The 12-point checklist
To qualify as a surrogate with almost any reputable US agency, you need to meet all 12 of these:
Age requirement: 21–39 (sometimes 42)
Minimum age is 21 at nearly every agency. At 21, you're old enough to have completed a pregnancy and to give informed consent for a complex legal and medical process. Some agencies go as low as 20 for experienced surrogates in specific states, but 21 is the standard.
Maximum age is typically 39 for first-time surrogates. Experienced surrogates can qualify up to 42 at many agencies, and occasionally up to 44 if their reproductive health is exceptional. Beyond 42, your options narrow significantly because fertility clinics' cutoffs apply regardless of agency flexibility.
BMI requirement: under 32
Most agencies require BMI under 32 for first-timers. This isn't an aesthetic choice — it's a medical safety cutoff. Higher BMI increases the risk of:
- Gestational diabetes
- Preeclampsia
- Cesarean section
- Pulmonary embolism
- Stillbirth
- Anesthesia complications
Some clinics accept up to BMI 33-34, and a few go to 35 for experienced surrogates. If you're close to the limit, lose the few pounds before you apply — it's faster and more reliable than arguing with agencies about flexibility.
Pregnancy history: at least one full-term
This is the single most firm requirement. Every reputable agency and fertility clinic requires at least one prior full-term pregnancy (37+ weeks) with a healthy delivery and a healthy baby. There are no exceptions.
The reason is evidence-based: the clinic needs proof your body can carry a pregnancy to term safely. A pregnancy that resulted in preterm delivery before 37 weeks may or may not count — it depends on the cause and your recovery. Severe preeclampsia, placental abruption, or uterine issues often disqualify you even if the baby was healthy.
Currently parenting
Most agencies require that you're currently raising at least one child of your own. This isn't about judgment — it's about ensuring you understand what pregnancy and postpartum feel like before committing to carry someone else's baby.
Agencies typically want you to have finished your own family before starting surrogacy. That doesn't mean you can't have more biological children later, but if you're still planning your own kids, most agencies recommend completing that before applying.
Smoke-free: 6-12+ months
No current smoking, vaping, or marijuana use (regardless of state legality). Most agencies require at least 6 months tobacco-free before applying. Some require 12 months. Drug testing is part of medical screening.
"Smoke-free household" is also checked at some agencies. If your partner smokes in the home, secondhand exposure can disqualify you. Outdoor smoking by other household members is usually fine.
No recreational drug use
Current use of marijuana (even in legal states), cocaine, methamphetamine, heroin, or other recreational drugs disqualifies you. Most agencies require 12 months drug-free. Past use that's been resolved for years is usually fine.
Prescription medications are handled separately — some are fine, some aren't. SSRIs (like sertraline), thyroid medications, and common antibiotics are usually fine. Opioid pain medications and psychiatric medications for severe conditions often aren't.
Health and chronic conditions
You need to be in overall good health. These are common disqualifying conditions:
- HIV, Hepatitis B, Hepatitis C
- Active cancer treatment (remission is often fine after 5+ years)
- Uncontrolled diabetes (well-controlled Type 2 sometimes accepted)
- Heart disease or high blood pressure requiring medication
- Active lupus or other autoimmune conditions in flare
- Severe depression or bipolar disorder
- History of eclampsia in prior pregnancies
- Two or more pregnancy losses without identified cause
Well-controlled conditions like hypothyroidism, asthma, or mild anxiety are usually fine. The fertility clinic makes the final call.
Check all 12 requirements in 2 minutes
Our quiz walks through every eligibility requirement and tells you where you stand. Free and confidential.
Check my eligibility →Housing and financial stability
You need stable housing throughout the 18-month journey. Couch-surfing, transitional housing, or unstable living situations disqualify you. This isn't about judging your situation — it's about ensuring you can properly attend prenatal appointments, store medications safely, and recover postpartum.
Most agencies also require that you're not currently on TANF (Temporary Assistance for Needy Families) or similar cash assistance programs. This is because surrogate compensation can interact with benefit eligibility in complicated ways. SNAP (food stamps) is usually fine.
Partner and family support
You need someone in your life who supports your decision to become a surrogate. This can be a spouse, partner, parents, close friends, or a therapist — it doesn't have to be a romantic partner. But you can't go through the journey alone with no support.
Psychological screening explicitly evaluates whether your home environment supports surrogacy. An unsupportive partner is a common reason for psychological screening to raise concerns.
U.S. citizen or permanent resident
Most agencies require that you're a U.S. citizen or permanent resident. The reasons are legal (citizenship affects your baby's citizenship in complex ways), insurance (residency affects health coverage), and logistical (travel and residence continuity during the journey).
Visa holders typically can't be surrogates in the US.
State-specific requirements
Your state affects which agencies will work with you. Some states have legal restrictions that limit surrogacy. Others require specific legal procedures. Surrogate-friendly states include:
- California (strongest legal framework)
- Texas, Florida, Illinois, Georgia (high-activity markets)
- Nevada, Washington, Oregon, Colorado (well-established)
- Most other states with established agency coverage
States where surrogacy is legally restricted:
- Michigan (surrogacy contracts void; felony penalties)
- Louisiana (restricted to married heterosexual couples)
- Nebraska (contracts unenforceable)
- New York (traditional surrogacy banned; gestational recently legalized but still limited)
See our surrogacy laws by state page for current details.
What if I'm close to meeting all the requirements?
Many women are 1-2 items short when they first apply. Common near-misses and what to do:
- BMI 1-3 points over — lose the weight, reapply in 3-6 months
- Smoke-free but only for 4 months — wait until 12 months, then apply
- On SSRIs — talk to your doctor about whether you can transition
- Currently on TANF — wait until you're off the program, typically 6 months
- Unsupportive partner — this isn't fixable by waiting; address the relationship first
- Recent felony — wait until 10+ years past offense