Infertility & Family-Building Glossary

The court hearing at which an adoption is legally completed, granting the adoptive parents full legal rights and responsibilities as the child's parents and issuing an amended birth certificate.

Finalization typically occurs 6–12 months after placement, depending on state requirements and the type of adoption. A judge reviews the home study, post-placement reports, and any interstate compact documentation. In most cases, the hearing is a brief, celebratory proceeding. After finalization, the adoptive parents are the child's legal parents in every respect, and the adoption cannot be reversed except under extraordinary circumstances.

A federal tax credit available to adoptive parents for qualified adoption expenses, including agency fees, attorney fees, court costs, and travel expenses related to the adoption.

For tax year 2024, the maximum adoption tax credit is approximately $16,810 per child. The credit is non-refundable (it can reduce your tax liability to zero but won't generate a refund) for domestic adoptions, but is refundable for foster care/special needs adoptions. Income phase-outs apply. The credit can be carried forward for up to five years if it exceeds your tax liability in the year claimed. Employer-provided adoption assistance is also available at some companies and may be excluded from gross income up to the same limit.

The three parties central to every adoption: the adoptee (child), the birth parents, and the adoptive parents. Also called the adoption constellation when extended to include siblings, grandparents, and other affected family members.

Understanding the adoption triad is essential because each member has a unique perspective, set of needs, and potential grief. Adoptees may grapple with identity, belonging, and loss. Birth parents may experience grief, relief, or complex emotions that evolve over time. Adoptive parents navigate bonding, openness decisions, and supporting their child's connection to their origins. Adoption-competent therapists are trained to work with all members of the triad.

A surrogacy arrangement in which the gestational carrier receives no compensation beyond reimbursement for pregnancy-related medical expenses and lost wages.

Altruistic surrogacy is the only form of surrogacy legal in Canada, the UK, Australia, and several other countries. In the U.S., altruistic surrogacy often occurs when a friend or family member carries for the intended parents. While it significantly reduces costs (by $30,000–$60,000), the same legal contracts, medical screening, and psychological evaluations are still recommended. Some agencies will facilitate altruistic arrangements at reduced fees.

Sedation administered during the egg retrieval procedure to minimize pain and discomfort. Typically IV sedation (conscious sedation) rather than general anesthesia.

Egg retrieval is performed under ultrasound guidance with a needle passed through the vaginal wall into each ovarian follicle. IV sedation keeps the patient comfortable during the 15-30 minute procedure. Anesthesia for egg retrieval typically costs $500-$1,000 and is administered by an anesthesiologist or nurse anesthetist.

A blood test that measures ovarian reserve — the quantity of remaining eggs. AMH levels help predict response to ovarian stimulation.

AMH is produced by the small follicles in the ovaries and provides a snapshot of egg supply. Normal AMH ranges from 1.0-3.5 ng/mL, though interpretation varies by age and lab. Low AMH (under 1.0) may indicate diminished ovarian reserve, while very high AMH (over 5.0) can be associated with PCOS. AMH does not measure egg quality.

The grief experienced in advance of a loss that feels inevitable — in infertility, this often manifests during treatment as fear of failure, or when facing the possibility of never having biological children.

Anticipatory grief in infertility can occur at many stages: before a pregnancy test, while awaiting genetic testing results, during the adoption matching process, or when considering ending treatment. Symptoms include sadness, anxiety, difficulty concentrating, irritability, and emotional numbness. Unlike post-loss grief, anticipatory grief can be especially confusing because the loss hasn't happened yet and the outcome is uncertain. Therapeutic techniques like mindfulness, cognitive behavioral therapy, and acceptance and commitment therapy have shown effectiveness.

A laboratory technique in which a small opening is made in the outer shell (zona pellucida) of an embryo to help it implant in the uterine lining.

Assisted hatching may be recommended for patients over 38, those with thick zona pellucida, or after repeated implantation failures. The technique uses a laser or chemical solution to thin or breach the embryo's outer shell. It typically adds $1,000-$1,500 to cycle costs.

A blood test measuring human chorionic gonadotropin (hCG), the hormone produced by a developing pregnancy. Used to confirm pregnancy after an IVF transfer.

A beta hCG level above 5-25 mIU/mL typically indicates pregnancy, though levels vary widely. Most clinics test 9-14 days after embryo transfer. Serial beta tests (measured 48-72 hours apart) should roughly double in early pregnancy. Abnormal rising patterns may indicate ectopic pregnancy or early loss.

The biological parent of a child who has been or will be placed for adoption. The term is preferred over 'real parent' or 'natural parent' in adoption-positive language.

Birth parents make an adoption plan for a variety of reasons — financial hardship, age, life circumstances, or the desire to provide opportunities they feel unable to offer. In domestic infant adoption, birth mothers (and sometimes birth fathers) may choose the adoptive family, decide the level of ongoing contact, and receive living-expense assistance during pregnancy as permitted by state law. Consent to adoption cannot legally be given until after the child is born, and revocation periods vary by state.

An embryo that has developed for 5-6 days after fertilization, containing approximately 100-200 cells organized into an inner cell mass and outer trophectoderm.

Blastocyst-stage transfer is preferred by most clinics because embryos that reach this stage have demonstrated developmental competence. Blastocysts are graded using a system that evaluates expansion, inner cell mass quality, and trophectoderm quality (e.g., 4AA is high quality). PGT-A biopsy is performed at the blastocyst stage.

A term used by individuals who wanted to have children but were unable to due to infertility, medical conditions, circumstances, or lack of a partner, distinguishing their experience from those who are voluntarily childfree.

Childless-not-by-choice individuals often describe a grief that society doesn't fully recognize — there is no funeral, no defined mourning period, and the loss is sometimes minimized by others. Communities like Gateway Women and World Childless Week provide peer support and validation. Mental-health professionals specializing in reproductive grief can help individuals work through the loss and build a fulfilling life that accommodates — rather than ignores — their experience.

An adoption in which no identifying information is shared between the birth family and the adoptive family, and there is no ongoing contact after placement.

Closed adoptions were the norm in the U.S. through the mid-20th century. Today they are less common, as research has shown that some degree of openness generally benefits the child. In a closed adoption, original birth records are typically sealed by the court. Some states have since passed laws allowing adult adoptees to access their original birth certificates, while others maintain sealed records unless a birth parent has filed consent.

The emotional and physical exhaustion that can occur in partners, family members, and friends who support someone going through infertility, as well as in the patients themselves after prolonged treatment.

Compassion fatigue in infertility affects both the person undergoing treatment and their support network. Partners may feel helpless, emotionally drained, or guilty for having their own grief. Friends and family may withdraw because they don't know what to say. Warning signs include emotional numbness, reduced empathy, physical exhaustion, and relationship withdrawal. Setting boundaries, seeking individual therapy, and maintaining non-fertility-related activities and relationships are key coping strategies.

A surrogacy arrangement in which the gestational carrier receives payment beyond reimbursement of pregnancy-related expenses. Also called commercial surrogacy.

Compensated surrogacy is legal in many U.S. states and is the most common arrangement domestically. Base compensation for first-time carriers typically ranges from $30,000 to $50,000, with experienced carriers earning $40,000 to $60,000+. Additional compensation may be paid for multiples, C-section delivery, invasive procedures, or breast-milk pumping. Some countries (including Canada, the UK, and Australia) prohibit compensated surrogacy and only allow altruistic arrangements where the carrier is reimbursed for expenses.

A condition in which the quantity or quality of remaining eggs is lower than expected for a patient's age, reducing the chance of natural conception and IVF success.

DOR is diagnosed through AMH levels (below 1.0 ng/mL), FSH levels (above 10 mIU/mL), and/or antral follicle count (AFC below 5-7). DOR can occur at any age but becomes more common after 35. Patients with DOR may require higher medication doses, may retrieve fewer eggs, and may benefit from multiple retrieval cycles (banking) before attempting transfer.

Grief that is not openly acknowledged, socially validated, or publicly mourned — common in infertility, pregnancy loss, failed adoptions, and the decision to stop treatment.

People experiencing infertility often feel their grief is invisible because there is no tangible loss that others can see. Comments like 'just relax' or 'you can always adopt' can deepen the sense of isolation. Disenfranchised grief can lead to complicated grief responses, depression, and anxiety when not addressed. Therapy with a reproductive-grief specialist, support groups (in-person or online), and journaling are evidence-based approaches to processing this type of loss.

Eggs provided by a donor for use in IVF when a patient cannot produce viable eggs of their own.

Donor egg IVF is often recommended for patients over 42, those with diminished ovarian reserve, or after repeated IVF failures with own eggs. Fresh donor egg cycles typically cost $20,000-$35,000 (including donor compensation), while frozen donor egg banks offer a lower-cost alternative at $12,000-$18,000. Success rates with donor eggs are generally 50-65% per transfer regardless of the recipient's age.

The process of retrieving, freezing, and storing unfertilized eggs (oocytes) for future use in fertility treatments.

Egg freezing (oocyte cryopreservation) uses vitrification, a rapid-freezing technique that significantly improved survival rates compared to older slow-freeze methods. The process is identical to the first half of an IVF cycle: ovarian stimulation followed by egg retrieval. Costs typically run $4,000-$7,000 plus annual storage fees of $500-$1,000.

A visual assessment system used by embryologists to evaluate embryo quality and development potential based on cell structure and appearance.

Day 3 embryos are graded by cell number and fragmentation (e.g., Grade 1 = 8 cells, minimal fragmentation). Blastocysts use a three-part grading system: expansion number (1-6), inner cell mass grade (A-C), and trophectoderm grade (A-C). While higher grades correlate with better outcomes, lower-grade embryos can still result in healthy pregnancies.

The cryopreservation (freezing) and long-term storage of embryos in liquid nitrogen for future use.

Embryos are frozen using vitrification and stored in liquid nitrogen tanks at -196°C. Annual storage fees typically range from $500-$1,000 per year. Frozen embryos can remain viable for decades. Patients should discuss storage duration, ownership in case of divorce or death, and disposition options with their clinic.

A biopsy-based test that evaluates whether the uterine lining is receptive to embryo implantation at the expected time during the cycle.

ERA identifies the optimal window of implantation (WOI) by analyzing gene expression in an endometrial biopsy. Results may show the patient is receptive, pre-receptive, or post-receptive, allowing the clinic to adjust transfer timing accordingly. The test costs approximately $800-$1,200 and is typically recommended after 2+ failed transfers with good-quality embryos.

The Employee Retirement Income Security Act — a federal law that governs self-insured employer health plans and exempts them from state insurance mandates.

Many large employers self-insure their health plans, meaning they pay claims directly rather than purchasing insurance. Because ERISA preempts state law, these self-insured plans are not required to follow state fertility mandates — even in states with strong mandate-to-cover laws. Approximately 60% of covered workers are in self-insured plans.

A third-party managed bank account used in surrogacy to hold the intended parents' funds and disburse payments to the gestational carrier and service providers according to the surrogacy contract.

Escrow accounts are managed by specialized surrogacy escrow companies and provide financial protection for both parties. Intended parents typically fund the account with the full carrier compensation plus a reserve for expenses before the embryo transfer. Payments are released at contractual milestones — monthly installments, heartbeat confirmation, maternity clothing allowances, and final payment after delivery. Escrow management fees typically range from $750 to $1,500.

A hormone produced by the pituitary gland that stimulates the growth of ovarian follicles and egg maturation.

FSH levels are measured via blood test, typically on cycle day 2-3. Elevated FSH (above 10-12 mIU/mL) may indicate diminished ovarian reserve. In IVF, synthetic FSH (gonadotropins) is administered via injection to stimulate multiple follicle growth during ovarian stimulation.

Adoption of a child from the public foster care system, typically after the biological parents' rights have been legally terminated. Foster care adoption is often the lowest-cost form of adoption.

There are approximately 115,000 children in the U.S. foster care system waiting to be adopted. Foster care adoption costs are minimal — often under $2,500 — because the state covers most expenses and families may receive adoption subsidies and Medicaid for the child. Many children available for adoption through foster care are older, part of sibling groups, or have special needs. Prospective parents must become licensed foster parents first, which involves training (typically 24–30 hours), a home study, and background checks.

The transfer of a previously frozen (cryopreserved) embryo to the uterus, either in a natural or medicated cycle.

FET has become the standard approach in many clinics, as freezing all embryos (freeze-all strategy) allows for PGT-A testing and better uterine preparation. FET success rates are comparable to or better than fresh transfers. A typical FET cycle costs $3,000-$5,000, significantly less than a full IVF cycle.

A blood or saliva test that determines whether a person carries a gene mutation for inherited conditions like cystic fibrosis, spinal muscular atrophy, or fragile X syndrome.

Expanded carrier screening panels can test for 100-300+ conditions simultaneously. If both partners carry the same recessive condition, each pregnancy has a 25% chance of being affected. Carrier screening costs $250-$500 and is recommended before starting IVF so that PGT-M can be incorporated if needed.

A person who carries and delivers a baby for another individual or couple (the intended parents) with no genetic relationship to the child. The medical term used by ASRM and most fertility clinics.

Gestational carriers undergo medical and psychological screening before being matched with intended parents. Medical requirements typically include having had at least one successful pregnancy and delivery, being between 21 and 45 years old, and having a healthy BMI. The carrier takes medications to prepare her uterine lining for embryo transfer. The carrier has no parental rights over the child in states with favorable surrogacy laws.

A surrogacy arrangement in which the surrogate (gestational carrier) carries an embryo created from the intended parents' or donors' eggs and sperm, with no genetic connection to the child.

Gestational surrogacy accounts for the vast majority of surrogacy arrangements in the U.S. The process involves IVF to create embryos, which are transferred to the carrier's uterus. Total costs typically range from $100,000 to $200,000+ including carrier compensation ($30,000–$60,000), agency fees ($15,000–$30,000), legal fees ($10,000–$15,000), medical costs, and insurance. Gestational surrogacy is legally recognized in most but not all U.S. states.

Injectable fertility medications containing FSH, LH, or both, used to stimulate the ovaries to produce multiple eggs during an IVF cycle.

Common brand names include Gonal-F, Follistim (FSH), and Menopur (FSH+LH). Gonadotropin costs typically range from $3,000-$6,000 per cycle depending on dosage and duration. Higher doses are often needed for patients with low ovarian reserve. These medications are a significant component of overall IVF costs.

A comprehensive evaluation required for all adoptions, conducted by a licensed social worker, that assesses prospective adoptive parents' fitness to parent through interviews, home visits, background checks, and documentation review.

The home study process typically takes 3–6 months and costs $1,500–$3,000. It includes individual and joint interviews, financial statements, medical clearances, reference letters, pet vaccinations, home safety inspections, and criminal background and child-abuse registry checks. Home studies must be updated or renewed (usually annually) if the adoption is not finalized within a set period. The report becomes part of the legal adoption file and is reviewed by the court before finalization.

A fertility treatment in which eggs are retrieved from the ovaries and fertilized with sperm in a laboratory. The resulting embryos are then transferred to the uterus.

IVF is the most common and effective form of assisted reproductive technology (ART). A typical cycle involves ovarian stimulation with medications, egg retrieval under sedation, fertilization in the lab, embryo culture for 3-5 days, and embryo transfer. IVF success rates vary significantly by age, with live birth rates ranging from about 54% for patients under 35 to around 4% for patients over 42.

A licensed mental-health professional who specializes in the psychological aspects of infertility, reproductive loss, third-party reproduction, and family-building decisions.

Infertility counselors may hold credentials from ASRM's Mental Health Professional Group (MHPG) and are trained in the unique psychological challenges of fertility treatment, donor conception, surrogacy, and adoption. They provide individual, couples, and group therapy. Many fertility clinics have an on-staff counselor or referral network. Sessions may address treatment decisions, relationship strain, grief, anxiety around procedures, or the transition to non-biological family building. RESOLVE: The National Infertility Association maintains a therapist directory.

The individual or couple who will become the legal parents of a child born through surrogacy. They may or may not have a genetic connection to the child depending on whether donor eggs or sperm are used.

Intended parents may be heterosexual couples who cannot carry a pregnancy, same-sex male couples, single individuals, or anyone for whom surrogacy is the chosen path to parenthood. The intended parents are typically responsible for all surrogacy-related costs. Their rights are established through a pre-birth order (in favorable states) or post-birth adoption proceedings.

Adoption of a child from another country, governed by the laws of both the child's country of origin and the adoptive parents' country of residence, as well as international treaties like the Hague Convention.

International adoption has declined significantly since the mid-2000s due to tightening regulations and some countries closing their programs. Costs typically range from $25,000 to $50,000+ and include agency fees, travel, immigration processing (I-800 or I-600 forms), translation, and in-country legal fees. Wait times vary from 1 to 5+ years depending on the country. The Hague Convention on Intercountry Adoption (effective in the U.S. since 2008) establishes safeguards to ensure adoptions are in the best interest of the child.

A legal agreement among all 50 U.S. states, the District of Columbia, and the U.S. Virgin Islands that governs the placement of children across state lines for adoption or foster care.

ICPC ensures that children placed across state lines receive the same protections they would in their home state. Before a child can leave the birth state, the ICPC office in both the sending and receiving states must approve the placement. This process typically takes 5–15 business days but can take longer. Families must remain in the birth state with the child until ICPC clearance is granted. Violating ICPC is a misdemeanor in most states.

A specialized IVF technique where a single sperm is injected directly into the center of an egg to facilitate fertilization.

ICSI is commonly recommended when there are concerns about sperm quality, quantity, or motility, or when previous IVF cycles have had poor fertilization rates. It adds approximately $1,500 to the cost of an IVF cycle. ICSI fertilization rates are generally 70-80%.

A fertility procedure in which prepared (washed) sperm is placed directly into the uterus around the time of ovulation.

IUI is a less invasive and less expensive alternative to IVF, typically costing $500-$2,000 per cycle. Success rates per cycle range from 10-20% and are influenced by the patient's age, cause of infertility, and whether fertility medications are used. Many insurance mandates require IUI attempts before covering IVF.

A state law requiring health insurers to include fertility treatment (often including IVF) in covered benefits for eligible health plans.

States with mandate-to-cover laws provide the strongest legal protection for fertility patients. However, coverage details vary significantly — including which treatments are covered, cycle limits, employer size requirements, and eligibility criteria. Self-insured employer plans (governed by federal ERISA law) are exempt from state mandates.

A state law requiring health insurers to make fertility coverage available as a purchasable option, though employers are not required to buy it.

Mandate-to-offer states (like Texas) require insurers to include IVF coverage in their product offerings, but the decision to purchase that coverage rests with the employer. This means many employees in these states still lack fertility coverage because their employer chose not to include it.

An adoption arrangement in which the adoptive family and the birth family maintain some form of ongoing contact, which may include letters, photos, phone calls, or in-person visits.

Open adoption has become the most common arrangement in domestic infant adoption, with studies showing it benefits adoptees' identity development and emotional well-being. The level of openness is agreed upon by both parties and can evolve over time. While post-adoption contact agreements (PACAs) are legally enforceable in some states, in others they are voluntary. Openness exists on a spectrum — some families share occasional updates while others have regular visits.

A potentially serious side effect of ovarian stimulation where the ovaries swell and fluid leaks into the body, causing bloating, pain, and in severe cases, blood clots or kidney problems.

Mild OHSS occurs in up to 33% of IVF cycles and resolves on its own. Moderate to severe OHSS occurs in 3-8% of cycles and may require medical intervention. Risk factors include PCOS, young age, low body weight, and high AMH. Modern protocols using GnRH agonist triggers and freeze-all strategies have significantly reduced severe OHSS rates.

A court order obtained before the child's birth that establishes the intended parents as the legal parents, allowing their names to appear on the original birth certificate.

Pre-birth orders are available in surrogacy-friendly states like California, Connecticut, Maine, Nevada, and others. They are typically filed in the second or third trimester and require the surrogacy contract, proof of the gestational arrangement, and sometimes genetic testing. In states that don't allow PBOs, intended parents may need to obtain a post-birth parentage order or complete a stepparent or second-parent adoption. The legal landscape varies significantly by state.

A genetic test performed on embryos before transfer to check for the correct number of chromosomes (aneuploidy screening).

PGT-A (formerly known as PGS) involves biopsying a few cells from each embryo at the blastocyst stage. Results help identify chromosomally normal (euploid) embryos, which have higher implantation rates and lower miscarriage risk. The test typically costs around $5,000 per cycle and is especially valuable for patients 35 and older, when aneuploidy rates increase significantly.

A genetic test on embryos to detect specific inherited single-gene disorders such as cystic fibrosis, sickle cell disease, or BRCA mutations.

PGT-M (formerly PGD) requires a custom probe developed for the specific mutation being tested. This probe development can cost $2,000-$5,000 and takes several weeks. Per-embryo testing adds additional costs. PGT-M is recommended when one or both partners carry a known genetic mutation.

A mental-health evaluation required for both the gestational carrier (and her partner, if applicable) and the intended parents before a surrogacy arrangement can proceed.

ASRM guidelines recommend psychological screening by a licensed mental-health professional experienced in third-party reproduction. The evaluation assesses the carrier's motivations, emotional stability, understanding of the process, support system, and any history of mental-health conditions. Intended parents are assessed for readiness, expectations about the carrier relationship, and coping strategies. Standardized testing (such as the MMPI-2 or PAI) is typically administered to the carrier. The evaluation costs $500–$1,500.

Defined as two or more consecutive pregnancy losses before 20 weeks of gestation. Affects 1–2% of couples trying to conceive and may indicate an underlying medical condition.

Causes of RPL include chromosomal abnormalities (responsible for ~50–60% of first-trimester losses), uterine anomalies, blood-clotting disorders (like antiphospholipid syndrome), hormonal imbalances, and immunological factors. After two consecutive losses, most reproductive endocrinologists recommend a full workup including karyotyping of both partners, uterine imaging, and thrombophilia screening. PGT-A testing of embryos during IVF can reduce miscarriage rates for those with chromosomal causes. The emotional impact is profound, and grief counseling is strongly recommended.

A physician who specializes in reproductive medicine and infertility. REIs complete OB/GYN residency plus a 3-year fellowship in reproductive endocrinology.

REIs are board-certified specialists who diagnose and treat infertility, perform IVF procedures, and manage complex reproductive conditions. Choosing an REI often involves reviewing their clinic's SART-reported success rates, specialty areas, and patient reviews. Most patients are referred to an REI after 6-12 months of unsuccessful attempts to conceive.

Psychological trauma resulting from distressing reproductive experiences including infertility diagnosis, invasive treatments, pregnancy loss, traumatic birth, NICU stays, or failed adoptions.

Reproductive trauma can produce symptoms similar to PTSD — intrusive thoughts, avoidance of triggers (pregnant people, baby showers, social media announcements), hypervigilance, emotional numbness, and sleep disturbances. It is increasingly recognized as a distinct form of trauma that deserves specialized treatment. EMDR (Eye Movement Desensitization and Reprocessing), trauma-focused CBT, and somatic experiencing are evidence-based approaches. Reproductive trauma may affect future family-building decisions and requires long-term therapeutic support.

The Society for Assisted Reproductive Technology — the primary organization that collects and publishes IVF clinic success rate data in the United States.

SART member clinics report their outcomes (cycles, pregnancy rates, live birth rates) annually. This data is publicly available at sart.org and is often used by patients to compare clinics. SART data breaks down results by patient age, diagnosis, and embryo type (fresh vs frozen). Over 90% of US IVF clinics are SART members.

The inability to become pregnant or carry a pregnancy to term after previously giving birth without difficulty. It affects approximately 11% of couples in the U.S.

Secondary infertility can be caused by age-related fertility decline, changes in health or weight, new medical conditions, complications from a prior pregnancy or delivery, or unexplained factors. It is often emotionally isolating because people may feel their grief is invalidated ('at least you have one'). Those experiencing secondary infertility face the same medical workup and treatment options as primary infertility, and support groups specific to secondary infertility can be especially helpful.

A legally binding contract between the intended parents and the gestational carrier that outlines compensation, medical decisions, behavioral expectations, insurance, legal parentage, and the rights and responsibilities of all parties.

Surrogacy agreements are drafted by reproductive attorneys and reviewed by independent counsel for both sides (the carrier must have her own attorney). Key provisions include base compensation and additional pay for multiples or C-section, health and life insurance coverage, allowable and restricted activities during pregnancy, selective reduction and termination clauses, and post-birth hospital arrangements. Legal fees for the agreement typically run $10,000–$15,000 total.

The legal process by which a parent's rights and responsibilities toward their child are permanently ended, which must occur before a child can be legally adopted by another family.

TPR can be voluntary (a birth parent signs a consent or relinquishment) or involuntary (a court terminates rights due to abuse, neglect, abandonment, or failure to comply with a reunification plan). Voluntary consent timelines vary by state — some allow consent as early as 24 hours after birth, while others require a waiting period of up to 15 days. Revocation windows also vary. Involuntary TPR requires a court proceeding with legal representation for the parents.

A surrogacy arrangement in which the surrogate uses her own eggs, making her the biological mother of the child. Conception occurs through IUI or IVF with the intended father's or donor's sperm.

Traditional surrogacy is far less common than gestational surrogacy today, largely because of the legal complexity — the surrogate has a genetic connection to the child. Many agencies refuse traditional surrogacy arrangements, and some states do not enforce traditional surrogacy contracts. When it is pursued, it tends to cost less than gestational surrogacy because no egg donor or egg-retrieval IVF cycle is needed. Legal parentage typically requires a post-birth adoption or parentage order.

An injection of hCG or GnRH agonist given to trigger final egg maturation approximately 36 hours before egg retrieval.

The trigger shot causes the eggs to complete their final maturation so they can be retrieved. hCG triggers (Ovidrel, Pregnyl) are the traditional approach, while GnRH agonist triggers (Lupron) are used in patients at risk for PCOS or ovarian hyperstimulation syndrome (OHSS). Timing is critical — retrieval must occur approximately 36 hours after the trigger.

The approximately 14-day period between embryo transfer (or ovulation) and the pregnancy blood test (beta hCG), often described as the most emotionally challenging part of a cycle.

During the TWW, the embryo is implanting (or not) and there is no way to determine the outcome. Most clinics perform a blood beta hCG test 9-14 days after transfer. Home pregnancy tests during this period may give false negatives or false positives. Support groups and mental health resources can be especially valuable during this waiting period.

A personal profile or portfolio created by prospective adoptive parents to introduce themselves to expectant parents considering adoption. Typically includes photos, a letter, and information about the family's life and values.

The waiting family profile (sometimes called a 'Dear Birth Mother' letter or adoption profile book) is a critical part of domestic infant adoption, as birth parents often choose the adoptive family based on this material. Profiles may be physical books, websites, or digital presentations. Agencies and adoption consultants often coach families on creating authentic, compelling profiles. Wait times after completing a profile vary widely — from weeks to several years — depending on the family's openness to different situations and the agency's volume.