Quick Summary
This guide explains how women can become gestational surrogates in the United States, including eligibility requirements, compensation expectations, timelines, legal protections, and what the surrogacy process involves nationwide. It reflects how Egg Donor & Surrogacy Institute EDSI supports surrogates from application through delivery, including coordination of required travel when applicable.
See if you qualify to become a surrogate
Egg Donor & Surrogacy Institute (EDSI) follows professional guidelines established by the American Society for Reproductive Medicine and works with board certified reproductive endocrinologists and licensed reproductive attorneys who specialize in surrogacy law.
Timelines, ranges, and examples in this guide reflect EDSI’s experience supporting hundreds of surrogacy journeys. Individual experiences may vary based on medical history, clinic protocols, location, and matching factors.
Information last updated: January 2026. Requirements and processes reflect current EDSI standards and may evolve as medical guidelines and state laws change.
Table of Contents
Becoming a surrogate: The complete guide to surrogate requirements and the surrogacy process
Quick answers to common questions
Surrogate requirements explained
How the surrogacy process works
Surrogate safety and the legal map in plain language
Becoming a surrogate: The complete guide to surrogate requirements and the surrogacy process
Who this guide is for
This guide is for women exploring gestational surrogacy who want clear information about eligibility, the surrogacy process, and how surrogacy programs coordinate medical, legal, and logistical steps.
- A qualified surrogate is a healthy woman with at least one prior full term birth who completes psychological screening and medical screening and lives in a stable living environment.
- Common disqualifiers include out of range BMI, major pregnancy complications, current nicotine use, active substance use, or residence in a state that does not support compensated surrogacy.
- In EDSI’s experience, many journeys move from application to embryo transfer within approximately eight to sixteen weeks, though individual timelines vary.
- Your coordinator reviews your existing health insurance and explains coverage requirements. If additional coverage is needed, options are discussed before the legal agreement is finalized.
- You may request a single embryo transfer plan. Your legal agreement and clinic treatment plan document that preference.
If you want to see whether you qualify, you can complete a short prescreening form here.
Requirements table
| Requirement | Typical Standard | Why It Matters |
|---|---|---|
| Age | 21 through 40 | Reproductive medicine programs use this age range based on clinical pregnancy outcome data and safety considerations. |
| Prior birth | At least one prior full-term birth | Demonstrates pregnancy history and helps physicians plan prenatal care safely. |
| Cesarean history | Usually 2 to 3 maximum, depending on recovery and individual medical assessment | Protects uterine health and reduces pregnancy-related risk in future deliveries. |
| Body Mass Index | Generally between 19 and 32, though specific thresholds vary by clinic | Clinics use BMI thresholds to support embryo transfer success and healthy prenatal outcomes. |
| Nicotine and substance use | No nicotine use and no recreational drug use | Required to reduce pregnancy risks and support healthy pregnancy conditions. |
| Support system | Identified support person or support network | Provides practical help with appointments and childcare, and emotional support throughout the journey. |
| Location | Residence in a surrogate-friendly state | Allows clear legal parentage planning and predictable court timelines. |
| Screening | Licensed psychological evaluation and medical clearance from a reproductive endocrinologist | Confirms medical readiness and psychological preparedness for surrogacy. |
Surrogate requirements explained
Age requirement
Most surrogacy programs accept candidates between the ages of 21 and 40. This age range is based on clinical pregnancy outcome data and safety considerations in reproductive medicine.
Prior birth requirement
Surrogates must have experienced at least one prior full term birth. A documented pregnancy history helps physicians plan prenatal care effectively.
Cesarean history
Most programs allow up to two or three prior cesarean deliveries, depending on recovery and individual medical assessment. These limits protect uterine health and reduce pregnancy related risk in future deliveries.
Body mass index requirement
Clinics generally require a body mass index between 19 and 32, though specific thresholds may vary by clinic. BMI guidelines support embryo transfer success and promote healthy prenatal outcomes.
Nicotine and substance use
Surrogate candidates must not use nicotine or recreational drugs. This requirement reduces pregnancy risks and supports healthy pregnancy conditions throughout the journey.
Support system requirement
Surrogates are required to identify a support person or support network. This support provides practical help with appointments and childcare, as well as emotional support during pregnancy and recovery.
Location requirement
Surrogates must reside in a surrogacy friendly state. Surrogacy friendly states have legal frameworks that enable clear parentage planning and predictable court timelines.
Screening requirements
All surrogates complete a licensed psychological evaluation and receive medical clearance from a reproductive endocrinologist. These screenings confirm both medical readiness and psychological preparedness for surrogacy.
How the Surrogacy Process Works
The surrogacy process follows a structured sequence designed to support medical readiness, legal clarity, and emotional preparedness from start to finish. From initial application to delivery, most surrogacy journeys take approximately sixteen to twenty four months, including screening, matching, pregnancy, and recovery.
Step 1 Application and prescreening
You begin by submitting an application and speaking with a coordinator who reviews your health history and prior pregnancy records. In EDSI’s experience, this stage typically takes two to four weeks, depending on how quickly medical records are received.
Begin the pre-screening process
A recent Pap smear and obstetric clearance are required before medical screening begins.
Step 2 Psychological screening
You meet with a licensed mental health professional who evaluates readiness, expectations, and support systems. Most candidates complete this step within one to two weeks.
Step 3 Medical screening
Medical screening includes lab work, ultrasound imaging, and a physical examination coordinated with a fertility clinic. In EDSI’s experience, this phase usually takes two to four weeks.
Step 4 Matching with intended parents
You are matched with intended parents whose preferences regarding communication during pregnancy, involvement at appointments, and delivery planning align with yours. Many matches are identified within one to four weeks, though timing can vary based on finding the right fit.
Step 5 Legal agreements
Independent reproductive attorneys draft and review the surrogacy agreement and prepare for legal parentage. Contract review and finalization typically takes three to six weeks.
Step 6 Medications and embryo transfer preparation
You follow a clinic provided calendar to prepare for embryo transfer. This preparation period usually lasts four to six weeks and includes monitoring appointments.
After the embryo transfer, a pregnancy test is performed approximately nine to twelve days later. If the transfer does not result in pregnancy, your agreement outlines whether additional embryo transfers will be attempted.
Step 7 Pregnancy care and monitoring
Early pregnancy care is managed by the fertility clinic through approximately eight to ten weeks of pregnancy. During this time, key milestones such as heartbeat confirmation and viability ultrasound are monitored. Once these milestones are met, care transitions to your regular obstetric provider for ongoing prenatal care.
Step 8 Delivery planning and recovery
Your delivery plan outlines hospital preferences, delivery room arrangements, and whether you choose to pump breast milk for the baby after delivery. Post delivery support continues through recovery and transition.
Surrogate Safety and the Legal Process Explained
Gestational surrogacy in the United States follows medical guidelines established by the American Society for Reproductive Medicine and clinical standards used by fertility clinics nationwide, with legal frameworks that vary by state.
Medical safety includes thorough screening, ongoing monitoring during pregnancy, and coordinated care between fertility clinics and obstetric providers.
Legal protection for surrogates includes a written surrogacy agreement and a court recognized parentage order. Depending on the state, parentage orders may be issued before delivery or after birth, and legal timelines and requirements vary significantly by jurisdiction.
EDSI works with licensed reproductive attorneys who specialize in surrogacy law and manage contract drafting and court filings throughout the journey.
Check if you qualify based on location
Surrogate Compensation and Support
Surrogate compensation includes a base payment plus additional benefits and allowances. Common benefits include paid travel, childcare during required appointments, maternity clothing, life insurance coverage, and support for work related leave during recovery or medically recommended rest.
Compensation varies based on prior surrogacy experience, geographic location, and specific journey factors. Specific compensation details are reviewed during an initial conversation with a coordinator and finalized in the legal agreement.
Learn what compensation may look like for you
Starting Your Surrogacy Journey
Considering surrogacy is a significant commitment. The first step is completing a brief online application, followed by a conversation with a coordinator who can answer questions and review next steps.
If you meet surrogate requirements, the process moves forward with personalized support at each stage of the journey.
Start Here To Become A SurrogateFAQ
A surrogate is typically a healthy woman with at least one prior full term birth who completes psychological screening and medical screening and lives in a stable living environment.
Apply as a surrogate
Common disqualifiers include out of range BMI, major pregnancy complications, current nicotine use, active substance use, or residence in a state that does not support compensated surrogacy.
No. Most surrogacy programs require at least one prior full term birth to demonstrate pregnancy history.
Medication history is reviewed during medical screening. Some fertility clinics require a look back period without certain medications before beginning medical protocols.
Many clinics accept two or three prior cesarean deliveries, depending on recovery and individual medical assessment.
You may apply for prescreening at any time. Most clinics require a recovery period after delivery before beginning surrogacy medications.
Some programs prefer that a surrogate is currently raising a child, while others are flexible. Having an identified support system is required.
Yes. Embryos are placed directly into the uterus, so tubal ligation does not prevent embryo transfer.
In EDSI’s experience, many journeys move from application to embryo transfer within approximately eight to sixteen weeks, though total timelines vary.
Pumping breast milk after delivery is optional and is documented in the legal agreement and birth plan.an.
Whether a surrogate carries twins depends on clinic policy and medical history. Many journeys plan for a single embryo transfer.
Yes. Your legal agreement and clinic treatment plan can document a preference for single embryo transfer.a single embryo transfer.
