Women might be interested in becoming a surrogate mother, also known as a gestational carrier, for a variety of reasons. However, not all of them will meet the initial requirements.
The purpose of surrogate screening is to ensure that the candidate is appropriate and to protect the health of the baby and the carrier during the entire process.
There are several factors we consider when we screen gestational carrier candidates. Prospective surrogates must be psychologically and physically ready for the process. Criteria might slightly vary from agency to agency, but according to the American Society for Reproductive Medicine (ASRM) recommendations, the general requirements for potential surrogates may include the following conditions.
Agencies generally set the age requirement for surrogate mothers between the ages of 21 and 45, following the recommendations of the ASRM. Women who are older increase the risk of obstetrical and perinatal complications. Criteria are even stricter when it comes to traditional surrogacy. Surrogates must be younger since their eggs will be used for the conception of the baby.
To become a surrogate, a woman must have carried at least one previous pregnancy successfully, and have no significant complications from them. This experience is a good indication she is physically able to carry a pregnancy to term. It also implies that she is aware of the medical risks of the process and the chance of emotionally bonding with the baby. Prospective mothers should also be currently raising their own child or children.
Obesity has a direct impact on fertility treatment outcome, including surrogacy. Most agencies and fertility clinics follow guidelines for a healthy body mass index (BMI) to assess whether the weight of the candidate is appropriate. BMI is derived from both the height and weight of an individual. A healthy weight reduces the risk of health complications during surrogacy, as we explain in more detail here.
IVF clinics and agencies usually require the surrogate’s BMI to be no greater than 30, which is the limit for considering a candidate. BMI values lower than 19 suggest that the candidate is underweight, which also can negatively affect her fertility.
Some sexually transmitted diseases (STDs) can spread to the baby during pregnancy or through the birth canal during labor. Surrogates must be free of any treatable STD for at least 12 months before surrogacy.
In gestational surrogacy, which does not involve the surrogate’s eggs, a tubal ligation does not prevent a candidate from being selected. It is advantageous since it ensures the surrogate will not become pregnant with her own eggs.
ASRM also recommends that surrogates must be psychologically stable and free of antidepressant medication for at least one year before starting with the surrogacy process. A history of mental illness or post-partum depression would likely disqualify a candidate.
Ideal qualities for a surrogate mother include having a responsible behavior and lifestyle. Prospective surrogates should provide a healthy and safe environment for the child they are carrying, as well as for themselves, throughout the surrogacy.
Carriers also must be non-smokers. Smoking during pregnancy increases the risk of obstetric and perinatal complications, such as miscarriage, premature birth, low birth weight, and Sudden Infant Death Syndrome, so this requirement is essential.
Also, surrogates must not use illegal drugs or abuse alcohol throughout IVF and pregnancy. Additionally, prospective surrogates must have no history of criminal activities or felony convictions.
Surrogates must be financially stable, and not on government assistance, so they do not feel coerced by the financial gain of the process.
Surrogacy is complicated, and it requires candidates to undergo multiple evaluations. This process can sometimes seem lengthy and tedious, but it is crucial to ensure the protection of all parties involved and, ultimately, the success of the journey.