What are the ASRM Guidelines and Why Do They Matter?

Author: GSHC Surrogacy


While navigating the world of surrogacy and throughout your surrogacy journey, you may hear the term “ASRM Guidelines” being used frequently, both by fertility clinics and by agencies. But what exactly are the ASRM guidelines and why do they matter?

The ASRM is the American Society for Reproductive Medicine, which is an organization dedicated to the advancement of the science and practice of reproductive medicine. Its members are made up of top fertility experts from all over the world. These experts created a set of guidelines for the use of a gestational carrier, and many fertility doctors, or “Reproductive Endocrinologists”, use these guidelines in their acceptance of a potential gestational carrier as a patient. These guidelines were created after years of study and deliberation, to determine the gestational carrier standards by which the best chance of a safe and successful pregnancy may be achieved.

What are the guidelines?

So, what exactly are these guidelines? The following are the suggested gestational carrier requirements as put forth by the ASRM:

  • Gestational carriers should be of legal age, and preferably between the ages of 21-45 years.
  • A gestational carrier should have carried at least one, term, healthy pregnancy without complications.
  • Ideally, a gestational carrier should have had no more than FIVE prior pregnancies, and no more than THREE cesarean section deliveries.
  • A gestational carrier should have a stable home environment with adequate support to help her cope with the added stresses of pregnancy.
  • A gestational carrier should be able to pass a psychological evaluation which will include a clinical evaluation and occasionally, psychological testing.
  • Before acceptance, the potential gestational carrier should undergo a complete medical evaluation by a qualified medical professional and be cleared for pregnancy before being considered.
  • A gestational carrier should not have had a tattoo or piercing within the past 12 months.
  • A gestational carrier AND her partner must not be users of illicit drugs and marijuana or abusers of alcohol.
  • A gestational carrier should be a non-smoker.
  • Additionally, many reproductive endocrinologists maintain that a gestational carrier should have a Body Mass Index (BMI) of <30, although this requirement varies from clinic to clinic and doctor to doctor.

Disqualifications for a gestational carrier as set forth by the ASRM

Absolute rejection criteria include:

  • Cognitive or emotional inability to comply or consent
  • Evidence of financial or emotional coercion
  • Abnormal psychological evaluation/testing as determined by the qualified mental health professional
  • Unresolved or untreated addiction, child abuse, sexual abuse, physical abuse, depression, eating disorders, or traumatic pregnancy, labor and/or delivery
  • History of major depression, bipolar disorder, psychosis, or a significant anxiety disorder
  • Current marital or relationship instability
  • Chaotic lifestyle, current major life stressor(s)
  • Inability to maintain a respectful and caring relationship with Intended Parent(s)
  • Evidence of emotional inability to separate from/surrender the child at birth

Relative rejection criteria include:

  • Failure to exhibit altruistic commitment to become a gestational carrier
  • Problematic personality disorder
  • Insufficient emotional support from partner/spouse or support system
  • Excessively stressful family demands
  • History of conflict with authority
  • Inability to perceive and understand the perspective of others
  • Motivation to use compensation to solve own infertility
  • Unresolved issues with a negative reproductive event


Many agencies and fertility clinics already follow these general requirements for selecting viable candidates to be gestational carriers; however, these are still only guidelines and some institutions may have requirements that vary slightly from the ASRM-suggested list. One thing that is a commonality across the board is that these guidelines and requirements are in place to ensure, as much as possible, the safety and wellbeing of both the potential gestational carrier and the baby she will be carrying.


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