The Screening Process: Part 1 – Taking the First Step

When people think about surrogacy, they often picture the embryo transfer or matching with intended parents. But in reality, the journey starts long before that.

For me, it all began on March 9, 2026.

That was the day I finally decided to take the leap and call my first surrogacy agency.

I had been researching surrogacy for quite a while, but making that first phone call felt like making it real.

From the beginning, the agency was incredibly detailed and answered every question I had. During that first conversation, I wanted to know what a typical timeline looked like, what medications were commonly used, and what I could realistically expect throughout the process.

One of my biggest concerns was the medication.

I've always been very sensitive to hormones that aren't my own. Birth control pills have never agreed with me emotionally or physically, so naturally I was nervous about the hormone injections required for IVF. I wanted to understand exactly what I would be putting into my body before committing to the process.

After that initial phone call, I spent about a month weighing the pros and cons.

More importantly, I spent that month talking with my partner.

At first, he wasn't on board at all.

His biggest concern was that I would become emotionally attached to the baby and that giving the baby to the intended parents would be too difficult.

I completely understood where he was coming from, but I explained that gestational surrogacy is very different than what many people imagine. The embryo is created through in vitro fertilization (IVF), meaning the baby wouldn't be genetically related to me at all. I would simply be carrying the pregnancy for another family.

I also reminded him that our own family felt complete.

From the time we first started dating, I had always envisioned having three children close together in age. Three felt like the perfect number for us—it fit our family, our lifestyle, and yes... it even fit comfortably in a regular car without needing extra accommodations!

Eventually, after many conversations and lots of questions, he came around and fully supported my decision.

While I was making my decision, I also scheduled an appointment with my OB because the agency had told me I would need medical clearance before moving forward. I'm so glad I planned ahead because appointments were booking about a month out.

On March 31st, I emailed the agency and let them know I was ready to move forward.

We had another phone call on April 2nd, this time with the Director of Surrogacy Admissions. She reviewed all of the qualifications to make sure I met their requirements before beginning the screening process.

To qualify, I needed to:

• Be between 21 and 40 years old

• Be a U.S. citizen or permanent U.S. resident

• Be a non-smoker in excellent health

• Be within a healthy height and weight ratio

• Have a healthy reproductive history and be raising at least one child

• Have delivered all pregnancies at 36 weeks or later without complications (unless carrying multiples)

• Not be receiving state or federal financial assistance

• Be willing to self-administer both subcutaneous and intramuscular injections

• Pass a background check (my partner would need one as well)

• Complete a psychological evaluation

After the call, she emailed me a stack of paperwork that included medical release forms, the benefits package, and an OB clearance letter for my provider to complete.

I was also instructed to obtain:

• An updated Pap smear

• Documentation of my height, weight, and blood pressure

• Blood work, including vitamin D and thyroid testing

• Proof of immunity to Rubella and Varicella

Thankfully, my OB appointment had already been scheduled for April 7th, so everything lined up perfectly.

One thing that unexpectedly came up was my thyroid.

About a month earlier, I had routine blood work done and my TSH level was 4.41. While that's considered within many laboratory reference ranges, I learned that surrogacy agencies typically require a TSH level below 2.5 before moving forward.

This requirement exists because, during the first trimester, the developing baby depends almost entirely on the mother's thyroid hormones until its own thyroid begins functioning. Maintaining healthy thyroid levels supports fertility and early fetal development while reducing the risk of miscarriage, preterm birth, and other pregnancy complications.

I started reading about thyroid levels and learned they can fluctuate based on several factors—including sleep.

Then I remembered something important.

My first blood draw had been done immediately after working a night shift.

Since I work nights, I know how much sleep deprivation can affect my body, so I asked my doctor if I could repeat the lab.

This time, I made sure I had three full nights of good sleep before getting my blood drawn again.

The difference was incredible.

My repeat TSH came back at 1.47, comfortably meeting the agency's requirements without any medication. It was a great reminder of how important proper rest can be and how one lab value doesn't always tell the whole story.

On April 16th, the agency officially requested all of my medical records from the hospital.

I submitted my lab results, OB clearance, Pap smear, vaccination records, and every other document they requested.

By April 22nd, they had received and reviewed everything.

The very next day—April 23rd—I received the news that I had been denied.

As I shared in my previous blog post, it wasn't because of one major issue. Instead, it was a combination of factors from my medical history, including mild anemia during my first pregnancy, a laparoscopic IUD removal, a LEEP procedure, and a 12-week miscarriage—even though I went on to have two healthy, uncomplicated pregnancies afterward.

Although I was disappointed, the agency told me something that gave me hope.

They explained that they are known for having very strict screening criteria and encouraged me not to give up. They genuinely believed I still had a strong chance of becoming a surrogate through another agency.

So instead of letting one "no" end my journey, I scheduled calls with two more agencies.

That decision changed everything.

In my next post, I'll share why I ultimately chose my third agency, how their screening process differed, and why finding the right fit made all the difference.