In a utopian world, we wouldn't need egg donors, sperm donors, or surrogates because no one would have a use for them. But our reality is not utopia. Donation and surrogacy are methods that allow for family building no matter what your circumstances are. Through technology, same sex couples can have a biologically related offspring, rather than only have the sole choice of adoption. People who have found love later in life can have a family too. Or people who had the surprising diagnosis of infertility now have opportunities to realize their dream of biological children.

Since these avenues exist, do you know what you are getting into? Standards exist for screening egg donors and gestational surrogates. These standards are continuously being scrutinized and considered by members of the American Society for Reproductive Medicine (ASRM). But not everyone adheres to these standards. For example, how old should an egg donor be? 18? 20? In fact, ASRM recommends that an egg donor be at least 21-years-old in order to donate. This enables the donor to have a true ability to consent and think through possible implications for donating.

Who can screen donors and surrogates? This can differ depending on which state you live in. In Maryland, only licensed psychologists and certain counselors with appropriate training are allowed to administer psychological measures to look at personality functioning. Typically, one of two tests are used, and each are multiple choice. These tests are able to look at if someone is trying to "game" the test, but like anything, tests are not a perfect measure. In addition to a psychometric test, potential donors and surrogates will be subjected to a clinical interview. This is a structured interview that explores motivation for donating (or becoming a surrogate), informed consent, understanding of what is involved, knowledge of possible risks, and exploring feelings, supports, or other areas that might come up. Typically, these interviews can can as short as a single hour, or they can take several hours to complete.

The licensed mental health professional will then write up their findings. In many places, the mental health professional is part of a team and doesn't have the sole role of "gatekeeper." The team will make a determination about who might be able to withstand the emotions of surrogacy or can handle the ups and downs of treatment for egg donation. Typically, this screening is an additional expense. For agencies that are seeking donors, they might cover the cost of the evaluation.

As an intended parent, you can make sure that the report is written by a licensed professional. All states have licensing boards that govern those practicing within the state. You can always call a given Board to ascertain that the evaluator has a license in good standing. Know that the tests are not valid if given by email or over the phone. When talking to an agency, make sure to ask them about their screening procedures. If they don't screen, this might be a red flag in terms of corners that they are cutting.