Screening and other requirements for US surrogates

One of the important safeguards in a US surrogacy journey is that experienced surrogacy agencies and fertility clinics apply rigorous screening processes for all potential surrogates. The screening aims to explore the suitability and motivations of women who want to act as surrogates, and ensure they are making a fully informed decision, as well as keeping them safe medically.

For intended parents from the UK, this gives a strong layer of protection as against most surrogacy options otherwise available in the UK or elsewhere abroad. It gives reassurance that any surrogate will be able to carry their child safely, that there are no ethical concerns around the surrogate being put at risk or taken advantage of, and that the surrogate is fully committed to the journey ahead.

How and when does surrogate screening work in practice?

Pre and post-match screening

The surrogacy agency will first make sure the surrogate meets all the agency requirements. This is a big part of what the agency is engaged by intended parents to do, and the screening process is typically rigorous, covering:

• Providing full information on the surrogacy process to facilitate informed decisions,
• A psychological evaluation to explore the surrogate’s motivations, mental health history and to exclude any risk of vulnerability or duress,
• Detailed health screening to ensure safety in pregnancy,
• Thorough background checks (including criminal records and financial checks for bankruptcy),
• Evidence of stable income and/or excluding women who are receiving state benefits,
• Similar checks of the surrogate’s partner, and
• A virtual or in person home visit to check the surrogate’s living situation.

The surrogate’s previous medical and pregnancy records will also typically be checked by the agency as well as the intended parents’ clinic to make sure that she meets their requirements, and that they are happy to treat her.  This can happen either before she is presented as a match to intended parents, or just after and will often depend on the relationship that the agency has with the intended parents’ clinic. Some agencies will also have a Maternal Foetal Medicine specialist review a surrogate’s medical records prior to her being accepted, however the treating clinic will still need to make sure that they are happy to accept her.

Pre-treatment in-person screening

When the clinic has confirmed that they are happy to treat her, and the match has been confirmed, they will ask that she and her husband/partner visits them for in-person pre-treatment screening, which will be at the intended parents’ clinic.

The surrogate will have a urine test and blood test to check for any drug use, infectious diseases or abnormalities and her partner will also be tested for drug use and infectious diseases. The surrogate will also then have a physical examination and an ultrasound to assess her uterus and ovaries to make sure that there are no abnormalities such as polyps or fibroids.

Once all test results have been returned and checked, which can take up to approximately two weeks, the surrogate will be given medical clearance by the clinic. This means that she, and her intended parents can move to the next part of the process of drawing up a gestational carrier agreement with their attorneys, before preparing for embryo transfer.

Legal clearance

The attorneys acting for the intended parents and surrogate will then step in to help everyone work through the detail of their agreement and to put things in writing. Surrogacy agreements are legally recognised in the US, which means that this is an important part of the process which establishes who the legal parents of any child conceived will be. It also gives a layer of protection to both surrogates and intended parents, since each has their own attorney to advise and represent them and make sure the agreement is fair and that they fully understand it.

Once the agreements are signed, the attorneys will confirm to the clinic that they are OK to proceed with treatment.

The thorough surrogate screening in the US helps to ensure that all parties are protected and prepared before moving forward to the next stage. Surrogates know what they are entering into and intended parents are reassured that their surrogate is not only medically ready but also mentally and legally too. This detailed process  helps to ensure that surrogacy is safe and ethical for everyone involved.