Surrogacy Requirements in the U.S. (Updated 2026 List)
Surrogacy Requirements in the U.S. (Updated 2026 Guide)
Becoming a gestational surrogate is one of the most meaningful ways to help someone build their family. But before embarking on this life-changing journey, it’s important to understand whether you meet the qualifications. Surrogacy requirements exist not to discourage potential surrogates, but to ensure the health and safety of everyone involved—the surrogate, the baby, and the intended parents.
If you're considering surrogacy, you may be wondering: Do I qualify? What exactly are agencies and fertility clinics looking for?
This comprehensive 2025 guide walks you through all current surrogacy requirements, including age ranges, BMI limits, pregnancy history, lifestyle factors, and medical criteria.
Why Do Surrogacy Requirements Exist?
These guidelines are based on recommendations from the American Society for Reproductive Medicine (ASRM) and decades of medical research. They exist to:
- Minimize health risks for both the surrogate and the baby
- Ensure the surrogate is physically and emotionally prepared
- Increase the likelihood of a healthy pregnancy
- Protect all parties throughout the process
Most agencies and fertility clinics follow similar standards, even if minor variations exist.
Age Requirements
Accepted age range: 21 to 38–42 years old
Age is one of the most important factors in surrogacy eligibility. Most agencies accept surrogates between ages 21 and 38, though many clinics will approve experienced surrogates up to age 42.
BMI Requirements
BMI range: 18.5 to 30–33
BMI is used to evaluate weight-related health risks. Although BMI isn’t a perfect measurement, it remains a standard requirement in surrogacy screening.
Most clinics require a BMI below 30, with some accepting up to 32–33.
A higher BMI increases risks such as:
- Gestational diabetes
- Hypertension or preeclampsia
- Blood clots
- Delivery complications
- Anesthesia challenges during C-sections
Pregnancy History Requirements
Required: At least one full-term, uncomplicated pregnancy
This ensures:
- The surrogate’s body has demonstrated the ability to carry a healthy pregnancy
- Medical records can be reviewed for safety
- She understands the physical and emotional experience of pregnancy
- Lower risk of postpartum depression due to having a child at home
Conditions that may disqualify candidates:
- Preeclampsia or eclampsia
- Gestational diabetes requiring insulin
- Multiple preterm births
- Postpartum hemorrhage requiring transfusion
- Recurrent pregnancy loss
- Placenta previa or placental abruption
The fertility clinic will thoroughly review all records.
Lifestyle & Health Requirements
No Smoking, Vaping, or Marijuana Use
Surrogates must be nicotine-free for 6–12 months prior to applying. This includes:
- Cigarettes
- Vaping/e-cigarettes
- Marijuana (even where legal)
- Secondhand smoke
All applicants complete urine drug and nicotine testing. Any detection results in denial.
Alcohol-Free During Pregnancy
Surrogates must abstain from alcohol during the entire journey, as no amount of alcohol is considered safe during pregnancy.
Mental Health Stability
Required: Psychological screening by a licensed mental health professional
Potential disqualifiers include:
- Certain psychotropic medications
- Untreated mental health conditions
- Schizophrenia, bipolar disorder, or borderline personality disorder
- Recent substance abuse
- Significant legal or family instability
Some medications may be acceptable depending on clinic approval.
Medical Conditions That May Disqualify Candidates
Certain pre-existing conditions increase pregnancy risks, including:
- Insulin-dependent diabetes
- Uncontrolled hypertension
- Epilepsy
- Certain cases of PCOS
- Serious heart conditions
- Autoimmune disorders (varies)
- Clotting disorders or history of blood clots
A full physical exam and detailed diagnostic testing are required.
Legal & Residency Requirements
Required: Residency in a surrogacy-friendly state
Supportive states include:
- California
- Nevada
- Illinois
- Washington D.C.
- Arkansas
- Oregon
- New Hampshire
States like Louisiana and a few others are not recommended due to legal barriers.
Citizenship Requirements
Most agencies require surrogates to be:
- U.S. citizens, or
- Legal permanent residents (green card holders) with adequate residency remaining
Criminal Background Requirements
Required: Clean criminal record for you and any adults in your home
Violent or child-related offenses lead to disqualification.
Financial Stability Requirements
Surrogates must be financially stable and not dependent on surrogacy compensation for basic living expenses. Surrogacy should be an empowering choice, not a financial lifeline.
Surrogates should not be on public assistance programs during their journey.
Why Work With Patriot Conceptions?
At Patriot Conceptions, we provide:
- Comprehensive guidance from first inquiry to delivery
- Fair, competitive compensation
- Access to top fertility clinics nationwide
- Experienced reproductive attorneys
- 24/7 support from dedicated coordinators
- Safe, streamlined, legally protected processes
We work exclusively with surrogates from surrogacy-friendly states to ensure smooth, successful journeys.
Sources
- American Society for Reproductive Medicine (ASRM) — Gestational Surrogacy Guidelines
- Yale Fertility Center — Surrogacy Requirements
About this article
Surrogacy is a legal and medical-adjacent topic. This article is for informational purposes only and is not legal or medical advice.
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