Which disqualifications are permanent and which are temporary?
Fourteen things disqualify a surrogate candidate at Private Label Surrogacy. Some are permanent. Several are timing issues that can change. Knowing which is which saves you from ruling yourself out too early, or from going through screening only to stop at the clinic.
A permanent disqualifier is part of your history and will not change, such as a pattern of serious pregnancy complications. A temporary one depends on where you are now: your BMI, a recent birth, breastfeeding, a current medication, your home situation. If yours is temporary, you can reapply when it changes.
| Factor | Permanent or temporary | Who decides | What would change the answer |
|---|---|---|---|
| Under 21 | Temporary | Law and PLS | Turning 21 |
| Over 43 | Permanent | PLS and the clinic | Nothing; most partner clinics decline older carriers |
| BMI of 33 or higher | Temporary | The clinic | A BMI under 33, held for three months |
| No prior full-term pregnancy | Temporary for some | PLS, ASRM guidance and law | Carrying your own full-term pregnancy |
| Not currently parenting a child | Temporary for some | PLS | Raising your own child |
| Recurrent miscarriage or serious pregnancy complications | Permanent | Physician and clinic | Usually nothing; each case is reviewed |
| Three or more C-sections | Usually permanent | Physician and clinic | Rarely, a clinic approves a third on review |
| Smoking, vaping or drug use, including cannabis | Temporary | PLS and the clinic | Stopping fully, confirmed by testing |
| History of alcohol abuse | Case by case | PLS and the evaluator | Reviewed in the psychological evaluation |
| Current antidepressant or anti-anxiety medication | Temporary | PLS and the clinic | A period off medication with a stable mood, on your prescriber's advice |
| Government assistance such as Medicaid, SNAP or Section 8 | Temporary | PLS | No longer receiving assistance |
| Unstable home or no support system | Temporary | PLS and the evaluator | A stable home and people who can help |
| Criminal record or pending legal case | Felony: permanent. Misdemeanor: case by case. Pending case: until resolved. | PLS, through the background check | Resolution of a pending case; review of a misdemeanor |
| Unwilling to discuss termination of a non-viable pregnancy | Depends on you | PLS and the intended parents | Nothing PLS can change; it is a personal decision |
| Living in a state where compensated surrogacy is not enforceable | Temporary | Law | Moving to an accepted state |
If you are still deciding whether to apply, start with the full list of surrogate requirements. This page covers the reasons a candidate does not qualify.
What medical history disqualifies a surrogate?
Medical disqualifiers come from one question: can you carry another pregnancy safely? Your records answer it better than anything else.
No prior full-term pregnancy. You must have carried at least one healthy full-term pregnancy, 37 weeks or more. It is the only reliable evidence that your body can carry to term.
Recurrent miscarriage. A single early loss usually does not disqualify you. Recurrent miscarriage, which ASRM defines as two or more losses, does.
Serious pregnancy complications. Severe preeclampsia, for example, can recur and can be dangerous for you. Other complications, such as gestational diabetes that was well controlled, may be acceptable. Each is read in context.
Three or more C-sections. PLS accepts one or two prior C-sections. A third is reviewed by the physician, and most partner clinics decline. Each cesarean scar raises the risk of placenta problems and uterine rupture in the next pregnancy.
Procedures on the uterus. An endometrial ablation or a hysterectomy rules out surrogacy, because the embryo needs a healthy uterine lining. A tubal ligation does not.
Age and BMI. You must be 21 to 43 and have a BMI under 33. Rates of gestational diabetes, preeclampsia and C-section rise above that BMI and after 40. See BMI requirements.
A recent birth or breastfeeding. Neither is a permanent no. Your body needs time to recover between pregnancies. Most clinics want at least 12 months between a C-section and an embryo transfer. Clinics also want you to have finished breastfeeding before fertility medications begin.
What lifestyle factors disqualify a surrogate?
Smoking, vaping and drug use. You must not smoke, vape or use drugs, including cannabis, even where cannabis is legal. Nicotine and other substances affect the pregnancy and the placenta. The clinic may test for nicotine and drugs during medical screening.
Alcohol abuse. A history of alcohol abuse is reviewed in the psychological evaluation. A current problem disqualifies.
Current antidepressant or anti-anxiety medication. PLS requires that you are not currently taking antidepressant or anti-anxiety medication. A treated history is reviewed, not ruled out. Never stop a medication to qualify. Talk with your prescriber first. See antidepressants and surrogacy.
An unstable home or no support system. A surrogate pregnancy has appointments, a transfer trip and a recovery. You need a stable home and people who can help with your children and your household. The independent psychological evaluation looks at this closely.
What financial and legal factors disqualify a surrogate?
Government assistance. You cannot be a surrogate while receiving government assistance such as Medicaid, SNAP or Section 8 housing. Medicaid will not cover a surrogate pregnancy, and compensation can affect your eligibility for benefits. The rule also protects you: surrogacy compensation should not be the thing that keeps your family stable. See government assistance and surrogacy.
A criminal record or pending legal case. PLS runs a background check on every adult in your household. A felony record or a pending case is disqualifying. Misdemeanors are reviewed case by case.
Citizenship. You must be a US citizen or permanent resident.
Unwillingness to discuss termination. You and the intended parents need to have the same view on what happens if a pregnancy is not viable or has a serious problem. You do not have to agree to any particular outcome at application. You do need to be willing to discuss it openly, because it goes into your agreement and into matching.
Where you live. PLS accepts surrogates in states where compensated surrogacy contracts are enforceable. PLS does not currently accept surrogates who live in Nebraska or Louisiana; the list is reviewed by counsel.
Why does PLS review records before the clinic does?
Because some disqualifiers only show up in your records. You may not know that a blood pressure reading in your third trimester was flagged, or what kind of incision your C-section used.
Mark Silverberg, DDS, MD, reads every candidate's prenatal and delivery records and writes a physician medical summary for the intended parents' fertility clinic. That happens during screening, before matching. If your records show a disqualifier, you learn it early, not after you have met a family, signed an agreement and started medications.
The clinic's reproductive endocrinologist still makes the final medical decision. The records review means the clinic is rarely the first to find a problem.
What can you do if you are disqualified today?
First, find out which kind of disqualifier you have. If you are turned down, your case manager will tell you why, plainly.
If it is temporary, plan for it. Bring your BMI under 33 with your own doctor. Finish breastfeeding. Let the right amount of time pass after a delivery. Come off assistance when your situation allows. Wait out a pending legal case. Then reapply. You start with the same five-minute prescreen.
If it is permanent, there may be another way to help. Egg donation has different requirements, and PLS places egg donors as well. You can also ask questions free on SurrogacyHotline.com, PLS's sister site, which usually responds within 24 to 48 hours.
If none of the fourteen factors applies to you, start at See if I qualify.
Sources
- ASRM (American Society for Reproductive Medicine), recommendations for practices using gestational carriers, and the definition of recurrent pregnancy loss. asrm.org
- ACOG (American College of Obstetricians and Gynecologists), guidance on preeclampsia, cesarean delivery and substance use in pregnancy. acog.org
- CDC (Centers for Disease Control and Prevention), adult BMI categories. cdc.gov