The Complete Surrogacy Glossary: Every Term You Need to Know

Surrogacy has its own language — and it can feel like a lot. Between medical procedures, legal filings, and financial structures, you’ll encounter dozens of new surrogacy terms before you ever reach an embryo transfer. That confusion is real, and it matters: misunderstanding a single term in your contract or medical plan can have serious consequences.

We put this glossary together because we’re the only OB-managed surrogacy agency in the U.S. Our in-house physicians, neonatologists, and maternal-fetal medicine specialists use these terms every day. The definitions here aren’t pulled from a generic medical dictionary — they’re written the way our clinical team actually explains them to surrogates and intended parents.

Use this as your reference throughout the journey, whether you’re a prospective surrogate working through the medical process or an intended parent preparing for your first consultation.

Surrogacy Types and Roles

These are the foundational surrogacy terms. Get these right before anything else.

1. Surrogate / Gestational Carrier (GC)

A woman who carries and delivers a baby for intended parents who cannot carry a pregnancy themselves. In professional medical and legal contexts, you’ll often see the term “Gestational Carrier” or “GC” — these mean the same thing.

2. Gestational Surrogacy (GS)

The standard form of surrogacy used today. The surrogate becomes pregnant through In Vitro Fertilization (IVF) and has no genetic connection to the baby she carries.

Eggs come from the intended mother or a donor. Sperm comes from the intended father or a donor. The embryo is created in a lab and transferred to the surrogate. This is a medical and legal distinction that matters enormously — the surrogate is not the biological mother.

3. Traditional Surrogacy

An older, legally complex arrangement where the surrogate’s own eggs are used to create the embryo. This makes the surrogate the biological mother of the child.

Traditional surrogacy is rarely practiced by reputable agencies today. The legal risks are substantial in most states. For a full comparison, see our guide on gestational vs traditional surrogacy.

4. Intended Parent(s) (IPs)

The legal parent or parents of the child born through surrogacy. Intended parents can be heterosexual couples, same-sex male couples, same-sex female couples, single individuals, or international parents.

In legal documents, you’ll see “Intended Mother (IM)” and “Intended Father (IF)” used as shorthand. Same-sex couples and single parents are both well-served through gestational surrogacy.

5. Egg Donor (ED)

A woman who donates her eggs (oocytes) for use in IVF. An egg donor is needed when the intended mother cannot use her own eggs — due to age, medical conditions, or diminished ovarian reserve — or when a same-sex male couple or single father is building a family.

6. Sperm Donor (SD)

A man who donates sperm for use in creating an embryo via IVF. This is common for single mothers, same-sex female couples, or couples dealing with male-factor infertility.

7. Double Donor

When both an egg donor and a sperm donor are used to create the embryo. Neither intended parent has a genetic connection to the child, but they remain the sole legal parents from birth.

8. Embryo Adoption

Intended parents who need a double donor have another option: adopting an existing frozen embryo. Families who completed their IVF journey and have remaining embryos can choose to donate them. The adopting family legally adopts the embryo before transfer.

9. Surrogacy Agency

An organization that manages the full surrogacy arrangement — surrogate recruitment, screening coordination, matching, legal referrals, escrow oversight, and ongoing support for both the surrogate and intended parents.

Not all agencies operate the same way. Most are run by non-medical staff. Physician’s Surrogacy is the only surrogacy agency in the U.S. managed by practicing OB/GYNs — a distinction that changes how screening, medical communications, and clinical decisions are handled throughout the journey. Learn more about our Physician’s Advantage.

10. Independent Surrogacy

A surrogacy arrangement where the intended parents and surrogate manage the process themselves — without an agency. Lower upfront cost, but no professional screening, no escrow management, and no medical oversight structure. Read more about independent vs agency surrogacy before deciding.

The Medical Team: Who Does What

One of the most common sources of confusion is understanding which doctor is responsible at which point in the journey. Here’s how it breaks down.

11. Obstetrician and Gynecologist (OB/GYN)

An OB delivers babies and manages pregnancy care. A gynecologist treats diseases of the female reproductive system.

In surrogacy, the surrogate typically transitions to her own OB/GYN after the first trimester, once she “graduates” from the fertility clinic. That OB then manages the pregnancy through delivery.

12. Reproductive Endocrinologist (RE)

A specialist — usually an OB/GYN with additional fellowship training — who manages the entire IVF process. The RE oversees cycle preparation, egg retrieval (if using a fresh donor), the embryo transfer, and early pregnancy monitoring.

After the first trimester, the RE releases the surrogate to her regular OB/GYN.

13. Maternal-Fetal Medicine Specialist (Perinatologist)

An OB who specializes in higher-risk pregnancies. A perinatologist is consulted when there are complications, twin pregnancies, or abnormal screening results. They perform high-resolution specialized ultrasounds and guide clinical decisions in complex cases.

14. Neonatologist

A pediatric specialist focused exclusively on newborn care — especially premature or medically complex infants. Neonatologists oversee the Neonatal Intensive Care Unit (NICU) when needed. This is relevant in surrogacy when a baby is born early or requires immediate medical support.

15. Surrogacy Monitoring Clinic

A local fertility clinic or specialized lab near the surrogate’s home where she goes for routine monitoring — blood draws, ultrasounds, and lab work during cycle preparation. This means surrogates don’t need to travel to the main IVF clinic in another city for every appointment.

The IVF Process: Medical Surrogacy Terms Explained

Gestational surrogacy depends entirely on IVF. These are the surrogacy terms you’ll encounter from the medical side of the process.

16. In Vitro Fertilization (IVF)

The process of combining an egg and sperm outside the body — in a laboratory dish — to create an embryo. IVF is performed by the RE at a partner fertility clinic. PS coordinates and monitors the surrogacy journey; the IVF itself is performed by our partner clinics.

17. Egg Retrieval

A minor outpatient procedure where mature eggs are removed from the ovaries of the intended mother or egg donor. The patient is under light sedation. A needle is guided through the vaginal wall to extract the eggs, which are then taken to the lab for fertilization.

18. Intracytoplasmic Sperm Injection (ICSI)

A specialized form of IVF where a single sperm is injected directly into an egg using a microscopic needle. Used when sperm count or quality makes standard fertilization less likely to succeed.

19. Blastocyst (“Blast”)

An embryo that has developed for 5–7 days after fertilization in the lab. An embryo must reach this multi-celled blastocyst stage before it can be transferred to the surrogate’s uterus. Roughly 40% of human embryos reach this stage.

20. Preimplantation Genetic Testing (PGT / PGD)

A laboratory process where one or two cells from an IVF embryo are tested for chromosomal abnormalities or specific genetic conditions before the embryo is transferred.

PGT-tested embryos carry a lower miscarriage risk. Testing can also reveal the baby’s sex. Transferring a chromosomally normal embryo reduces the chance of a pregnancy that doesn’t progress — a benefit for both the surrogate and the intended parents.

21. Single Embryo Transfer (eSET)

The practice of transferring only one embryo at a time. Reputable agencies and modern IVF clinics strongly encourage eSET because carrying multiples — twins or triplets — carries higher health risks for both the surrogate and the babies.

For a surrogate’s full experience of this procedure, see our complete embryo transfer guide.

22. Frozen Embryo Transfer (FET)

The most common type of embryo transfer in surrogacy. A previously frozen embryo is thawed and transferred into the surrogate’s prepared uterus using a soft catheter guided through the cervix. Most surrogacy journeys use frozen embryos rather than fresh transfers.

23. Surrogate Cycle Schedule

The master medical calendar created by the IVF clinic. It lists every medication protocol, monitoring appointment, ultrasound check, and key date leading up to the embryo transfer. Timing is precise — surrogates follow this calendar closely.

Read about what cycling means in the surrogacy process for a full breakdown.

24. Cycle Suppression and Self-Injectables

Before a transfer, the surrogate’s natural cycle is suppressed — often with birth control pills or Lupron — to allow the doctors to control the timing precisely. Then self-injectable medications build up the uterine lining to prepare for the embryo.

25. Progesterone in Oil (PIO)

Because a gestational surrogate’s body didn’t ovulate naturally to create the pregnancy, it won’t produce enough progesterone on its own to sustain it. PIO is an intramuscular injection — typically into the upper buttocks — that provides the progesterone needed in the early weeks of pregnancy.

26. Mock Cycle

A practice run before the actual transfer. The surrogate takes the same medications she would for a real transfer. The RE monitors how her uterine lining responds — but no embryo is transferred. This confirms the medication protocol is correct before a real embryo is used.

27. Lining Check

A transvaginal ultrasound appointment to measure the thickness and quality of the surrogate’s uterine lining. The lining typically needs to reach around 7–8mm with a “trilaminar” (three-layered) appearance before the RE approves the embryo transfer.

Surrogacy Terms for Pregnancy Monitoring

These terms describe what happens after the embryo transfer — and throughout the pregnancy.

28. Beta Testing

A quantitative blood test measuring human chorionic gonadotropin (hCG) levels to confirm pregnancy. Performed 10–14 days after the embryo transfer. Two or three betas are run a few days apart to confirm that hCG levels are rising appropriately — a healthy sign that the pregnancy is progressing.

29. Human Chorionic Gonadotropin (hCG)

The hormone the placenta produces after an embryo implants in the uterine wall following a successful transfer. It’s what home pregnancy tests detect. In surrogacy, hCG is monitored closely in the early weeks through blood draws — not just a test strip.

30. Confirmation of Pregnancy (COP)

After positive beta tests, a heartbeat ultrasound (usually at 6–7 weeks) officially confirms a viable clinical pregnancy. COP is a major milestone — medically, legally, and financially. It often triggers the release of the first portion of the surrogate’s compensation.

31. Non-Invasive Prenatal Testing (NIPT)

Performed between 9–13 weeks, this advanced screening analyzes fetal DNA through a simple blood draw from the surrogate. It’s 97–99% accurate for detecting chromosomal conditions like Down Syndrome and Trisomy 18, and can also confirm the baby’s sex.

32. Nuchal Translucency (NT) Sonogram

A specialized ultrasound performed between 10–14 weeks that assesses the developing baby’s risk for Down Syndrome, congenital heart problems, and other chromosomal concerns. Usually performed alongside the first-trimester screening blood test.

33. AFP Quad Screen

A maternal blood screen performed between 15–20 weeks. It evaluates risk for Down Syndrome and neural tube defects by measuring four specific substances: AFP, hCG, Estriol, and Inhibin-A.

34. Fetal Echocardiogram

A detailed cardiac ultrasound performed between 18–24 weeks. Recommended in all IVF pregnancies per American Heart Association guidelines, it assesses the baby’s heart chambers and valves for structural integrity. Our in-house physicians can order this testing directly — most surrogacy agencies cannot.

35. Amniocentesis

A diagnostic prenatal test performed between 14–20 weeks. A thin needle extracts a small amount of amniotic fluid surrounding the baby. The cells in that fluid are examined for chromosomal abnormalities, neural tube defects, and genetic disorders.

36. Chorionic Villus Sampling (CVS)

A diagnostic prenatal test performed between 10–12 weeks. A small sample of placental cells is taken either through the abdomen or the cervix. Like amniocentesis, CVS can identify chromosomal abnormalities such as Down Syndrome — but it can be done earlier in pregnancy.

37. Hysterosalpingogram (HSG) and Saline Sonogram (SIS)

Diagnostic imaging procedures used to assess the uterus before an embryo transfer. An SIS involves injecting sterile saline into the uterus to expand it so the doctor can identify polyps, fibroids, or scar tissue that could prevent successful implantation.

38. Psychological Evaluation / MMPI-2

During the screening phase, surrogates (and often egg donors) undergo a psychological evaluation to assess emotional readiness for the journey. This may include the Minnesota Multiphasic Personality Inventory (MMPI-2), a standardized test that provides the clinical team with a detailed picture of mental health and emotional stability.

39. Surrogate Twins Risk

Even with single embryo transfer, twins can occasionally result from embryo splitting. Carrying multiples carries higher health risks for the surrogate and the babies. This is one reason reputable agencies advocate strongly for eSET. For a full medical breakdown, read our article on surrogacy twins risks.

40. Postpartum Recovery

What happens to the surrogate’s body after delivery. Recovery timelines vary depending on whether the birth was vaginal or via C-section. At Physician’s Surrogacy, surrogates receive 3–6 months of post-delivery support — coordinator access, medical follow-up referrals, and ongoing check-ins.

Read more about postpartum recovery for surrogates and what to expect in those months.

41. Surrogate and Gestational Diabetes

Gestational diabetes is a pregnancy condition a surrogate may develop during the journey. It’s monitored through routine prenatal care and typically resolves after delivery. Our physicians are experienced in managing this condition throughout surrogacy pregnancies.

See our guide on surrogates and gestational diabetes for what to expect.

Legal Surrogacy Terms

The legal side of surrogacy protects everyone — surrogate, intended parents, and the baby. These surrogacy terms will appear in your contract and court filings.

Understanding your surrogacy contract before you sign it is one of the most important steps of the journey. For a deeper dive into the full legal process, our surrogacy legal process guide covers contracts, orders, and parental rights in detail.

42. Carrier Agreement / Surrogacy Contract

The legally binding contract between the surrogate and the intended parents. It governs everything: medical procedure expectations, reimbursement terms, communication preferences, selective reduction clauses, and what happens in various medical scenarios. Both parties must have separate attorneys review this document.

43. Independent Legal Counsel / Reproductive Attorney

A lawyer who specializes in third-party reproductive law. Ethical surrogacy requires that the surrogate and the intended parents each have their own separate attorney — no shared counsel. The intended parents pay for the surrogate’s independent legal representation.

44. Pre-Birth Order (PBO)

A court order obtained before the baby is born that legally establishes the intended parents as the child’s legal parents. It grants them the right to make medical decisions for the baby at the hospital and ensures their names appear on the birth certificate from day one.

A PBO is standard in surrogacy-friendly states like California. For how this works specifically in that state, see our guide on California surrogacy laws.

45. Post-Birth Order

In some states, a court order obtained after delivery is required to replace the surrogate’s name with the intended parents’ names on the birth certificate. Whether a PBO or post-birth order is used depends entirely on state law.

46. Selective Reduction / Termination Clause

A clause in the surrogacy contract that addresses what happens if the fetus is diagnosed with a severe condition, or if a multiple pregnancy puts the surrogate’s health at serious risk. The surrogate’s and intended parents’ positions on termination and selective reduction must be aligned before the journey begins — not discussed for the first time during a medical crisis.

47. Power of Attorney (POA)

A legal document that designates a trusted person to make decisions on behalf of someone else. In surrogacy, a medical POA is established before birth so a designated guardian can care for the baby if the intended parents cannot arrive at the hospital immediately after delivery.

Financial Surrogacy Terms

Compensation and financial structures are often the least-explained part of the surrogacy process. These terms determine how money moves — and how it’s protected.

48. Escrow Account

A regulated trust account managed by a licensed, bonded third-party escrow company. All surrogacy funds — the surrogate’s compensation and all reimbursements — are deposited here before the journey begins.

Never accept direct personal payments from intended parents. An escrow account legally protects your compensation from bankruptcy, financial changes, or relationship breakdowns on their end. It also removes money from your personal relationship with the family.

49. Surrogate Compensation

The total payment a surrogate receives for carrying a pregnancy. At Physician’s Surrogacy, surrogates receive a fixed-rate compensation package of $55,000–$75,000+ depending on state, experience, and journey specifics.

For a detailed breakdown, see how much surrogates make. Some agencies use a “line-item” model with many separate reimbursements that may or may not materialize. Our fixed-rate model covers all included expenses upfront — no submitting receipts for mileage or childcare.

50. Surrogacy Income and Taxes

Surrogate compensation is generally not taxed as regular income in the U.S. — but the tax treatment depends on how the payments are structured. Our article on surrogacy income and taxes explains what the IRS says and what to tell your accountant.

51. Lost Wages Stipend

If a doctor orders you on bed rest and you’re employed, you may be entitled to compensation for lost income. At Physician’s Surrogacy, this protection is built directly into the fixed-rate compensation package — it’s there whether you need it or not.

52. Surrogate Maternity Insurance

Many standard health insurance policies have explicit exclusions for acting as a surrogate. If yours does, the intended parents must purchase an Affordable Care Act (ACA) compliant maternity policy or a specialized surrogacy insurance policy to cover all prenatal and delivery costs. This is reviewed during the screening process.

53. Surrogacy Financing

Intended parents often explore loan and financing options to cover surrogacy costs. Several lenders specialize in reproductive healthcare financing. For an overview of available options, see our surrogacy financing guide.

54. Confirmation of Pregnancy (COP) Payment

COP — the confirmed heartbeat ultrasound — often triggers the release of the first portion of a surrogate’s compensation. The full payment schedule is spelled out in the carrier agreement before the journey begins.

The Matching and Screening Process

These surrogacy terms describe the stages between application and embryo transfer — the phases that determine whether a surrogate qualifies and gets matched.

55. Medical Pre-Screening / Medical Clearance

The physician-led review of a surrogate candidate’s full pregnancy history, medical records, and diagnostic lab work before she is presented to any intended parents. Once cleared, a medical clearance letter confirms that her body is ready for pregnancy.

Our screening process is physician-designed and exceeds ASRM guidelines for third-party reproduction. This rigorous upfront evaluation is why we maintain the largest active pre-screened surrogate pool in the country.

56. Surrogate Requirements

The medical, personal, and lifestyle criteria a surrogate must meet before qualifying. At Physician’s Surrogacy, requirements include age 20.5–40.5, at least one prior successful pregnancy, and a Body Mass Index (BMI) below 35. Surrogates with BMI 35–37 are welcome to apply and are evaluated individually.

For a full breakdown of what qualifies and what doesn’t, see our surrogate requirements page and our guide to surrogacy disqualifications.

57. Matching Process

The phase during which the agency aligns a surrogate and intended parents based on compatibility, expectations, communication preferences, and medical requirements. At Physician’s Surrogacy, this happens after our physician-designed screening confirms a surrogate is medically qualified.

For what intended parents weigh during this phase, see our guide on working with a surrogate mom.

58. Medically Cleared Program

An optional program at Physician’s Surrogacy where surrogates complete all medical and psychological screening before matching — instead of after. This eliminates the 3–5 week post-match screening wait and gives both the surrogate and the intended parents immediate clarity on eligibility. The screening is the same; the order is smarter.

59. How to Become a Surrogate

The step-by-step path from initial interest to matched surrogate. This covers the application, medical and psychological screening, legal preparation, and matching. Our complete guide to becoming a surrogate walks through each stage in detail.

When you’re ready to apply, the surrogate application is online and takes about 20 minutes.

Ready to Put These Surrogacy Terms Into Practice?

Knowing the language is step one. The next step is understanding how all of these surrogacy terms apply to your specific situation — your medical history, your state, your goals.

Physician’s Surrogacy is the only agency in the U.S. where practicing OB/GYNs manage the entire process. Our physicians designed the screening criteria behind these medical terms. They monitor clinical communications after every appointment and can consult directly with a surrogate’s managing OB when questions arise.

If you’re a prospective surrogate, see if you qualify and start your application. If you’re an intended parent ready to learn more, schedule a free consultation with our team.

Frequently Asked Questions About Surrogacy Terms

Julianna Nikolic

Chief Strategy Officer Julianna Nikolic leads strategic initiatives, focusing on growth, innovation, and patient-centered solutions in the reproductive sciences sector. With 26+ years of management experience and a strong entrepreneurial background, she brings deep expertise to advancing reproductive healthcare.