Psychological screening is an important part of responsible surrogacy and egg donation—but it is often misunderstood.
It is not designed to determine whether someone has the “perfect personality.”
It is not a test to see whether a surrogate will become emotionally attached to the baby.
It is not intended to find an egg donor whose personality traits can be passed on to a future child.
And having previously experienced anxiety, depression, counseling, grief, or another mental-health concern does not automatically mean someone can never become a surrogate or egg donor.
A good psychological evaluation has a much more practical purpose.
It helps determine whether everyone involved:
At Simple Surrogacy, psychological preparation does not apply only to surrogates.
Our intended parents also participate in psychological consultation before matching.
Egg donors undergo their own psychoeducational evaluation as part of the donor-screening process.
That matters because ethical third-party reproduction should prepare everyone involved, not simply evaluate the woman providing the pregnancy or eggs.
Surrogacy is not simply a medical arrangement.
A gestational surrogate is committing to:
She may also face situations she cannot predict at the beginning of the journey.
An embryo transfer may fail.
A pregnancy may end in miscarriage.
Prenatal testing may identify a serious medical condition.
The intended parents may become highly anxious during pregnancy.
Communication may become difficult.
She may require a C-section.
The baby may need NICU care.
The delivery may become very different from the birth plan everyone imagined.
Psychological screening helps make sure these possibilities are discussed before pregnancy.
Current ASRM recommendations call for psychosocial evaluation and counseling by a qualified mental-health professional for potential gestational carriers and their partners or primary support people.
The purpose is preparation and informed decision-making—not finding a woman who promises she will never experience difficult emotions.
One of the biggest problems with older discussions of psychological screening is that they make it sound as though the surrogate needs to be examined while the intended parents simply wait for the results.
We do not believe screening should work in only one direction.
At Simple Surrogacy, intended parents complete a psychological consultation before entering matching.
That is consistent with current professional guidance.
Intended parents may need to process:
The goal is not to decide whether someone is emotionally “worthy” of becoming a parent.
It is to make sure intended parents understand the unusual relationship they are entering and are prepared to participate in it respectfully.
People sometimes worry:
“I went to therapy before. Will I be disqualified?”
“I had postpartum depression years ago. Does that automatically rule me out?”
“I take medication for anxiety. Should I hide it?”
The answer to the last question is especially important:
No.
Never hide mental-health history or stop prescribed medication in order to qualify for a surrogacy or egg-donation program.
Mental-health history should be considered in context.
A qualified professional may look at:
Someone who experienced well-treated anxiety several years ago is not automatically in the same situation as someone currently experiencing a severe untreated condition.
Individual evaluation matters.
Psychological screening works only when everyone answers honestly.
Surrogates and donors sometimes worry that mentioning something difficult will cause an automatic rejection.
That fear can encourage people to minimize:
But withholding important information creates a larger problem.
The mental-health professional is trying to understand whether participation is appropriate now and whether additional support may be helpful.
The safest application is an accurate one.
Every professional may structure an evaluation somewhat differently, but several issues commonly matter.
Why do you want to become a surrogate?
There does not have to be one perfect answer.
Many surrogates sincerely want to help another family and also value the compensation.
Those motivations can coexist.
The important question is whether the decision is voluntary and well considered.
Do you understand what you are agreeing to?
That includes more than knowing you will be pregnant.
You should understand:
The mental-health professional may discuss your previous pregnancies from an emotional perspective.
For example:
Your actual obstetric records and medical qualification are evaluated separately by medical professionals.
Surrogacy affects more than one person.
Your household may have to adjust when you:
The evaluator will want to know whether you have people who genuinely support the journey.
Because pregnancy affects the household.
A spouse or partner may need to:
ASRM recommends psychological evaluation and counseling involving a gestational carrier’s partner or primary support person when applicable.
This does not mean the partner owns the decision.
The ultimate decision to become a surrogate remains the surrogate’s.
The purpose is to identify whether the home environment will support rather than undermine the journey.
Children do not necessarily need a formal psychological evaluation.
But their understanding of the pregnancy matters.
Age-appropriate questions might include:
Children often understand surrogacy surprisingly well when adults explain it clearly.
A simple explanation may be:
“Mom is helping another family grow their baby because they can’t carry the baby themselves.”
The goal is not to turn children into decision-makers.
It is to make sure they are not confused about a major event occurring in their household.
That is not an accurate way to describe gestational surrogacy.
A gestational surrogate is not entering pregnancy expecting to parent the child and later deciding to surrender that child.
She enters the process knowing from the beginning that she is carrying for the intended parents.
She also does not provide the egg and therefore has no inherited genetic relationship to the child.
The psychological evaluation may discuss:
But the purpose is not to prove that she is incapable of caring about the baby.
Surrogates can feel affection, pride, and emotion while still understanding completely that they are not the child’s parent.
This deserves discussion before embryo transfer.
Pregnancy loss during surrogacy can affect:
A surrogate may grieve.
That does not indicate inappropriate attachment.
She may be grieving the pregnancy, the intended parents’ loss, the physical experience, or the journey everyone hoped would result in a baby.
A good psychological evaluation helps participants understand that difficult emotions are possible—and that support should remain available if they occur.
Some of the most difficult surrogacy conflicts involve pregnancy decisions.
Psychological preparation should therefore include discussion of topics such as:
These issues are also addressed during matching and legal agreements.
Why discuss them psychologically too?
Because a person can agree with a concept intellectually and still have powerful feelings when facing it in real life.
These conversations can identify incompatible values before pregnancy.
And importantly, the surrogate remains the medical patient and retains authority over her own care.
A surrogate and intended parents may be wonderful people individually and still be a poor match.
One person may expect daily communication.
Another may prefer a weekly update.
One intended parent may want to attend every appointment.
A surrogate may want them present only for major ultrasounds.
One family may envision lifelong contact.
Another may expect the relationship to become occasional after birth.
None of these preferences is automatically wrong.
But large differences should be discovered during matching rather than pregnancy.
Psychological preparation can help people identify what they actually want rather than simply saying:
“We’re fine with anything.”
ASRM recommends that the psychological process include a joint session between the prospective gestational carrier and intended parents, even when they knew each other before the surrogacy arrangement.
That session provides an opportunity to discuss issues such as:
This does not replace Simple Surrogacy’s matching process.
It adds another professional opportunity to identify issues before pregnancy begins.
Our [Surrogate Matching guide] explains how Simple Surrogacy approaches compatibility before a journey moves forward.
Sometimes the recommendation may be:
Proceed.
Sometimes:
Proceed with additional support.
Sometimes:
Pause and address a specific issue first.
And occasionally:
This person should not proceed.
That may be disappointing.
But screening exists because not everyone who wants to participate is necessarily ready at that particular point in time.
The purpose should be protecting the prospective surrogate, intended parents, donor, and future child—not simply moving every applicant through the program.
Egg donation creates different psychological questions from surrogacy.
An egg donor does not carry the pregnancy.
But she contributes genetic material.
That means the implications can extend far beyond the retrieval cycle.
Current ASRM guidance strongly recommends psychoeducational counseling by a qualified mental-health professional for egg donors.
Issues may include:
This is a much more meaningful evaluation than simply asking whether a donor has a “good personality.”
The current version of this article says personality testing can help intended parents screen for traits and find their “perfect match.”
We would remove that entirely.
Psychological tests are not genetic shopping tools.
An egg donor’s personality does not allow anyone to predict exactly what personality a future child will have.
Psychological evaluation is used to assess the donor’s suitability and understanding of donation, not to rank her as genetically desirable.
Intended parents may naturally connect with donors whose personalities, values, interests, or backgrounds appeal to them.
That is different from using psychological screening to promise inherited personality traits.
An egg donor undergoes:
She is also making a long-term decision involving genetic material.
The psychological evaluation helps determine whether she understands both the immediate medical process and the future implications.
Current ASRM guidance recommends considering factors including mental-health history, current psychoactive medications, substance-use concerns, stress, relationship stability, ability to provide informed consent, and potential feelings about future contact with donor-conceived people.
Again, these factors require professional interpretation.
A history of seeing a therapist is not the same thing as being psychologically unfit to donate.
This has become one of the most important topics in modern donor counseling.
An egg donor may choose a nonidentified arrangement.
That does not mean she should be promised that no resulting child will ever learn who she is.
Consumer DNA testing, genetic genealogy, social media, and testing by relatives have made permanent anonymity increasingly unrealistic.
Current ASRM guidance specifically recommends discussing these technological changes with donors and intended parents.
A donor should consider:
How would I feel if a donor-conceived adult contacts me 20 years from now?
She does not need to promise a relationship.
But she should understand that identification may be possible even if no one planned it.
One donor may potentially have genetically related children in more than one family.
That can create future questions involving:
These possibilities are part of informed consent.
Egg donation should not be presented as:
“Complete one medical cycle, collect compensation, and never think about it again.”
For some donors, that may largely describe their lived experience.
For others, genetic connections may become relevant years later.
They benefit from psychoeducational counseling too.
Current ASRM guidance specifically recommends consultation for recipients using donor eggs, sperm, or embryos.
Topics can include:
This is not because there is something psychologically wrong with using donor eggs.
It is because donor conception creates questions parents may eventually need to answer for their child.
Thinking about those questions before treatment is easier than confronting them for the first time years later.
Our [Egg Donation Guide for Intended Parents] and [Egg Donation Process for Intended Parents] discuss those issues in greater detail.
When an intended parent already knows the egg donor, everyone may initially assume psychological preparation is less important.
It may actually be more important.
Imagine the donor is:
The parties may see one another regularly for decades.
Questions can include:
ASRM recommends separate and joint consultation for directed donation specifically to address these relationship issues.
No.
They are separate parts of screening.
A background check can look at matters such as criminal history or other program-specific records.
A psychological evaluation is conducted by a qualified mental-health professional.
The current article combines the two.
We would separate them.
Simple Surrogacy uses both because they answer different questions.
No.
A psychologist does not determine whether your uterus is medically appropriate for embryo transfer.
Likewise, a fertility doctor does not replace the psychological evaluation.
Surrogacy screening involves multiple professionals because the process has multiple dimensions.
For gestational surrogates:
Agency screening evaluates whether an applicant appears to meet program requirements.
Psychological evaluation examines readiness, understanding, support, and relevant psychosocial factors.
Medical screening determines whether the fertility clinic considers the surrogate medically appropriate for embryo transfer.
Background screening evaluates separate safety and eligibility considerations.
Our [Gestational Surrogate Medical Screening guide] explains the medical side in detail.
No.
Passing an evaluation is not a guarantee that a journey will be easy.
A surrogate can pass screening and still experience:
An intended parent can complete psychological preparation and still become anxious after years of infertility.
An egg donor can feel differently about genetic connection later in life than she expected at age 24.
People change.
Circumstances change.
That is why psychological support should not end when someone passes the evaluation.
ASRM’s ethics guidance emphasizes that gestational carriers should have access to psychological counseling before, during, and after participation.
We strongly agree.
Mental-health support may become particularly useful after:
Seeking counseling does not mean the journey failed.
Sometimes using support early prevents a manageable concern from becoming a larger conflict.
The exact process depends on the professional and program.
It may involve:
Simple Surrogacy’s current program may also use standardized psychological measures such as the MMPI or PAI when requested or appropriate.
Do not try to “study” for these assessments.
There are no bonus points for figuring out what you think the evaluator wants to hear.
The most useful approach is:
be honest.
Psychological evaluation and counseling are an established part of responsible gestational-surrogacy screening, and ASRM recommends them for prospective gestational carriers and their partners or primary support people.
Simple Surrogacy requires intended parents to complete psychological consultation before matching. ASRM strongly recommends psychosocial education and counseling for intended parents using gestational carriers.
Because surrogacy is a two-sided relationship. Intended parents should understand the process, respect the surrogate’s autonomy, have realistic expectations, and be prepared for the emotional issues involved.
No automatic statement should be made without evaluating the individual circumstances. History, severity, treatment, stability, medication, current symptoms, and professional assessment all matter.
No. Never stop prescribed medication in order to qualify without discussing it with the prescribing medical professional.
Not simply because you have participated in therapy. Mental-health history is considered in context.
No. Medical clearance is performed separately by the fertility clinic.
A mental-health professional may discuss your emotional experiences during previous pregnancies, but medical-record review and medical qualification are separate parts of screening.
The evaluation explores expectations, boundaries, previous pregnancy experiences, and understanding of the surrogate role. It cannot—and should not—attempt to prove someone will experience no emotions.
Yes. Wanting to hold a baby she carried does not mean she failed psychological screening or misunderstands her role.
ASRM strongly recommends psychoeducational evaluation and counseling for egg donors.
No. Psychological testing evaluates the donor, informed consent, and relevant mental-health or psychosocial concerns. It should not be presented as a way to select inherited personality characteristics.
A donation can be structured as nonidentified, but lifelong anonymity cannot be guaranteed because of consumer DNA testing and genetic genealogy.
They should be. Current professional guidance recommends discussing disclosure, grief, genetic relationships, donor-conceived children’s interests, DNA identification, donor siblings, and future medical information.
Psychological preparation is still important. ASRM recommends a joint consultation even in directed or pre-existing relationships.
The next step depends on the reason. Sometimes additional information or support may be appropriate; in other cases the professional may recommend that the person not proceed.
Yes. Psychological support can be valuable throughout treatment, pregnancy, delivery, and postpartum recovery.
The purpose of psychological screening is not to divide applicants into:
normal
and
abnormal.
It is not about finding a surrogate who promises never to become emotional.
It is not about finding an egg donor with the “best personality.”
And it should not place every responsibility for the success of a journey on the woman providing the pregnancy or eggs.
Ethical third-party reproduction requires preparation from everyone.
The surrogate needs to understand what pregnancy for another family will ask of her.
Her partner or support person needs to understand how the journey may affect the household.
The intended parents need to understand the surrogate relationship, boundaries, communication, uncertainty, and medical autonomy.
The egg donor needs to understand the medical process and the long-term meaning of contributing genetic material.
Intended parents using donor eggs need to think about the future child—not merely the next IVF cycle.
That is what good psychological screening can accomplish.
At Simple Surrogacy, our team has worked with intended parents, surrogates, and egg donors since 2002. Many of us have firsthand experience as surrogates or donors ourselves.
We know that people do not enter these journeys as emotionless participants.
Nor should they.
The goal is to make sure they enter informed, supported, and prepared.
If you are considering becoming a surrogate, review our current Surrogate Requirements and How to Become a Surrogate guide.
If you are considering egg donation, review our current Egg Donor Requirements and Egg Donation Process.
If you are an intended parent, our Intended Parent Surrogacy Process explains how psychological consultation fits into screening and matching.
Psychological screening should not make you feel as though someone is trying to catch you saying the wrong thing.
It should help everyone ask the right questions before the journey begins.
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