Being a gestational surrogate is nothing short of amazing. Just ask any of our surrogates at FSC! 

If you’ve only just started thinking about becoming a surrogate yourself, you’re sure to have lots of questions. And we’re here to answer them!

The questions we hear most often about becoming a surrogate are about the medical screening process. Such as, “Why do surrogates have to go through a medical screening? What does it involve?”

This post explains the medical screening process so you know what to expect if you or someone you know is considering becoming a gestational carrier.

Surrogate medical screening: what, why, and how

Medical and psychological screening is absolutely non-negotiable for anyone who wants to become a surrogate. These tests will ensure that you are physically and mentally fit to give birth to a healthy baby. The screening process protects you, your Intended Parents, and their much-longed-for child. 

It’s also essential that a surrogate has given birth to at least one baby. This helps to ensure that you are capable of carrying a surrogate pregnancy. 

In addition, you must be free from any diseases or health conditions that may affect the pregnancy or the baby. Screening confirms that you are a safe choice as a surrogate. That’s all any parent wants! 

Your initial screening will include the following: 

  • Consult and physical examination with medical practitioners
  • Surrogate Pre-Screening Panel
  • HIV screening
  • Complete blood count and blood group testing
  • Cervical cultures
  • Chemistry panel
  • Hepatitis panel
  • Rapid plasma reagent (syphilis)
  • Saline infusion sonogram

Let’s go over the various steps involved in the medical screening process. 

Physical exam

You’ll first need to undergo a full physical exam. This is necessary to ensure that you are physically healthy and capable of carrying a pregnancy to term without complications.

This exam will also ensure that you are able to receive the necessary hormone medications for IVF. 

The physical exam will involve your heart, lungs, abdominal area and pelvis. Your uterus and ovaries will also be examined by a physician or an ultrasonographer using a sonohysterogram. 

Blood and urine tests

Next, you’ll have to take some blood tests to screen for any infections.

Your pre-screening panel involves basic testing to ensure you are suitable for in-vitro fertilization (IVF). The panel will test for: 

  • Hepatitis B Surface Antigen
  • HIV 4th Generation
  • Syphilis TPA
  • Chlamydia
  • Gonorrhoea
  • Thyroid Stimulating Hormone
  • Free T4
  • Rubella Titer
  • Varicella Titer
  • Blood Type
  • Antibody Screen
  • Vitamin D 25-Hydroxy
  • Comprehensive Metabolic Panel (CMP)
  • Complete Blood Count (CBC)
  • Chickenpox, German measles, and other tests at the discretion of the physician

The physician will test your blood type to make sure it’s compatible with that of the sperm donor or Intended Father. They will also check your Rh status to prevent complications such as Rh immunization, which can occur with blood incompatibility. At the same time, you’ll have hormone tests – usually for thyroid hormone and prolactin. These results are necessary for doctors to gauge the correct dosage of fertility drugs for you.

If you have a spouse or partner, they will also undergo blood tests to check for infectious diseases, along with a drug screening. 

Cervical cultures 

A pap smear will check for abnormal cells on the cervix that could indicate precancers. You’ll also have a cervical swab to check for STDs such as chlamydia and gonorrhea and diseases such as HIV, Hepatitis B/C, syphilis, and HTLV-1. Some clinics may also test for ureaplasma/mycoplasma (bacteria associated with certain urogenital infections and pregnancy complications).

Pelvic ultrasound

A physician will then take a transvaginal ultrasound to check that your uterus is healthy and able to carry a pregnancy to term. This procedure also screens for abnormalities such as cysts, fibroids or endometriosis. 

The pelvic ultrasound is followed by saline infusion sonography, another kind of ultrasound. A sonography involves filling the uterine cavity with saline (salty water) in order to open the walls of the uterus. This procedure allows the physician to evaluate the lining of the uterus for issues such as fibroids, polyps, or scar tissue. Any of these things will require treatment and may mean that you are not eligible for surrogacy. 

What happens after my medical screening?

Once you’ve cleared the screening and ticked all the boxes, you’ll be granted your medical clearance. And the journey can begin! 

The next steps will involve undergoing the medical process to prepare your body for embryo transfer. This usually begins with blood work and an ultrasound on the second or third day of your menstrual cycle. If the results are normal, you’ll start taking estrogen to prepare the lining of your uterus. 

After around 10-14 days, you’ll have another ultrasound to measure the thickness of your uterus lining. If it’s ready, you’ll start your next medication – progesterone. This helps to get the uterus ready for embryo transfer. 

Don’t worry. All of these steps will be explained in much greater detail when you get past the medical screening stage! 

Learn more about the surrogate medical screening process

Think you’ve got what it takes? Or just want to chat? Great! Contact the Family Source team and we’ll answer your every question. 

Staci Swiderski, CEO and owner of Family Source Consultants, has been a prominent leader in reproductive medicine for over two decades. Through her strategic vision and dedication, she has developed Family Source Consultants into a globally recognized agency specializing in comprehensive egg donation and gestational surrogacy services. Under Staci’s leadership, the agency has become a trusted partner for intended parents, surrogates, and egg donors worldwide, known for its rigorous standards, compassionate support, and commitment to excellence in third-party reproduction.

Her professional insight is uniquely informed by her own family-building experiences. As an intended parent, Staci welcomed her son via gestational surrogacy in 2005, and as a known egg donor, she assisted an infertile couple in expanding their family. These experiences lend a rare depth to her leadership and have fueled her ongoing dedication to ethical, empathetic, and professional support within the field of reproductive medicine.