How to Become a Surrogate

At a glance

Most "how to become a surrogate" articles are agency recruitment pages. Their goal is to get you to fill out an application. Our goal is different. We want you to know what you're signing up for before you talk to anyone.

This guide is the decision page. It covers who qualifies, what disqualifies you, the 10 steps in brief, the real timeline, the real pay, and the parts agencies tend to skip. If you want every step in full detail, that lives on our step-by-step surrogacy process page. If you read all of this and still want to do it, our quiz matches you with a vetted agency. If you decide it's not for you, that's a good outcome too.

Who qualifies to be a surrogate

Here's the short version. Most agencies require all of this:

• Age 21–39Some agencies accept up to 42 for experienced surrogates
• At least one healthy full-term pregnancy and deliveryWith no major complications. Every reputable agency requires this.
• Currently raising at least one child of your own
• Non-smokerNo smoking, vaping, marijuana, or recreational drugs, and nobody smokes in your home
• BMI under about 32–33ASRM guidance says under 35. The fertility clinic sets the final line, and it varies.
• Stable housing and reliable transportation
• A partner or family that supports your decision
• U.S. citizen or permanent resident
• Willing to travel for medical appointmentsSometimes overnight, at the intended parents' expense
• Currently receiving government cash assistance (TANF)A firm no at most agencies. Ask your agency how other benefits are handled.

Some of these are firm. Others vary. A BMI of 34 might be fine at one agency and a no at another. Two prior C-sections are usually fine; three is the ASRM ceiling.

For the full breakdown, see our complete surrogate requirements page. If you want a faster answer, take the 2-minute eligibility quiz. It checks the biggest disqualifiers without any commitment.

What disqualifies you

These are the most common reasons agencies decline applications:

• No prior pregnancy. You must have carried at least one baby to term. Clinics need proof your body can do this safely.
• BMI above the clinic's limit. Higher BMI raises the risk of gestational diabetes, preeclampsia, and delivery complications. The clinic, not the agency, usually sets this cutoff.
• Smoking or drug use. Any current nicotine, marijuana, or recreational drug use is an automatic no. Some agencies decline if anyone smokes inside your home.
• Certain medical conditions. Some conditions rule you out at every clinic. Others are case by case. The clinic's medical team makes that call, not us and not the agency.
• Repeated pregnancy loss. Two or more miscarriages or stillbirths may disqualify you, depending on the cause.
• Felony record. Most agencies require a clean background check. Old non-violent offenses sometimes get exceptions. Drug-related felonies are usually a hard no.
• Unstable housing. If you're in transitional housing or an unstable living situation, agencies will decline.
• Government cash assistance. TANF and similar programs can affect benefit eligibility once compensation starts. Most agencies treat it as a firm no.
• No family support. If your partner opposes surrogacy, agencies consider this a risk factor.

See our full disqualifications guide for more detail, including which conditions are negotiable and which are hard lines.

The 10-step surrogacy process, in brief

From first search to the baby going home with their parents, here's what happens and how long each part takes. Each step gets a full page of detail on our step-by-step process guide.

1. Step 1 · 1–4 weeks

   Research and self-assessment

   Before you contact anyone, answer honestly: can you handle 9 months of pregnancy plus 2–4 months of screening first? Is your partner truly on board, hormone shots and hospital visits included? If money is your only reason, will you still want this 14 months in? This step is free. Skipping it is expensive.

2. Step 2 · 2–4 weeks

   Choose an agency

   Going independent is possible but adds risk, work, and legal exposure. Look for independent escrow, published compensation, an attorney of your own paid by the intended parents, years of track record, and former surrogates on staff. Compare our partner agencies or read the agency red flags first.

3. Step 3 · 2–6 weeks

   Submit your application

   It's long. Expect your full medical history, pregnancy records, current medications, photos, lifestyle questions, a background check, and insurance details. Be honest. Agencies verify everything, and a hidden miscarriage or medication gets you dropped later, after you've invested months.

4. Step 4 · 1–2 months

   Medical screening

   This happens at the intended parents' fertility clinic, not your OB, and may mean travel. Bloodwork, a physical, a uterine evaluation, STI and drug screening, and a review of your pregnancy history. The clinic makes the final call. You can pass the agency and still be declined by the clinic. What medical screening involves.

5. Step 5 · 2–4 weeks

   Psychological screening

   A standardized personality inventory (MMPI-2, MMPI-2-RF, or PAI) and a clinical interview with a licensed psychologist, usually including your partner. It isn't about finding something "wrong" with you. It confirms you understand the hard parts and have support. Psychological screening explained.

6. Step 6 · 1–6 months

   Matching with intended parents

   The biggest variable in the whole timeline. You set preferences on contact level, family type, number of embryos, and location. The more specific your requirements, the longer it takes. The match meeting is usually a video call, and both sides can decline.

7. Step 7 · 2–6 weeks

   Legal contracts

   Your attorney is paid by the intended parents but works for you. The contract covers base pay, allowances, the payment schedule, medical decisions, communication, what happens after a loss, insurance, and post-birth contact. Read every word. Don't let anyone rush this.

8. Step 8 · 1–2 months

   Medications and embryo transfer

   Estrogen and progesterone for 2–4 weeks before transfer. Progesterone-in-oil is an intramuscular shot with a thick needle, and it leaves bruises and knots. The transfer itself takes about 15 minutes. Then a two-week wait for the blood test. Not every first transfer works, so your contract should say how many attempts you've agreed to.

9. Step 9 · ~9 months

   Pregnancy

   Familiar because you've done it before. Different because you're carrying someone else's child and managing their anxiety alongside your own. Hormone shots usually continue through 10–12 weeks. Communication with the intended parents follows whatever your contract says.

10. Step 10 · birth + 1–2 months

    Delivery and post-birth

    You and the intended parents set a hospital plan ahead of time. In pre-birth-order states the parents are already the legal parents; elsewhere there's a post-birth step your attorney handles. Final payment usually lands within 2–4 weeks of delivery. Expect real emotions afterward, even when everything went well.

    Read all 10 steps in full detail →

How long the whole thing takes

Total timeline: 14–24 months from first application to delivery. Here's how the phases overlap across two years.

Month

06121824

1 · Research

2 · Choose an agency

3 · Application

4 · Medical screening

5 · Psych screening

6 · Matching (1–6 mo)

7 · Legal contracts

8 · Meds + transfer

9 · Pregnancy

10 · Post-birth

The biggest variable is matching. Your flexibility on intended-parent type, location, and contact level affects it a lot. If a first transfer fails, add 1–3 months.

Any agency telling you this takes "just a few months" isn't being straight with you. The fastest realistic path, where everything goes right the first time, is still about 14 months. For the month-by-month view, see our full surrogacy timeline.

What you actually get paid

Two numbers matter. Base is the cash you're paid for carrying the pregnancy. Contingent items (allowance, clothing stipend, transfer fees, C-section or twins bonuses) are only paid if that thing happens. Agencies advertise the total. You should plan around the base.

Here's what each of the four partner agencies publishes:

Intended parents also cover medical costs, legal fees, travel, and approved expenses on top of this. You have $0 out of pocket on anything pregnancy-related. Compensation is usually taxable, so set some aside. For the full picture, see how much surrogates get paid, first-time vs experienced pay, and base pay vs total compensation.

Want the 10-step checklist and pay breakdown in your inbox?

We'll send this guide's checklist and the base-vs-contingent table. One email, no drip sequence.

Your email Email me the checklist

Opens a pre-filled email to hello@realtalksurrogacy.com. We reply within one business day. No agency sees your address.

What agencies won't tell you upfront

We've talked to surrogates who completed journeys. Here's what they wish someone had told them:

• The screening process feels invasive. You're sharing medical records, a psychological profile, financial details, criminal history, and body measurements with people you've never met. Some women feel reassured by the thoroughness. Others feel exposed. Both reactions are normal.
• Matching can take months. The agency said 2–4 weeks. It's been 3 months. You start wondering if something's wrong with you. Usually it's timing and preferences. Nobody prepares you for the wait.
• The shots are the part nobody warns you about. Ask any surrogate who has done progesterone-in-oil. Plan for bruising, sore muscles, and a partner who has to learn to give an intramuscular injection.
• Your relationship with the intended parents is complicated. Even when everyone means well. They may be more anxious than you expected. They may want more contact than you're comfortable with, or less. Managing someone else's hopes alongside your own is hard.
• Post-birth emotions are real. Sad, relieved, proud, empty, all at once. Your body goes through the same postpartum shift as any birth. Give yourself space to feel whatever comes up, and ask the agency about post-birth counseling before you need it.
• Recovery takes time. Your body may not bounce back the way it did with your own pregnancies. Be patient with it.

Is surrogacy right for you?

There's no scorecard for this. But after enough conversations, a few patterns hold.

Women who tend to do well

• Had straightforward pregnancies and, honestly, liked being pregnant.
• Have a partner or support person who is in, not just tolerating it.
• Are done growing their own family, or are certain they're not risking it.
• Can hold a boundary with the intended parents and still be kind.
• Want the money and something more than the money. Both, out loud.

Reasons to wait, or to say no

• Your finances are in crisis right now. Payments start months in, and a failed transfer means more waiting.
• Your partner is against it, or your support system is thin.
• Your last pregnancy was hard on your body or your mind.
• You'd struggle to hand the baby over. Most surrogates say the moment is joyful, but you know yourself best.

Three contract clauses first-timers miss

You'll sign a long document in Step 7. These are the parts people skim and later regret:

1. What "lost wages" actually covers. Some contracts exclude bed rest, or cap the weeks. Ask for it in writing.
2. Selective reduction and termination terms. Both sides have to agree on this before transfer, not during a crisis. Be honest about your limits.
3. How many transfers you've agreed to. If it doesn't say, you may be expected to try more than you planned.

Still on the fence? Read Is surrogacy right for me? It's the longer, more personal version of this section.

Becoming a surrogate by state

Your state affects your legal protections, which agencies serve you, and how the post-birth legal handoff works. Here's how the states with a partner agency and a state guide compare:

We don't match surrogates in states where compensated surrogacy is prohibited or legally unclear. For the full picture, see surrogacy laws by state. To see which partners cover your state, take the quiz.

Specific eligibility questions we hear a lot

Can I be a surrogate after a C-section?

Usually yes. Most agencies accept surrogates with 1–2 prior C-sections, and ASRM guidance allows up to 3. The key is how your body healed and whether your OB clears you for another pregnancy. The clinic will look closely at your uterine health.

Can I be a surrogate with my tubes tied?

Yes. Gestational surrogacy uses IVF. The embryo is placed directly into your uterus, so your fallopian tubes aren't involved. Tubal ligation doesn't affect your eligibility.

Can I be a surrogate on antidepressants?

It depends on the medication and the agency. Some accept surrogates on certain SSRIs at a stable dose. Others require you to be medication-free. The fertility clinic also weighs in. Never stop a prescribed medication without talking to your doctor first, and be upfront with the agency from the start.

How many times can you be a surrogate?

Most agencies allow 2–3 surrogate journeys. ASRM guidance caps a carrier at five prior deliveries, counting your own children. The limit protects your health. Responsible agencies enforce it even if you feel great.

Frequently asked questions