Skip to main content

Surrogacy is a profoundly generous act, and like any medical process, it comes with eligibility standards meant to protect your health, emotional well‑being and the intended parents you’d carry for. Many prospective surrogates wonder what might disqualify them and whether those disqualifications can be addressed over time.

While some are permanent, many are temporary and medically manageable. This blog breaks down the most common surrogacy disqualifications, from body mass index (BMI) and substance use to medical history and emotional readiness, to help you understand the difference between not yet eligible and truly disqualified.

When “Not Eligible” Might Just Mean “Not Yet”

If you’re told you don’t qualify to become a surrogate, it doesn’t always mean the door is closed forever. Many surrogacy disqualifications are temporary and reflect medical or lifestyle factors that can improve over time. In other words, it may simply not be the right time yet.

Surrogacy eligibility prioritizes health and safety, ensuring the best outcomes for you, the baby and the intended parents. Understanding eligibility through this lens can help shift the narrative from rejection to readiness.

Why Surrogacy Has Strict Eligibility Requirements

Surrogacy standards exist to protect everyone involved. Fertility clinics and surrogacy agencies follow strict guidelines that:

  • Safeguard the health and safety of the surrogate
  • Minimize risk for the baby and intended parents
  • Comply with medical and legal standards for assisted reproduction

These requirements may feel personal, but they’re grounded in evidence-based care. A disqualification today could be a green light tomorrow, especially with the right guidance and support.

BMI Requirements Are One of the Most Common Disqualifiers

Body Mass Index (BMI) is one of the most frequently cited medical criteria in surrogacy, but also one of the most misunderstood. While it’s not a measure of overall health, fertility clinics and surrogacy professionals use BMI as a standardized screening tool to reduce risks during pregnancy and IVF.

Having a BMI that falls outside the recommended range doesn’t mean you’ll never qualify, but it may mean you’ll need to make some changes before being approved. This is considered a temporary disqualification, not a permanent one.

Can You Reapply After Meeting BMI Requirements?

Yes. Many women who don’t initially meet BMI guidelines go on to become successful surrogates after making sustainable health changes. If you’re actively working toward your health goals, our team encourages you to reapply when you’re ready. This can be as soon as three to six months, depending on your clinic’s timeline.

We always recommend making these changes under the guidance of a medical professional, with an emphasis on your overall health, not just BMI numbers.

Thinking about applying? Read this guide to becoming a Joy of Life surrogate.

Smoking, Vaping and Substance Use Can Delay Approval

Smoking, vaping and substance use (including nicotine and recreational drugs) are some of the most common lifestyle-related surrogacy disqualifiers. These substances can negatively impact pregnancy outcomes and fertility, which is why agencies and clinics enforce strict, medically backed policies around them.

If you are a smoker or use nicotine regularly, you’ll need to be fully smoke- and vape-free for a specific period of time before you can be approved for surrogacy. The exact timeline can vary by clinic, but most require you to be completely smoke- and nicotine-free for at least 3–6 months, with your abstinence medically verified before moving forward.

Why Clinics Require a Smoke-Free Lifestyle

This requirement exists to protect both the surrogate and the baby. Smoking and substance use are linked to:

  • Increased risk of miscarriage and pregnancy complications
  • Restricted fetal growth and developmental issues
  • Legal and insurance complications for all parties involved

If you’re ready to quit, we commend you, and we’re here to support your future surrogacy journey once your smoke-free period is complete.

Medical and Pregnancy History Matter

Your medical and pregnancy history play a major role in determining whether surrogacy is a safe option for you. Fertility clinics and agencies want to ensure that your body is well-prepared to carry a healthy pregnancy, not just for your safety, but also for the well-being of the baby and the intended parents.

A key requirement is having at least one prior full-term, uncomplicated pregnancy and delivery. This provides doctors with insight into how your body responds to pregnancy and helps establish a baseline of reproductive health.

Certain past complications, such as multiple C-sections, preterm deliveries or severe postpartum issues, may require additional medical review and could result in disqualification, depending on severity.

Medical Conditions That May Affect Eligibility

Some health conditions may disqualify you from becoming a surrogate, while others might require further evaluation. These can include:

  • A history of high blood pressure
  • Gestational diabetes during a previous pregnancy
  • Autoimmune or chronic illnesses
  • Specific mental health diagnoses under active treatment

Even if you’ve been diagnosed with a condition in the past, it’s worth speaking with an agency to understand how it may impact your eligibility today. Medical requirements are always reviewed on a case-by-case basis in consultation with healthcare providers.

If you’re unsure whether your health history qualifies, take our Surrogacy Requirements Quiz for a personalized starting point.

Mental Health and Lifestyle Factors Are Also Evaluated

Emotional readiness and overall life stability are just as important as physical health when it comes to becoming a surrogate. Surrogacy is a deeply personal and emotionally complex experience, and ensuring that candidates are prepared for that journey is essential.

Part of the screening process includes a psychological evaluation, where licensed professionals assess your mental health history, emotional resilience and understanding of the surrogacy process. A past diagnosis won’t automatically disqualify you, though. What matters most is your current emotional well-being and having a solid support system in place.

Stable housing, reliable transportation and a safe, supportive environment are also considered during the application process. These factors help ensure a healthy and low-stress pregnancy for all involved.

Why Emotional Readiness Is Essential in Surrogacy

Becoming a surrogate is a long-term commitment that requires emotional strength, open communication and trust. You’re carrying someone else’s baby, which means navigating legal agreements, medical procedures and emotional milestones with the utmost care and clarity.

If you’re not quite ready now, that’s okay. Many prospective surrogates take time to prepare emotionally or work on making small lifestyle changes before applying.

A Reputable Agency Helps You Understand Your Most Viable Path Forward

The surrogacy process isn’t one-size-fits-all, and neither are eligibility requirements. That’s why partnering with an experienced, ethical surrogacy agency is so important. A reputable agency won’t just tell you “yes” or “no”; they’ll help you understand what’s behind the decision and what steps, if any, can help you qualify in the future.

At Joy of Life, we know that many candidates come to us with questions, uncertainty or a mix of both. Whether you’re ready to apply today or just beginning to explore the surrogacy process, we’re here to guide you with compassion and clarity.

Turning “No” Into “Not Yet”

Some disqualifications are permanent, but many are not. January is one of the most popular times to apply to become a surrogate, and it’s also when many people are working toward health goals, making lifestyle changes or seeking more meaningful ways to grow in the year ahead.

If you’re committed to becoming a surrogate but aren’t currently eligible, don’t be discouraged. With the right support, your “no” today could become a “yes”, and we’ll be here when you’re ready.

Frequently Asked Questions About Surrogacy Disqualifications

Many prospective surrogates have similar questions when reviewing eligibility requirements. Below are answers to some of the most common concerns.

1. What will disqualify me from being a surrogate?

Common surrogacy disqualifications include:

  • Smoking, vaping, or nicotine use
  • Body mass index (BMI) outside the clinic’s accepted range
  • Unmanaged medical conditions, such as high blood pressure or diabetes
  • History of complicated pregnancies
  • Certain mental health conditions without current treatment or stability
  • Lack of a stable support system
  • Substance use or recent cessation without a verified smoke-free window

Some of these may be temporary and can be addressed with time and support. Others may be permanent based on clinic or medical guidelines.

2. Does anxiety disqualify you from being a surrogate?

Not always. A past diagnosis of anxiety doesn’t automatically disqualify you, especially if it’s well-managed. However, all candidates undergo psychological screening to ensure emotional readiness for the demands of surrogacy.

3. Can you be denied surrogacy?

Yes. Surrogacy agencies and fertility clinics follow strict guidelines to ensure safety and legal compliance. If you’re denied, it may be due to medical, psychological or lifestyle factors, but in many cases, you may be able to reapply later.

4. Does having had an abortion disqualify you from being a surrogate?

Not necessarily. A past abortion does not automatically prevent someone from becoming a surrogate. Eligibility will depend on your overall reproductive and medical history, including any complications.

5. What is the weight limit to be a surrogate?

Most agencies follow BMI guidelines (typically between 19 and 32) to ensure a healthy pregnancy. However, these numbers can vary depending on clinic policies. If your BMI is outside this recommended range, you may be asked to reapply later once medically cleared.

Still Have Questions?

Explore our full Surrogacy FAQs page for more detailed answers and guidance.

Explore Your Eligibility With Joy of Life

If you’re thinking about becoming a surrogate but aren’t sure whether you qualify, we’re here to help — no pressure, just honest guidance. You can take our Surrogacy Requirements Quiz  to better understand your current eligibility, or apply now  if you feel ready to start your journey today.

Joy of Life

Author Joy of Life

I’m Joy, the founder and CEO of Joy of Life. With a professional background as a fertility clinician, I’ve spent thousands of hours working with surrogates and intended parents alike. As a mother of two, I often wished for more support and a deeper commitment to care for those embarking on non-traditional family-building journeys. This is why I established Joy of Life: to create a more robust, compassionate experience in parenthood for both parties involved with surrogacy. In 2021, I stepped back from daily operations at Joy of Life to fight cancer. Fortunately, the combined 20 years of experience from our incredible team has allowed me to focus on my health & recovery. I continue to provide company guidance and serve as the head liaison for our network of doctors, clinicians and caregivers.

More posts by Joy of Life