Can You Be a Surrogate If You Get Migraines?

Migraines are common, and they rarely end a surrogacy application on their own. Here's how pregnancy tends to affect them, why aura and certain medications get a closer look, and what a clinic will want to know.

Published October 21, 2026

Often, yes - migraine that is well controlled without high-risk medications is usually not a barrier to becoming a surrogate. Migraine with aura, frequent attacks or daily preventive medication will get a closer look, and the IVF clinic's physician makes the final call after reviewing your history.

Migraine is common in women of childbearing age, so if you get them, you're far from alone. Many women assume a headache condition rules them out and never apply. In most cases it doesn't. What matters is the kind of migraine you have, how well it's controlled, and what you take for it.

What pregnancy usually does to migraines

For many women, pregnancy is a break from migraines. ACOG's guidance on headaches in pregnancy notes that up to 80% of pregnant women with migraine or other primary headaches have fewer headaches by the second trimester. A large review of studies found that about two-thirds of women with migraine improved or stopped having attacks during pregnancy, and only about 8% got worse.

Two caveats are worth knowing. The first trimester is the least predictable stretch, and early pregnancy is also when transfer medications, nausea and disrupted sleep pile up. And migraines often come back after delivery, sometimes within the first week. Breastfeeding seems to delay that return for some women, and surrogates typically don't nurse the baby, so it's realistic to plan for your usual pattern coming back after the birth.

Why clinics still ask about it

Migraine is linked to some pregnancy complications. A 2019 review of studies found that women with migraine had roughly twice the odds of developing preeclampsia, and a smaller increase in the odds of preterm birth. Large hospital studies have also found higher rates of stroke and blood clots in pregnant women with migraine, although those events remain rare. None of this means you would have a complication. It does mean the clinic will look at your overall picture, including your blood pressure.

It also shapes how a headache is handled during the pregnancy. ACOG advises that a headache with high blood pressure from 20 weeks onward, or in the first weeks after delivery, should be checked for preeclampsia. If you're used to waiting out a migraine, your care team may ask you to call instead. If you've had preeclampsia before, our article on surrogacy after preeclampsia or gestational diabetes covers that history.

Migraine with aura gets a closer look

Aura means warning symptoms before or with the headache, such as zigzag lines, flashing lights, blind spots, or tingling or numbness. Doctors pay attention to aura because it's linked to a higher risk of stroke, and because estrogen can matter.

Most surrogacy transfer cycles use estrogen to build the uterine lining, followed by progesterone. For birth control, CDC guidance says pills, patches and rings that contain estrogen carry an unacceptable health risk for women with migraine with aura. A transfer cycle isn't birth control, and we're not aware of a published guideline that applies that rule to IVF, but it explains why a clinic will ask. Expect questions about how often you get aura, whether you've ever taken estrogen-containing birth control, and how you tolerated it. Some programs ask for a note from your primary care doctor or neurologist. Our guide to the medications you'll take before embryo transfer explains a typical cycle.

Your migraine medications

This is usually the biggest part of the review, because some migraine medicines are fine in pregnancy and others are not. ACOG's guidance gives the general picture:

• Acetaminophen is the usual first choice for headaches in pregnancy. In 2025, federal health officials announced a label change about a possible link to autism. ACOG said that claim is not supported by the full body of scientific evidence and that acetaminophen remains one of the few options for pain and fever in pregnancy. Ask your OB how to use it.
• Sumatriptan is the triptan ACOG names as a second-line option, and pregnancy registry data have been reassuring. Other triptans have less data.
• NSAIDs such as ibuprofen and naproxen are generally avoided, and the FDA advises against them from 20 weeks of pregnancy onward. Low-dose aspirin prescribed by your doctor is an exception.
• Valproate and topiramate, sometimes used to prevent migraines, are linked to birth defects and are avoided in pregnancy.
• CGRP-blocking medicines, the newer preventive injections and pills, have very little pregnancy data, and ACOG advises avoiding the antibodies. Some of them stay in your body for months, so timing matters.

There's one more point that comes from ASRM. Its list of criteria for rejecting a gestational carrier candidate includes current use of psychoactive medication. Some migraine preventives are antidepressants, such as amitriptyline. If you take one, even for headaches, it can rule you out, so tell the program up front and ask how it would be viewed. Our article on surrogacy and antidepressants explains ASRM's criteria in more detail. Whatever you take, never stop or change a medication on your own. Any change should happen with your own doctor, on a plan that keeps you safe.

What clinics usually look at

ASRM doesn't single out migraine. It recommends a complete medical evaluation by a qualified medical professional before a carrier is accepted, and that's where your history is reviewed. In practice, programs tend to ask:

• Whether you have aura, and how often.
• How many headache days you have in a typical month.
• What you take to treat attacks and to prevent them.
• How your migraines behaved in your past pregnancies.
• Whether you've ever had a stroke, a mini-stroke or high blood pressure.

Women with occasional migraines without aura, treated with medications that are acceptable in pregnancy, are often cleared. Frequent aura, a history of stroke or migraines that need medications you can't safely stop are more likely to lead to a no.

Where Borne fits

Our questionnaire asks about your health history and medications. If you get migraines, tell us what kind and what you take, and if you're a good fit, we'll talk it through honestly on your screening call, including whether partner agencies are likely to move forward.