If you are considering becoming a surrogate, a psychological evaluation is a normal and important part of the process. This guide explains, in plain language, what the evaluation is for, what a clinician may ask, how psychological testing fits in, how India’s requirements differ from professional guidance, and what can happen afterwards. It is written for prospective surrogates, their partners and families, and the professionals who support them. It offers general information and does not replace advice from your fertility clinic, legal adviser or treating professionals.
What is a surrogate psychological evaluation?
A surrogate psychological evaluation is a structured mental-health and psychosocial assessment. It is used to understand a prospective surrogate candidate’s readiness, current functioning, relevant history, support system, understanding of the surrogacy process, and the factors that may affect wellbeing during pregnancy and after delivery.
In most cases it combines a private clinical interview with psychological or psychometric assessment where appropriate. A clinician typically explores your mental-health history, reproductive history, motivation and understanding, relationships and support, coping, and any risk factors, and then documents the findings and recommendations in a report. The exact shape of the evaluation is not identical everywhere; it can vary with the referring clinic, the reason for the assessment and your individual circumstances. For a broader overview, see our guide to understanding psychological and psychiatric evaluations in fertility and surrogacy.
The evaluation is not about finding a “perfect” surrogate
A history of therapy, depression, anxiety, psychiatric treatment, medication or difficult life experiences does not automatically determine the outcome. A clinician looks at the whole picture, which can include diagnosis, severity, stability, treatment history, current symptoms, coping, insight, support, reproductive history, substance use and your individual context. Being open and honest helps far more than trying to give “perfect” answers.
Why the evaluation matters
Surrogacy is a significant physical, emotional and relational commitment. A psychological evaluation is there to support your wellbeing, to make sure your decision is informed and voluntary, and to identify any support that could help you before, during and after the pregnancy. It also helps the wider care team understand how best to support you.
The goal is care, not judgement. Thinking through motivation, expectations, support and coping in advance can make the experience safer and more positive for everyone involved. It is one careful step in a wider process rather than a hurdle designed to catch anyone out.
India: regulatory requirements
It is important to separate two different things: Indian law and regulation on one hand, and professional guidance from bodies such as ASRM on the other. They are not the same, and one does not replace the other.
Surrogacy in India is governed by the Surrogacy (Regulation) Act, 2021 and the associated Surrogacy Rules. In broad terms, the framework permits only altruistic surrogacy and sets eligibility criteria and official approvals. Under the current Indian regulatory framework, the surrogate mother’s eligibility requirements include a certificate of medical and psychological fitness for surrogacy and surrogacy procedures from a registered medical practitioner. This is why a psychological evaluation commonly forms part of the process.
Because regulations and clinic processes can be amended, the specific documentation, certificates and steps that apply to you should be confirmed with your treating fertility clinic and legal team rather than assumed from any single source. For an India-focused explanation, see our India-specific guide to surrogacy psychological evaluation. This page provides general information and is not legal advice.
ASRM professional guidance
ASRM is the American Society for Reproductive Medicine. Its recommendations are professional clinical and ethical guidance. They are widely respected internationally, but they are not Indian statutory law, and ASRM is not an Indian regulator.
ASRM guidance recommends that a prospective gestational carrier (and, where relevant, a partner) undergo psychosocial evaluation and counselling by a qualified mental-health professional. ASRM’s 2022 committee opinion describes psychological assessment of a gestational carrier as including a clinical interview, psychological testing and implication counseling. It also identifies areas such as psychiatric and reproductive history, substance use, relationships and support, motivation, autonomy, possible coercion and current mental status for consideration. Because these are recommendations rather than absolute rules, clinics may apply them alongside local legal requirements.
What the current regulatory framework requires
Surrogacy in India is regulated, and medical and psychological fitness of the surrogate is part of the official process. These are statutory requirements, and the exact documents should be confirmed with your fertility clinic and legal team.
What professional guidance recommends
ASRM guidance is professional clinical and ethical best practice, not Indian law. It recommends psychosocial evaluation and counselling as good practice, and clinics may follow it alongside local requirements.
What happens during the evaluation
A typical evaluation moves from referral, through the interview and any assessment, to a report. The clinician leads throughout; this is a considered clinical process, not an automated score.
Referral and booking
The evaluation usually begins with a referral from a fertility clinic or a direct booking. The purpose of the assessment and who has requested it are clarified at the start.
Background information
Relevant history and, where needed, records are gathered. You may be asked to bring identification, medical or reproductive history, and any documents the referring clinic requests.
Clinical interview
A private, conversational interview with a mental-health clinician explores your history, current wellbeing, understanding of surrogacy, support and expectations.
Psychological assessment
Where appropriate, structured psychological or psychometric measures may be used alongside the interview to add standardised information. Testing supports, and never replaces, clinical judgement.
Review of readiness and support
The clinician considers readiness, support systems, coping, reproductive history, substance use and other factors that may affect wellbeing during pregnancy and afterwards.
Report and next steps
The findings are documented in an evaluation report with recommendations. Exact report wording and next steps can depend on the referring clinic and current regulatory requirements.
The exact process can vary depending on the referring clinic, any legal or regulatory needs, your individual circumstances, and whether additional records or collateral information are needed. Your clinic or evaluator should explain what to expect in your case.
What does the evaluator actually assess?
The evaluation looks at several areas together. None of these is a checklist you can score yourself against, and no single item decides an outcome on its own. The clinician is building a rounded, individual understanding.
Mental-health history
Current and past symptoms, any diagnoses, therapy or psychiatric treatment, medication, and current functioning. A history of therapy or a past diagnosis does not by itself determine the outcome; what matters includes severity, stability, insight, coping and support.
Pregnancy and postpartum history
Previous pregnancies and births, any complications or loss, postpartum adjustment and mood, and how you feel about carrying a pregnancy for intended parents and about the period after delivery.
Motivation and understanding
Your reasons for considering surrogacy, your understanding of the process and its emotional and practical implications, and your ability to make an informed, considered decision. Compensation or personal circumstances are considered in context, not treated as pressure by default.
Support system
Practical and emotional support from a partner, family or others, help with childcare and daily life, work implications, and your ability to reach out for help during and after pregnancy.
Coping and resilience
How you have managed stress, health events and difficult experiences in the past, and the strategies and resources you can draw on during a surrogacy pregnancy.
Substance use
A neutral review of alcohol, tobacco, cannabis, other substances, and any misuse of medication, including current use and any past concerns or treatment. This matters for wellbeing, pregnancy safety and informed consent, not as a moral judgement.
Relationships and boundaries
Relationship stability where clinically relevant, how expectations with intended parents are understood, and comfort with the boundaries of a surrogacy arrangement.
Autonomy and informed choice
Whether the decision is voluntary, informed and understood, and free from inappropriate pressure or undue influence. This is about protecting your autonomy and informed decision-making.
Current mental-status factors
How you are functioning now, including mood, thinking and any current psychiatric factors that could affect wellbeing during pregnancy and the postpartum period.
Questions about alcohol, tobacco and other substances are a routine, neutral part of this, and they matter for wellbeing, pregnancy safety and the reliability of informed consent rather than as a moral judgement. For more detail on this area, see what substance-use screening in a surrogacy evaluation may involve.
Will I have to take a psychological test?
Sometimes. In addition to the clinical interview, some evaluations use structured psychometric or psychological instruments. The purpose is to add standardised information: for example, about psychological functioning, symptom screening, or areas that may need clarification.
Two things are worth knowing. First, testing supports the clinician and does not replace clinical judgement. Second, it is not a “lie detector”; it is a structured way of gathering information that the clinician then interprets in context. Whether any testing is used, and which measures, depends on the evaluation and the clinic.
Partner and support-person involvement
Depending on the clinic process, professional guidance and your circumstances, a spouse, partner or support person may also be involved in the evaluation or in counselling. This is because household support, shared understanding of the process, the impact on your relationships, and practical help all matter for a surrogacy pregnancy.
Involvement of a partner or support person is not universal, and whether it applies to you should be confirmed with the referring clinic. A supportive network is helpful, and the evaluation does not assume a single “correct” family structure.
What should you prepare?
Your clinic or evaluator will tell you exactly what is needed, and you do not need to arrange anything that has not been requested. Depending on the situation, preparation may include:
- • identification or referral information, where requested;
- • relevant medical and reproductive history;
- • mental-health treatment information, where relevant;
- • a list of any current medication;
- • previous psychological or psychiatric reports, if requested;
- • surrogacy or fertility documents from the referring clinic;
- • any questions or concerns you would like to raise;
- • a partner or support person, if you have been asked to bring one.
What happens in the interview?
The interview is a conversation, held in a private setting. The clinician will ask detailed questions about your history, wellbeing, understanding of surrogacy, support and expectations. There are no “perfect” answers to rehearse, and feeling nervous is completely normal.
Honesty and context matter more than polished answers, and you are welcome to ask questions or ask for something to be clarified at any point. The clinician may also ask for clarification where something is unclear. The aim is understanding, not catching anyone out.
Confidentiality and report sharing
The evaluation is clinical, but it is also carried out for a specific surrogacy and fertility purpose. That means relevant information is usually documented in an evaluation report and may be shared with the authorised referring party or clinic.
What is shared, and with whom, is guided by your consent, the clinic process, applicable law and the purpose of the evaluation. It is therefore more accurate to think of the evaluation as private and handled with care, rather than as a conversation that stays only between you and the clinician. If anything about how your report will be used is unclear, ask before the assessment so you understand it in advance.
In short
Your evaluation is private and handled with care, and it is also carried out for a specific surrogacy and fertility purpose, so relevant findings are usually documented in a report. Asking in advance how your report will be used is always reasonable.
Common concerns and misconceptions
A few worries come up often. Here is a plain, honest view of each.
Common concern
A history of depression or therapy
What it means
A history of depression, anxiety or therapy does not automatically disqualify you. The clinician considers the individual picture, not a single label.
Common concern
Questions about substance use
What it means
These are routine, neutral clinical questions, and past use does not automatically rule anyone out.
Common concern
Feeling nervous
What it means
Nervousness is expected and does not by itself count against a candidate.
Common concern
Worrying about being caught out
What it means
The evaluator is not trying to trap you. The goal is understanding and wellbeing.
Common concern
If the evaluator has concerns
What it means
This may lead to a request for more information, a recommendation for support, or further discussion, rather than an automatic ending.
The important principle is that this is not a “pass or fail” test with trick questions. It is a careful, respectful assessment focused on your wellbeing and informed choice.
What happens after the evaluation?
After the assessment, the clinician documents the findings and recommendations. Rather than a simple pass or fail, there are several possible outcomes, for example:
The evaluation is completed with no major psychological concern identified.
Additional information or records are requested.
Further assessment or clarification is recommended.
A concern is identified that would be helpful to address before proceeding.
The evaluator concludes that proceeding is not currently recommended.
The exact report wording, any suitability categories, and the next steps can depend on the referring clinic, current regulatory requirements and the evaluator’s findings. Importantly, the psychological evaluation is one part of a wider medical and legal process. On its own it does not guarantee medical eligibility, legal eligibility, clinic acceptance or final approval to proceed; those are decided within the broader surrogacy pathway.
Surrogacy psychological evaluations at ReACH Psychiatry in Bangalore
At ReACH Psychiatry, surrogacy psychological evaluations are carried out as a structured, clinician-led assessment. This can include a mental-health and psychosocial review, psychometric assessment where appropriate, a review of support, motivation and readiness, and a written report prepared for the surrogacy and fertility purpose. ReACH offers evidence-based, careful and respectful assessment as part of its psychiatric and psychological services.
Clinic
ReACH Psychiatry & Counselling Centre
319, 7th Main Road, CMR Main Road
HRBR Layout 2nd Block, Kalyan Nagar
Bengaluru, Karnataka 560043
How to begin
Evaluations are usually arranged through a referral or a direct booking. You can learn more about the surrogacy psychological evaluation services at ReACH or book an appointment below.
Frequently asked questions
What is a surrogate psychological evaluation?
It is a structured mental-health and psychosocial assessment that helps understand a prospective surrogate candidate’s readiness, current wellbeing, relevant history, support system and understanding of the surrogacy process, along with factors that may affect wellbeing during pregnancy and after delivery. It usually combines a clinical interview with psychological assessment where appropriate.
Why is a psychological evaluation part of surrogacy in India?
Under the current Indian regulatory framework, surrogacy is regulated and a certificate of medical and psychological fitness for the surrogate is part of the process. Professional guidance also recommends psychological evaluation as good practice. The exact documents required should be confirmed with your fertility clinic and legal team, as rules and clinic processes can change.
Does a history of depression automatically disqualify me?
No. A past diagnosis or treatment does not by itself decide the outcome. A clinician looks at the individual picture, which can include severity, stability, current symptoms, treatment history, coping, insight and support, rather than a single label.
What if I have been to therapy?
Having attended therapy is not a problem in itself, and for many people it reflects self-awareness and healthy help-seeking. The evaluator is interested in your overall wellbeing and readiness, not in penalising you for seeking support.
Will I be asked about alcohol or substance use?
Most likely yes, as a routine and neutral part of the assessment. Questions may cover alcohol, tobacco, cannabis, other substances and any misuse of medication. This information matters for wellbeing, pregnancy safety and informed consent, and past use does not automatically rule anyone out.
Will my partner be interviewed?
Sometimes. Depending on the clinic process, professional guidance and your circumstances, a partner or support person may be involved in the evaluation or in counselling, because household support and shared understanding matter. Whether this applies to you should be confirmed with the referring clinic.
Will I have to take a psychological test?
Sometimes. Some evaluations use structured psychological or psychometric measures alongside the interview to add standardised information. Testing is not a lie detector and does not replace the clinician’s judgement.
What if I feel nervous during the interview?
That is completely normal, and it does not count against you. There are no perfect answers to rehearse. The interview is a conversation, honesty and context matter more than polish, and you can ask the clinician questions at any point.
What happens if the evaluator has concerns?
Concerns do not automatically mean the process ends. The clinician may request additional information, recommend further assessment or support, or, in some situations, conclude that proceeding is not currently recommended. Any concerns are discussed respectfully and framed around wellbeing.
Is the evaluation confidential, and does completing it mean I am approved?
The evaluation is clinical, but it is carried out for a specific surrogacy purpose, so relevant findings are usually documented in a report and shared with the authorised referring party according to your consent, the clinic process and applicable law. Completing the psychological evaluation is one part of a wider medical and legal process; on its own it does not guarantee medical eligibility, legal eligibility or final approval to proceed.
Guidelines & further reading
View the guidelines and sources used in this guide
This guide draws on Government of India regulatory sources, ASRM professional guidance, and peer-reviewed and authoritative professional sources.
- [1]Government of India. The Surrogacy (Regulation) Act, 2021 (India Code). Source
- [2]Ministry of Health and Family Welfare, Government of India. The Surrogacy (Regulation) Rules, 2022 and subsequent amendments. Source
- [3]Department of Health Research / National Surrogacy Board, Government of India. Official surrogacy information and forms. Source
- [4]Ethics Committee of the American Society for Reproductive Medicine. Consideration of the gestational carrier: an Ethics Committee opinion. Fertility and Sterility. Source
- [5]Practice Committee of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. Recommendations for practices using gestational carriers: a committee opinion. Fertility and Sterility. Source
- [6]American Society for Reproductive Medicine, Mental Health Professional Group. Guidance on psychosocial evaluation and counselling of gestational carriers. Source
- [7]Jadva V, et al. Surrogacy: the experiences of surrogate mothers and the psychological wellbeing of surrogates (peer-reviewed literature). Source
- [8]National Institutes of Health / peer-reviewed reviews on the psychological evaluation and screening of gestational carriers. Source
This page is for general education and does not constitute legal advice or a treatment recommendation for any individual. Current surrogacy requirements, documentation and next steps should be confirmed with your fertility clinic, legal adviser and treating professionals.