What Could Disqualify You from Becoming a Surrogate?

You've looked into the surrogacy requirements, and now you're wondering about the other side of the equation — what could disqualify you? It's a question worth asking early, and the answer is more nuanced than a simple yes-or-no list.

Some disqualifying factors are firm. They exist because of medical risks that can't be safely managed during a surrogacy pregnancy. Others are situational — things that might need evaluation on a case-by-case basis. And some are factors you can actually change over time if surrogacy is something you're serious about.

Let's go through this honestly.

Medical Conditions That Typically Disqualify

Certain health conditions create risks that are too significant for a surrogacy pregnancy. These aren't judgments about you as a person — they're medical realities about what a pregnancy demands of your body and what could put you or the baby in danger.

Conditions that are usually disqualifying include: hypertension or chronic high blood pressure, diabetes (type 1 or type 2, not gestational), heart disease, cancer (active or recent), HIV or hepatitis, sickle cell disease, endometriosis, polycystic ovary syndrome (PCOS), adenomyosis, and autoimmune conditions that affect pregnancy.

Pregnancy-related complications that are typically disqualifying include: preeclampsia in a prior pregnancy, pre-term labor or delivery, uterine inversion, placental abruption, and any prior pregnancy that was classified as high-risk with serious complications.

If you've had more than two C-sections, that's also generally disqualifying. Each cesarean delivery increases the risk of complications like uterine rupture and placenta accreta in future pregnancies, and most IVF clinics won't clear a surrogate beyond two prior C-sections.

Conditions That Don't Automatically Disqualify You

Here's where things get more nuanced. Some conditions that women assume would disqualify them actually don't — they just require a closer medical evaluation.

Tubal ligation (tubes tied). This is one of the most common misconceptions. Having your tubes tied does not disqualify you from surrogacy. In gestational surrogacy, the embryo is placed directly in your uterus through IVF — your fallopian tubes aren't part of the equation.

One or two prior C-sections. As long as you haven't had more than two, a C-section history is not disqualifying. The IVF clinic will evaluate your uterine health and scar tissue, but many surrogates have delivered via cesarean before and gone on to have successful surrogacy journeys.

HPV or herpes. These are evaluated on a case-by-case basis. Both conditions need to be monitored during pregnancy, and an active herpes outbreak near delivery would likely require a C-section. But neither is an automatic disqualifier — your doctor will assess the specific situation.

Recent pregnancy. If you've recently had a baby, you'll typically need to wait at least six months and be done breastfeeding before starting a surrogacy journey. Your body needs time to recover fully, and breastfeeding can interfere with the hormone protocols used in embryo transfer preparation.

Lifestyle Factors That Disqualify

Smoking, vaping, or marijuana use. You must be a non-smoker, and that includes vaping and cannabis. These substances directly affect fetal development, and intended parents need to trust that the woman carrying their child is maintaining a healthy environment. You also can't live in a household with heavy secondhand smoke exposure.

Recreational drug use or alcohol dependence. This is non-negotiable. Any current substance use is disqualifying, and a history of substance abuse will also be carefully evaluated.

BMI above the threshold. Most IVF clinics require a BMI at or below 30–35 (the exact number varies by clinic). A higher BMI is associated with increased pregnancy complications. This is one of the most common factors that delays an application rather than permanently disqualifying it — more on that below.

Financial instability. If you're relying on surrogate compensation as your primary income or are under significant financial stress, that's a concern. Surrogacy is a long process with variable timelines, and the compensation is paid in installments — not as a lump sum. Financial pressure during a pregnancy adds stress that isn't healthy for you or the journey.

Criminal history. A background check is standard. Felony convictions, particularly those related to violence, abuse, or substance offenses, are typically disqualifying.

What About Mental Health?

This is an area that deserves careful, honest discussion. Every surrogate goes through a psychological evaluation — and having a mental health history doesn't automatically disqualify you. What matters is how your mental health is managed.

The complicating factor is medication. Many antidepressants and anti-anxiety medications cross the placental barrier and can affect fetal development. Most IVF clinics require surrogates to be off these medications during the journey. That's a medical decision, and it's one that needs to be made carefully — with your prescribing doctor, the IVF clinic, and your own honest assessment of whether pausing medication is something you can safely do.

If you're in a stable place with your mental health and your doctor supports pausing medication for the duration of a surrogacy pregnancy, this doesn't have to be a barrier. But if stopping medication would put your own wellbeing at risk, that's important information — and it's worth being honest about it early in the process.

What If Something Is Disqualifying Right Now but Could Change?

Several of the factors above aren't permanent. If surrogacy is something you feel drawn to but you're not quite there yet, here are the most common things women work on before reapplying:

BMI. If you're above the threshold, many women use the time before their surrogacy journey to focus on their health. Even a modest weight loss can bring you within range. We're happy to talk through realistic timelines.

Smoking or substance use. If you're in the process of quitting, most agencies and clinics want to see at least a year of being substance-free before you apply.

Recent pregnancy. If you've just had a baby, the waiting period is typically six months to a year, and you'll need to be finished breastfeeding.

Financial stability. If you're working toward a more stable financial position, the surrogacy application will still be there when you're ready.

The point is — not qualifying today doesn't mean no forever. If this is something you care about, it's worth having a conversation about where you are and what might need to change.

Not Sure If You Qualify?

If you've read through this and you're still not sure where you stand, the easiest thing to do is reach out. We'll have an honest conversation about your situation — no pressure, no judgment — and help you figure out whether surrogacy is a realistic path for you right now, or whether there are steps you can take to get there.

Ask us about your eligibility →