What is MFM clearance for IVF or surrogacy?
MFM clearance is a maternal-fetal medicine evaluation of whether someone is medically ready to carry a pregnancy, and under what conditions. Ouma provides it for IVF patients before embryo transfer and for gestational-carrier candidates before they’re matched or before transfer.
What is a preconception MFM consult?
A preconception MFM consult is a visit with a maternal-fetal medicine physician before pregnancy, for someone whose medical history could make pregnancy riskier. Ouma’s board-certified MFMs do these by telehealth for IVF patients, gestational-carrier candidates, and patients with chronic conditions who are planning a pregnancy.
What happens in a preconception consult?
The MFM starts with the referring physician’s question, takes a full history, stratifies risk, and sets out a plan for the pregnancy. If a condition such as blood pressure, thyroid disease, or inflammatory bowel disease isn’t well controlled, the plan covers getting it there before conception. The physical exam comes from the patient’s primary care physician, and the MFM orders labs or imaging when needed.
What does the referring clinic or agency receive?
A standard MFM consultation note that includes the history, risk assessment, plan, and the reasoning behind the recommendation. Surrogacy agencies also receive a written clearance letter for each gestational-carrier candidate.
What are the medical requirements to be a surrogate or gestational carrier?
ASRM’s 2022 recommendations say a carrier should be of legal age, preferably 21 to 45, and ideally should have had at least one term, uncomplicated pregnancy, with no more than five previous deliveries or three cesarean deliveries. A prior cesarean doesn’t rule someone out on its own; ASRM’s guideline sets the limit at three. Screening also covers medical history, infectious disease testing, a psychosocial evaluation, and a uterine evaluation. Ouma’s MFMs screen candidates against these criteria and SMFM practice. Our
guide to MFM clearance for surrogacy and IVF has more detail.
What can disqualify someone from being a surrogate?
Common reasons are not having had an uncomplicated term pregnancy, more prior deliveries or cesareans than ASRM’s guideline, serious complications in a past pregnancy such as preterm birth, and medical conditions that aren’t well controlled. An MFM looks at the whole history, and a reason on paper isn’t always the end of it: in one Ouma case, a candidate’s disqualifying diagnosis turned out to be a records error, and the candidate was cleared (
the case study on this page).
Can a candidate who doesn’t meet every ASRM criterion still be cleared?
Sometimes. ASRM’s criteria are the starting point. When a candidate falls outside one but their overall history makes them a good candidate in the MFM’s judgment, the consult note says so and explains why. When a candidate isn’t a good fit, the note explains that too.
Do intended parents meet with the MFM?
Only if they want to, or if a risk needs to be explained to everyone. Most carriers are cleared without the intended parents in the visit. Intended parents can ask for a session to go over the plan, and when an intended parent has a condition such as HIV or hepatitis B, the MFM can meet with the carrier and intended parents together.
Is Ouma available nationwide for reproductive programs?
Yes. Ouma’s physician network holds active licenses to practice medicine in all 50 states, so fertility clinics and agencies can refer patients and carriers wherever they live, including patients who travel to a clinic in another state.
Is Ouma an app or a medical practice?
Ouma is a physician-led, MFM-founded medical practice. Every consult is with a board-certified, US-based maternal-fetal medicine physician employed by Ouma, not software and not a contractor.
Does Ouma provide MFM clearance for gestational carriers and surrogates?
Yes. Ouma provides gestational carrier medical clearance and surrogacy MFM consults by telehealth, with standardized documentation for intended parents, agencies, and fertility programs, wherever the carrier lives.
Can agencies see where a gestational-carrier candidate is in MFM clearance?
Yes. Ouma Connect shows every candidate an agency has referred, with progress through five stages from referral received to MFM completed, the days in the current stage and the next appointment. Referrals that need the agency’s attention come first. Each agency sees only its own referrals.
What do intended parents see on an Ouma Connect status page?
The carrier’s first name and last initial, the current step in clearance, and the next appointment’s date and time (shown in Pacific time), under the agency’s name. The page shows nothing clinical and no reports, and it needs no login. The agency can revoke it at any time, and it expires 60 days after clearance.
Do agencies need access to Ouma’s medical records system?
No. Ouma Connect is a separate, invitation-only portal, so agencies never touch Ouma’s clinical systems.
Can agencies download MFM clearance letters from Ouma Connect?
Yes. When Ouma releases a report, it appears on the agency’s Reports page within seconds, with a first-page preview and a download named by candidate, report type and date. Connect carries MFM clearance letters, screening summaries, counseling summaries, lab results, ultrasound reports and diagnostic reports. A report reaches an agency only when Ouma releases it, and the agency can request a revision from the report itself.
How does an agency ask Ouma to pause, resume or cancel a referral, or resend a scheduling link?
From the referral in Connect, in one click. The request lands with the Ouma team tied to that referral, shows its status from sent to closed, and the reply comes back in the same thread. Agencies can also message the Ouma team, send new records and request a report revision, with up to three attachments.
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