Glossary


These are some of the fertility-related terms I may use on this blog. It is not an exhaustive list of terms used during infertility treatment.

Anti-Mullerian Hormone (AMH): A hormone produced by cells from the small follicles in a woman's ovaries that is used as a marker of egg quantity. A fertility specialist may use a blood test measuring AMH to assess a woman's ovarian reserve or egg count.
  
Assisted Hatching (AH): Placing a small opening in the “shell” that surrounds every embryo. This assists the embryo in breaking out of this shell and extruding itself to implant in the endometrium. This is done by embryologists in the laboratory prior to embryo transfer in IVF cycles.

Assisted Reproductive Technologies (ART): A group of fertility therapies that employ manipulations of the oocyte (egg) and sperm in the laboratory in order to establish a pregnancy. These include IVF, ICSI, donor egg cycles, assisted hatching, preimplantation genetic diagnosis (PGD) and others.

Basal Body Temperature (BBT): The body temperature at rest taken in the morning before arising from bed. Successive BBT’s can be measured orally each morning and recorded on a calendar chart. These charts can be studied to help identify the time of ovulation, or even if a patient is ovulating at all. Menstrual calendar information is also an important part of a BBT chart. An ovulation predictor kit (OPK) can be used instead of daily temperature readings.

Blastocyst: A fertilized egg in its second phase of growth. This takes place from days five to nine after fertilization.

Cervical Mucus: Normal secretions of the cervix which change in volume and consistency throughout the menstrual cycle. Its quality is a reflection of hormonal stimulation.

Cervix: The lower section of the uterus which protrudes into the vagina and serves as a reservoir for sperm. Its anatomical functions include being a natural barrier to the inner uterus, and also keeping pregnancies from delivering prematurely.

Clinical Pregnancy: A pregnancy in which the fetal heartbeat has been identified by ultrasound.

Corpus Luteum: A special gland that forms from the ovulated follicle in the ovary. It produces progesterone during the second half of the menstrual cycle which is necessary to prepare the uterine lining for implantation. It also supports early pregnancies by secreting the necessary hormones until the placenta becomes fully functional between 8-10 weeks of gestation.

Cryopreservation: Controlled freezing and storage. This may be employed for sperm, embryos and oocytes (eggs).

Cyst: A fluid-filled structure. Cysts may be found anywhere in the body, but in reproductive medicine we primarily refer to them in the ovaries. Ovarian cysts may be normal or abnormal depending on the circumstances. Often they are just follicles that have not been fully reabsorbed from previous menstrual or treatment cycles. They are very common in both natural and stimulated cycles.

Donor Egg Cycle: The use of donated eggs from an anonymous or known donor. These eggs are harvested via an IVF cycle performed on the donor. The resultant eggs are inseminated with sperm and then form embryos which are transferred into the womb of the intended parent.

Donor Embryo Transfer: The transfer of embryos resulting from the oocyte (egg) and sperm of another patient, who may be anonymous or known, to an otherwise infertile recipient

Donor Insemination: The introduction of sperm from an anonymous volunteer donor into the vagina, cervix, or uterine cavity in order to achieve a pregnancy.

Egg Retrieval: The procedure during an IVF cycle where the oocytes (eggs) are harvested through a minimally-invasive surgical procedure. This is done under light anesthesia so that patients are sleeping during the entire process. Typically takes about 30 minutes total.

Embaby: an embryo created as part of an IVF procedure.

Embryo: The term used to describe the early stages of fetal growth. Strictly defined from the second to the ninth week of pregnancy but often used to designate any time after conception.

Embryo Transfer: The procedure of transferring embryos into the endometrial cavity (womb) of a patient during an IVF cycle.

Endometrium: The inner lining of the uterus that responds to female hormones during the menstrual cycle and treatment cycles. This lining, when properly prepared, forms the area of attachment and implantation of the embryo. A portion of this lining is shed each month with menstruation.

Endometritis: Inflammation of the endometrium.

Estradiol: The principal hormone produced by the growing ovarian follicle. It is frequently measured in the blood to gauge the strength and development of your follicles during treatment cycles.

Fallopian Tube: The anatomic and physiologic connection between the uterus and the ovary which serves to transport the oocyte (egg) and sperm. It is also the site of fertilization and supports and transports the conceptus in route to the uterus.

Fertilization: Union of a sperm with an oocyte (egg) to facilitate creation of a genetically unique embryo.

Follicle Stimulating Hormone (FSH): A hormone produced by the pituitary gland in the brain that stimulates the ovarian follicles to grow and develop. FSH is measured in the blood at specialized times during the menstrual cycle to help measure ovarian reserve.

Gamete: A mature haploid male or female germ cell which is able to unite with another of the opposite sex in sexual reproduction to form a zygote.

Gestation: Pregnancy.

Human Chorionic Gonadotropin (hCG): A hormone of early pregnancy that is monitored to determine the viability of the gestation. This hormone is also used as an injection to induce ovulation and maturation of the oocyte (egg) in ovarian stimulation protocols.

Hysterosalpingogram (HSG): An x-ray procedure to examine whether the fallopian tubes are patent (open) or not. This test helps determine if the tubes are blocking sperm from reaching the ovulated eggs through the fallopian tubes. Special x-ray dye is gently injected through the uterus and then x-ray pictures are taken to see where the dye travels.

Implantation: The attachment and embedding of the conceptus (embryo) into the lining of the uterus.

Insemination: Transfer of sperm for the purpose of establishing a pregnancy. Inseminations are performed by placing a small, soft catheter through the cervix into the uterine cavity and depositing the concentrated and activated sperm.

Intracytoplasmic Sperm Injection (ICSI): Placement of a single sperm into a single oocyte (egg) by penetrating the outer coatings of the egg. This technique is used in cases where there are very low sperm numbers, motility or morphology. ICSI is also used for patients who have had previous IVF cycles with failed fertilization.

In Vitro Fertilization (IVF): A powerful procedure to help patients conceive pregnancies. IVF entails stimulating your ovaries to develop multiple follicles. This is achieved with injectable medications. The goal of IVF is to produce a large number of growing follicles, then harvest the eggs inside the follicles through a short surgical procedure performed in our office. The eggs are then inseminated with sperm in the laboratory, sometimes using ICSI, in order to create embryos that can then be transferred back to the endometrial cavity (the womb) of the patient. The name in vitro fertilization refers to the fact that the oocyte is fertilized by the sperm in the laboratory, rather than inside the female reproductive tract.

Lupron: A synthetic form of GnRH (Gonadotropin-Releasing Hormone, secreted by the hypothalamus) used to suppress ovarian function.

Luteal Phase: The menstrual cycle is divided up into two main parts- the follicular phase and the luteal phase. This refers to the second half of the cycle, usually the last fourteen days of an ovulatory. It begins from the time of ovulation to the onset of menses, but is prolonged during pregnancy cycles. It is associated with progesterone production from the corpus luteum that facilitates implantation of embryos and supports early pregnancies.

Ovary: The female sex gland with both a reproductive function (releasing oocytes) and a hormonal function (production of estrogen and progesterone).

Ovulation: The release of a mature egg from the surface of the ovary.

Pap test: A screening test to determine the presence of cervical cancer. It is done by gently touching a swab to the cervix to collect cells for examination by a pathologist.

Preimplantation Genetic Screening (PGS): A test used to screen embryos for chromosome abnormalities.

Progesterone: A hormone produced by the ovary which prepares the uterus for implantation and supports the early pregnancy.

RESOLVE: A non-profit organization with an established, nationwide network of chapters mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders. www.resolve.org

Semen Analysis: Examination of the male ejaculate under the microscope to determine the number of sperm, their ability to move forward (motility) and their shapes (morphology). The semen analysis is a cornerstone of the evaluation of couples experiencing infertility. The sperm counts, motility and morphology all provide important information about how the sperm will perform in treatment cycles.

Single Embryo Transfer (SET): Transferring a single embryo at the culmination of an IVF cycle. This is different from the conventional practice of transferring more than one embryo. Traditional embryo transfer strategies include the idea of transferring as many embryos as is deemed safe in your age group. This ensures the highest pregnancy rates, but also exposes you to the possibility of having more than one baby, such as twins or more.

Society for Assisted Reproductive Technology (SART): Regulatory and consultative organization of the American Society for Reproductive Medicine responsible for assisted reproduction. This organization works with the CDC to publicly post fertility rates of all IVF centers in the USA.

Testicular/Epididymal Sperm Aspiration (TESA): The surgical removal of sperm directly from the testis or the epididymis using a needle for aspiration. This procedure is used for men who have no sperm in their ejaculates or have had vasectomies in the past. Sperm obtained through TESE requires ICSI to ensure fertilization of the oocyte (egg).

Transvaginal: Through the vagina.

Tubal Patency: Lack of obstruction of the Fallopian tubes.

Ultrasound: High-frequency sound waves that can be used painlessly, safely, and without radiation, to view the internal portions of the body. Ultrasound is especially useful for visualizing the female reproductive organs and pregnancies.

Uterus: Womb. The reproductive organ that houses protects and nourishes the developing embryo and fetus. It consists of the cervix, the endometrium and the muscular layer that comprises the body of this reproductive organ.

Zygote: A conceptus in which the genetic material (pronuclei) of the egg and sperm have united.

Adapted from Reproductive Medicine Associates and RESOLVE.