Short answer: the most common surrogacy disqualifiers are no prior pregnancy, BMI over 32–35, age outside 21–42, nicotine or drug use, certain medical conditions, and felony records. Several of them vary by agency and clinic, and one borderline item is usually a conversation, not a hard no.

The 12 disqualifiers at a glance

These are the reasons applications get declined most often. An ✕ means it's firm almost everywhere. A ? means some agencies are flexible on it.

  1. No prior pregnancyFirm at every agency and clinic. You need a prior full-term birth of your own.
  2. BMI over 32–35Most agencies cut off at 32; some clinics accept up to 35. Above 35 is firm.
  3. Under 21 or over 4221 is firm. The top end varies: 39, 40, or 42 depending on agency and experience.
  4. Smoking, vaping, or drug use, including marijuanaFirm. Some agencies are flexible on how long you've been clean, 6 vs. 12 months.
  5. Alcohol misuseFirm. Occasional moderate drinking before pregnancy is fine.
  6. HIV, active Hepatitis B or C, or active cancerFirm. Cancer in remission is reviewed case by case.
  7. Two or more pregnancy lossesDepends on the cause. Explained and treated losses are often fine.
  8. Felony recordDepends on the offense and how long ago. Violent crimes and crimes against children are firm.
  9. Unstable housingFirm. Agencies need a settled home for the journey.
  10. Current cash assistance (TANF)Most agencies decline while you're receiving it. SNAP is usually fine.
  11. Unsupportive partner or homeCase by case, and often the reason a psychological evaluation raises concerns.
  12. Unwilling to travel for IVFFirm. Screening and transfer happen at the intended parents' clinic.

All 18 disqualifiers by how firm they are

Every disqualifier on this page, sorted into three columns. Tap any one to jump to the detail.

Firm no

Every agency and clinic we've reviewed

Case by case

The clinic or psychologist evaluates you

Depends

On your state or the agency's policy

Pregnancy and medical history disqualifications

No prior pregnancy Firm no

Every agency and fertility clinic we've reviewed requires at least one prior full-term pregnancy and delivery of your own, and ASRM's guidance says the same. The reason: the clinic needs evidence your body can safely carry and deliver a baby. Surrogacy is not the place to find out for the first time. There's no workaround, and no agency we'd recommend makes an exception.

BMI over 32–35 Case by case

Most agencies require BMI under 32 for first-timers. Clinics sometimes accept up to 35, which is the ceiling in ASRM's 2022 guidance, especially for experienced surrogates with clean histories. Above 35 is a decline almost everywhere. The concern is real: higher BMI is associated with more gestational diabetes, preeclampsia, and delivery complications.

Some agencies are flexible on this one within the 32–35 band, and the clinic, not the agency, usually has the final say. If you're at 33, ask the specific agency what their clinics accept before you assume the answer is no.

Age under 21 or over 42 Depends

Twenty-one is firm; several state statutes require it and every agency uses it. The top end is where it varies: most agencies cap first-timers at 39, some use 40, and many take experienced surrogates to 42. ASRM guidance allows gestational carriers up to 45, so a clinic may go further for an experienced surrogate with a strong history. Past 42, options narrow because clinics set their own cutoffs regardless of the agency.

HIV, active Hepatitis B or C, or active cancer Firm no

Active infectious disease or cancer under treatment is disqualifying, for the safety of the pregnancy and for yours. Cancer in remission is a different question: clinics review it case by case, usually wanting an oncologist's clearance and several years cancer-free. A cleared, treated Hepatitis C infection is also evaluated individually by some clinics. Ask rather than assume.

Two or more pregnancy losses Case by case

Two losses prompt a closer look, not an automatic decline. If the cause was identified and treated (a cervical issue resolved with a cerclage, for example), many clinics will still approve you. Three or more losses without an explanation is a much harder decline, because the clinic can't rule out that it would happen again.

Severe complications in a prior pregnancy Case by case

Mild preeclampsia or gestational diabetes in a prior pregnancy isn't necessarily disqualifying if you recovered fully, especially if a later pregnancy was uncomplicated. Severe preeclampsia, HELLP syndrome, placental abruption, or placenta previa are evaluated individually and often lead to a decline. The clinic reads your delivery records, so get them yourself first and know what they say.

Certain autoimmune conditions Case by case

Well-controlled thyroid disease, including Hashimoto's, is usually fine. Lupus, multiple sclerosis, or any condition that's in active flare or requires immunosuppressive medication may disqualify you, because of the medication's effect on pregnancy and the risk of a flare. Some agencies are flexible on stable, medication-free autoimmune conditions with a specialist's letter.

Lifestyle disqualifications

Nicotine, drugs, or alcohol misuse Firm no

Current nicotine use (smoking, vaping, chewing), marijuana use regardless of state law, recreational drug use, or alcohol misuse is a decline at every agency we've reviewed. Drug and cotinine testing is part of medical screening, so it will come up.

Where agencies are flexible: the clean window. Most want 6 months nicotine-free; many want 12. For recreational drugs, 12 months is standard. Occasional moderate drinking before pregnancy is fine; regular heavy drinking isn't. Household smoking matters too: some agencies decline if anyone smokes inside the home.

Unstable housing Firm no

Transitional housing, living in a car, couch-surfing, or an unsettled living situation will get an application declined. Surrogacy is a 14–24 month commitment that needs a stable home for prenatal care, refrigerated medication, and recovery. This one closes when your housing does.

Current cash assistance (TANF) Depends

Most agencies decline applicants currently receiving TANF or similar cash benefits, because compensation interacts with eligibility in ways that are hard to untangle. SNAP is usually fine. Medicaid depends on your state's rules for surrogacy pregnancies. Some agencies are flexible here; ask the specific agency and a benefits counselor before you assume.

No partner or family support Case by case

If your partner opposes surrogacy, or your home doesn't support the process, most agencies treat that as a real risk, and it's one of the more common reasons a psychological screening raises concerns. Surrogacy affects your whole household.

You don't need to be married. Single surrogates are accepted at most agencies. You do need a support network of some kind: family, close friends, someone who can drive you to a monitoring appointment or give an injection.

One borderline item usually isn't a hard no. The quiz tells you which requirements flex and where you stand on each, in about two minutes.

Not sure if you qualify?

The quiz checks the big disqualifiers: age, BMI, pregnancy history, state, health, lifestyle. Calm answer, no calls.

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Felony criminal record Case by case

Agencies run background checks on you and usually on your partner. Violent crimes, crimes against children, and recent felonies are a decline everywhere. Drug-related felonies are usually a decline. Older non-violent offenses, often 10 or more years back, sometimes get an exception depending on the agency. Disclose it on the application; an undisclosed record found on the background check is a firm no even when the offense itself wouldn't have been.

Domestic violence in the current home Case by case

A documented history of domestic violence in your current relationship is disqualifying because of the stability risk to you and the pregnancy. If you're a survivor who left that situation years ago and your current home is safe, it's typically not a barrier. The psychologist will ask about it; answer honestly.

Living in a restricted state Depends

Paid surrogacy is effectively barred in Louisiana and Nebraska, so partner agencies don't match surrogates there. A few states, including Arizona, Indiana, and Kansas, leave contracts unenforceable, and agencies are cautious about them. Michigan legalized compensated gestational surrogacy in 2025 after decades of prohibition. Our surrogacy laws by state page has the current status for all 50 states and DC.

Medication disqualifications

Antidepressants (SSRIs) Depends

This is the most agency-dependent item on the page. Some agencies accept surrogates on certain SSRIs, like sertraline, at a stable dose with a prescriber's letter. Others require you to be medication-free for a period before screening. The fertility clinic weighs in too. Ask each agency you're considering what their policy is. Never stop a prescribed medication to qualify without talking to your doctor first.

Opioids and pregnancy-unsafe medications Firm no

Current opioid use for chronic pain, even with a prescription, typically disqualifies you; past use is usually fine if you've been off for 12 or more months. Medications known to cause birth defects or affect pregnancy viability (isotretinoin, some immunosuppressants, certain seizure medications) are disqualifying while you're taking them. The clinic reviews your full medication list at screening. If you're on something that could be switched, that's a conversation with your prescriber, not a reason to stop on your own.

Logistical disqualifications

Unwilling to travel for IVF Firm no

Screening and the embryo transfer happen at the intended parents' fertility clinic, which may be in another state, and some clinics require monitoring on site. That means overnight trips and time away from home, reimbursed but real. If you can't travel at all, you can't be a surrogate. Our step-by-step process guide shows exactly where the travel falls.

Work with physical hazards Case by case

Jobs with heavy lifting, chemical exposure, or high physical demands may need to change during pregnancy. Most agencies work with this. If your job is incompatible with pregnancy, like active-duty firefighting, you'll need a plan for temporary leave, and lost-wage terms should be in your contract.

If you've been declined: your path back

A no from one agency is a data point, not a verdict. Policies differ, and the same file can be a decline at one agency and an approval at another. Here's how to read a decline:

  1. Get the reason in writing. "Not a fit right now" isn't a reason. Ask which requirement you missed and whether it's their policy or the clinic's.
  2. Sort it into a column. Firm-no items on this page don't change by shopping agencies. Case-by-case and depends items might.
  3. If it's fixable, fix it and set a date. BMI, a nicotine window, a medication that can be reviewed with your prescriber, a benefit that's ending: each has a timeline. The requirements checklist lays out the 3–6 month prep plan for each gap.
  4. If it's a hard medical no, respect it. It exists to protect your health. A second opinion from a reproductive endocrinologist is reasonable; agency-hopping to find one that says yes isn't.
  5. If it's about your home, address the home first. An unsupportive partner or an unsafe living situation doesn't resolve by waiting. Surrogacy comes after.

Once you know which column you're in, the process guide shows what screening looks like the second time around.

Frequently asked questions

What's the most common reason surrogates are declined?
BMI is the most common fixable one: most agencies require under 32, some clinics accept up to 34 or 35. After that, lifestyle items — current nicotine, recent drug use, alcohol concerns — and a partner who isn't on board.
Can you be a surrogate with depression?
Often, yes. A history of depression that's treated and stable isn't disqualifying at most agencies. What matters is whether you're currently stable, whether your medication is one the agency and clinic accept, and what the psychological evaluation finds. Severe or untreated depression, or active treatment for a severe episode, will usually pause the process. Never stop a prescribed medication to qualify without talking to your doctor.
Does weight disqualify you from surrogacy?
It can. Most agencies require BMI under 32 and clinics generally cap at 35. Weight below the normal range can also be a concern for the clinic. If you're a few points over the cutoff, it's one of the most fixable items on this page; bring it under the line before you apply, since the clinic weighs you at screening.
Can I be a surrogate if I'm on antidepressants?
It depends on the medication, the dose, the agency, and the clinic. Some agencies accept certain SSRIs at stable doses; others require a medication-free period. Ask each agency directly, and don't change your medication without your prescriber.
Does a C-section history disqualify me?
No. Most agencies accept one or two prior C-sections, and ASRM guidance allows up to three, with no more than five prior deliveries in total. The clinic evaluates your uterus to confirm another pregnancy is safe.
Can I be a surrogate with a felony on my record?
Sometimes. Violent crimes, crimes against children, and recent felonies are a decline. Drug-related felonies usually are. Older non-violent offenses sometimes get an exception depending on the agency. Always disclose it.
Will a past miscarriage disqualify me?
One loss usually doesn't. Two prompt a closer look, especially if the cause is known and was treated. Three or more unexplained losses make approval much harder.
Can I become a surrogate if I've had my tubes tied?
Yes. Gestational surrogacy uses IVF, so the embryo is placed directly in your uterus and your fallopian tubes aren't involved. A tubal ligation doesn't affect eligibility. If the clinic sees fluid in a blocked tube on ultrasound, they may want to address that first.

Sources

  1. ASRM Practice Committee, "Recommendations for practices using gestational carriers: a committee opinion" (2022) — age, BMI, prior term pregnancy, cesarean and delivery limits, psychological evaluation — asrm.org, accessed 2026-08-26
  2. ACOG Practice Bulletin No. 230, "Obesity in Pregnancy" (2021) — acog.org, accessed 2026-08-26
  3. Real Talk Surrogacy, Surrogacy laws by state (Louisiana, Nebraska, Arizona, Indiana, Kansas, Michigan status), research current to Aug 2026
  4. Partner agency eligibility policies as published on each agency's site, summarized in our agency reviews, checked Aug 2026