What to make sure your agency checks in a surrogate

Every agency will tell you it has a "rigorous screening process". Your job is not to believe — it's to verify. Here is what real screening should include, and how to check that it actually happened rather than just being written on the website.

What the screening should include

Age and previous births — a surrogate in a healthy age range for pregnancy, who has given birth at least once in an uncomplicated pregnancy. Her previous births are the best evidence of her ability to carry safely.

No significant complications in past pregnancies — her full medical records collected and reviewed by a medical professional, not just a questionnaire she filled in herself.

And here it's important to understand how medical screening really works: part of it depends on *your clinic*. Every clinic has slightly different thresholds and requirements — just as every couple has slightly different requirements — and agencies have medical and personal criteria of their own. Three layers of screening that need to talk to each other, which is why it's important to discuss all of it with the agency explicitly: what they check, what your clinic will check, and what remains yours.

Psychological evaluation — a session with a professional confirming she understands the emotional meaning, comes by choice, and knows exactly what her role is — including that the baby is not hers, and that she is at peace with that. If she's married or partnered — the partner is part of the process too.

Motivation — a genuine personal reason beyond money. A surrogate who comes from a place of purpose and choice is an entirely different partner from one who comes from distress.

Financial stability — not wealth; stability. Screening should confirm she isn't leaning on surrogacy to solve a financial crisis — both for ethical reasons and because financial distress is fertile ground for complications later.

Criminal and background checks — for her, and for her partner if she has one.

A supportive environment — family or close friends who know about the decision and support it. A surrogacy pregnancy is not a project done alone.

Insurance — does she have medical insurance, and has the policy been reviewed for surrogacy exclusions.

How to verify it actually happened

• Ask the agency to walk you through the process step by step — who performs each check, and when.
• Ask explicitly: is the psychological evaluation done before the profile is offered to parents, or only after the match?
• And the parallel question on the medical side: is the profile shown to you before or after your clinic has approved it? A match that falls apart in the clinic's screening is months lost.
• Ask who reviews the medical records — a fertility physician, or a coordinator?
• Ask what share of applicants ends up accepted into the database. A serious agency rejects most — and will tell you so with pride.
• And when you receive a profile: don't be shy about asking for the screening documents themselves. "Everything was checked" is a sentence; a document is a document.

And there is much more to ask an agency — about money, the team, the matching. That's exactly why I built the agency comparison tool: all the questions organized for the call, with room for answers and a comparison at the end.