Surrogates are thoroughly vetted before contracting with intended parents. Many considerations also go into matching intended parents with surrogates.
During every surrogacy journey, gestational carries will be screened extensively by both your surrogacy agency and fertility center to ensure the best possible outcome — you with a baby in your arms.
But before we turn to the types of screenings that a surrogate undergoes, let’s first take a moment to address some common misconceptions about the women who decide to become surrogate mothers.
Who are the women who decide to become surrogates?
Many people wonder why any woman would voluntarily choose to carry a child for someone else — particularly a stranger — other than for financial motivations. This can cause a lot of suspicion of surrogate mothers. However, as anyone who has ever met one of the thousands of incredible women who have served as surrogates can tell you, the main reasons behind a surrogate mother’s motivations to undertake such a monumental task are almost always rooted in a deep desire to help those who can’t have children on their own start their families.
“Most women decide to become surrogates not because they need the money, but because they know they have a gift to give,” said Sam Hyde, President and CEO of Circle Surrogacy. “They are altruistic, inspirational women who really want to help another person’s family.” Apart from a proven ability to carry and deliver healthy babies — all surrogates are mothers themselves. Many of them work in public service jobs as teachers or nurses. Many others are stay-at-home mothers, taking care of their own families.
“They’ve had babies — they don’t want your baby,” said Dr. Mark Leondires, Founder and Medical Director of RMA of Connecticut and Gay Parents To Be. “But they like being pregnant and are happy to help someone else have a family.”
How are surrogates screened?
Surrogates don’t share these altruistic characteristics by accident, but thanks to the rigorous screening process they must undergo prior to contracting with a surrogacy agency — in fact, fewer than 5% of applicants typically clear the screening process and proceed on to serve as a surrogate.
ASRM Guidelines: The American Society for Reproductive Medicine (ASRM), which sets guidelines for the ethical practice of surrogacy in the United States, advises that surrogates be between the ages of 21-45 years old — most tend to fall somewhere in the age range of 25 to 35. All surrogates must have completed at least one previous full-term pregnancy without major complications, and can have had no more than three cesarean deliveries. Guidelines also stipulate that surrogates must independently have sufficient emotional and financial support throughout the process. These guidelines, however, typically are just the very beginning of the screening process.
“As a surrogacy agency, one of the things you can expect is for your surrogate to be pre-screened by the agency,” said Stephanie Scott, Co-Owner, Executive Program Director, and Director of Finance and Legal at Simple Surrogacy. “The first thing that an agency should do is run criminal background checks, psychological evaluations, create a profile — and have her husband or partner participate in these processes as well.”
Psychological evaluation: Surrogates undergo comprehensive psychological testing prior to being approved. This evaluation will seek to identify her motivations for wanting to become a surrogate, whether or not she has adequate support, both financially and emotionally, in her network, and additional measures such as her particular style of communication. Surrogates are also given a mental health test to help identify any potential personality or mental disorders that may complicate her ability to serve as a surrogate. Her partner or husband will be screened along many of these lines as well.
“Clinical psychologists and social workers know what to ask and look for — and believe me they will tell us if they don’t believe an applicant is ready to be a surrogate,” said Victoria T. Ferrara, Founder and Legal Director of Worldwide Surrogacy Specialists. “Or they will tell us if the surrogate’s husband is not onboard, which is another reason why they wouldn’t be approved.”
Medical screening: Applicants will also undergo extensive medical screening to ensure she is a proper candidate to serve as a surrogate. Typically, this will include a thorough review of her medical history, pre-pregnancy planning, a physical exam, a pap smear, STI testing, drug testing, and a uterine cavity evaluation. Surrogates will also be screened for blood antibodies to maximize the chances for a healthy pregnancy. Finally, the levels of certain hormones, like thyroid hormone are also checked.
How will I be matched with a surrogate?
Most reputable agencies will match surrogates with intended parents based on three main areas:
Legal fit: Surrogacy laws depend on the country the intended parents are from, and the state in which the surrogate resides, and vary widely depending on the combination of those two factors.Your lawyer will help with the legality of matches, and determine if the match between you and your surrogate is legally sound. “So for example, if you have a single parent who needs both a sperm donor and an egg donor, there will be certain states with laws we’ll want to stay away from,” said Ferrara of Worldwide Surrogacy. This is another area of expertise of the agency — choosing the right jurisdiction or state for the parents.
Timing fit: Your agency will also want to ensure there is a proper fit with regards to timing and scheduling between you, as the intended parent, and your potential surrogate match. “This surrogate may want to move fast, this one wants to move slow — we want to match them up with parents who feel the same way,” said Hyde of Circle Surrogacy.
Personality fit: In some ways, the most important part of the matching process is whether the intended parents and surrogates are a good personality fit. Agencies will try to generate matches so that both share expectations, hopes, and dreams for their upcoming journey. The agency will also ensure both parties match in regards to their views on important topics like views on abortion and selective reduction, and in what instances.
Matching call: If the IPs and surrogates both express mutual interest, the process will continue, and your agency will coordinate an initial conversation — most often by video chat — for you to discuss the process further.
Experts interviewed for this article: