Surrogacy is complicated, and fertility providers must protect the health of each of the participating parties throughout the process. Choosing an appropriate and healthy surrogate mother is an important first step.
From both medical and legal perspectives, age is a key factor when deciding if a woman is suitable for becoming a surrogate. For this reason, agencies usually set age limits and restrictions for gestational carriers. Surrogacy agencies must ensure that the candidates are as fit as possible for the procedure.
Lower age limit
The American Society for Reproductive Medicine recommends that surrogates or gestational carriers be at least 21 years old. The lower age threshold ensures that prospective applicants are physically and emotionally ready to manage the intricacies of the process, and fully understand the potential risks.
Additionally, potential surrogates are required to be financially independent and have carried at least one previous successful pregnancy. Having children proves that the candidate is, in principle, fertile, able to sustain a pregnancy and bear a child. Women also must be economically solvent and demonstrate they have a stable and secure living situation during their surrogacy journey. Candidates should not be coerced by monetary compensation. Women under 21 do not generally meet these requirements; most surrogates typically are in their thirties.
Upper age limit
Most agencies are not as strict with upper age limits for gestational surrogacy because egg quality (provided by the intended mother or egg donor) is a more critical factor impacting pregnancy and live birth success rates than the age of the surrogate mother.
However, for couples who pursue traditional surrogacy where the surrogate mother also provides the genetic material for insemination and pregnancy, the age of the woman is a critical requirement.
Some programs cap the age for prospective gestational carriers at 35, while others may accept older women. Although it is true that women’s fertility significantly declines after 35, this drop-off is mainly due to deterioration in oocyte quality, and it does not affect, as markedly, the ability to carry a pregnancy. Endometrial stimulation treatments before the embryo transfer can make pregnancy possible even in postmenopausal women. There are examples of women who have served as surrogates over age 50, including grandmothers-to-be. Most of these older surrogates are related to the intended parents.
The older the woman who carries the pregnancy is the higher the risk of complications of pregnancy and childbirth. Women past a certain age are more likely to:
Develop gestational diabetes.
Suffer from preeclampsia.
Go into premature delivery.
Have low birth weight babies.
Experience placental abruption.
Have placenta previa, where the placenta is abnormally positioned, and partially or completely blocks the cervix. This condition makes vaginal delivery dangerous, requiring a cesarean section (C-section) for women who develop it.
Even without complications, pregnancies are physically demanding. Generally, young women find them easier to endure and need smaller recovery times after childbirth. Surrogacy agencies try to select healthy, appropriate candidates by following the guidelines of the fertility center and the American Society for Reproductive Medicine.