How to Become a Surrogate, Step by Step

Most women who look this up are asking two things at once: do I qualify, and what actually happens if I say yes? Here's the whole path in order, with what each step involves and roughly how long it takes.

Published October 9, 2026

To become a surrogate, you check that you meet the basic requirements, apply through an agency or a matching service, complete medical, psychological and background screening, match with intended parents, sign a contract with your own lawyer, and then begin the medical steps toward an embryo transfer. Most programs look for women aged 21 to 42 who have had at least one healthy, full-term pregnancy, and the whole journey typically takes 15 to 24 months from application to delivery.

That's the short version. The longer version matters, because each step has its own logic, and knowing it ahead of time takes a lot of the guesswork and anxiety out of the process. Here's how it usually unfolds.

Step 1: Check the basic requirements

Every program sets its own criteria, but they're built on the same foundation. ASRM, the American Society for Reproductive Medicine, publishes guidance for clinics that work with gestational carriers, and agencies layer their own rules on top. The common ones:

• Age. Most programs accept women between 21 and 42, and some cap lower, in the high thirties or at 40.
• A prior pregnancy. ASRM says that, ideally, a carrier should have had at least one term, uncomplicated pregnancy. It shows a clinic how your body has handled pregnancy before.
• Delivery history. ASRM also says that, ideally, a carrier should not have had more than five previous deliveries or three deliveries by cesarean.
• BMI. Most programs look for a BMI under 32, and a few accept up to 35.
• Time since your last baby. Programs commonly want 6 to 12 months after a vaginal birth and 12 to 18 months after a cesarean before a transfer.
• Legal and background. You'll need to be a US citizen or permanent resident, with no felony convictions for you or your spouse or partner. Agencies run a background and credit check, typically with a seven-year look-back for bankruptcy.
• Health and lifestyle. Clinics screen for nicotine and drug use, and ASRM's criteria for declining a candidate include current use of psychoactive medication. ASRM also says carriers must have a stable family environment with adequate support.
• Where you live. Most states work, but a couple of states don't, so where you live is part of the picture too.

None of these is a judgment of you as a person. Several of them, like time since delivery or BMI, are often "not right now" rather than "never."

Step 2: Decide how you'll apply

Most surrogates work with an agency, which handles matching, coordination, escrow for payments and support through the pregnancy. Some women carry for a friend or relative and work directly with a clinic and lawyers. A matching service like Borne sits in front of the agencies: we screen you first and then connect you with a partner agency that fits your situation, so you're not filling out ten applications to find the right one.

Step 3: Apply and have a first conversation

Our questionnaire takes about 10 minutes. We respond within 2 business days, and if it looks like a fit, the next step is a 30-minute screening call where we talk through your pregnancies, your health, your family and what you're hoping for. From applying to that call usually takes one to two weeks. Once you move on to an agency, you'll typically fill out its application and sign releases so it can request the records from your prior deliveries.

Step 4: Screening

This is where most of the waiting happens. Agencies run the background check and review your medical records. You'll also have a psychological evaluation, which ASRM treats as required for every carrier candidate and for her partner or primary support person. It typically includes a clinical interview, standardized psychological testing such as a personality inventory, and implications counseling about what the journey can involve. ASRM says this evaluation should happen before any legal contracts are signed. Some programs also do a home visit.

Step 5: Matching

Your agency shares your profile with intended parents whose expectations line up with yours: how much contact you want, how you feel about testing and other medical decisions, and the kind of relationship you're comfortable with. When there's mutual interest, you meet, usually by video first. Screening and matching together typically take two to eight weeks, though it varies. ASRM also says clinics should require a joint session with a mental health professional, so you and the intended parents start out aligned on expectations.

Step 6: Medical screening at the IVF clinic

The intended parents' fertility clinic does its own exam, often in a single day, sometimes two. Expect bloodwork, an ultrasound and a look inside the uterus, which ASRM highly recommends, often by saline sonogram. ASRM also recommends infectious disease testing for you and your partner before a transfer.

Step 7: Your contract and your own lawyer

ASRM says you should have independent legal counsel of your own choosing, and it's common for the intended parents to pay for it. The contract covers compensation, expenses, insurance and how decisions get made. Two ASRM points are worth holding onto: you are the sole source of consent for your own medical care, and no contract can compel you to have or refuse a procedure. A fully executed contract and legal clearance come before any medical treatment begins.

Step 8: Medications and transfer

You'll typically take hormone medications to prepare your uterine lining, then come in for the embryo transfer, a short procedure that many women compare to a pap smear. ASRM strongly recommends transferring a single embryo in all gestational carrier cycles. From match to transfer typically takes two to four months, depending on your clinic, agency and contract.

Step 9: Pregnancy and delivery

After a positive test, the fertility clinic monitors you closely, and you commonly move to your own OB somewhere around 8 to 12 weeks. Depending on your state, your lawyers may also arrange a pre-birth order so the intended parents are recognized as the legal parents at birth. From match to delivery is usually 11 to 14 months.

Is it hard to become a surrogate?

The screening is thorough on purpose. Programs are asking you to take on a pregnancy for someone else, and every step exists to protect your health, your family and the baby. Many women who apply aren't a fit right away. Screening is real, and it's meant to be. But if you meet the basics and you're steady at home, much of what the process asks of you is time.