What is the rule on antidepressants and anxiety medication?
Private Label Surrogacy requires that you are not currently taking antidepressant or anti-anxiety medication when you apply. That includes SSRIs and other daily medications prescribed for depression or anxiety.
Most partner fertility clinics also require at least six to twelve months off medication, with a stable mood, before they will transfer an embryo. The exact window varies by clinic.
This rule is about timing, not about judging anyone who has needed medication. Many mothers have. The question PLS and the clinic are asking is narrower: is now a safe time for you to take on a pregnancy for someone else?
| Situation | PLS position | Typical clinic position |
|---|---|---|
| Currently taking an SSRI or anti-anxiety medication | Not eligible while taking it | Requires six to twelve months off medication with a stable mood |
| Past SSRI use, off medication 12 months or more | Reviewed in your records and the psychological evaluation | Usually acceptable with a stable mood and evaluator clearance |
| Treated postpartum depression in the past | Reviewed case by case | Reviewed case by case; the evaluator's recommendation carries weight |
| Talk therapy only, no medication | Not disqualifying | Not disqualifying |
| Bipolar disorder or a past psychiatric hospitalization | Generally not eligible; reviewed by the physician and the evaluator | Generally declined |
Does a history of depression or postpartum depression disqualify you?
No, not automatically. A history of treated depression, anxiety or postpartum depression is reviewed, not ruled out.
Two people look at it. Mark Silverberg, DDS, MD, reads your prenatal, delivery and postpartum records for every pregnancy. He looks at when symptoms started, how they were treated, how long treatment lasted and how you have been since. Then an independent licensed mental health professional talks with you directly in the psychological evaluation.
What helps your file is clarity. If you had postpartum depression after your second baby, were treated, and have been well and off medication since, say so on your prescreen. It is far better for your case manager to hear it from you than to find it in a record later.
One thing PLS will never ask: do not stop or change a medication to qualify. Talk with your prescriber first about whether, when and how to come off it, and only on their advice. If you are doing well on medication now, that is a good outcome for you and your children. Surrogacy can wait.
Why do clinics require time off medication?
Clinics want two things before they transfer an embryo: a pregnancy that is as low-risk as possible, and a surrogate whose mood is stable without support she might need to restart mid-pregnancy.
Pregnancy changes your hormones, your sleep and your daily life. So does the fertility medication before transfer. A surrogate pregnancy adds things your own pregnancies did not: a legal agreement, a relationship with intended parents, and the moment at delivery when the baby goes home with them. For most surrogates that is manageable and meaningful. For someone whose mood was recently unsettled, it can be the thing that tips the balance.
A period off medication with a stable mood is the clinic's way of seeing that you are on solid ground before all of that begins. The rule exists so that a surrogate pregnancy does not become the thing that destabilizes you.
What does the psychological evaluation cover?
Every PLS candidate completes a psychological evaluation. It covers:
- Why you want to carry for another family.
- How you handled your past pregnancies, deliveries and any losses.
- Your mental health history, including treatment and medication.
- Your support system: partner, family, childcare, friends.
- How you would handle hard moments, such as a failed transfer or a difficult decision.
Your spouse or live-in partner joins part of the evaluation, because they will live this with you. Read the full detail in what the psychological evaluation is like.
Who does the evaluation and why it is independent
The evaluation is done by an independent licensed mental health professional experienced in third-party reproduction, often by video. That person is not a PLS employee.
That is deliberate. PLS does not employ in-house psychologists, attorneys or escrow agents. An evaluator employed by an agency is assessing candidates the agency needs to place, which is a conflict of interest. An independent evaluator answers to the standard of care, and to you, not to a matching quota.
What mental health support do PLS surrogates receive?
Mental-health support is part of every PLS surrogate's package, written into your agreement and paid for by the intended parents. If you want to talk to someone during the medical cycle, the pregnancy or after delivery, you can, without arguing for it.
You also work day to day with case managers who have been where you are. Natalie Gaudio-Fricano delivered as a gestational surrogate in 2016. Jenni Symons delivered as a surrogate in 2019 and 2021. When a transfer does not take, or a week is hard, the person on the other end of the phone has lived it. Read more on mental health support for surrogates.
If you are unsure where your history fits, ask before you apply. SurrogacyHotline.com, PLS's sister site, answers questions free, usually within 24 to 48 hours. If you are off medication and your mood is stable, start the prescreen at See if I qualify, or review the full requirements first.