What Happens at Your Medical Screening

Once you and an intended-parent family agree to move forward, the fertility clinic does its own clearance. Here's what that day (or two) actually looks like — and what each test is really checking for.

Published May 22, 2026

By the time you're booking your medical screening, you've already cleared the questionnaire, the Borne call, and the agency's intake. So this part can feel like a formality. It isn't. The fertility clinic does a separate, independent workup — and they're the ones who say whether your body is cleared to start cycle medications. Their answer matters more than anyone else's in the process.

The good news: the screening is straightforward, almost everything happens in one or two appointments, and there's nothing to study for. You can't pass it harder by preparing. Here's what to expect.

Where the screening happens

The fertility clinic that's caring for the intended parents is the same clinic that screens you. That's true even if they're across the country — clinics will fly you in (covered by the intended parents) for one or two days of appointments. Most of the actual work happens in a single morning. Bloodwork, ultrasound, and the medical interview are usually stacked back to back. The psych evaluation is typically scheduled separately, often by video.

The four things they're checking

Every clinic has its own checklist, but the workup falls into four buckets. Knowing what each one is for makes the experience a lot less mysterious.

1. Your uterus

The clinic needs to see, with their own equipment, that your uterine cavity is in shape to carry a pregnancy. They'll do a saline-infusion sonogram (sometimes called a SIS or sonohysterogram) — a quick ultrasound where saline is gently flushed into the uterus so the walls show up clearly. Some clinics use a hysteroscopy instead, which uses a thin camera. Either way, they're looking for fibroids, polyps, scarring, or anything else that could interfere with implantation. The test takes about ten minutes and feels similar to a Pap with mild cramping.

2. Your bloodwork and infectious-disease panel

This is the longest list, but it's the same panel every clinic runs and the FDA actually requires most of it. Expect a draw of several tubes that get tested for:

• HIV, hepatitis B and C, syphilis, and HTLV (FDA-mandated)
• CMV (cytomegalovirus), which most adults have been exposed to — the clinic just wants to know your status
• Routine bloodwork: complete blood count, blood type and Rh, thyroid, vitamin D, fasting glucose, prolactin
• Immunity to rubella, varicella, and measles
• Drug and nicotine screen (urine)

Cervical cultures (chlamydia and gonorrhea) and a current Pap are also part of the workup. If your last Pap is more than a year old, the clinic will run a new one during the same visit.

3. Your partner, if you have one

If you live with a spouse or partner, the clinic will ask them to do a smaller version of the same infectious-disease panel — usually HIV, hepatitis B and C, and syphilis. This is a CDC and FDA requirement, not a judgment of your relationship. The draw can typically be done at a local lab and faxed in.

4. Your mental health

The psychological evaluation is done by a licensed mental health professional who specializes in third-party reproduction. It's two parts. First, a standardized inventory — most often the MMPI-3 or PAI — which you'll take online, usually in about an hour and a half. Then a clinical interview, normally by video, that runs about 60 to 90 minutes.

The evaluator is checking three things: that you understand what surrogacy involves and have realistic expectations, that you have a stable support system and aren't carrying for the wrong reasons, and that there's no untreated mental health issue (active depression, untreated PTSD, unmanaged anxiety) that would make the pregnancy harder than it needs to be. Past therapy is fine. So is a history of postpartum depression that was treated and resolved. They're not looking for a perfect score — they're looking for someone they're confident can carry safely.

What happens if something doesn't pass

Three categories of issues come up most often:

• Something fixable. A polyp on the SIS, a low vitamin D, an immunization that's lapsed. The clinic will outline the fix (a brief hysteroscopy, a supplement, a booster shot), give you a timeline, and you re-screen when you're cleared.
• Something that requires a pause. A positive drug screen, a result outside the clinic's tolerance for thyroid or glucose, a recently completed pregnancy that's still close to the postpartum window. The clinic will tell you what they need to see and when to come back.
• A hard no. Rare, and it's almost always something that would have been a problem before you ever applied — a uterine condition that isn't safely correctable, an active infectious disease, a contraindication that surfaced during the psych eval. In those cases, the agency and Borne are in the loop, and we'll talk you through what it means.

Most surrogates get cleared cleanly. The ones who don't almost always have a defined path back.

What gets paid, and when

Medical screening is fully covered by the intended parents, including travel. You're also reimbursed for lost wages if appointments fall on a workday. Some agencies pay a screening fee — usually a few hundred dollars — once the clinic clears you. Your base compensation officially starts when you begin cycle medications, which is the next milestone after clearance. The full compensation range for first-time surrogates is $60,000–$75,000, and $75,000–$100,000+ for experienced surrogates, varying by state.

How long the whole thing takes

From the day the clinic schedules you to the day you get cleared, plan on three to five weeks. The bottleneck is usually lab turnaround on the infectious-disease panel (some tests take 7–10 days) and the psych eval write-up (another week or so). The clinic visit itself is a single day for most surrogates, two if you're flying in and they want a follow-up scan.