What is a Surrogate?

The surrogate is the hero of the surrogacy process. She may be paid for her efforts, but she is NOT an employee. She is an equal partner in the conception of your family, and she has equal say in almost every aspect of the journey.

Jump Down this Article:

Also in The Guide:


Your surrogate is more than just an incubator to carry a fetus. She is the primary caregiver to your nascent family. For nine months your surrogate will carry your pregnancy and take care of your developing baby. Starting with an array of medical and psychological evaluations, followed by weeks of fertility treatments, your surrogate’s role will take a full year’s effort to complete.

Surrogates provide a tangible service that requires significant effort and personal risk. Their service adds clear value to our lives and society, and their work has a clear altruistic component as well. This is why SENSIBLE (and our international partners) advocates ‘Ethical Surrogacy.’
For more info, visit https://www.sensiblesurrogacy.com/how-does-surrogacy-work/#ethical-surrogacy

Whether your surrogate is from Kiev or California, Intended Parents should remember that the surrogates is an equal participant in the surrogacy journey. The Surrogacy Contract is a partnership agreement, with each person having obligations toward the other.

Matching & Preparing your Surrogate

Surrogate Matching refers to the process of recruiting surrogates and assigning them to waiting Intended Parents. Once matched, a surrogate candidate will undergo extensive health and fertility exams, plus legal and psychological checks. This is often a requirement by the IVF clinic to accept the surrogate as a patient.

Surrogates in many overseas countries are pre-evaluated and readily available with no waiting period. In the United States, the process to recruit and evaluate a surrogate requires a six to eight week screening process (a service called “Surrogate Matching”).

Once the surrogate has passed her initial evaluation and been “matched” to an Intended Parent, it is often another 2 months before she is fully prepared for her embryo transfer (called “Surrogate Preparation”). While these two processes are underway, parents often work with the clinic to complete their own donations and IVF cycle.

Find a surrogateThe initial matching stage requires a series of blood tests and ultrasound scans, as well as a litany of personal evaluations (including criminal and psychological evaluations). The Preparation stage includes fertility boosting hormone injections to thicken the surrogate’s endometrium and make her more receptive to the intended parents’ transplanted embryo.

Surrogates overseas are often not as thoroughly screened as in Western countries. Even in the United States some agencies perform far more rigorous evaluations of their surrogate candidates than others. The disparity in surrogate evaluation may be one reason for the differences in pregnancy rates between countries and between clinics within the same country. if you worry about the health of your surrogate, you may ask her agency to perform additional medical tests, although you likely will need to pay extra for this.

Although the depth of her initial evaluation and medical screening is often quite different, the preparation and fertility treatments for your surrogate are basically the same from country to country.


Qualifications of a Surrogate

To become a surrogate women must meet strict medical, psychological, and personal criteria. Here is a short list of the minimum that every surrogate should meet.

Have at least one successful, natural pregnancy

The first requirement is the most obvious… all surrogate candidates must demonstrate they are fertile and capable of maintaining a healthy pregnancy by having their own successful pregnancy. In addition having gone through pregnancy gives an important understanding of what is involved and the physical and emotional toll that pregnancy may bring. Raising a child is also a sign of emotional stability and responsibility.

Be generally healthy and take good care of themselves

We all know that it’s important to eat healthy and exercise regularly, and even more so during a pregnancy. All surrogates must be able to demonstrate that they live a healthy lifestyle, including regular exercise and personal wellness habits. Surrogates must also live in a well-maintained home unless they will be offered housing by their agency.

Healthy body weight

Women who are overweight are at a greater risk of developing gestational diabetes, which can be a risk not only to the surrogate but also to the pregnancy. IVF clinics have become very strict regarding the body mass index (BMI) a surrogate must maintain, and may accept a possible surrogate only if she can modify her lifestyle to meet this criteria.

Be between 21-40 years old

Different clinics have different requirements regarding the age of a surrogate. In general surrogates need to be at least 21 years to have the emotional stability needed to be a surrogate. Meanwhile, while there are instances of women successfully serving as surrogates into their 50s, most clinics will only accept surrogates up to the age of 35.

No drugs. Responsible alcohol.

A woman must live a stable lifestyle to qualify to become a surrogate. This means no drugs of any kind, whether it is street or prescription pills without a doctor’s prescription. While an occasional drink is normal and acceptable, heavy or regular use of alcohol is also a reason for exclusion. The surrogate also must agree to regular drug screenings throughout the pregnancy.

Be a non-smoker

Smoking during pregnancy can cause a stillbirth, premature delivery, and low birth weight. It will also cut the oxygen off to the baby by narrowing blood vessels throughout your body, including the ones in the umbilical cord.

No criminal history.

All surrogate candidates go through an extensive criminal background check.

Have a stable relationship or support network

Being pregnant is often hard work, and most women will need some form of emotional or physical support during their pregnancy. A good surrogate should have either a husband/partner able to assist her throughout the pregnancy. If not a spouse, then an available network of family and friends can often provide the needed support.

Emotionally stable

Every surrogate candidate must pass a psychological review to ensure she is emotionally capable of fulfilling the requirements of being a surrogate. Surrogates must be able to schedule appointments, remember to attend them and follow doctor’s orders. They have to also be able to read and understand the legal Surrogacy Contract with the help of an independent lawyer. Most importantly, a surrogate must be able to care for the growing baby responsibly throughout the pregnancy, and then she must relinquish her parental rights when the baby is delivered.

Positive outlook on life

Intended Parents should look for a surrogate who is generally positive and optimistic. This type of attitude is important as she goes through the pregnancy (which can sometimes include physically and emotionally challenging days.). A good attitude will help her stay focused on the important work that she is doing, and the joy that she is bringing to a childless couple.

Be able to handle the logistics of the surrogacy process

This includes and ability to Take time away from your employer and family for surrogacy (appointments, bedrest, birth, post partum) It also means the surrogate must often we willing to travel to fertility clinics, lawyers, doctor’s/ultrasound appointments.

Frequent Questions about Your Surrogate

What is a Surrogate?

Your surrogate is the primary caregiver to your nascent family. For nine months your surrogate will carry your pregnancy and take care of your developing baby. Read More about what is a Surrogate.

How much do Surrogates earn?

Your surrogate will comprise about one-half of your total surrogacy budget. In the US, that’s from $50,000 to $70,000 USD for a typical journey. Overseas, surrogates earn about $13,000 to $16,000 Read more about Surrogate pay

How to find a Surrogate

You can find your own surrogate online. The most popular places are dedicated groups on Facebook and similar social networks. Other strategies include looking locally using traditional classified advertising methods. Read more about finding a Surrogate

How to find medical insurance for your surrogate?

In general, only 1 in 10 potential surrogates have insurance that will include maternity care. For those with insurance, most policies include co-payments and deductibles of $5000 or more. Read more about insurance for your Surrogate.

What are the qualifications to be a Surrogate?

To become a surrogate women must meet strict medical, psychological, and personal criteria. Here is a short list of the minimum that every surrogate should meet. Read more about Surrogate qualifications

Are Surrogate treated ethically?

Ethical Surrogacy is focused on the health of the surrogate. Advocates of Ethical Surrogacy take special effort to ensure the complete physical and emotional well being of these important women. Read more about the ethics of surrogacy

What does a Surrogate have to do?

As a surrogate, you will be required to undergo several medical tests and procedures and take fertility medications throughout the process. Because your health is so central to a successful surrogacy, it will be closely monitored throughout the entire surrogacy process. But there are also psychological evaluations, interviews with the Intended Parents, and reviewing legal agreements. Read more about being a Surrogate

About the authors

  • Bill-Houghton
  • Author: William Houghton

    Bill Houghton is the founder of Sensible Surrogacy, author of the Sensible Surrogacy Guide, 2x surrogacy dad, and a dedicated advocate for secure, legal and ethical Gestational Surrogacy. Read Bill's Biography

Didn`t find what you need?

Search our complete library for all the answers...

...or return to the ‘Sensible’ Surrogacy Guide.