Who reads your records at PLS?
A physician does. At Private Label Surrogacy, Mark Silverberg, DDS, MD, personally reads every surrogate candidate's prenatal and delivery records. Not a sample of them, and not a checklist filled in by someone else. Every candidate, every pregnancy.
Dr. Silverberg is PLS's Executive Director. He has more than 30 years of medical practice, and he has worked as an anesthesiologist in Chicago-area operating facilities, where many of his cases were obstetric and gynecologic. He has been in the room for deliveries and C-sections, which is the experience that matters when reading yours. The PLS agency agreement defines this step as review by a board-certified physician.
At many agencies, a coordinator checks records for obvious red flags and the first physician to read them works at the fertility clinic, after a match has been made. PLS puts a physician in front of the clinic, before matching. You will hear from him, through your case manager, if anything in your history needs a closer look.
What records are requested and from whom?
You do not have to collect your records yourself. You sign a release, and PLS requests them from every OB practice and hospital where you received care or delivered. If you delivered in two different states, or changed doctors between pregnancies, list them all on your intake form.
Records usually take two to four weeks to arrive. The table shows what is requested and why.
| Document | Source | Why it matters | Typical turnaround |
|---|---|---|---|
| Prenatal records and flow sheets | Your OB or midwife practice | Show blood pressure, weight and visit notes across each pregnancy | Requested by PLS at intake (usually two to four weeks) |
| Lab results, including glucose screening | OB practice or outside lab | Show gestational diabetes, anemia or infection | Requested by PLS at intake (usually two to four weeks) |
| Ultrasound reports | OB practice or imaging center | Show placenta position, fetal growth and any concerns | Requested by PLS at intake (usually two to four weeks) |
| Delivery summary | Hospital where you delivered | Shows gestational age at birth, type of delivery and any complications | Requested by PLS at intake (usually two to four weeks) |
| Operative report for any C-section | Hospital where you delivered | Shows the uterine incision type and any surgical complications | Requested by PLS at intake (usually two to four weeks) |
| Anesthesia record | Hospital where you delivered | Shows how an epidural or surgical anesthesia went | Requested by PLS at intake (usually two to four weeks) |
| Postpartum notes | OB practice | Show recovery, bleeding, blood pressure and mood after birth | Requested by PLS at intake (usually two to four weeks) |
| Recent Pap test result | Your current OB or gynecologist | Shows current cervical health before clinic screening | Requested from your OB (a result within 12 months of clinic screening) |
| OB clearance letter | Your current OB | Confirms your OB sees no reason you cannot carry another pregnancy | Requested from your current OB during screening |
What Dr. Silverberg looks for
He reads each pregnancy as a whole, start to finish. The questions he is answering are simple to state: did this pregnancy go well, and is there anything in it that could happen again in a surrogate pregnancy?
In practice, he looks at:
- Gestational age at delivery. Whether each baby was born at 37 weeks or later.
- Blood pressure. Any reading that suggests gestational hypertension or preeclampsia, during pregnancy or after.
- Glucose. Screening results and any diagnosis of gestational diabetes.
- Placenta and bleeding. Placenta previa, abruption, or heavy bleeding at delivery.
- Labor and delivery. Preterm labor, how long labor lasted, and whether delivery was vaginal or by C-section.
- Surgical details. For any C-section, the incision type and recovery. See C-sections and surrogacy.
- Anesthesia. How an epidural or surgical anesthesia went. This is his own specialty.
- Postpartum recovery. Infection, readmission, and any postpartum mood changes and how they were treated.
- Losses. Any miscarriage or other loss, and what is known about its cause.
Many complications are reviewed in context rather than ruled out. See pregnancy complications and surrogacy for how specific conditions are weighed.
What the physician medical summary contains
After reading your records, Dr. Silverberg writes a physician medical summary. It goes to the intended parents' fertility clinic, where the reproductive endocrinologist uses it at your medical screening.
The summary sets out each pregnancy and delivery in plain medical language, notes any finding that bears on a surrogate pregnancy, and lists anything he recommends the clinic check, such as scar thickness on ultrasound or additional labs.
The summary does not replace the clinic's judgment. The clinic's reproductive endocrinologist makes the final medical decision about whether to transfer an embryo to you. What the summary does is make sure that decision is informed by a physician who has already read every page.
Why a physician review before matching protects you
Consider what happens when a problem surfaces late. You are matched with a family. You meet them on video. Attorneys negotiate your agreement. Escrow is funded. You start medications. Then the clinic reads your delivery records for the first time and declines the transfer. You have spent months, and the intended parents have spent money and hope, on a match that was never going to work.
A physician review before matching moves that moment to the start. If something in your history rules you out, you learn it in the first weeks, before anyone else's plans depend on you. If something needs a clinic opinion, it is asked early. And if your history is clear, the clinic starts your medical screening with a physician's summary already in hand.
It protects intended parents too. They know a physician has read the history of the woman who will carry their child. And you know your own risks were weighed by someone qualified to judge them, before you agreed to anything.
What happens if something is found?
There are three possible outcomes:
- Acceptable. Many findings, such as a single uncomplicated C-section or one early miscarriage, are noted in the summary and do not change your eligibility.
- Needs clinic input. Some findings are not clear-cut. Dr. Silverberg flags them, and PLS asks the clinic for its view before you are matched.
- Disqualifying. Some findings, such as recurrent loss or a serious complication likely to recur, mean a surrogate pregnancy would carry too much risk for you.
If you are disqualified, you will hear why, plainly, from your case manager. You will not be left wondering. If the reason is something that can change over time, you will be told that too.
How long does the records review take?
Most of the time is spent waiting for records. Records usually take two to four weeks to arrive. Some hospitals are slower than others. Once they are in, the review itself moves quickly.
You can help: list every OB and hospital accurately, sign the releases promptly, and tell your case manager if you know a hospital has closed or merged. The records review is one part of screening, which usually takes one to two months in total. See the full surrogate process and what follows at medical screening.
If you are ready to start, the five-minute prescreen is at See if I qualify.
Sources
- ASRM (American Society for Reproductive Medicine), recommendations for practices using gestational carriers, including medical evaluation of the carrier. asrm.org
- ACOG (American College of Obstetricians and Gynecologists), guidance on hypertensive disorders, gestational diabetes and cesarean delivery. acog.org