Can You Be a Surrogate If You Have Herpes?

Genital herpes is common, and having it doesn't automatically close the door. Here's what ASRM guidance says about herpes at the medical exam, how clinics and agencies tend to look at a controlled history, and what a surrogate pregnancy with HSV usually involves.

Published October 8, 2026

It depends on the program, but a history of genital herpes (HSV-1 or HSV-2) doesn't automatically rule you out, and some programs work with candidates whose outbreaks are infrequent and well controlled. What ASRM guidance does say is that a carrier should not be used when the physical exam shows evidence such as herpes simplex lesions, so signs of an active outbreak at the screening exam are a reason not to proceed, and the final decision belongs to the fertility clinic and the agency.

If you're reading this, you may have typed the question into a search bar late at night rather than ask anyone out loud. That's understandable, and you're far from alone. The CDC estimates that 11.9 percent of people aged 14 to 49 in the United States have HSV-2, the virus behind most genital herpes, and many of them don't know it. It's an ordinary medical history question in surrogacy screening, and it deserves a plain answer.

What ASRM guidance says

The American Society for Reproductive Medicine's recommendations for practices using gestational carriers (2022) describe two separate steps where infections come up.

The physical exam. ASRM says a carrier should not be used when the exam finds physical evidence of risk for a sexually transmitted infection, and it names genital ulcerative lesions and herpes simplex among those findings. In plain terms, signs of herpes at your exam mean the clinic should not move forward with you as a carrier.

Laboratory testing. ASRM recommends testing carriers and their partners before embryo transfer for HIV, hepatitis B and C, syphilis, gonorrhea and chlamydia, plus HTLV and CMV for a male partner. A herpes blood test isn't on that list, although an individual clinic may choose to run one. So in practice, herpes usually comes up through your medical history and the exam rather than a required lab result.

ASRM doesn't set a rule for women with a past herpes diagnosis and no active outbreak. That decision is left to the clinic, the agency and their medical teams.

How clinics and agencies tend to look at it

Programs set their own policies here, and they genuinely differ. Some decline any history of genital herpes. Others will consider a candidate whose history looks stable. When a program does consider it, the questions are usually practical:

• How often do you have outbreaks, and when was the last one?
• Was it diagnosed and managed by a doctor, and are there records?
• Do you take a daily antiviral, or only treat outbreaks when they happen?
• How was it handled in your own pregnancies, and how did you deliver?

Intended parents will also see your medical history before a match, and they may have their own preferences. That isn't a judgment about you. It's one more reason it helps to work with a matching service that knows which programs will consider your history before you spend weeks on paperwork.

What a surrogate pregnancy with herpes usually involves

The CDC's treatment guidelines draw a clear line between two situations. The risk of passing herpes to a newborn is high, 30 to 50 percent, when a woman first acquires genital herpes close to delivery. It's low, under 1 percent, for women with a history of recurrent herpes before the pregnancy. A surrogate with a known, long-standing history is in the second group.

Management late in pregnancy follows the same guidance your own OB would use:

• Suppressive medication near the end. The CDC guidelines list daily acyclovir or valacyclovir starting at 36 weeks for women with recurrent genital herpes, which lowers the chance of an outbreak at delivery and the need for a cesarean.
• A plan for labor. If there are no lesions or warning symptoms when labor starts, a vaginal delivery is an option. If there are, the CDC recommends a cesarean delivery to reduce the risk to the baby.
• Your consent, throughout. ASRM's Ethics Committee is clear that a gestational carrier is the sole source of consent for her own medical care through delivery and aftercare, and she cannot be compelled to accept or refuse a procedure, whatever the contract says.

Tell us, and tell the clinic

It can feel tempting to leave a herpes diagnosis off a form, especially if you haven't had an outbreak in years. Please don't. You'll sign medical releases, your records will be reviewed, and you'll have a physical exam. A history you disclosed is something a program can evaluate. A history that surfaces later raises questions about what else was left out, and that usually ends the journey.

On Borne's 30-minute screening call, it's an ordinary part of the health conversation. If it narrows which programs fit you, we'll say so plainly and point you toward the ones whose criteria match your history.