“I want to be a surrogate” – I remember uttering these same words to my husband a long time ago, shaking in my boots as I prepared for his response. Taking the first steps in becoming a surrogate can be scary, overwhelming and extremely exciting all at the same time. There’s a lot to think about. It’s a big decision and life changing at the same time. Let’s break down the surrogacy process in steps to make it not so overwhelming and easier to understand!

If you are wanting to be a gestational carrier, the first place to start it to make sure you meet the certain initial requirements. These are general guidelines and you may experience some slight differences from one fertility clinic to another. Keep reading this blog post from Family Makers Surrogacy to learn more about what you should expect.

i want to be a surrogate

Surrogate Requirements

– Must be age 21-40 years old

– Must have delivered a baby in the last 10 years

– Must be a citizen or permanent resident of the U.S.

– Must have at least one previous pregnancy

– Must have a great healthy pregnancy history – free of complications or health conditions

– Must have had no more than 5 deliveries, max of 2 deliveries via caesarian section

– Must consent to a background check for herself and adults living in her home

– Must have a stable home life, strong support system and reliable childcare

– Should not have a recent history of smoking or vaping

– Should be willing to refrain from any alcohol during pregnancy

– Should not take prescription medications recreationally or use illicit drugs

– Should be financially stable

– Should not have had an endometrial ablation or the Essure® procedure

– Should not be taking medications that are labeled Category D or Category X

– Should not be taking antipsychotics, anti-anxiety or anti-depressants

– Should have flexibility for 3-6 morning appointments

– Should understand that daily injections for up to 12 weeks may be necessary

– Should have no plans for international travel in the next 18-24 months

Independent or Agency

If you meet the above requirements, the next step in the surrogacy process is deciding whether you want to pursue an Independent journey or if you’d like to use an agency. An independent surrogacy journey is one where the intended parents and surrogate find each other without the assistance of a surrogacy agency or matching program.

A Surrogacy Agency helps you manage all aspects of your journey, like contacting fertility clinics, attorneys or mental health professionals for psychological evaluations, They have contacts for it all and will lead you through each step. Finding a reputable surrogacy agency can be difficult. There is a FaceBook page for Surrogacy Agency Reviews that provides real world surrogacy experiences from not only Intended Parents, but Gestational Carriers as well.

If you have chosen to go with an agency, the next steps look like this:

A surrogacy application: Consists of some general questions about yourself, your hobbies, your pregnancy history, health history and views on termination and communication. After submitting the application, you will be contacted by a Case Manager or Surrogacy Specialist, who will gather more detailed information and provide paperwork required to move forward.

Medical records review: Your complete pre-natal and delivery records from your own pregnancies will be collected and reviewed to be sure there were not complications that would disqualify you from a gestational surrogacy journey. Your OBGYN will also need to complete a clearance form, and you will need to have a recent, clear PAP within the last 12 months.

Health Insurance: You will need a usable insurance policy to become a gestational carrier. Your health insurance policy will be reviewed to be sure it does not have any exclusions for prenatal care when you act as a surrogate. If your insurance does not cover surrogacy, Family Makers will help you to enroll in a marketplace policy during the annual open enrollment period.

An in-home “visit”: This visit is generally a zoom meeting with you in your home to talk more about your goals and motivations for pursuing surrogacy. This meeting helps the agency get to know you better for matching and also allows you to ask any questions. This meeting generally takes place with a Surrogacy Professional from the agency.

Background checks: You will need to consent to criminal records and background checks as required by the fertility clinic.

Related Post: Can a Surrogate Keep the Baby?

Matching with Intended Parents

What would spur someone to be a surrogate? For me the strong desire to help someone create a family was rooted in a personal experience, a close family members infertility struggle. Year after year, test after test, a final diagnosis, a hysterectomy, resentment & ultimately divorce – infertility left a trail of destruction in its path. Standing witness to this, is where my surrogacy dream was born. If I could help one family!

For many intended mothers and intended fathers, the path to surrogacy looks very much like the above story. Filled with highs, lows, loss, heartache, failure – nothing short of an emotional rollercoaster. As a gestational surrogate, you are their Ray of hope – their desire to be a parent is not lost.

In the matching process, it important that your views closely align with your Intended Parent(s). Your stance on decisions like termination and communication are things that you shouldn’t have to compromise on and will ultimately be written into the surrogacy agreement.

After matching with Intended Parents, both parties will undergo Psychological Evaluations. You will meet with a mental health professional to ensure that you fully understand the surrogacy process and journey you are about to embark on. This appointment will include your significant other as well as requiring just the surrogate, to have a PAI assessment. The Intended Parents will also be requirement to meet with the mental health professional. Then all parties will have a joint session together to make sure everyone is supportive and on the same page for the journey.

Related Post: Are You Ready? Preparing to Become a Surrogate

Medical Clearance Process for Surrogacy

After matching, your medical records will be sent to your Intended Parents chosen fertility clinic for their fertility doctor to review. Once the doctor reviews and approves and reviews them, you will be schedule for a medical screening appointment. Medical Screening consists of a few things.

A Routine Physical Exam

Lab Work – You will be screened for sexually transmitted diseases and other communicable diseases, as well as certain viruses and infections and drug use.

Transvaginal ultrasound or saline sonogram – to determine the health of your uterus.

Your partner will also be screened for STD’s and drug use as well.

Related Post: Surrogacy Medications: What, When, and Why

Psychological Screening for Gestational Surrogates

During the medical screening process, you will also be required to undergo a psychological screening. This appointment includes a personality assessment, and will also go over your complete medical and social history. If you have a spouse or partner, they will also be involved in the screening. After you have passed, you will also have a group appointment with your Intended Parents to discuss all of the ins and outs of what to expect during the entire surrogacy process. This group session is especially important because everyone will be able to discuss their surrogacy goals, and the emotional impact of surrogacy on everyone involved.

What is the contract and legal process for surrogacy?

After being fully medically cleared by the fertility clinic and also by a metal health professional, a surrogacy contract will be drafted. Each legal contract is different depending on state, surrogacy laws, circumstances and the relationship with your Intended Parents.

Prior to any embryo transfers, you and the intended parents must agree to and sign the contract, which will clearly outline the legal aspects of surrogacy, including but not limited to:


Possible Risks

Your Responsibilities as the Gestational Surrogate

Relinquishment of the Child

And More

Two Surrogacy Attorneys are needed for this process – one to represent the Intended Parents and one to represent the Surrogate. The contract is usually drafted by the intended parents’ legal counsel and when complete will be sent over to your lawyer for review and revisions. Once the draft is agreed upon, the contract will be notarized and signed by both parties. At this point, with the guidance of the fertility clinic you can begin cycling for embryo transfer.

What’s Next to become a surrogate?

A lot goes into making the decision to become a surrogate. For 10+ months, your body will not be your own. Pregnancy is a 24/7 job – it’s not something that you can walk away from and come to the next morning. It not only requires sacrifices but compromises and a deep understanding that even though this is your body and your pregnancy, it is not your baby.

Even though the relationship was formed with a common goal – to have a successful pregnancy and make these people parents – this journey turned into so much more for me. Forming a natural and organic friendship before, during and after the journey was important to me.

I am not discounting that being a gestational surrogate is a large commitment. From medical screening to monitoring appointments, fertility medications to injections but I promise you, the look on your Intended Parents faces the first time they see that little flicker of a heartbeat on the screen – it will instantly become ingrained in your memory.

Whether it’s helping people, loving pregnancy, the compensation that will ultimately help your own family or a combination of all – there is never a bad reason for coming to surrogacy. Blessing someone and changing their lives forever is a one of kind experience!

Not sure if you meet the requirements? Take our 3 minute Surrogate Quiz!

Learn more about joining the surrogate sisterhood, and how you can earn $50,000 in base compensation as a gestational carrier.