A gestational surrogate carries a pregnancy for intended parents using an embryo created through in vitro fertilization (IVF). Since the embryo uses the intended parents’ or donors’ genetic material, the surrogate has no biological connection to the child. Surrogacy requires a significant commitment of time, body, and emotion, and the process is governed by strict medical, legal, and personal standards. Understanding these requirements is the first step in determining eligibility.
Essential Physical and Parental Qualifications
The initial screening process establishes whether a candidate meets the baseline physical and parental requirements set by surrogacy agencies and fertility clinics. These criteria are in place to maximize the chances of a healthy, successful pregnancy. Most agencies require candidates to be between 21 and 40 years old, though some clinics may extend the upper limit to 44 years, as pregnancy risks generally increase with age.
A candidate must demonstrate a history of successful, uncomplicated pregnancy and delivery, having carried at least one child to full term, which proves the uterus is capable of sustaining a pregnancy. This also ensures the candidate understands the physical and emotional experience. Guidelines typically limit the total number of prior deliveries to five and prior C-sections to three. Candidates must also be actively raising a child of their own, which indicates stability and maturity and helps ensure they have no desire to retain the child.
Physical health is assessed through Body Mass Index (BMI), with most clinics requiring a BMI between 18 and 32, or up to 35. A BMI outside this range increases the risks of complications like gestational diabetes and preeclampsia. Candidates must also be non-smokers and free from drug or alcohol dependency, and must reside where compensated surrogacy is permitted.
Mandatory Medical and Psychological Screening
Once initial qualifications are met, a candidate proceeds to comprehensive clinical evaluations designed to ensure both physical and mental readiness for the demands of a gestational pregnancy. Medical screening is conducted at the intended parents’ fertility clinic, starting with a thorough review of the candidate’s medical and obstetric history. This includes a physical exam, a Pap smear, and a uterine evaluation, often involving a transvaginal ultrasound or hysteroscopy to confirm the uterine cavity is structurally normal for embryo implantation.
Laboratory tests screen for infectious diseases, including HIV, Hepatitis B and C, Syphilis, Chlamydia, and Gonorrhea, using blood work and cervical swabs. Blood tests also check hormone levels, blood type, and Rh factor to ensure compatibility with IVF protocols. The candidate’s partner may also require infectious disease screening to prevent any risk of transmission during the cycle.
The psychological evaluation is administered by a licensed mental health professional, such as a psychologist or social worker. This assessment involves a clinical interview and often a standardized personality test to evaluate mental stability, coping mechanisms, and support system. The goal is to confirm the candidate fully understands the emotional complexities of carrying a child with no genetic link and is prepared for the unique dynamic with the intended parents.
Navigating the Surrogacy Journey
The surrogacy journey is a structured, multi-stage process beginning after medical and psychological clearance. The agency facilitates the matching process, pairing the surrogate with intended parents based on mutual preferences regarding communication and expectations.
The legal phase must be finalized before medical procedures commence. This involves a comprehensive gestational surrogacy agreement, negotiated with separate legal counsel for both the surrogate and the intended parents. The intended parents cover the surrogate’s legal fees. Once the contract is executed, the parties receive “legal clearance,” permitting the fertility clinic to move forward with the medical cycle.
The medical preparation phase involves the surrogate starting hormonal medications, typically estrogen and progesterone, to suppress her natural cycle and prepare the uterine lining. This cycle is monitored through blood tests and ultrasounds to synchronize the uterus with the embryo’s developmental stage. The embryo transfer is a non-surgical procedure where the embryo is placed into the uterus. Pregnancy is confirmed ten to fourteen days later via a blood test, followed by ultrasounds to confirm a fetal heartbeat. The surrogate then transitions to receiving prenatal care from her own obstetrician.
Legal Framework and Compensation
The legal contract is the foundational document, clearly defining the rights, responsibilities, and decision-making authority for all parties involved. This agreement explicitly states that the gestational carrier has no parental rights or obligations to the child, which is a core tenet of modern gestational surrogacy. The contract outlines all medical decisions, including agreements on issues like selective reduction or termination, ensuring clarity and protection.
Financial compensation covers two main categories: base compensation and expense reimbursement. Base compensation is a fee paid to the surrogate for her time, commitment, and physical demands of the pregnancy. Intended parents also cover all necessary expenses related to the surrogacy, including:
- Medical co-pays.
- Travel for clinic appointments.
- Maternity clothing.
- Compensation for lost wages due to appointments or bed rest.
The legal framework for surrogacy varies significantly by state, impacting contract enforceability and the legality of compensation. Some states fully support compensated, or commercial, surrogacy, providing clear legal pathways for establishing parentage through pre-birth orders. Other states may only permit altruistic surrogacy, where only expenses are reimbursed, or may have laws that make surrogacy contracts void or unenforceable, which introduces significant legal risk for both the surrogate and the intended parents.