Advanced Surrogacy Definitions: A Complete Glossary

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ConceiveAbilities - Advanced Surrogacy Definitions
The world of surrogacy is a complex process that includes many moving pieces. While a reputable agency will ensure that you have a support team available to answer questions and quell anxieties, a more thorough grasp of the semantics will make anyone involved – intended parent or surrogate – feel more comfortable and in control of their situation. The importance of understanding surrogacy speak simply can’t be, well, overstated. If you’re already familiar with the basics from our Guide to Surrogate Speak, brush up on some of the general terms and read on for an advanced compendium of surrogacy definitions.

General Terms

Gestational Carrier

The woman carrying someone else’s baby, fertilized using the intended mother or a donor’s egg and the intended father’s or a donor’s sperm. Also referred to as a GC or surrogate. The surrogate is not genetically linked to the baby in any way, as the baby is conceived via in-vitro fertilization.

Intended Parent

The legal (and often biological) parents of the infant born through a surrogacy arrangement. May also be referred to as the intended mother (IM) or intended father (IF).

Domestic Surrogacy

A surrogacy arrangement in which both the surrogate and the intended parent(s) reside in the United States.

International Surrogacy

A surrogacy arrangement in which the intended parents do not currently reside in the United States. For the purposes of ConceiveAbilities’ matches, all surrogates are from the U.S. in surrogacy-friendly states.


The surrogate mother pay earned by a woman from the intended parents in a surrogacy arrangement. The amount can vary, but is separate from medical and legal costs and is earned for the dedicated time and effort a surrogate puts in over the course of many months.

Medical Terms

Informed Consent

Permission granted in the knowledge of possible consequences; often given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits. In a surrogacy arrangement, the informed consent includes but is not limited to the IVF clinic, the legal team and the surrogacy agency.

Personality Assessment Inventory (PAI)

A self-report, 344-item personality test that assesses a respondent’s personality and psychopathology. Each item is a statement about the respondent that the respondent rates with a 4-point scale. It provides information relevant for screening for psychopathology and when combined with an evaluation from a mental health professional, is an appropriate tool to assess a woman’s eligibility for surrogacy. It is a required component of ConceiveAbilities’ rigorous pre-screening process.

Monitoring Clinic

An IVF clinic that can accommodate a surrogate in the weeks before the embryo is transferred to her uterus. Appointments may include blood work, ultrasounds and other testing to determine her eligibility for transfer. A monitoring clinic is typically used if the surrogate will be traveling to a different clinic for the transfer.

Selective Reduction and Termination

Also referred to as fetal reduction or selective pregnancy reduction, selective reduction and termination is the practice of reducing the number of fetuses in a multiple pregnancy (quadruplets, for example) to a twin or singleton pregnancy. It is a complex balance of relative risks and benefits and must be discussed prior to pregnancy.

Insurance Terms

Infertility Coverage

Health insurance coverage for infertility and IVF treatments. Currently, about 15 states offer an infertility coverage mandate to help with payment for fertility and IVF services.

Surrogate Health Insurance

Health insurance coverage specifically for surrogate mothers during the course of the pregnancy. Part of ConceiveAbilities thorough screening process is reviewing a surrogate’s current health insurance coverage, but intended parents are encouraged to purchase a Universal Life Plan through Lloyd’s of London.

Comprehensive Surrogacy Insurance

Health insurance purchased by the intended parent that allows a surrogate to see any doctor agreed upon by all parties and to deliver at any hospital.

Newborn Health Insurance

Health insurance for a new baby that is purchased by the intended parents. In the United States, parents have 30 days from the birth to enroll their baby. This ensures coverage is effective as of the baby’s birth date and cannot be subject to a preexisting condition clause.

Legal Terms

Legal Clearance

The legal clearance status is granted by the surrogate’s and intended parents’ legal team once all necessary documentation has been fully executed. It is required by the agency before the surrogate and intended parents can have direct communication, and prior to the surrogate starting medical treatment.

Escrow Account

An escrow account is set up to ensure funds are properly dispersed at the correct time. In a surrogacy arrangement, money is put into the account at the beginning of the process by the intended parent so that the escrow agent can ensure payment to the surrogate as specified by their direct agreement. It is required in order to make the payments to the surrogate.

Egg Donor Direct Agreement

The direct agreement is the contract between you and your egg donor. This agreement will lay out all the terms and stipulations regarding your match. It is called the Direct Agreement because it is the only document in the process that is directly between the Intended Parents and Donor.

Anonymous Signature Page

Because you and the donor need to sign the Direct Agreement and anonymity needs to be maintained, both parties are asked to sign the anonymous signature page. You and the donor will receive a copy of this page for your files. You will sign as “Intended Parent” and the donor will sign as “Egg Donor.”

Gestational Surrogacy Agreement (GSA)

The GSA is the contract between you and the surrogate. Much like the Direct Agreement it will outline all the terms and specific information regarding your match. It also referred to as the Direct Agreement as it is one of the only document in the process that us directly between the Intended Parents and the Gestational Carrier.


The parentage process happens after confirmation of pregnancy and will be handled by your in-state attorney. The process consists of drafting and obtaining signatures on all the documents required to assign you as the child’s legal parents and guardians. It is also the process in which the surrogate is relieved of all legal responsibilities to the child. The documents required for this process differ between states.

Pre-Birth Order (PBO)

The Pre-Birth Order is an example of a parentage document. It is a legal document assigning you as the legal parent of your child and not the surrogate. You may or may not need a PBO depending on the state in which your surrogate will deliver. If your match requires a PBO the process usually begins at around 15-18 weeks of gestation. Once the PBO is complete our legal team will ensure the hospital has the Order prior to the birth, but you will also take a copy with you at the time of delivery.

Post-Birth Order

Some states require a Post-Birth Order as a part of the parentage process. A Post-Birth Order is a document assigning you as the legal parents of your child. The Post-Birth Order will be drafted and ready for signature prior to the birth of your child and will be signed by the judge within a few days after your child’s birth.

Healthcare Power of Attorney

A health care power of attorney is a document in which you designate someone to be your representative, or agent, in the event that you are unable to make or communicate decisions about aspects of your healthcare. All states have statutes that authorize the form, scope, and requirements of this document.

Second Parent Adoption

Illinois, along with several other states, has laws that explicitly allow same-sex couples to adopt. Second-parent adoption occurs when the biological or legal parent of a child is in a relationship with another adult who wants to share parental rights and responsibilities. In contrast to a co-parent adoption (defined above), one of the parents shares a biological or legal relationship with the child. The biological or legal parent consents to relinquish sole custody of the child so that his/her partner can become a second, legal parent. Second-parent adoptions give the child two (2) legal guardians. The adoption protects both parents by giving each of them legally recognized parental status. If the couple were to later dissolve their adult relationship, each parent would be equally entitled to custody, which a court would determine based on the best interests of the child, without giving an automatic advantage or preference to either parent.

You can find just about everything you need to know about surrogacy know about surrogacy on our blog, or contact our team to get started. We look forward to working with you on this exciting journey!