“Why are there SO many questions?” 😂

And honestly… that’s completely fair.

Sometimes our intake calls can feel like a first date, a medical interview, and a therapy session all combined together. We ask about your pregnancies, your family, your support system, your lifestyle, your delivery history, your mental health history, your relationship, your schedule, your insurance… and sometimes applicants wonder if they are being judged or interrogated.

But the truth is: every single question has a reason behind it.

Most of the questions we ask are actually there to protect YOU.

One of the first and most common questions we hear is:

“Will the baby be genetically related to me? Will it use my egg?”

And first of all — this is NOT a stupid question.

Years ago, traditional surrogacy existed, where the surrogate also used her own eggs. But today, almost all journeys are gestational surrogacy. That means the embryo already belongs to the Intended Parents and/or their chosen egg or sperm donor. The surrogate is not genetically related to the baby.

The IVF clinic will transfer a PGT-A tested embryo into your uterus and hope it implants successfully. This process is called embryo transfer. If everything goes well, you carry the pregnancy just like your own pregnancies, but biologically, the baby is not yours.

Another common concern we hear is:

“What protections do surrogates actually have?”

Many women are interested in surrogacy, but they are also scared because they do not know what they will go through, what role they play in the process, or how they will be treated. The good news is that surrogacy in the United States is heavily structured with legal protections.

Before anything medical even starts, both the Intended Parents and the surrogate will sign a legal contract. The Intended Parents have their own attorney, and the surrogate also has her own independent attorney representing HER interests. The contract covers compensation, travel, communication expectations, medical responsibilities, delivery preferences, and many important “what if” situations. Everything is discussed openly before transfer happens.

Surrogates are not “employees.” They are protected participants in the journey.

Another question we sometimes hear is:

“If I’m medically and psychologically cleared, does that mean I can match with any Intended Parents?”

The answer is: not always, because surrogacy is not only medical — it is also deeply legal.

Many people outside of the industry do not realize that surrogacy laws are completely different depending on the state. Some states are very surrogacy-friendly, while others have restrictions involving international Intended Parents, LGBTQ+ couples, or single Intended Parents.

For example, Texas has strict requirements for Intended Parents and is generally more favorable toward married couples. Some states remain legally unclear or “neutral” regarding surrogacy, which means attorneys must carefully evaluate every case individually. California remains the most surrogacy-friendly state in the United States because it has the longest legal history supporting surrogacy, LGBTQ+ families, international Intended Parents, and single parents.

This also leads to another common misunderstanding about agency licenses and qualifications. Years ago, when I first started browsing Reddit and Facebook surrogate groups, I saw people accusing agencies of being “fake” simply because they did not have a New York license. In reality, only agencies working with New York surrogates are legally required to hold a New York surrogacy license. Outside of New York, most states do not require a specific surrogacy agency license to operate. We strictly follow those legal requirements, which is why we rarely work with NYC surrogates at the moment. When we do, we often refer them to trusted friends and agencies already licensed there while our own application remains under review.

Another major part of intake calls involves preference questions.

We usually ask applicants things like:

Are you comfortable working with married couples? LGBTQ+ couples? Single parents? International Intended Parents? HIV-positive Intended Parents using sperm washing?

Some applicants feel nervous answering these questions because they worry they might sound rude or judgmental if they say no. But surrogacy is not about forcing people together. It is about finding a GOOD match, not simply the fastest match.

It is completely okay to have boundaries and preferences.

Even after a match call, surrogates still have the right to say no. Your comfort matters too. Your voice matters just as much as the Intended Parents’ voice because surrogacy is a long emotional journey for BOTH sides.

And finally, let’s talk about two questions that sometimes surprise surrogate applicants during intake calls:

“Would you feel comfortable working with Intended Parents who are HIV or Hepatitis-B carriers?”

“Would you feel comfortable carrying a mosaic embryo?”

Many applicants feel nervous when hearing these questions for the first time, but most of the fear comes from not understanding the medical process behind them.

For Intended Parents who are HIV positive, modern reproductive medicine is far more advanced than many people realize. Through a process called sperm washing, fertility doctors separate healthy sperm cells from the seminal fluid before creating embryos through IVF. The embryos are also carefully tested before transfer, including PGT-A genetic testing in many cases. This means the process is designed to greatly minimize medical risk for the surrogate.

In some situations, surrogates may need additional medications or injections before transfer to further increase immune protection and safety precautions. Because of those extra steps, Intended Parents will usually provide additional compensation or bonuses to the surrogate as part of the legal agreement.

Another term applicants often hear is “mosaic embryo.” A mosaic embryo means that during genetic testing, some cells appeared normal while some showed abnormalities. It is considered a “gray area” embryo — not fully abnormal, but not fully normal either. Many mosaic embryos still result in healthy pregnancies and healthy babies, but they may come with slightly lower success rates or require additional monitoring during pregnancy.

And just like every other part of surrogacy, carrying a mosaic embryo is always YOUR choice. Some surrogates are comfortable with it, and some are not. There is no right or wrong answer. Our job during intake is not to pressure anyone — it is simply to understand your comfort level so we can help create the safest and best possible match for everyone involved.

That is exactly why we created Yunda Surrogate 101 — to make surrogacy feel less mysterious, less scary, and more transparent for the women who are considering this journey.

Education removes fear. And informed surrogates make stronger, safer journeys.

Hi, I’m Kayla from Yunda Surrogacy.

Welcome to ‘Yunda Surrogate 101’, this is a series designed to educate and support women interested in surrogacy. We’ll walk through the process step by step and share the real information you need to better understand the journey.

One of the most common questions we hear is:

“Why do some women qualify for surrogacy while others don’t?”

The truth is — becoming a gestational surrogate is not about being “good enough” or “bad enough.”
It’s about safety, medical predictability, emotional readiness, and creating the healthiest possible journey for everyone involved: the surrogate, the baby, and the intended parents.

What Does an Agency Review Before Moving Forward?

Before moving forward with a surrogate applicant, agencies typically begin with an intake process based on ASRM recommendations and clinic standards.

During intake, we gather important background information, including:

• Age

• Height, weight, and BMI

• Pregnancy and delivery history

• Family and support situation

• Employment and lifestyle stability

• Marital status

• Smoking, alcohol, or drug history

• Medication history

• Mental and emotional wellbeing

• Social stability and living environment

• Criminal background history

After learning more about an applicant’s background, we request medical records from previous OB/GYNs, hospitals, and delivery providers.

These records are extremely important because they help verify medical history and provide a clearer picture of previous pregnancies, deliveries, and any complications that may have occurred. Medical records may also include documentation related to medications, smoking or substance use history, mental health history, and social history.

At Yunda Surrogacy, our medical review team carefully reviews hundreds of pages of records before determining whether we can move forward to the next step.

One thing many applicants don’t realize is that every hospital and clinic has a different timeline for releasing records. Some providers send records within a day, while others may take several weeks or even up to two months.

As an agency, part of our job is continuously following up with hospitals, requesting updates, and keeping applicants informed throughout the process so they know we are actively working behind the scenes for them.

Only after medical records are fully reviewed and approved can we move forward to the next stage of the surrogacy journey.

Why Pregnancy History Matters

Your pregnancy and delivery history is one of the most important factors IVF clinics review during surrogate screening because it is the clearest indicator of how your body responds to pregnancy.

According to ASRM recommendations, a woman should have at least one previous full-term pregnancy and delivery before becoming a gestational surrogate. A prior healthy pregnancy helps doctors better understand uterine health, pregnancy outcomes, and overall reproductive stability.

Clinics will also typically request:

• Previous OB/GYN and delivery records

• A recent Pap smear (usually within the last 3 years)

• An OB clearance form completed by your doctor confirming you are medically qualified for another pregnancy

Your medical records help clinics evaluate whether there were any complications during prior pregnancies or deliveries that could increase risks in a future surrogate pregnancy.

Some examples clinics may review include:

• Severe preeclampsia

• Placental abruption

• Preterm delivery

• Multiple C-sections

• Uncontrolled gestational diabetes

• Significant postpartum complications

Some women with these histories may still qualify at certain clinics, while others may not. Every IVF clinic has different guidelines and different levels of risk tolerance.

Why BMI Is Reviewed

BMI requirements are usually determined by IVF clinics, not agencies alone.

Higher BMI levels can sometimes increase risks during:

• IVF medications

• Embryo transfer

• Pregnancy

• Delivery and anesthesia

Different clinics have different BMI limits. Some clinics are more flexible, while others follow stricter guidelines.

We also understand this can be an emotional topic for many women.

Many warmhearted women truly want to help another family through surrogacy, but struggle with weight changes after pregnancy and motherhood. Balancing children, family responsibilities, work, and personal health is not easy, and maintaining weight after having children can be especially challenging.

Over the years, I’ve met many amazing women who were disappointed when clinics declined them because of BMI requirements. It can feel frustrating and unfair, especially when someone has such a kind heart and genuine desire to help.

However, these guidelines exist for medical safety reasons, not judgment.

Obesity during pregnancy can increase risks for both the surrogate and the baby, including complications during pregnancy, delivery, recovery, and anesthesia. IVF clinics ultimately want to create the safest possible journey for everyone involved.

Maintaining a healthy lifestyle, stable BMI, and balanced nutrition is viewed as an important part of preparing for a successful surrogate journey — not because anyone expects perfection, but because health and safety always come first.

Mental Health & Emotional Readiness

Surrogacy is not only a medical journey, it is also an emotional and psychological one. Mental health is a very important part of surrogate screening and something agencies and clinics carefully review during the intake process.

We completely understand that many women may have gone through difficult periods in life, including family trauma, personal hardships, postpartum anxiety, or postpartum depression. These experiences are more common than people think, and we respect every woman’s life experiences and personal journey.

Having experienced emotional challenges in the past does not automatically disqualify someone from becoming a surrogate.

The purpose of reviewing mental health history is not to judge someone’s past, it is to ensure that a surrogate is now emotionally stable, fully prepared for the responsibility of surrogacy, and able to safely handle the emotional, medical, and physical demands of the journey.

That is why IVF clinics typically require a professional psychological evaluation. The goal is to confirm that:

• You clearly understand the surrogacy process

• You are emotionally prepared for the journey

• You have healthy coping skills

• You have realistic expectations

• You have a stable support system around you

Short-term emotional struggles related to life events or postpartum recovery may still be acceptable depending on treatment history, recovery, and current stability.

However, more severe or ongoing mental health conditions, especially those requiring long-term psychiatric medication management, may prevent approval at many IVF clinics. Certain conditions, such as uncontrolled bipolar disorder, severe ADHD, or significant untreated anxiety and depression, may increase risks during pregnancy or affect medical compliance throughout the surrogacy process.

Additionally, some psychiatric medications may not be considered safe during pregnancy, which is another factor clinics must carefully evaluate.

Ultimately, the goal is to protect both the surrogate and the baby, while ensuring the surrogate feels fully supported, emotionally prepared, and confident throughout the journey.

Drug Use, Smoking & Lifestyle Factors

Many potential surrogates ask me why these histories matter so much. If something happened in the past, but they have been completely clean and stable for a long time now, why can’t they still qualify?

The reality is that clinics and agencies are not only reviewing your current situation — they are reviewing your entire pregnancy and lifestyle history. Becoming a qualified surrogate is actually very difficult, because clinics evaluate much more than just how your body handled delivery. They also look closely at your mental health history, family stability, substance use history, lifestyle during pregnancy, and overall decision-making throughout previous pregnancies.

A clean record plays a major role in determining whether a clinic believes you are capable of safely and successfully completing a surrogate journey. Intended parents and clinics are generally looking for candidates who are low-risk, emotionally stable, medically reliable, and able to maintain a healthy pregnancy environment.

That said, not every past issue leads to an automatic disqualification. For example, a history of occasional vaping, or a temporary period of emotional trauma caused by a major life event — especially if it has been fully resolved and well documented — may still be considered acceptable by some clinics.

However, documented marijuana or other drug use during pregnancy, especially positive drug screenings while pregnant, is considered a major concern by most clinics and is very often treated as an automatic decline.

Family Stability & Medical Compliance

At the same time, this is also one of the most overlooked — yet extremely important — parts of surrogate screening: support systems and compliance history.

Many people do not realize that missed OB appointments, skipped medications, or failure to follow medical instructions during pregnancy are all documented in medical records and reviewed as part of a candidate’s compliance history. Clinics want to see that a surrogate is reliable, communicative, and able to consistently follow medical guidance throughout pregnancy.

In addition, histories involving domestic violence, unstable or high-conflict relationships, repeated arguments or safety concerns, housing instability, unemployment, or lack of financial stability may also appear in medical and social work records. These factors matter because surrogacy requires a strong support system and a stable environment.

When a woman decides to become a surrogate, her emotional stability, family support, financial situation, and sense of responsibility are all critically important. A surrogate journey is far more medically and emotionally demanding than a typical pregnancy. It involves extensive screening, fertility medications, injections, embryo transfer preparation, frequent monitoring appointments, routine OB care, and ultimately delivery.

Intended parents and agencies do everything they can to support the journey — coordinating appointments, maintaining communication, helping with follow-up care, and providing guidance throughout the process. But a surrogate’s willingness and ability to cooperate is essential.

Unfortunately, the industry has seen extreme cases where insufficient screening led to devastating outcomes — including surrogates disappearing during the journey, pregnancies being lost due to unstable or unsafe domestic situations, or major compliance failures. For intended parents, who may have invested hundreds of thousands of dollars and years of emotional energy into having a child, these situations can be absolutely heartbreaking.

Who Makes These Rules?

Then people often ask: who created all of these rules, and why do we have to follow them?

These guidelines largely come from the American Society for Reproductive Medicine (ASRM), which is the leading professional organization for reproductive medicine and surrogacy standards in the United States. Nearly all IVF clinics, surrogacy agencies, attorneys, psychologists, and third-party professionals involved in surrogacy follow these guidelines in some form.

These standards were not created randomly. They are based on decades of medical experience, real-life cases, risk management, and long-term research gathered across the surrogacy and fertility industry. The goal is to maximize the safety, health, and protection of everyone involved — including the surrogate, the baby, and the intended parents.

Many of the screening requirements may feel strict or even unfair at times, but they exist because surrogacy is an extremely complex medical and legal journey. Every rule is designed to reduce risks, improve pregnancy outcomes, and help ensure that the journey can be completed safely and successfully for all parties involved.

Do All Clinics Have the Same Rules?

However, what surprises many people is that not all clinics follow the exact same standards.

Different doctors and IVF clinics often have their own comfort levels, medical judgment, and clinical experience on top of the general ASRM guidelines. While there are industry-wide recommendations, every clinic still has some flexibility in how strict or conservative they choose to be.

For example:

• Some doctors may not accept surrogates with a BMI over 30, while others are more open to working with overweight candidates.

• Some clinics are less comfortable working with surrogates over 40 years old, while others may still approve candidates up to 45 if their uterine health and pregnancy history are strong.

• Some doctors are very strict about prior psychological history, while others may be more understanding of a past period of depression or anxiety if the surrogate has been stable and well-supported for a long time.

• Some clinics are more conservative about prior pregnancy complications, while others are willing to review cases individually.

A surrogate being declined by one clinic does not automatically mean she can never become a surrogate. Often, it simply means that particular clinic or doctor is not comfortable with the specific risk factors involved.

This is also one of the most important roles of a surrogacy agency — finding the right overall match. It is not only about matching intended parents with a surrogate, but also matching the surrogate with the right clinic, doctor, and medical team that best fits her history and circumstances.

Final Thoughts

Being declined does not define your worth as a woman or mother.

Surrogacy screening exists to protect everyone involved and create the safest possible journey.

At Yunda Surrogacy, we believe education and transparency matter.
The more informed surrogates are, the more empowered and supported they can feel throughout the process.

This is the beginning of our Surrogate 101 series — where we’ll continue sharing honest answers, behind-the-scenes insights, and guidance for women exploring the surrogacy journey.