to qualify.

7. Other Underlying Health Conditions

Other severe medical conditions unrelated to pregnancy could disqualify a surrogate, such as mental illnesses requiring medication/treatment and any conditions that require medications deemed unsafe for pregnancy.

Agencies defer to IVF doctors to set the parameters for the health and safety of surrogates and babies alike by providing them with medical records to review for surrogate candidates in the best effort to mitigate avoidable risks. 

Other Surrogacy Disqualifications

While not all medical, below are more barring factors that can prevent women from becoming surrogates. 

8. No Previous Children

Agencies and IVF clinics require their surrogates to give birth to at least one child they are raising, and it should also be uneventful and risk-free. Many have questioned why agencies have this requirement at the top of their lists.

However, did you know that some women never experience a successful pregnancy? Without having a previous child, agencies can't clarify whether a potential surrogate can carry a child to term. Apart from that, it also shows the agency that the women are psychologically prepared for pregnancy.

9. Under or Over the Childbearing Age

You must be between the ages of 21 and 42 to qualify as a surrogate. If you are under or over this age limit, there are increased chances of pregnancy complications. However, note that the age restrictions will differ from one agency to the next.

In most cases, the IVF clinic will get the final say on whether you are a suitable surrogate. Women past menopause usually experience multiple pregnancy complications because their body works to prevent future pregnancies.

10. Drug Use

Despite drinking and smoking not being labeled as illegal behaviors, they are not healthy habits for pregnant women. Therefore, prospective surrogates with any history of drug or alcohol abuse get eliminated from the vetting process. Surrogates must abstain from tobacco, cannabis, and alcohol products pre-conception and throughout the surrogacy. 

At PFCLA, for example, a thorough vetting process ensures a staggering success rate of more than 13,500 healthy births

11. Not Being a U.S Citizen or Legal Resident

The lengthy surrogacy process is safe and smooth when working with a US-based IVF clinic. Therefore, agencies only work with surrogates who are legal residents or U.S. citizens, ensuring the entire journey is safer and more convenient for all involved parties.

A surrogate agency will undergo extensive screening to ensure a candidate is a great fit to become a surrogate socially, medically, and psychologically. Expect state and federal background checks as well as financial screenings.  Surrogates are entrusted with great responsibility; extensive screening for safety and peace of mind comes with that.

12. Living in a Non-Surrogacy-Friendly State

Some state laws make surrogacy either complicated or prohibited. Due to surrogacy laws, we are currently not accepting surrogates residing in the following states:

  • Arizona
  • Indiana
  • New York
  • Louisiana
  • Nebraska
  • Michigan

Learn more about surrogacy laws across the U.S. in our blog "Explore the Best U.S. States for Surrogacy."

13. Living in an Unsafe Environment

Agencies must ensure that their surrogates live in a stable environment that will not negatively impact their pregnancies. All intended parents want to be reassured that their surrogate is in a healthy environment conducive to pregnancy. It is up to the agencies to determine that a potential surrogate is committed to maintaining a healthy lifestyle. 

Women experiencing financial difficulties, receiving state assistance such as food stamps, or having serious concerns about their criminal and financial background checks will not qualify.

See if You Qualify To Become a Surrogate

Do you want to change the lives of intended parents by giving them the gift of parenthood? At Hatch, we can help you start your journey to becoming a surrogate mother. Apply today to help create families with the assistance of life.