YOUR HEALTH HISTORY: How It Impacts Your Surrogacy Application

Medical issues you should be aware of when considering becoming a surrogate.

As any would-be surrogate quickly learns, there are requirements that you must meet before becoming a surrogate — everything from age and financial stability to whether or not you have the support of your family.

Your health and your medical history are among the most important criteria for becoming a surrogate.

The need for a surrogate to be in overall good health before she can carry a child for someone else is probably a given. Beyond that, though, there are specific conditions that could make it unlikely, unwise, or in some cases impossible for you to be considered as a surrogate to carry a baby for another. On the other hand, there may be health “issues” that you might assume would disqualify you from surrogacy that in fact do not.

As a starting place, here is a list of issues and conditions and their implications that may impact your eligibility to be a surrogate.

In reviewing the list, please keep in mind that health-related requirements around surrogacy are in no way a judgment of any kind. They are there for your protection. At ARTparenting we believe that no woman, however well-intentioned, should risk her own health to become a surrogate for another.

Health and medical history issues and conditions that may impact your eligibility to become a surrogate.

Adenomyosis
This is a condition of your reproductive system in which the uterus thickens and enlarges. The tissue that lines the inside of the uterine wall grows into the walls of the uterus. This can make it difficult for an embryo to implant, and can affect your ability to be a surrogate, and in many cases may prevent it.

Age
Though age is obviously not a medical condition, you must be between 21 and 44 years of age at the start of your surrogacy process.

Antidepressants
Most surrogacy professionals advise being off any antidepressants for 6 – 12 months before beginning the clinical part of surrogacy. It will also be relevant to consider why you may be on an antidepressant and for how long. Please ask us if you are unsure if this will prevent you from proceeding.

Bariatric Surgery
Having had certain surgeries makes you ineligible to be a surrogate, according to the rules of some IVF centers. Bariatric surgery, or weight-loss surgery, is one example. Ask us about this to see if you are able to proceed.

C-sections
If you’ve had several previous children, you must not have had more than two or three C-sections to be considered as a surrogate (the number will depend on the particular IVF center).

Diabetes
Both Type 1 and Type 2 diabetes offer risks to pregnant women, primarily because of the challenge of controlling blood sugar levels. Women with either type of diabetes are generally discouraged from pursuing surrogacy. An exception is gestational diabetes experienced during a previous pregnancy, which might not disqualify you (ask us and we will be able to answer if this is a disqualifier for you).

Endometriosis
This is a sometimes uncomfortable disorder in which tissue that lines the inside of your uterus grows outside your uterus. It can directly impact your fertility. A fertility clinic would likely advise against surrogacy; however, ask us first before you make the decision that this disqualifies you. It will depend on the severity, generally.

Essure
Essure is a birth-control option in which metal coils are placed into the fallopian tubes to induce blockages. You cannot be a surrogate if you have this method of birth control.

Herpes
Perhaps surprisingly, this does not necessarily disqualify you from gestational surrogacy — but should there be a outbreak close to delivery time, a C-section will most likely be necessary.

HIV
HIV-positive women cannot serve as surrogates because of the danger of spread from surrogate to baby.

HPV (Human Papilloma Virus)
It’s possible to proceed with surrogacy if you have HPV, but in the event of a genital-warts outbreak, there is a danger of transmission to the child, in which a C-section will be recommended.

Illegal Substances
You must currently use no illegal substances.

Menopause
Because the upper age limit for surrogacy eligibility is 44, it’s probable that if a menopausal woman wants to be a surrogate, she’s beyond that age limit.

Miscarriage
If you have had multiple miscarriages, that may indicate proneness to miscarriage and may preclude surrogacy. Be sure to share your medical history with us and discuss from the start.

Postpartum Depression
Mental health is as important as physical health during gestational surrogacy. This should be discussed during psychological screening, and if your depression has been successfully treated, there is generally no reason to prohibit pursuing surrogacy.

Preeclampsia
Generally, physicians will discourage women who have experienced severe preeclampsia, a serious pregnancy condition, from pursuing gestational surrogacy. There is an increased risk of miscarriage and other complications for the pregnancy and for yourself, and statistically preeclampsia is likely to re-appear in later pregnancies. Do check with us though, as mild preeclampsia will not necessarily preclude you from proceeding.

Pre-term Deliveries
In your previous pregnancy or pregnancies, generally you must not have had a premature delivery before 36 weeks, unless it was a multiple-birth. Ask us about whether this disqualifies you or not.

Previous Pregnancies
Surrogates must already have had at least one successful pregnancy and normal delivery, in part simply so you are familiar with the physical and emotional demands of pregnancy and having your own child. There is also a maximum number of prior deliveries, which differs among IVF centers.

Sickle Cell
Sickle cell disease, or what used to be called sickle-cell anemia, can increase the risk of miscarriage, premature labor, and low birth weight. Because of these and other risks, it is generally considered unsafe for a woman with sickle cell disease to become a surrogate.

Smoking
You must currently be a non-smoker.

Tubal Ligation
You can be a gestational surrogate after having had your tubes tied. This procedure, which prevents you from ovulating, is completely unrelated to your ability to carry a pregnancy to term.

Weight
There are no specific weight requirements, but your body mass index (BMI) must generally be equal to or lower than 32.

Please remember that this list is meant to be only a guideline, and is not meant to discourage you from pursuing your goal of becoming a surrogate. The guidelines are also a way of reminding you that ARTparenting considers the health of surrogates of primary importance. We follow the guidelines of the American Society for Reproductive Medicine (ASRM), together with the input of the IVF specialists we work with, in considering every surrogate applicant. Keep in mind that requirements of IVF centers differ and we do take those variables into consideration.

As part of the pre-screening process, we will ask you for your medical records, including all available prenatal and delivery records, so that they may be reviewed by the medical specialists to ensure you are healthy and may carry a baby for another person without undue risk to yourself or to the baby. Anything in your health history that you may have a question about can be discussed openly, honestly, and always confidentially.

We are in this together to ensure the safest and happiest process for everyone!