Before a gestational surrogate can move forward with an embryo transfer, she must first complete an important step:
medical screening.
But what exactly does surrogate medical screening involve?
Is it just a blood test? Will you need an ultrasound? What happens if something abnormal appears in your results? And if you've already had healthy pregnancies, why is additional testing necessary?
Surrogacy medical screening is designed to help the fertility clinic determine whether another pregnancy and embryo transfer are medically appropriate for the prospective gestational carrier.
According to the American Society for Reproductive Medicine (ASRM), evaluation of a prospective gestational carrier should include medical evaluation, infectious-disease screening, medical history, physical examination, laboratory and preconception testing, and evaluation of the uterine cavity.
Here's what prospective surrogates and intended parents should know before embryo transfer.
A surrogate may already be a mother who has experienced one or more healthy pregnancies.
So why does she need to be screened again?
Because every new pregnancy carries medical considerations, and IVF adds another layer to the process.
Medical screening helps the fertility clinic evaluate:
ASRM recommends that gestational carriers ideally have previously experienced at least one term, uncomplicated pregnancy. It also recommends, ideally, no more than five previous deliveries in total or three deliveries by C-section.
Importantly, passing an agency's initial surrogate requirements is not the same thing as receiving medical clearance from the IVF clinic.
The fertility clinic ultimately evaluates whether a candidate can proceed medically.
One of the first parts of screening isn't actually a test.
It's a detailed review of your medical history.
The fertility clinic may ask about:
This is why being completely transparent during your application is important.
A past medical issue does not necessarily mean automatic disqualification. Instead, the clinic needs enough information to determine whether another pregnancy would be appropriate.
Your previous pregnancy records can be an important part of surrogate medical clearance.
The fertility clinic may request records from your OB/GYN or hospital, including information related to:
Prenatal care
Labor and delivery
Previous C-sections
Pregnancy complications
Postpartum recovery
For example, if you've previously had a C-section, the clinic may want to understand why it was performed and whether there were surgical or postpartum complications.
This is one reason prospective surrogates should provide accurate information about where and when their previous children were delivered.
Medical-record collection can sometimes take time, so getting started early may help avoid unnecessary delays later in the process.
A prospective gestational carrier should receive an appropriate medical evaluation before being accepted for treatment.
ASRM recommends a complete medical evaluation by a qualified medical professional, together with preconception counseling.
The exact examination depends on the clinic and individual circumstances.
The goal is not simply to determine whether someone "looks healthy."
Instead, the medical team is evaluating whether there are current health concerns that may require further investigation before pregnancy.
Infectious-disease screening is another important part of the process.
ASRM recommends infectious-disease testing of prospective gestational carriers and their partners before embryo transfer, even though FDA rules regarding donor screening apply differently to the carrier herself.
Depending on the circumstances and clinic protocol, screening may include tests relating to:
Additional testing may apply to the surrogate's partner.
This is an area where it's important not to assume that every person will receive an identical laboratory panel. The fertility clinic determines the appropriate tests and timing.
Preconception testing may also include determining the surrogate's:
ABO blood type
and
Rh factor
Why does this matter?
Rh compatibility can become relevant during pregnancy when an Rh-negative pregnant person is carrying an Rh-positive fetus.
This doesn't automatically prevent someone from becoming a surrogate. It is a routine obstetric consideration that medical professionals know how to evaluate and manage.
ASRM specifically includes blood type and Rh factor among recommended preconception testing for gestational carriers.
The fertility clinic may also check immunity to:
Rubella
and
Varicella (chickenpox).
ASRM includes rubella and varicella titers among its recommended preconception tests for gestational carriers.
Why check before embryo transfer?
Because pregnancy changes how certain vaccines and infections need to be managed.
If testing shows inadequate immunity, the medical team can advise the candidate about the appropriate next steps and timing before pregnancy.
Prospective surrogates should also expect questions about smoking, recreational drugs, medications, and other substance use.
ASRM's recommended preconception screening includes a urine drug screen.
This isn't simply an administrative agency requirement.
A surrogate will be carrying a pregnancy for another family, so the fertility team needs to evaluate factors that could affect her health or the pregnancy.
This is one of the most important parts of medical screening before embryo transfer.
Even if a woman has previously become pregnant naturally, the fertility clinic may want to evaluate the inside of the uterus before transferring an embryo.
ASRM states that evaluation of the uterine cavity by saline-infusion sonogram or another modality is highly recommended for prospective gestational carriers.
Depending on the fertility clinic, evaluation may involve a procedure such as a saline sonogram or another imaging technique.
The purpose is to assess the uterine cavity and identify findings that may require further evaluation before embryo transfer.
For many first-time surrogates, this may be one of the less familiar parts of the screening process.
The clinic may also review whether routine preventive screening is current.
ASRM recommends cervical cancer screening according to appropriate professional guidance and mammography when indicated based on applicable recommendations.
This does not mean every surrogate receives every possible test.
The appropriate screening depends on factors such as age, medical history and current clinical recommendations.
Psychological evaluation isn't a blood test or physical examination, so technically it is separate from medical testing.
However, it is an important part of the overall gestational carrier screening process.
ASRM recommends psychosocial evaluation and counseling for prospective gestational carriers and their partners. The assessment is designed to address emotional readiness, expectations, support systems and understanding of the surrogacy process.
Topics may include:
The goal isn't to find a "perfect personality."
It's to make sure everyone understands the emotional and practical realities of the journey.
Potentially, yes.
A spouse or sexual partner may also be involved in parts of the screening process.
ASRM recommends infectious-disease screening of gestational carriers and their partners before embryo transfer, with some partner-specific tests included in its recommendations.
Partners may also participate in psychological counseling or evaluation because surrogacy can affect the entire household.
The exact requirements depend on the fertility clinic and individual situation.
An abnormal result does not always mean immediate or permanent disqualification.
What happens next depends entirely on the finding.
For example, the clinic may:
or determine that pregnancy would not be medically appropriate.
For certain treatable infections, ASRM guidance provides for treatment and retesting before a person is reconsidered as a gestational carrier. Other conditions may present more significant concerns.
This is why applicants shouldn't try to determine eligibility solely from one laboratory result without speaking with the medical team.
There is no universal timeline.
The actual process depends on factors such as:
A candidate with complete records and straightforward medical history may move through screening more smoothly than someone whose clinic needs additional records or specialist evaluation.
For that reason, it is better to think of medical screening as a clearance process, rather than a single appointment.
Passing medical screening is a major milestone—but embryo transfer doesn't necessarily happen immediately afterward.
The journey generally continues through steps such as:
Medical Clearance
↓
Psychological Clearance
↓
Legal Contracts & Legal Clearance
↓
Embryo Transfer Cycle Preparation
↓
Monitoring
↓
Embryo Transfer
↓
Pregnancy Test
The exact order can vary depending on the agency, fertility clinic and circumstances.
Legal agreements should be completed before treatment proceeds according to the applicable program and jurisdiction.
A fertility clinic may use transvaginal ultrasound or another imaging method during evaluation and treatment monitoring. The exact imaging protocol depends on the clinic and individual circumstances.
ASRM highly recommends uterine cavity evaluation using saline-infusion sonography or another appropriate modality before a prospective gestational carrier is accepted.
Yes, infectious-disease screening is an important part of gestational carrier evaluation. ASRM recommends testing prospective carriers and their partners before embryo transfer.
Certain infectious-disease screening and psychosocial evaluation may also involve the surrogate's partner. Exact requirements depend on the fertility clinic and individual circumstances.
A fertility clinic may determine that a candidate is not medically appropriate to proceed, or it may request additional evaluation before making a decision. Some findings can be temporary or treatable, while others may make another pregnancy inadvisable.
The fertility clinic and its medical professionals determine whether a prospective gestational carrier satisfies their medical requirements for treatment.
Surrogate medical screening may sound intimidating, but its purpose is straightforward:
to determine whether another pregnancy and embryo transfer are medically appropriate before treatment begins.
It isn't just one blood test or one ultrasound.
The process can involve previous pregnancy records, medical history, physical evaluation, infectious-disease testing, blood work, uterine evaluation, preconception screening and psychological assessment.
And most importantly, surrogate screening is individualized.
Having a previous C-section, an unusual laboratory result or another medical-history detail doesn't necessarily tell you whether you qualify. Your complete history needs to be evaluated by the appropriate fertility professionals.
At New Grace, we help prospective surrogates understand each step of the journey—from initial application and medical-record review through matching, medical screening, legal clearance, embryo transfer and pregnancy.
If you're wondering whether your pregnancy history may meet surrogate requirements, the first step is to complete an application and allow the appropriate professionals to review your individual circumstances.
👉 Apply to Become a Surrogate
👉 Learn More About Surrogate Requirements
This article is for informational purposes only and does not constitute medical or legal advice. Medical screening requirements vary by fertility clinic, individual medical history, jurisdiction and treatment protocol. Always follow the recommendations of your fertility clinic and qualified healthcare professionals.
New Grace Fertility | Asian Family Surrogacy Inc.
📧 Email: info@newgracefertility.com
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