Does one miscarriage disqualify you?
Usually not. One early miscarriage does not disqualify you from being a surrogate with Private Label Surrogacy. About one in four recognized pregnancies ends in loss. A single first-trimester loss alongside a healthy full-term delivery is common in surrogate records.
Most early miscarriages happen because the embryo had a chromosomal error that made it unable to develop. That is a problem with that one embryo, not with the uterus that carried it. It says little about how your body would carry the next pregnancy.
A chemical pregnancy, a very early loss detected only by a pregnancy test, is counted by clinics as an early loss. One chemical pregnancy is not disqualifying.
What does disqualify a candidate is a pattern, or a cause that could recur. The table sets out how each situation is treated.
| Situation | PLS position | ASRM position |
|---|---|---|
| One first-trimester loss | Not disqualifying | Not considered recurrent loss |
| Two or more losses | Disqualifying | Meets the definition of recurrent pregnancy loss |
| Loss after 20 weeks (stillbirth) | Reviewed individually; usually requires the OB's explanation of cause | Requires evaluation of cause |
| Loss with a D&C | Not disqualifying in most cases, once the clinic confirms a healthy uterine lining on ultrasound | Uterine evaluation before transfer |
| Loss due to a known uterine cause | Disqualifying when the cause could recur, such as fibroids, a septum or cervical insufficiency | A uterine factor must be evaluated and addressed before a carrier is accepted |
What counts as recurrent pregnancy loss?
ASRM defines recurrent pregnancy loss as two or more clinical pregnancy losses. A clinical loss is one confirmed by ultrasound or tissue examination, not only by a pregnancy test.
Recurrent loss disqualifies a candidate because it can point to a cause that would affect the next pregnancy too: the shape of the uterus, a blood clotting disorder, a hormonal problem or something not yet found. A surrogate pregnancy should not be the one that tests it.
A loss linked to a uterine problem is also disqualifying, even if it happened once. Fibroids that distort the uterine cavity, a uterine septum (a band of tissue dividing the cavity) and cervical insufficiency (a cervix that opens too early in pregnancy) can all cause a loss and can all cause another.
What Dr. Silverberg looks for in your loss records
Mark Silverberg, DDS, MD, reads every candidate's prenatal and delivery records, and that includes the records for every loss. For each one he looks at:
- When it happened. A loss at seven weeks reads differently from a loss at 18.
- Whether a D&C was performed. A D&C (dilation and curettage) clears the uterus after a loss. Rarely, it can leave scar tissue inside the uterus, which the clinic checks for.
- What was found. Any testing of the pregnancy tissue, any ultrasound findings, and anything the OB noted about the uterus or cervix.
His findings go into a physician medical summary that is sent to the intended parents' fertility clinic. You do not collect the records yourself. You sign a release and PLS requests them. See the records review.
Stillbirth and second-trimester loss
A stillbirth, meaning a loss at 20 weeks or later, is reviewed individually. So is a loss earlier in the second trimester. These losses are less common than early miscarriage, and the cause matters much more.
The review usually requires your OB's explanation of the cause. Some causes, such as an infection or a cord accident, are unlikely to recur. Others, such as cervical insufficiency or a placental problem linked to a condition you still have, could. The clinic makes the final call with Dr. Silverberg's summary in hand.
If you have had a loss like this, it may be hard to put on a form. Write what you know. Your case manager will ask the rest with care.
Losses before versus after your full-term birth
Timing matters. Losses after your full-term delivery carry more weight than losses before it.
A loss before your full-term birth was followed by a healthy pregnancy, which is good evidence your body can carry to term. A loss after it is the most recent information about your body, so it gets a closer look.
Every candidate needs at least one healthy full-term pregnancy and must be parenting a child now. See the prior pregnancy requirement.
What happens if you miscarry as a surrogate?
It can happen in any pregnancy, including a surrogate one. The pregnancy test comes 9 to 11 days after transfer, and early losses can follow a positive test.
If it happens, your clinic and OB manage your medical care first. Your case manager stays with you through it. Natalie Gaudio-Fricano and Jenni Symons, who carry PLS's active matches, are both former surrogates. Mental-health support is part of every PLS surrogate's package.
Contracts typically pay the compensation earned to the date of the loss, plus a loss fee. See compensation after a miscarriage or failed transfer.
If you have a question about your own history, ask it free on SurrogacyHotline, PLS's sister site, which answers within 24 to 48 hours. If your history fits, start at See if I qualify.