At a glance
Most "how to become a surrogate" articles are agency recruitment pages. Their goal is to get you to fill out an application. Our goal is different — we want you to know what you're actually signing up for before you talk to anyone.
This guide walks through the full process, the real requirements, the compensation breakdown, and the parts agencies tend to skip. If you still want to do it after reading this, we'll match you with a vetted agency via our quiz. If you decide it's not for you, that's fine too. Either way, you'll have the facts.
Who qualifies to be a surrogate
Here's the short version. Most agencies require all of this:
- Age 21–39 — some agencies accept up to 42 for experienced surrogates
- BMI under 32 — some fertility clinics go up to 33 or 34
- At least one healthy full-term pregnancy and delivery, with no major complications
- Currently raising at least one child of your own
- Non-smoker — no smoking, vaping, marijuana, or recreational drugs, and nobody smokes in your home
- Stable housing and reliable transportation
- Not currently on government cash assistance (TANF, welfare)
- A partner or family that supports your decision
- U.S. citizen or permanent resident
- Willing to travel for medical appointments, sometimes overnight
Some of these are firm. Others vary. A BMI of 34 might be fine at one agency and a no at another. Two prior C-sections are usually fine; three might not be.
For the full breakdown, see our complete surrogate requirements page. If you want a faster answer, take the 2-minute quiz — it checks the biggest disqualifiers without any commitment.
What disqualifies you
These are the most common reasons agencies decline applications:
- No prior pregnancy. You must have carried at least one baby to term. No exceptions. Clinics need proof your body can do this safely.
- BMI over 33–35. Higher BMI means higher risk of gestational diabetes, preeclampsia, and delivery complications. The clinic, not the agency, usually sets this cutoff.
- Smoking or drug use. Any current nicotine, marijuana, or recreational drug use is an automatic no. Some agencies will decline if anyone in your household smokes in the house.
- Certain medical conditions. HIV, Hepatitis B/C, active cancer treatment, certain autoimmune conditions. Others are case-by-case.
- Repeated pregnancy loss. Two or more miscarriages or stillbirths may disqualify you depending on the cause.
- Felony record. Most agencies require a clean background check. Old non-violent offenses sometimes get exceptions. Drug-related felonies are usually a hard no.
- Unstable housing. If you're in transitional housing or an unstable living situation, agencies will decline.
- Government cash assistance. TANF and similar programs create legal complications with compensation.
- No family support. If your partner opposes surrogacy, agencies consider this a risk factor.
See our full disqualifications guide for more detail, including which conditions are negotiable and which are hard lines.
Not sure if you qualify?
Our 2-minute quiz checks the big disqualifiers — age, BMI, pregnancy history, state, health. No account required.
Check your eligibility →The 10-step surrogacy process
From first search to the baby coming home with the intended parents, here's what actually happens.
1 Research and self-assessment
1–4 weeksBefore you contact any agency, answer these honestly:
- Can I handle 9 months of pregnancy plus 3–6 months of screening first?
- Is my partner actually on board? Not "they said yes" — have they thought about the hormone shots and hospital visits?
- If money is my only reason, will I still want to do this 14 months in?
- Is my mental health in a good place right now?
This step is free. Skipping it is expensive.
2 Choose an agency
2–4 weeksGoing independent is possible but adds risk, work, and legal exposure. Most surrogates work with an agency that has:
- SEEDS or ASRM membership
- Independent escrow accounts (not "in-house" escrow)
- Transparent compensation posted publicly
- Independent legal counsel for you (paid for by intended parents)
- At least 5 years in operation
- Former surrogates on staff, not just salespeople
See our partner agency reviews or our guide to agency red flags to watch for.
3 Submit your application
2–6 weeksThe application is long. Expect questions about your full medical history, pregnancy records, current medications, photos (full-body and face), lifestyle, criminal background, and insurance.
Be honest. Agencies verify everything. Lying about a prior miscarriage or a medication gets you dropped from the process and wastes everyone's time — including yours.
4 Medical screening
1–2 monthsIf your application is approved, you move to medical screening at the intended parents' fertility clinic — not your OB. This may be in a different city or state.
Medical screening includes comprehensive bloodwork (infectious disease panel, hormones, genetic markers), a physical exam, a uterine evaluation (sonohysterogram or hysteroscopy), pap smear and STI testing, drug screening, and a review of your full pregnancy history.
The clinic makes the final medical call. You can pass agency screening and still get declined by the clinic — this happens more often than agencies tell you.
For more, see our page on what to expect from medical screening.
5 Psychological screening
2–4 weeksEvery surrogate journey requires a psychological evaluation. It's not optional.
- MMPI-2 or PAI personality assessment. A standardized 300+ question psychological test.
- Clinical interview. A licensed psychologist talks with you (and your partner) about your motivations, support system, expectations, and how you handle stress.
- Evaluation of your understanding. The goal is to confirm you know what you're signing up for — including the hard parts.
This isn't about finding something "wrong" with you. About 10–15% of applicants don't clear this stage, usually because of external factors like an unsupportive partner or high current life stress.
See psychological screening explained for more.
6 Matching with intended parents
1–6 months (biggest variable)Once you clear both screenings, you enter the matching pool. This is where your flexibility on preferences matters most.
You can usually specify contact level, family type, number of embryos you'll transfer, location preferences, and any deal-breakers. The more specific your requirements, the longer matching takes.
The match meeting is usually a video call. Both sides can decline. There's no pressure, and there shouldn't be.
7 Legal contracts
2–6 weeksOnce both sides agree to move forward, attorneys get involved. Yours is paid for by the intended parents, but works for you — not them.
The contract covers base compensation, monthly allowances, payment schedule, medical decisions during pregnancy, communication expectations, what happens in a miscarriage or selective reduction scenario, insurance coverage, and post-birth contact.
Read every word. Ask questions. Don't let anyone rush this. This is the document that protects you when something unexpected happens.
8 Medical protocol and embryo transfer
1–2 monthsNow the medical part starts. Your body needs to be prepared to receive an embryo.
- Hormone injections. Estrogen and progesterone shots for 2–4 weeks before the transfer. Progesterone-in-oil is an intramuscular shot with a thick needle. They leave bruising, knots, and soreness. Agencies describe them as "a small pinch." They're not.
- Monitoring appointments. Blood draws and ultrasounds to check your uterine lining.
- Embryo transfer. About 15 minutes at the fertility clinic. Not painful for most women. Stressful for almost everyone.
- The two-week wait. A blood test confirms pregnancy around day 10–14. The anxiety is real.
About 30–40% of first transfers don't result in pregnancy. If that happens, you repeat the protocol for a second or third attempt. Your contract should specify how many transfers you've agreed to.
9 Pregnancy
~9 monthsPregnancy itself is both familiar and different. Familiar because you've done it before. Different because you're carrying someone else's child, managing their anxiety, and the ultrasound photos aren't yours.
Expect prenatal care with an OB, regular check-ins with your agency coordinator, continued hormone injections through the first trimester (usually 10–12 weeks), and communication with the intended parents per your agreement. Some agencies schedule monthly video calls. Others leave communication loose.
If you're carrying twins, you get extra compensation. Most agencies pay $5,000–$10,000 additional for multiples.
10 Delivery and post-birth
Birth + 4–8 weeks recoveryYou and the intended parents create a hospital birth plan ahead of time. Who's in the delivery room. How the baby is handled right after birth. What the legal handoff looks like.
In states with pre-birth orders (California, Illinois, and others), the intended parents are already the legal parents before the baby arrives. In other states, post-birth legal steps are needed. Your attorney handles it.
Final compensation is typically paid within 2–4 weeks of delivery. Your monthly allowance continues for 6–8 weeks postpartum. Physical recovery is the same as any birth — longer for a C-section.
Emotional processing is normal, even when the journey went well. Postpartum hormones don't care that the baby isn't genetically yours. Many agencies offer post-birth counseling. If yours doesn't, ask for it.
How long does the whole thing take
Total timeline: 14–24 months from first application to delivery. Here's the breakdown:
| Phase | Typical Timeline |
|---|---|
| Research + self-assessment | 1–4 weeks |
| Agency selection | 2–4 weeks |
| Application + review | 2–6 weeks |
| Medical screening | 1–2 months |
| Psychological screening | 2–4 weeks |
| Matching | 1–6 months (biggest variable) |
| Legal contracts | 2–6 weeks |
| Medical protocol + transfer | 1–2 months |
| Pregnancy | ~9 months |
| Post-birth recovery | 4–8 weeks |
The biggest variable is matching. Your flexibility on intended parent type, location, and contact level affects this a lot. If a first transfer fails, add 2–3 months.
Any agency telling you this takes "just a few months" isn't being honest. The fastest possible path — everything goes perfectly, instant match, first transfer works — is still about 14 months.
For more, see our full surrogacy timeline breakdown.
What you actually get paid
Compensation varies by agency, experience level, and state. Here's what the four partner agencies we work with pay:
| Agency | First-Timer Base | First-Timer Total | Experienced Total |
|---|---|---|---|
| Family Makers (Atlanta, GA) | $60,000 | $95,000 | $105,000+ |
| Family Tree Surrogacy (San Diego, CA) | $60,000 + $1K bonus | $80,000+ | $90,000–$105,000 |
| Simple Surrogacy (Dallas, TX) | $58,000–$63,000 | $73,000 | $89,000 |
| NewGen Families (Las Vegas/LA) | $60,000 | $72,000+ | $92,000 |
Your base is what you're paid just for completing the pregnancy. Your total includes monthly allowance, maternity clothing, lost wages, travel reimbursement, milestone bonuses, legal fees, and (if applicable) multiples bonus. Intended parents cover all medical costs — you have $0 out of pocket on anything pregnancy-related.
For the full compensation breakdown, see our pages on surrogate compensation, first-time vs experienced pay, and base pay vs total compensation.
What agencies won't tell you upfront
We've talked to surrogates who completed journeys. Here's what they wish someone had told them:
- The screening process feels invasive. You're sharing medical records, psychological profiles, financial information, criminal history, and body measurements with people you've never met. Some women feel empowered by the thoroughness. Others feel exposed. Both reactions are normal.
- Matching can take months. The agency said 2–4 weeks. It's been 3 months. You start wondering if something's wrong with you. Usually it's just timing and preferences. Nobody prepares you for the wait.
- Hormone injections are uncomfortable. Agency pages describe them as "a small pinch." In reality, progesterone-in-oil leaves bruising, knots, and soreness. Ask any surrogate who's done them.
- Your relationship with the intended parents is complicated. Even when everyone means well. They may be more anxious than you expected. They may want more contact than you're comfortable with, or less. Managing someone else's hopes alongside your own is hard.
- Post-birth emotions are real. You may feel sad, relieved, proud, or all at once. Postpartum hormones don't care that the baby isn't genetically yours. Give yourself space to feel whatever comes up.
- Recovery takes time. Your body may not bounce back the same way it did with your own pregnancies. Be patient with it.
Becoming a surrogate by state
Your state affects your legal protections, which agencies serve you, and how the post-birth legal handoff works. Here's how the major surrogate-friendly states compare:
| State | Partner agency | Legal protections |
|---|---|---|
| California | Family Tree, NewGen | Pre-birth orders for all family types. Gold standard. |
| Texas | Simple Surrogacy | Legal under Texas Family Code. Court approval required. |
| Florida | Family Makers | Surrogate-friendly for married couples. Evolving laws. |
| Georgia | Family Makers | No statute, but surrogacy is practiced routinely via court order. |
| Illinois | Family Makers | Gestational Surrogacy Act. Pre-birth orders available. |
| Nevada | Family Tree, NewGen | Explicitly legal. Pre-birth orders routine. |
We don't work in states where surrogacy is prohibited or legally unclear. For more, see our surrogacy laws by state page.
Specific eligibility questions we hear a lot
Can I be a surrogate after a C-section?
Usually yes. Most agencies accept surrogates with 1–2 prior C-sections, and some allow up to 3. The key is how your body healed and whether your OB clears you for another pregnancy. A C-section history doesn't automatically disqualify you, but the clinic will look closely at your uterine health.
Can I be a surrogate with my tubes tied?
Yes. Gestational surrogacy uses IVF — the embryo is placed directly into your uterus. Your fallopian tubes aren't involved. Tubal ligation has zero effect on your eligibility.
Can I be a surrogate on antidepressants?
It depends on the medication and the agency. Some accept surrogates on certain SSRIs like sertraline. Others require you to be medication-free. The fertility clinic also weighs in. Never stop a prescribed medication without talking to your doctor first — and be upfront with the agency from the start.
How many times can you be a surrogate?
Most agencies allow 2–3 surrogate journeys, with a cap of 5–6 total pregnancies (including your own children). The limit protects your health. Responsible agencies enforce this even if you feel great.