The American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology make a very strong recommendation that both surrogate candidates and egg donors undergo a psychological screening before being cleared. Hence, most reputable clinics or agencies that work in this field require their egg donors or surrogate candidates to do just that. Think about it for a second. If you were someone in the market for securing an egg donor, wouldn’t you want that individual to be screened for a history of mental illness? And for “open donors,” contact between the child and the egg donor is legally allowed once the child reaches 18 years of age, suggesting that a future, long-term relationship might transpire. Any thoughtful potential parent will want to know the mental health history of the individual whose genetics will be forever embedded in their child, as well as knowledge of their socio-emotional capabilities. The genetics of that person will be forever a part of one’s family. Likewise, when it comes to choosing a gestational surrogate, the potential impact of the relationship between the gestational carrier and intended parent should be explored, as well as any plans that may exist relating to disclosure and future contact. Although the genetics of the surrogate are not at play here, their family and socio-emotional world is. The environment within which the growing fetus/baby is developing includes not just the physical world of the carrier’s uterus but also the psychological, emotional, spiritual, and social components as well. For example, a review of research on prenatal depression effects on the fetus and newborn suggests that they experience prenatal, perinatal and postnatal complications. Fetal activity is elevated, prenatal growth is delayed, and prematurity and low birth-weight occur more often. Being a gestational surrogate is serious business and the candidate needs to be screened carefully. At the same time, it is important to keep in mind that egg donors and surrogates provide a useful and life changing service. For intended parents who cannot have children the traditional way, these individuals provide something that otherwise would not occur and that’s pretty cool!