Can You Be a Surrogate With Fibroids?

Fibroids are very common, and having them doesn't automatically rule you out. Where they sit, how they've behaved in your pregnancies, and how they were treated is what clinics look at.

Published October 14, 2026

Often yes, if your fibroids are small, don't change the shape of the inside of your uterus, and haven't caused problems in your pregnancies, though the clinic makes the final call after looking at your uterus. Fibroids that bulge into the uterine cavity, or past fibroid surgery, need a closer look; a hysterectomy rules surrogacy out, and uterine artery embolization often does too.

Fibroids are one of those things a lot of women find out about by accident, on an ultrasound for something else, and then quietly wonder whether they count against them. If that's you, you're in very large company. According to MedlinePlus, from the National Library of Medicine, as many as one in five women may have fibroids during their childbearing years, and half of all women have them by age 50. Many cause no symptoms at all.

Where the fibroid sits matters most

Fibroids are noncancerous growths of the uterine muscle, and clinics care far more about where they are than whether you have them.

• Submucosal fibroids sit just beneath the uterine lining and can bulge into the cavity where an embryo implants. These get the most attention.
• Intramural fibroids grow within the muscle wall. Some have a part that pushes into the cavity, and those are treated more like submucosal ones.
• Subserosal and pedunculated fibroids sit on the outside of the uterus or on a stalk, away from the lining.

ASRM's 2017 guideline on fibroids found fair evidence that removing submucosal fibroids through a hysteroscope improves pregnancy rates. For fibroids that don't distort the cavity, it says removing them is generally not advised just to improve pregnancy outcomes. In practice, that means a small fibroid on the outside of the uterus is often a non-issue, while one inside the cavity may need to be dealt with before a transfer, if it can be.

What the clinic will look at

ASRM's guidance for gestational carriers says a uterine cavity evaluation, by saline-infusion sonogram or another method, is highly recommended before acceptance. That's the test that shows whether anything, including a fibroid, is in the way. The clinic will typically also review:

• Your imaging: the number, size and location of any fibroids.
• Your symptoms: heavy bleeding or anemia, which can point to fibroids affecting the lining.
• Your past pregnancies: whether fibroids caused problems such as early labor, a baby in an awkward position or heavy bleeding after birth. ASRM says a carrier should ideally have had at least one term, uncomplicated pregnancy, so this history counts.
• Any treatment you've had, and the records from it.

Policies differ from clinic to clinic, so treat this as the questions they'll ask rather than a ruling.

Fibroids during pregnancy

MedlinePlus notes that fibroids may grow during pregnancy, likely because of increased blood flow and estrogen, and usually return to their earlier size afterward. Complications are uncommon but possible: early delivery if the uterus runs out of room, a cesarean if a fibroid blocks the birth canal or affects the baby's position, and heavy bleeding right after birth. If you've already had a pregnancy with your fibroids and it went smoothly, that's useful evidence for the clinic.

If you've had a myomectomy

A myomectomy removes fibroids and keeps the uterus, so it doesn't rule you out on its own. What matters is how it was done and how deep it went.

• Hysteroscopic myomectomy removes fibroids from inside the cavity without any incision in the abdomen. The clinic will usually want to confirm the lining healed without scarring.
• Laparoscopic, robotic or abdominal myomectomy removes fibroids through the uterine wall. ASRM's patient education site, ReproductiveFacts, notes that all surgery on the uterus carries a risk of scarring and adhesions, and that it may be one to six months before you're cleared to try for pregnancy.

The rarer but more serious concern after surgery through the wall is the scar opening during a later pregnancy. Reviews generally put that risk under 1%, but it's why many doctors plan delivery carefully after a myomectomy, sometimes with a scheduled cesarean, especially if the surgery was extensive or entered the cavity. ACOG lists a prior myomectomy among the medical reasons a delivery may be planned before 39 weeks. Your operative report is the document that answers most of these questions, so get a copy before you apply.

Fibroids can also come back. ReproductiveFacts puts the risk of new fibroids at about 30% over 10 years, which is why a recent ultrasound matters even if your surgery was years ago.

Other fibroid treatments

• Uterine artery embolization shrinks fibroids by cutting off their blood supply. ReproductiveFacts says it's not recommended for people who want to get pregnant in the future, so programs often decline after it.
• MRI-guided focused ultrasound can't be recommended for people hoping to maintain their fertility, according to the same source.
• Endometrial ablation is a different procedure from fibroid removal and is generally treated as disqualifying, because it intentionally destroys the uterine lining; our article on having your tubes tied covers it in more detail.
• Hysterectomy removes the uterus, so carrying a pregnancy is no longer possible.

Where this comes up with Borne

Our questionnaire asks about your health history and past pregnancies. If you mention fibroids or fibroid surgery, we'll ask on the screening call where they are, whether they've caused symptoms, and what was done, and we'll tell you honestly how partner agencies are likely to see it. The final medical decision always belongs to the clinic's doctor.