The short list
These are the most common reasons women are declined from surrogacy:
- No prior pregnancy
- BMI over 33-35
- Under 21 or over 42 years old
- Smoking, vaping, or drug use (including marijuana)
- Alcohol abuse
- Certain medical conditions (HIV, Hepatitis B/C, active cancer)
- Two or more pregnancy losses
- Felony criminal record
- Unstable housing
- Current government cash assistance (TANF)
- Unsupportive partner or home environment
- Unwilling to travel for IVF appointments
Each of these is explained in detail below with the reasoning and which are negotiable.
Pregnancy and medical history disqualifications
No prior pregnancy
Firm disqualifier. Every reputable agency and fertility clinic requires at least one prior full-term pregnancy and delivery. No exceptions. The reason: the clinic needs evidence your body can safely carry and deliver a baby. Surrogacy is not a good place to discover complications for the first time.
BMI over 33-35
Mostly firm, slight flexibility. Most agencies require BMI under 32 for first-timers. Fertility clinics sometimes accept up to 33-35 for experienced surrogates or in borderline cases. The reason: higher BMI increases the risk of gestational diabetes, preeclampsia, and delivery complications. The clinic, not the agency, usually sets the cutoff.
If you're borderline, ask the specific agency about their BMI policy. A BMI of 32.8 might be fine at one agency and not at another. Significantly over (35+) is almost always a hard no.
Age under 21 or over 42
Firm on the low end, flexible on the high end. Minimum age is 21 at nearly every agency. The maximum is 39-42 depending on the agency and fertility clinic. Some experienced surrogates can qualify up to 44 if their reproductive health is exceptional.
HIV, Hepatitis B or C, active cancer
Firm disqualifier. Active infectious disease (HIV, Hep B, Hep C) or active cancer treatment disqualifies you. The reason is embryo safety and your own health during pregnancy. Some agencies will reconsider after cancer remission (typically 5+ years cancer-free).
Two or more pregnancy losses
Case by case. Two miscarriages or stillbirths may disqualify you, depending on cause. If the cause was known and treated (e.g., cervical incompetence resolved with cerclage), some clinics will still approve you. Unexplained recurrent pregnancy loss is a harder decline.
Severe pregnancy complications in prior pregnancies
Case by case. Mild preeclampsia or gestational diabetes in a prior pregnancy isn't necessarily a disqualifier if you recovered fully and had subsequent healthy pregnancies. Severe preeclampsia, HELLP syndrome, or placenta previa may disqualify you. The clinic evaluates this individually.
Certain autoimmune conditions
Case by case. Well-controlled autoimmune conditions like hypothyroidism are fine. Active lupus, multiple sclerosis in flare, or conditions requiring immunosuppressive medications may disqualify you.
Lifestyle disqualifications
Smoking, vaping, or drug use
Firm disqualifier. Any current nicotine use (smoking, vaping, chewing), marijuana use (regardless of state legality), or recreational drug use is an automatic no. Most agencies require you to be tobacco/marijuana/drug-free for at least 6 months before applying. Some require 12 months. Drug testing is part of medical screening.
Household smoking also matters. Some agencies will decline if anyone in your household smokes inside the home. Secondhand smoke affects the pregnancy.
Alcohol abuse
Firm disqualifier. Alcohol abuse or alcoholism is an automatic decline. Moderate, occasional drinking is typically fine (you'd abstain during the pregnancy anyway). The line is different at different agencies but regular heavy drinking disqualifies you.
Unstable housing
Firm disqualifier. If you're in transitional housing, living in your car, couch-surfing, or in an unstable living situation, agencies will decline. Surrogacy is an 18-month commitment that requires a stable home environment for prenatal care, medication storage, and baby-related appointments.
Current government cash assistance (TANF, welfare)
Firm disqualifier at most agencies. TANF and similar programs create legal complications with surrogate compensation. Most agencies require that you're not currently receiving cash assistance. SNAP (food stamps) is usually fine — it's only cash benefits that cause issues.
No partner or family support
Case by case but often disqualifying. If your partner opposes surrogacy or your home environment doesn't support the process, most agencies consider this a risk factor. Surrogacy affects your whole household. An unsupportive partner makes the journey much harder.
You don't need to be married. Single surrogates are accepted at many agencies. But you need some support network.
Not sure if you qualify?
Our 2-minute quiz checks the big disqualifiers — age, BMI, pregnancy history, state, health, lifestyle. Get an answer fast.
Check your eligibility →Legal disqualifications
Felony criminal record
Case by case. Most agencies require a clean background check. Drug-related felonies are typically a hard no. Old (10+ years) non-violent offenses sometimes get exceptions. Violent crimes, crimes against children, or recent felonies disqualify you.
Domestic violence history
Case by case. A documented history of domestic violence in your current relationship can be disqualifying because of the stability risk. If you're a survivor who left the situation years ago and the current home is safe, this isn't typically a barrier.
State restrictions
Depends on your state. Living in Michigan, Louisiana, or Nebraska limits your options because surrogacy is legally restricted or banned. You may need to work with an agency in a different state that's willing to take you.
Medication disqualifications
Antidepressants (SSRIs)
Case by case. Some agencies accept surrogates on certain SSRIs like sertraline (Zoloft) at stable doses. Others require you to be medication-free. The fertility clinic also weighs in. Never stop a prescribed medication without consulting your doctor first.
Opioid pain medications
Firm disqualifier. Current opioid use for chronic pain (even with prescription) typically disqualifies you. Past opioid use is usually fine if you've been off for 12+ months.
Fertility-affecting medications
Firm disqualifier. Medications that affect pregnancy viability or cause birth defects (isotretinoin, some immunosuppressants, certain seizure medications) disqualify you. The fertility clinic reviews your medication list during screening.
Logistical disqualifications
Unwilling to travel for IVF
Firm disqualifier. You must be willing to travel to the intended parents' fertility clinic for screening, embryo transfer, and sometimes follow-up appointments. This often means overnight stays and time away from home. If you can't travel, you can't be a surrogate.
Work that involves physical hazards
Case by case. Jobs with heavy lifting, chemical exposure, or high physical demands may require modification during pregnancy. Most agencies work with this. If your job is incompatible with pregnancy (e.g., firefighter on active duty), you may need to plan for temporary leave.
What if I'm declined?
Being declined by one agency doesn't mean you can't be a surrogate. Policies vary. If the decline reason is fixable (e.g., BMI you can adjust, medication you can taper, waiting period for a past condition), address it and reapply. If it's a hard medical disqualifier, respect that — it exists to protect your health.
Common fixable situations:
- BMI 1-3 points over the limit → lose the weight and reapply
- Less than 6 months smoke-free → wait until you've been tobacco-free for 12+ months
- Currently on SSRIs → work with your doctor on whether you can safely transition
- Recent felony → wait until 10 years past the offense
- Unsupportive partner → address the relationship first, not surrogacy