What the Surrogacy Psychological Evaluation Actually Covers

A surrogacy psychological evaluation is a readiness and informed-consent step, not a pass/fail exam. Surrogate Alternatives refers surrogates to Dr. Steven Covelluzzi, an independent psychologist, for this evaluation; he is not employed by Surrogate Alternatives, and Surrogate Alternatives does not take part in the clinical evaluation itself. This post walks through exactly what happens during that appointment: what Dr. Covelluzzi assesses, whether standardized testing is involved and how long the process takes. For the fuller picture of why psychological preparation matters and how matching compatibility works, see <a href="/blog/psychological-preparation-surrogacy">Diana Olmeda's companion post on psychological preparation</a>.

Why ASRM Recommends a Psychosocial Evaluation for Every Candidate

ASRM recommends a psychosocial evaluation because gestational surrogacy carries major medical, legal, financial and emotional stakes, and confirming readiness before an embryo transfer reduces the risk of problems later. The American Society for Reproductive Medicine (ASRM)'s 2022 Practice Committee guidance covers medical screening, psychosocial evaluation, psychoeducational counseling and legal counseling for both carriers and intended parents. Psychosocial consultation is recommended for all gestational carrier candidates, while testing is recommended only when appropriate.

This guidance is the leading U.S. professional framework, though it is guidance rather than a federal law or universal licensing rule. Once Surrogate Alternatives makes the referral, intended parents and the surrogate each meet with Dr. Covelluzzi separately, and a joint session later brings both sides together.

What Does a Surrogate Psychological Evaluation Actually Assess?

A surrogate psychological evaluation assesses motivation and informed consent, mental health and coping history, family and support system and understanding of boundaries and relationships. Why the candidate wants to become a gestational carrier, whether she understands the medical, contractual, financial and emotional demands and whether the decision is voluntary all factor into that first area.

The interview also addresses mental health and coping history: prior counseling or treatment, trauma, anxiety or depression, substance use and coping tools. A past diagnosis does not automatically disqualify someone; evaluators weigh stability, treatment and current functioning. A 2025 Ontario cohort study found that carriers were more likely to receive a new mental-illness diagnosis during and after pregnancy than comparison groups, which supports the case for meaningful screening and ongoing support rather than suggesting carriers are unfit.

The remaining areas cover a candidate's family and support system and her understanding of boundaries: communication with intended parents, privacy, medical decision-making, the carrier's role before, during and after birth and the emotional transition after delivery. The goal is identifying whether expectations are compatible and thought through before a legal agreement and embryo transfer. These questions apply to the surrogate's own household, separate from the joint compatibility conversation between the surrogate and intended parents.

The intended parents' own evaluation with Dr. Covelluzzi is different in focus: it centers on mental, emotional and financial readiness rather than the areas above. He discusses any past infertility and how the intended parents have processed it, to confirm they are mentally prepared to have someone else carry a child for them.

Do Surrogates Have to Take a Personality Test?

Yes, though it is only one piece of a broader assessment. Some programs use a standardized self-report personality measure such as the MMPI, a longstanding personality inventory, or the PAI. A peer-reviewed review found a consistent structure, pairing a clinical interview with one objective personality inventory across most programs.

For surrogates referred through Surrogate Alternatives, standardized testing is part of Dr. Covelluzzi's evaluation; the intended parents' evaluation is interview-based, focused on readiness rather than a personality inventory. He interprets a PAI or MMPI result alongside the interview, history, context, medical screening and professional judgment, not as a pass/fail exam on its own. That same principle applies across the industry: no single test result stands alone.

How Long the Evaluation Actually Takes

There is no single industry-wide duration. Published examples show meaningful variation: roughly 90-minute interview, or a three-hour structured interview plus PAI administration, with the personality assessment often taking about an hour on its own. The evaluator typically issues a written report to the clinic, agency or intended parties afterward. The clinician does not promise a set number of days to a decision, since that depends on the evaluator and whether follow-up is needed.

What Happens After a Surrogate's Psychological Evaluation?

What happens after a surrogate's psychological evaluation depends on two things: who reviews the findings, and what Dr. Covelluzzi identifies. Surrogate Alternatives does not provide a copy of the evaluation to either the intended parents or the surrogate, and does not review the results with them directly, since the clinical evaluation is performed and interpreted solely by Dr. Covelluzzi, not by Surrogate Alternatives.

He shares a summary of the findings with Surrogate Alternatives and the IVF clinic, and Surrogate Alternatives uses that summary to decide whether to move forward with the match. An issue from years earlier that the surrogate has already worked through usually does not stop the process. A current or ongoing concern that suggests she is not ready for the emotional demands of surrogacy can lead Dr. Covelluzzi to recommend she wait and reapply in a year or two.

Talk to Surrogate Alternatives About the Screening Process

A free, no-obligation consultation answers these questions directly. Surrogate Alternatives coordinates medical screening and psychological evaluation after matching, so prospective surrogates know exactly what to expect before they apply. For more on how psychological preparation supports a strong match, see Diana Olmeda's companion post.