The surrogacy journey is built on a unique foundation of trust. Before a surrogate and intended parents are matched, several evaluations take place to ensure everyone is protected physically, emotionally, and legally. One of the most important, yet often misunderstood, parts of this process is the substance use screening during the psychological evaluation.
While the word screening can feel intimidating or even clinical, its purpose is actually quite simple: to ensure a safe environment for the surrogate, the intended parents, and the future child. This blog aims to demystify this part of the evaluation so you can approach it with confidence and clarity.
In the world of assisted reproduction, the goal is always a healthy pregnancy and a healthy baby. Medical professionals and psychologists work together to minimize risks. Substance use screening is a standard requirement because it ensures that a surrogate’s body and mind are in the best possible condition to support a complex medical journey.
Beyond the physical health of the pregnancy, this screening helps clinicians understand a surrogate’s lifestyle and how she manages stress. For intended parents, knowing that a thorough screening has taken place provides essential peace of mind as they entrust a surrogate with their deepest hopes.
During the psychological evaluation, a mental health professional will lead a conversation about your lifestyle and history. This isn't an interrogation; it is a clinical interview designed to get a full picture of your health and habits.
You can expect questions about:
The psychologist looking for patterns. They want to understand if substances play a significant role in your daily life or if they were part of a distant, unrelated past.
One of the biggest fears prospective surrogates have is that a mistake from their younger years will disqualify them. It is important to know that psychologists make a clear distinction between past experimentation and problematic use.
Trying a substance once in college years ago is viewed very differently than a recent or ongoing struggle with dependency. Psychologists look at the context: How long ago did it happen? Was it a one-time event or a habit? What has changed in your life since then? In many cases, a history of experimentation that is long in the past and has not recurred will not prevent you from moving forward.
Transparency is the most valuable currency in surrogacy. Being upfront about your history even the parts that feel uncomfortable actually works in your favor. When you are honest, it demonstrates maturity, integrity, and your ability to be a reliable partner in the process.
If a psychologist discovers a history of substance use that wasn't disclosed during the interview, it raises questions about honesty and the ability to communicate openly during the pregnancy. On the other hand, discussing a past challenge and how you overcame it can actually show resilience and self-awareness, which are excellent traits for a surrogate.
It is natural to wonder who sees the notes from these sensitive conversations. While the evaluation is part of a professional process, there are strict parameters regarding your privacy.
The psychologist typically writes a summary report. Instead of listing every detail of your past, they provide a clinical assessment of your readiness. They will indicate if you meet the professional guidelines for surrogacy or if there are areas that require further discussion. This report is shared with the surrogacy agency and the fertility clinic to assist with medical and legal clearance. Your private stories remain private; the focus is on the conclusion of your eligibility.
Not every "yes" in a substance use screening leads to a disqualification. If a concern arises, the psychologist may simply recommend further assessment. This could mean a follow-up conversation or a request for more information from a previous healthcare provider to ensure you are in a stable place.
Disqualification usually only occurs if there is evidence of current, active substance abuse, a very recent history of dependency without a stable period of recovery, or if the use of a substance would pose a direct medical risk to a pregnancy. The goal is never to catch someone in a lie, but to ensure that the timing is right for such a significant undertaking.
The psychological evaluation does not happen in a vacuum. It is integrated with your physical medical screening and your legal contracts. Once the mental health professional provides their assessment, it helps the medical team finalize your protocol and helps the legal team ensure the contracts reflect a clear understanding of health expectations.
This multi-step approach ensures that by the time you reach an embryo transfer, every person involved surrogate, intended parents, and professionals is on the same page and fully supported.
As you look toward your evaluation, remember that this process is meant to support you, not judge you. You are doing something incredibly brave and generous by considering surrogacy. This screening is simply a way to make sure that the foundation you are building with the intended parents is as strong and healthy as possible.
Think of it as a moment to check in with yourself and confirm that you are truly ready for this amazing chapter. Your honesty and your health are the best gifts you can bring to the table.