The 12-point checklist
Tick what applies to you. Firm means every agency and clinic we've reviewed requires it. Flexible means the number moves at the edges. Varies means it depends on the agency or your state.
- 21 is the floor everywhere. Most agencies cap first-timers at 39; many take experienced surrogates to 42.Flexible
- Most agencies. Some clinics accept up to 35, the ceiling in ASRM's 2022 guidance.Flexible
- A prior uncomplicated pregnancy of your own, carried to term.Firm
- Standard agency policy, not a medical rule. A few agencies don't require it.Varies
- No smoking, vaping, or chewing. Cotinine testing is part of screening.Firm
- Includes marijuana, regardless of state law, at most agencies.Firm
- The fertility clinic decides case by case. Well-controlled conditions are often fine.Varies
- A settled home for prenatal care, medication storage, and recovery.Firm
- Most agencies. SNAP is usually fine; Medicaid depends on your state.Varies
- Partner, family, or close friends. Single is fine; alone is not.Flexible
- Most agencies. Visa holders are generally not accepted.Firm
- Most states qualify. Louisiana and Nebraska don't; a few others are county-dependent.Varies
Meeting all 12 on paper isn't clearance; the clinic and the psychologist still make their own calls. Missing one or two isn't a no, either. Skip to your path to qualifying if you're close.
Age requirement: 21–39, sometimes 42
Surrogates must be 21–39 at most agencies to start a first journey. The floor is firm: 21 is standard, and the Illinois, Texas, and Washington statutes write it into law. The ceiling flexes. Many agencies take experienced surrogates to 42, some agencies use 40 as the first-time cutoff, and ASRM's 2022 guidance allows gestational carriers up to 45.
Why the ceiling moves: pregnancy risk rises with age, but the fertility clinic weighs your actual history, not just your birthday. An experienced surrogate at 41 with two smooth journeys is a different case than a 39-year-old first-timer. Past 42, options narrow fast, because most clinics set their own cutoff regardless of what the agency says.
BMI requirement: under 32 at most agencies
Most agencies require BMI under 32 for first-time surrogates, and many clinics cap it at 35, the ceiling in ASRM's 2022 committee opinion. Between 32 and 35 is the gray zone: some clinics accept it, especially for experienced surrogates with clean histories, and others don't. Above 35 is a decline almost everywhere.
This isn't about appearance. Higher BMI in pregnancy is associated with higher rates of gestational diabetes, preeclampsia, cesarean delivery, blood clots, and anesthesia complications, according to ACOG's obesity-in-pregnancy guidance. The clinic is protecting you and the pregnancy.
If you're a few points over, the reliable move is to bring it down before you apply. It's faster than arguing about flexibility, and the clinic will weigh you at screening anyway.
Pregnancy history: at least one full-term birth
This is the firmest item on the list. Every agency and clinic we've reviewed requires at least one prior pregnancy of your own, carried to term (37+ weeks) with a healthy delivery. ASRM recommends the same: at least one term, uncomplicated pregnancy.
The reason is evidence: the clinic needs proof your body can carry a pregnancy safely. A prior preterm delivery may or may not count, depending on the cause and how you recovered. Severe preeclampsia, placental abruption, or uterine complications in a prior pregnancy are evaluated individually and often lead to a decline, even if the baby was healthy.
Currently raising a child
Most agencies require that you're currently raising at least one child of your own. It's not a medical requirement, and a few agencies don't apply it. The reasoning is experiential: you know what pregnancy, delivery, and postpartum feel like before you commit to doing it for someone else.
Agencies also prefer that you've finished building your own family. You can have more children later, but if you're actively planning another pregnancy of your own, most agencies will ask you to do that first.
Nicotine-free: 6–12 months
No smoking, vaping, or chewing tobacco. Most agencies want at least 6 months nicotine-free before you apply; many ask for 12. Screening includes a cotinine test, which detects nicotine from any source.
Some agencies also ask about your household. A partner who smokes inside the home can be an issue because of secondhand exposure; smoking outdoors is usually fine. Be straightforward about it on the application.
No recreational drug use
Current use of marijuana, cocaine, methamphetamine, opioids, or other recreational drugs is disqualifying at most agencies, and marijuana counts even in states where it's legal. Most agencies want 12 months drug-free. Past use that ended years ago is usually not an issue.
Prescription medications are a separate conversation. Thyroid medication, common antibiotics, and some SSRIs at stable doses are frequently accepted. Prescribed opioids for chronic pain and medications that are unsafe in pregnancy generally aren't. Never stop a prescribed medication to qualify without talking to your doctor first. Our disqualifications guide covers medications in detail.
Health and chronic conditions
You need to be in good overall health, and the fertility clinic makes the final call. Conditions that most agencies and clinics treat as disqualifying include:
- HIV, or active Hepatitis B or C infection
- Cancer under active treatment; cancer in remission is evaluated case by case, usually with an oncologist's clearance and several years cancer-free
- Uncontrolled diabetes (well-controlled type 2 is sometimes accepted)
- Heart disease or high blood pressure that requires medication
- Autoimmune conditions in active flare or requiring immunosuppressants
- Severe mental-health conditions under active treatment; stable, treated anxiety or mild depression is often fine, and the psychologist evaluates it individually
- Eclampsia or HELLP syndrome in a prior pregnancy
- Two or more pregnancy losses without an identified cause
Well-controlled hypothyroidism, asthma, and similar managed conditions are usually fine. If you're unsure where you fall, apply and let the clinic evaluate you; that's what screening is for.
Not medical advice
This list describes common agency and clinic policy, not a diagnosis. A reproductive endocrinologist decides what applies to you. The page is pending review by a licensed clinician; the byline will name them when that's complete.Check all 12 in 2 minutes
The quiz walks through every requirement and tells you where you stand. Free, no account, and nobody calls you.
See if you qualifyHousing and financial stability
You need stable housing for the whole 14–24 month journey. Couch-surfing, transitional housing, or an unsettled living situation will get an application declined. This isn't a judgment; agencies need to know you can get to prenatal appointments, store refrigerated medication, and recover after birth.
Most agencies also require that you're not currently receiving TANF or similar cash assistance, because compensation can affect benefit eligibility in ways that are hard to untangle. SNAP is usually fine. Medicaid depends on your state; some programs exclude surrogacy pregnancies and some don't. Ask the agency and a benefits counselor before you apply.
Partner and family support
You need people in your corner. A spouse, a partner, parents, close friends, a therapist — it doesn't have to be a romantic partner, and you don't have to be married. But you can't go through 18 months of appointments, injections, and pregnancy alone.
The psychological screening looks at this directly. A partner who opposes surrogacy is a common reason evaluations raise concerns, because the strain shows up mid-journey. If your partner isn't on board yet, that's the conversation to have before the application, not after.
U.S. citizen or permanent resident
Most agencies require U.S. citizenship or permanent residency. The reasons are legal (parentage and the baby's citizenship), insurance (residency affects coverage), and practical (you need to stay in the country for the full journey). Visa holders are generally not accepted.
A surrogacy-friendly state
Where you live decides which agencies can work with you. Most states allow compensated gestational surrogacy through statute or court practice. California, Illinois, Nevada, Washington, Texas, and most of New England have the clearest laws. Louisiana and Nebraska effectively bar paid surrogacy, and a few states like Arizona and Indiana leave contracts unenforceable, so agencies are cautious there.
Our surrogacy laws by state page has every state in one table. If you're in a restricted state, the honest answer is that partner agencies won't match you there.
One item short? Your 3–6 month path to qualifying
Many women are one or two items away when they first look at this list. Most of those gaps close with time. Here's the forward plan, with realistic timelines:
| Where you are | The plan | Typical timeline |
|---|---|---|
| BMI 32–35 | Bring it under the agency's cutoff before you apply. The clinic weighs you at screening, so the number has to be real. | 3–6 months |
| Quit nicotine recently | Stay off it. Apply once you're past the agency's window (6 or 12 months); ask which one they use. | Until month 6–12 |
| On an SSRI | Don't stop on your own. Ask the agency which medications they accept at stable doses, then talk to your prescriber. | 1–3 months |
| On TANF | Apply after the benefit ends. Ask a benefits counselor how compensation would affect any other assistance. | Varies |
| Still finishing your own family | Complete your own pregnancy and recovery first. Most clinics want 6–12 months between a delivery and a transfer. | 12–18 months |
| Partner not on board | This one doesn't close by waiting. Have the conversation, together, possibly with a counselor. Apply only when you're both in. | No fixed timeline |
Once you qualify, the next thing most women want to know is what surrogates actually earn, base and contingent shown separately, and then what happens after you qualify, step by step.
Frequently asked questions
What are the basic surrogate requirements?
Can I be a surrogate if I'm 40 or older?
What's the BMI cutoff for surrogates?
Do I need to be married to be a surrogate?
How long do I need to be nicotine-free?
Can I be a surrogate if I'm on Medicaid or TANF?
Sources
- ASRM Practice Committee, "Recommendations for practices using gestational carriers: a committee opinion" (2022) — age 21–45, BMI under 35, prior term pregnancy, psychological evaluation — asrm.org, accessed 2026-08-26
- ACOG Practice Bulletin No. 230, "Obesity in Pregnancy" (2021) — pregnancy risks associated with higher BMI — acog.org, accessed 2026-08-26
- Washington Uniform Parentage Act, RCW 26.26A (minimum age 21, prior birth) — app.leg.wa.gov, accessed 2026-08-26
- Illinois Gestational Surrogacy Act, 750 ILCS 47 (minimum age 21) — ilga.gov, accessed 2026-08-26
- Partner agency eligibility policies as published on each agency's site, summarized in our agency reviews, checked Aug 2026