Evaluating Surrogate Mothers

Medical and Psychological Evaluation of CACRM Surrogates

One of the major advantages of using our physician-directed surrogacy program is that intended parents only will be presented with potential surrogates who have passed our rigorous medical and psychological process for evaluating surrogate mothers.

CACRM requires all surrogate candidates to obtain medical and psychological clearance before they are selected and matched with our intended parents. Only a small percentage of applicants qualify and meet our high standards for screening and evaluation.

We incorporate protocols from these organizations for optimal testing for sexually transmitted infections (STI), psychological assessments for individuals involved in third-party reproduction with a gestational carrier, and a comprehensive medical and psychological evaluation to ensure the surrogate-to-be is medically, physically, and psychologically ready for in vitro fertilization, pregnancy, and childbirth.

Psychological Evaluation

Our qualified mental health professionals, who have doctorates in psychology, conduct psychological evaluations and counseling for all potential gestational carriers and their partners. The assessment includes a clinical interview and psychological testing. We handle psychological test data in accordance with the American Psychological Association Ethical Standards.

During the psychosocial evaluation and counseling session, the psychology experts consider the impact of the surrogate pregnancy on family and community dynamics. Our psychologists explore the potential effect of the relationship between the gestational carrier and the intended parents as well as any plans for disclosure and future contact.

The carrier should have a stable family environment with adequate support to help her cope with the added stress of pregnancy.

A surrogate applicant who will be part of evaluating surrogate mothers
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The Medical Evaluation

We perform a complete history and physical exam as part of the screening and testing process. The comprehensive evaluation includes assessment for:

  • Infectious diseases
  • Vaccinations
  • Pre-existing medical conditions
  • Body Mass Index
  • Overall health 
  • Physical exam
  • Pelvic ultrasound, hysteroscopy, and mock transfer

Infectious diseases

We will obtain complete personal and sexual histories to identify individuals who might be at high risk for human immunodeficiency virus (HIV), sexually transmitted infections (STIs), or other infections that might be transmissible to the fetus.  CACRM tests all gestational carriers and their partners for these diseases before the treatment phase begins, going beyond the Federal Drug Administration (FDA) requirements.

Women or their partners should not have traveled recently to Zika virus-infected regions where they could have been exposed to this virus, which can have dire consequences on the health of the fetus and baby. We will test the surrogate and her partner, if applicable, for Zika exposure.

All carriers are screened and tested for COVID-19.

Generally, we do not allow individuals to serve as gestational carriers if they test positive for COVID 19, ZIKA, HIV-1, HIV-2, HIV group O antibody, hepatitis B, or hepatitis C.  Exceptions to these recommendations require careful counseling, informed consent, and documentation of these risks in the medical chart.


Gestational carriers need to be up-to-date on their vaccinations. We test for the recommended immunizations and will prescribe the required vaccines for those who are not fully inoculated to avoid delays in treatment and pregnancy.

Pre-existing medical conditions

CACRM requires surrogates to get medical clearance for pregnancy from their treating physicians if they have pre-existing medical conditions such as hypothyroidism or controlled hypertension that necessitates them taking daily medications. Also, the surrogate’s appropriate laboratory testing should be within the normal range.

Body Mass Index (BMI)

We consider a normal Body Mass Index (BMI) an important factor in the success of a surrogate pregnancy. BMI is a measure of body fat based on height and weight.

We will monitor the surrogate’s weight and blood pressure at medical visits.

Overall health assessment

We will assess the surrogate’s nutritional and exercise routine to ensure she has a healthy lifestyle as well as complete a detailed history for exposure to occupational and environmental hazards.

Physical exam

We will take vital signs and administer an overall health assessment.

Pelvic ultrasound

The pelvic ultrasound evaluates the normalcy of the pelvic cavity. The uterus and ovaries should appear within normal limits


The doctor will introduce a small telescope into the uterine cavity where the baby will grow and develop. Dr. Arnold will visualize directly the home where your baby will live and make sure the cavity is normal by direct visualization.

Mock transfer

We map and measure the cervical canal and uterine cavity so the doctor knows exactly where to place your embryo (s). Also, this step prepares the carrier to have a smooth embryo transfer, which is one of the main components of success

The extensive medical and psychological evaluation helps ensure the surrogate-to-be is physically and medically appropriate before we select and match her with you.

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