Surrogacy screening: What do infectious disease tests actually tell you?
Becoming a surrogate involves medical appointments, health history reviews and laboratory testing. One important part of this process is infectious disease screening.
These tests help your fertility team identify infections, assess whether additional care is needed and plan treatment with your health in mind. But receiving a result marked “positive” can raise questions especially when different tests measure different things.
In an educational video, Dr. Bradford Kolb of HRC Fertility discusses why infectious disease screening matters for surrogates, intended parents and egg or sperm providers.
What Is Infectious Disease Screening in Surrogacy?
Infectious disease screening combines a review of relevant medical history with laboratory testing to help identify infections that could affect treatment or pregnancy.
For a gestational surrogate, testing commonly includes HIV, hepatitis B, hepatitis C and syphilis, along with other tests recommended by the fertility clinic. Your clinic determines the appropriate screening and timing for your circumstances.
Screening also involves the people providing the eggs and sperm. Reviewing everyone’s results helps the medical team make informed treatment decisions and recommend precautions where needed.
Why Do Surrogates and Egg or Sperm Providers Have Different Testing Requirements?
You may hear your clinic distinguish between routine clinical testing and FDA donor testing.
The U.S. Food and Drug Administration (FDA) regulates donated reproductive tissue, including eggs and sperm. Applicable donor requirements address medical history, infectious disease testing and other eligibility considerations. Requirements and exceptions depend on how the reproductive tissue will be used.
This means a surrogate and an egg or sperm provider may undergo different testing procedures, even when some of the infections being assessed overlap.
Your clinic can explain which requirements apply to your journey and why a particular test is needed.
Does a Positive Result Always Mean an Active Infection?
No. The meaning depends on the specific test and the combination of results.
Some tests look for antibodies, which are part of your immune response. Others look for components of a virus or its genetic material. A result may reflect vaccination, a previous infection or a current infection, depending on what was measured.
This is why a result marked “positive” should be reviewed with your medical team before you draw conclusions about your health or surrogacy eligibility.
What Do Hepatitis B Antibody Results Mean?
Hepatitis B testing provides a useful example of why the test name matters:
Hepatitis B surface antibody (anti-HBs) can indicate immunity after vaccination or recovery from a previous infection.
Hepatitis B core antibody (anti-HBc) generally indicates previous or ongoing infection; vaccination alone does not produce this antibody.
Hepatitis B surface antigen (HBsAg) generally indicates a current infection.
Clinicians interpret these markers together. A positive surface antibody result is therefore very different from a positive surface antigen result.
If you are unsure whether you are immune to hepatitis B, ask your clinic to review your results and vaccination history.
What Does a Positive CMV Result Mean?
CMV, or cytomegalovirus, is another infection discussed in the video.
A positive CMV IgG antibody result indicates infection at some point in the past. By itself, it does not establish when the infection occurred or whether there is a recent active infection.
Other results and clinical information may be needed to understand the situation. Your clinic should explain how a surrogate’s or donor’s CMV results affect the proposed treatment plan.
What If an Intended Parent Has HIV or Hepatitis?
An intended parent’s chronic infection calls for an individual medical assessment.
Depending on the infection and circumstances, care may involve antiviral treatment, specialist consultation, laboratory precautions, a review of the surrogate’s immunity or additional preventive measures.
For HIV, treatment that achieves and maintains viral suppression is an important part of care. However, “undetectable” does not mean someone has become HIV-negative. The fertility team should explain the specific implications for the proposed treatment.
As a surrogate, you should receive clear information about relevant risks, recommended precautions and your options before consenting. Your questions and comfort with the proposed plan matter.
ASRM’s ethical guidance recognises a gestational carrier’s right to be fully informed about the risks of the process.
Does Screening Eliminate Every Risk?
Screening is an important way to identify concerns and reduce avoidable risks. It cannot guarantee a risk-free treatment or pregnancy.
Results must be considered alongside medical history, possible recent exposures and any recommended follow-up testing. Your clinic may also explain whether testing needs to be repeated before treatment.
The goal is to make informed decisions with appropriate medical support—not simply to complete a checklist.
What Should Surrogates Ask Their Fertility Clinic?
Before moving forward with treatment, consider asking:
Which infections am I being tested for?
Does this result indicate immunity, a past infection or a current infection?
Do I need follow-up testing or vaccinations?
Are there infection-related considerations for my proposed match?
What additional precautions would you recommend, and why?
Who can explain my results if I have questions after this appointment?
You do not need to understand every laboratory abbreviation before your appointment. You deserve an explanation in language that makes sense to you.
Learn More About Screening Before Becoming a Surrogate
Understanding medical screening can help you approach your surrogacy journey with greater confidence. A conversation with your fertility team can turn an unfamiliar laboratory report into a clear explanation of what happens next.
At ACRC Surrogacy, we encourage prospective surrogates to ask questions and understand the medical steps involved in their journey.
Interested in becoming a surrogate? Complete ACRC’s initial interest form to connect with our team and learn about the next steps.
Medical disclaimer: This article provides general educational information and accompanies the linked video. It does not replace personalised medical advice or reproduce every statement made in the video. Screening requirements, result interpretation and treatment recommendations depend on individual circumstances. Consult your fertility specialist about your results and care.
Video credit: Dr. Bradford Kolb, HRC Fertility.
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