Can You Be a Surrogate With HPV, HSV or Another STI?

Yes—past genital herpes, HPV, or a treated infection such as chlamydia does not automatically rule you out as a surrogate. What matters is whether you have symptoms or an active infection now, whether treatment and follow-up are complete, what your cervical tests show, and how earlier pregnancies went. The fertility clinic makes the medical decision after reviewing those details. At LittleBee, I’d start by helping you explain your history clearly, including the part you feel nervous about putting on the form.

You may be reading this after the kids are asleep, wondering whether an old diagnosis closes a door you were ready to open. Start with the section that matches your history. HSV, HPV and other sexually transmitted infections need different questions answered.

Does a past HSV diagnosis rule me out?

A genital herpes diagnosis from years ago is different from having genital sores today. ¹ That distinction is useful if your infection has been quiet, because HSV stays in the body even when you have no symptoms. ²

You don’t have to remember every appointment to explain your history. Start with roughly when you were diagnosed, whether it was genital or oral herpes, when symptoms last appeared, and what treatment you used. Include how it was managed during your pregnancies. I’d help you put those details in order so you don’t have to begin the same difficult explanation every time someone asks for another piece of information.

Nina had that same worry when she started considering surrogacy.

She was diagnosed with genital herpes before her second pregnancy. Years had passed since her last outbreak, and both her children had been born safely. Still, the STI question on the application made her hesitate: would writing “HSV” mean the conversation ended there? The clinic asked about her diagnosis, recent outbreaks, treatment and previous births. Her old delivery notes helped answer those questions. She also received a plan for what would happen if symptoms returned during pregnancy.

For Nina, the conversation moved from a frightening label to the care another pregnancy might need. If you recognize that hesitation, the table below can help you find the information that fits your own history.

The pregnancy and testing sections below explain what those findings can mean. For the other parts of the evaluation, our medical screening guide explains the tests and appointments.

How is herpes managed during pregnancy and birth?

With recurrent genital herpes—or infection acquired in the first half of pregnancy—CDC puts the risk of newborn infection below 1%. ³ That is the group most relevant to someone whose diagnosis predates a future surrogacy pregnancy, like Nina. CDC gives a much higher range, 30%–50%, when genital herpes is acquired near delivery. ³ The two estimates describe different groups of pregnancies, rather than an exact prediction for yours.

The difference is why your earlier history matters. A longstanding infection and a new infection close to birth need different care. CDC recommends specialist involvement when genital HSV is acquired in the second half of pregnancy. ³ Tell your pregnancy care team about any new sores or symptoms, even if earlier pregnancies went smoothly.

For recurrent genital herpes, antiviral suppression late in pregnancy can reduce outbreaks at term and the need for a C-section because of an outbreak. It cannot prevent every newborn infection. ³ Ask your doctor how your outbreak history affects the medication and birth plan for this pregnancy. If you already take medication regularly, our medication and surrogacy guide explains what to include in that history.

Having HSV does not mean you must always have a C-section. At labor, the team asks about symptoms and checks for genital lesions. Under CDC guidance, vaginal birth is possible when there are no genital lesions or warning symptoms, called prodrome. Pain or burning before a sore appears can be a warning symptom. Recurrent genital lesions at labor call for a C-section to reduce newborn exposure, although surgery does not eliminate transmission risk. ³

There is also a first-episode exception: ACOG says a C-section may be offered for a primary or nonprimary first genital HSV episode in the third trimester because viral shedding may continue. ⁴ That is different from assuming every woman with an old diagnosis needs surgery.

I can help you bring your earlier pregnancy care notes into the conversation. The goal is for your obstetric team to know the history before labor, when there is less time to sort it out.

Can I be a surrogate with HPV or an abnormal Pap result?

HPV itself and an abnormal Pap result tell the team different things: an HPV test looks for high-risk virus, while a Pap test looks for changes in cervical cells. ⁵ A positive HPV result can therefore come with a normal Pap result. An abnormal Pap result also does not, by itself, mean you have cancer. ⁶

If all you remember is “my Pap was a little abnormal,” I’d help you find the report. That wording leaves out what the gynecologist found and what happened next. You may have been advised to repeat screening, have a colposcopy to examine the cervix more closely, or have a biopsy. A biopsy examines tissue and can report cervical intraepithelial neoplasia, or CIN. The follow-up depends on the findings and your earlier results. ⁵

An unsatisfactory Pap is different again: the sample could not be assessed adequately. It needs repeat screening. ASCCP also cautions that a negative HPV result obtained with an unsatisfactory cell sample should not be treated as valid reassurance. ⁷ If that is the wording on your report, an unfinished test still needs attention.

Past treatment belongs in the discussion too. If you had a LEEP—a procedure that removes abnormal cervical tissue—or a cone biopsy, include the procedure and follow-up results. ACOG explains that most women have no pregnancy problems after LEEP, but premature birth and a low-birth-weight baby are possible risks. ⁸ Those details help the team review another pregnancy alongside the cervical findings.

A newly positive HPV test after earlier negative tests can feel confusing. NCI explains that HPV can become active again after many years, so the result does not necessarily mean a new infection. ⁵ Your useful next step is to complete the follow-up already recommended and bring the latest HPV, Pap and any biopsy or procedure reports together. Avoid reducing several different findings to a single “HPV positive” label.

What if I had another STI—or a positive HIV or hepatitis test?

A treated infection such as chlamydia can be reconsidered after treatment and retesting; HIV and hepatitis B or C fall under different restrictions. ¹

For syphilis, gonorrhea or chlamydia, ASRM recommends treatment, retesting and postponing consideration as a gestational carrier until successful treatment is documented and the person is no longer considered infectious. ¹ Finishing an antibiotic prescription is only part of that answer. The follow-up shows the team what happened after treatment.

Partner care matters for these infections too: treatment of sexual partners helps prevent reinfection. ⁹ If you had treatment years ago, say which infection it was and whether follow-up was completed. If an infection is active now, address it before trying to arrange a transfer. I’d help you identify the missing result or treatment information so you know what to look for when the clinic asks for more information.

Syphilis tests can be especially confusing after treatment. Some antibodies can remain positive for years, while the treatment history and other test results help clinicians judge whether infection is present. ¹⁰ A positive result needs the appropriate interpretation; it is not something you should try to clear up by leaving it off the form.

For confirmed HIV or hepatitis B or C results, ASRM generally recommends that the person should not serve as a gestational carrier. Its guidance says exceptions require careful counseling, informed consent and risks documented in the medical record. ¹ That is a significant restriction. If this is your result, ask whether the clinic considers exceptions at all before investing more time in an application. The answer concerns the pregnancy and carrier arrangement, not your worth or the care you deserve.

The exact hepatitis result matters. A reactive hepatitis C antibody can reflect current infection, a past resolved infection or a false-positive result; RNA testing identifies current infection. ¹¹ Hepatitis B surface antibodies can indicate immunity after vaccination or recovery and are different from the surface antigen used to identify infection. ¹² The clinician needs to interpret the complete panel before discussing what those results mean for your application.

State-specific guidance can be stricter. In New York, the state’s gestational surrogacy guidelines list an HIV diagnosis and laboratory-confirmed hepatitis B or active/untreated hepatitis C among clinical factors for absolute rejection. ¹³ If you are considering an arrangement there, that New York guidance needs to be part of the initial conversation.

Which infection tests will my partner and I need?

ASRM recommends infectious-disease testing for you and your partner before embryo transfer, even if neither of you has symptoms. ¹ Plan for both appointments when you are arranging work and childcare; a test from an earlier pregnancy may not be the test requested for this journey.

The ASRM list includes:

• HIV antibody testing for HIV-1, HIV-2 and group O, plus nucleic acid testing for HIV, hepatitis B and hepatitis C;
• hepatitis B surface antigen and core antibodies, and hepatitis C antibodies;
• syphilis blood testing;
• gonorrhea and chlamydia nucleic acid testing, using urine or a cervical or urethral swab;
• HTLV-1/HTLV-2 and CMV antibody testing for a male partner only in this list. ¹

These recommendations concern gestational carriers and their partners. FDA’s reproductive-tissue donor requirements concern donated eggs and sperm. ¹⁴ ASRM specifically notes that FDA does not require carrier screening or testing for infections transmissible to the fetus, while ASRM recommends this testing. ¹ The donor rules and your carrier evaluation are different requirements.

You may wonder why herpes is not automatically in that list. CDC does not recommend routine herpes testing for people without symptoms in most situations, including routine blood screening during pregnancy. ³ Asking for “all STI tests” may or may not include a herpes blood test. ¹⁵ If HSV is already part of your history, tell the team directly. A standard panel cannot communicate everything you know about earlier symptoms and diagnoses.

If an unexpected HSV blood result is the issue, FDA warns that HSV-2 tests can produce false reactive results and recommends confirmation of reactive results according to test instructions and professional guidance. ¹⁶ Bring the full report rather than just the word “positive.”

I can help you sort out which earlier results you have and which appointments the clinic is requesting. Once pregnant, you will still need prenatal screening: CDC recommends HIV, hepatitis B, hepatitis C and syphilis testing during each pregnancy. ¹⁷ Our surrogacy screening guide explains the broader sequence.

Who will see my results, and when should I tell the team?

Your clinic needs the relevant medical information, and the intended parents need information pertinent to the carrier arrangement before treatment. ASRM recommends a medical release allowing the fertility clinician to share relevant information with everyone involved. ¹ You can ask what will be shared before you send the results.

You may feel comfortable telling the doctor and still want to know who else will hear about the diagnosis. Before you sign, check which records the form covers, who may send and receive them, and when permission ends. ¹⁸ A release can allow sharing of your entire medical record if it is written that way. ¹⁹ If you expected to share only an STI result, ask the coordinator to explain the wider wording before you sign.

California, for example, sets rules for when medical information may be shared and what a written release must include; ask which state’s rules apply to your records. ²⁰²¹

Before sharing, you can ask the coordinator:

• Who receives the lab result itself, and who receives a summary?
• What will the intended parents be told, and when?
• Does this form cover my STI results or a wider medical history?
• Where should I send sensitive reports, and who can access them?

Knowing who will hear about a diagnosis mattered to Nina too. She wanted the intended parents to have the information they needed while keeping her diagnosis out of casual conversation. Her coordinator explained the disclosure process and gave her room to ask questions before her profile moved forward. If you share that concern, bring it up alongside those four questions before you send your reports.

There are two practical ways to begin, both with early, honest disclosure. If you already have the reports, explain the history and send them through the requested channel together. That can reduce back-and-forth, but gathering scattered reports can take time. It suits someone whose diagnosis and follow-up are readily available.

If you are still tracking them down, tell the team what you know now and explain which results are missing. That gets your questions into the conversation sooner, though the assessment may have to wait for the reports. I’d start this way if finding old files would otherwise make you put off mentioning the history. Revealing it only after matching or scheduling can lead to repeat testing, treatment or delays that could have been addressed earlier.

Thinking about applying? Tell me the diagnosis, whether you have symptoms now, and what treatment or follow-up you have had. Through LittleBee’s surrogate application, I can help you organize the information and questions for the next conversation. You can also browse our For Surrogates articles.

References

1. Recommendations for practices using gestational carriers: a committee opinion (2022) — asrm.org, 2022
2. Genital Herpes — acog.org, accessed 2026-10-09
3. Genital Herpes — STI Treatment Guidelines — cdc.gov, 2021-07-22
4. Management of Genital Herpes in Pregnancy — acog.org, 2020-05
5. HPV and Pap Test Results: Next Steps after an Abnormal Test — cancer.gov, accessed 2026-10-09
6. Abnormal Cervical Cancer Screening Test Results — acog.org, accessed 2026-10-09
7. Tips for Best Practice on Unsatisfactory Cytology — asccp.org, 2024-11-15
8. Loop Electrosurgical Excision Procedure (LEEP) — acog.org, 2022-02
9. Chlamydia, Gonorrhea, and Syphilis — acog.org, accessed 2026-10-09
10. Syphilis During Pregnancy – STI Treatment Guidelines — cdc.gov, accessed 2026-10-09
11. Clinical Screening and Diagnosis for Hepatitis C — cdc.gov, 2025-01-31
12. Clinical Testing and Diagnosis for Hepatitis B — cdc.gov, 2026-08-14
13. Clinical Guidelines for Screening of Gestational Surrogates (NYSDOH) — health.ny.gov, 2021-02
14. What You Should Know – Reproductive Tissue Donation — fda.gov, 2010-11-05
15. Screening for Genital Herpes — cdc.gov, 2024-02-20
16. HSV-2 Tests for Genital Herpes Can Produce False Reactive Results – Letter to Clinical Laboratory Staff and Health Care Providers — fda.gov, 2023-12-27
17. Screening and Testing for HIV, Viral Hepatitis, STD & Tuberculosis in Pregnancy — cdc.gov, accessed 2026-10-09
18. What is the difference between “consent” and “authorization” under the HIPAA Privacy Rule? — hhs.gov, 2022-12-28
19. May a covered entity use or disclose a patient’s entire medical record based on the patient’s signed authorization? — hhs.gov, 2023-01-09
20. California Code, CIV 56.10. — leginfo.legislature.ca.gov, accessed 2026-10-09
21. California Code, CIV 56.11. — leginfo.legislature.ca.gov, 2024-01-01

About this guide

I’m Vivi, a client manager at LittleBee Surrogacy. This guide draws on Nina’s story and the medical and privacy sources listed above. Reviewed October 9, 2026.