Common Fertility Terms and Their Meanings
Scar tissue that abnormally attaches to internal organs, such as the fallopian tubes, ovaries, bladder, uterus, or other internal organs. Adhesions can distort these organs, limiting their movement and function, causing infertility and pain.
American Society of Reproductive Medicine (ASRM):
A steroid hormone which promotes male characteristics. The two main androgens are, androstenedione and testosterone.
The loss of the ability to feel pain, caused by the administration of a drug or other medical intervention.
Removal of fluid and cells by suction through a needle. This technique applies to many procedures in reproductive medicine.
Assisted Hatching (AH):
Assisted hatching occurs in the lab prior to the embryo transfer. Before the embryo can attach to the uterine wall, it must break out of its membrane. In some women (particularly older women), this membrane is hardened, making it difficult for the embryo to hatch and implant. The embryologist will use a laser or mild acid to thin the shell, enabling hatching.
Assisted Reproductive Technologies:
A group of fertility therapies that employ manipulations of the oocyte (the egg) and sperm in the laboratory in order to establish a pregnancy. These therapies include IVF, ICSI, donor egg cycles, assisted hatching, and pre-implantation genetic diagnosis.
Basal Body Temperature:
Also known as the 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 recorded charts can be studied to help identify the time of ovulation, or even if a woman is ovulating at all.
The process that sperm must undergo in order to fertilize an oocyte.
Infertility due to a structural of hormonal abnormality of the cervix. This can be induced by previous surgery on the cervix that leaves the cervical canal scarred or closed, termed stenosis. Factors associated with the cervix which inhibit sperm function such as thickened mucus preventing the sperm from traveling through the cervix into the female reproductive tract also applies. Cervical factor infertility can usually be overcome using insemination of sperm past the cervix in to the uterus.
The narrow neck-like passage forming the lower end of the uterus serving as a reservoir for sperm.
A positive pregnancy test, with levels of pregnancy hormone (beta hCG) too low for ultrasound documentation of a pregnancy. This also includes pregnancies that have low beta hCG levels that spontaneously decline without any further development.
Division of one cell into two, two into four, four into eight, etc. This is measured in the embryology laboratory during IVF cycles.
A pregnancy in which the fetal heartbeat has been identified by ultrasound.
Clomiphene Citrate (Clomid):
An oral medication used to stimulate the ovaries and synchronize follicle development.
A special gland that forms from the ovulated follicle in the ovary and 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 weeks 8-10 of gestation.
To preserve cells, tissues, or embryos by freezing at a very low temperature in tank of liquid nitrogen. This may be employed for sperm, embryos, and oocytes.
A fluid filled structure found anywhere in the body. In reproductive medicine we primarily refer to them in the ovaries. Ovarian cysts may be normal or abnormal depending on the circumstances. Often times they are just follicles that have not been fully reabsorbed from previous menstrual or treatment cycles.
The use of donated eggs from an anonymous or known donor. Eggs are harvested through 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 and sperm of another patient, who may be anonymous or known, to the infertile recipient.
The introduction of sperm from an anonymous volunteer donor into the vagina, cervix, or uterine cavity in order to achieve a pregnancy.
The process by which a man gives or sells his semen to be used for assisted reproduction.
A thick walled tubular structure running from each testis into the ejaculatory duct. These structures carry sperm from the testicles to the epididymis to the penis from ejaculation. The vas deferens can be scarred or damaged by surgery, trauma, or infection to the point where it doesn’t allow sperm to pass through.
A pregnancy implanted outside the uterus; most often in the fallopian tube. This is also called a tubal pregnancy. This can usually be diagnosed in its early stages by following the pregnancy hormone beta hCG, closely during the early part of the pregnancy. If this is left undiagnosed or untreated it can have serious medical consequences.
The procedure during an IVF cycle where the oocytes are harvested through a minimally-invasive surgical procedure. This is performed under light anesthesia so that patients are sleeping during the entire procedure.
The term used to describe the early stages of fetal growth. Defined from the second to ninth week of pregnancy, but often used to designate any time after conception.
The procedure of transferring embryos back into the endometrial cavity of a patient during an IVF cycle. This will occur on the third of fifth day after an egg retrieval.
The study of hormones, their function, and the organs that produce them along with how they are being produced.
A procedure in which a sample of the edometrium (the tissue lining the inside of the uterus) is removed for microscopic examination.
The space inside the uterus that is created by the inner lining of the uterus that responds to female hormones during the menstrual and treatment cycles. When properly prepared, this lining forms the area of attachment and implantation of the embryo. This is also known as the womb.
The presence of endometrial tissue in abnormal locations such as the ovaries, fallopian tubes and abdominal cavity. These lesions lead to local irritation and inflammation that can cause scarring to occur which can bind up pelevic organs to the point of dysfunction and pain.
The inner lining of the uterus that responds to female hormones during the menstrual cycle and treatment cycles. When properly prepared, this lining forms the area of attachment and implantation of the embryo. A part of this lining is shed every month with menstruation.
A portion of the male genital tract, next to the testis where sperm maturation is partially accomplished.
The principle hormone produced by the growing ovarian follicle. It is frequently measured in the blood, as to gauge the strength and development of the follicles during treatment cycles.
The anatomic and physiologic connection between the uterus and the ovary which serves to transport the oocyte and the sperm. It is also the site of fertilization, which supports and transports the conceptus en route to the uterus.
The union of a sperm with an oocyte to facilitate creation of a genetically unique embryos.
The overgrowth of the muscular tissue of the uterus. Fibroids are typically knotty masses of benign muscle tissue that can distort the shape and function of the uterus.
The soft and supple finger-like of the fallopian tube that aids in gathering the oocyte at the time of ovulation.
A fluid-filled pocket in the ovary that acts as a house for the microscopic egg. Each ovary has many follicles within it. Follicles start out extremely small and then grow larger under the influence of hormones. They are lined with granulosa cells which produce estrogen and nourish the oocyte. Each follicle contains a single ooctye.
Follicle Stimulating Hormone (FSH):
A hormone produced by the pituitary gland in the brain that stimulates the ovarian follicles to grow and develop. A woman’s FSH level is the measured in the blood at specialized times during the menstrual cycle to help measure ovarian reserve.
The menstrual cycle is divided up into two main parts-the follicular phase and the luteal phase. The follicular phase refers to the first half of the cycle, from onset of menses to ovulation, and last approximately fourteen days. This is associated with developing follicles that produce estradiol.
Another term for pregnancy.
A woman who agrees to carry a baby on behalf of someone else. The woman carrying the baby is not the baby’s genetic mother. An egg retrieval from the biological mother would take place and then injected with sperm to form an embryo. The embryo would then be placed in the gestational carrier.
Hormones that stimulate the ovary.
Gonadotropin Releasing Hormone:
The hormone produced by the hypothalamus in the brain that stimulates the pituitary gland to secrete gonadotropins.
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 in ovarian stimulation protocols.
Human Menopausal Gonadotropin (HMG) :
A purified extract of LH and FSH, the hormones secreted by the pituitary gland to stimulate the ovary. This is a commercial preparation used by injection to facilitate development of multiple follicles in treatment cycles.
A portion of the brain that stimulates the pituitary gland to secret LH and FSH in order to stimulate ovarian follicle development. The hypothalamus acts as a pacemaker for many important hormone-driven processes, controlling production and periodic release of the hormones from the pituitary gland.
An X-ray of the uterus and the fallopian tubes using gas or a radiopaque substance introduced through the cervix to allow visualization of the uterus cavity and the passageway of the tubes. This test will help determine if the tubes are blocking sperm from reaching the ovulated eggs through the fallopian tubes.
A minimally invasive surgery where a small telescopic camera is placed through the cervical canal into the uterine cavity. This will allow a direct visual of the endometrium, where pregnancies implant. This surgery allows the removal of any impediments to implantation such as polyps or fibroids in the uterine cavity.
The attachment and embedding of the embryo into the lining of the uterus.
In Vitro Fertilization:
A powerful procedure to help patients conceive pregnancies. In vitro fertilization entails stimulating one’s ovaries to develop multiple follicles, which is achieved with injectable medications. The goal is to produce a large number of growing follicles, then harvest the eggs inside the follicles through a surgical procedure. The eggs are then inseminated with sperm in the lab (sometimes using ICSI) in order to create embryos that can be transferred back to the womb of the patient. In vitro refers to the oocyte being fertilized by the sperm outside of the body (in the lab) rather than inside the female reproductive tract.
The 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):
This is the placement of a single sperm into a single oocyte by penetrating the outer coatings of the egg. This technique is used in cases there are very low sperm numbers, motility, or morphology. ICSI is also used for patients who have previous failed IVF cycles.
Intrauterine Insemination :
Artificial insemination in which specially washed sperm is injected through the cervix directly into the uterus. It bypasses the vaginal and cervical defense mechanisms of the female reproductive tract and allows better sperm delivery to the fallopian tubes. This allows the sperm and egg to interact in close proximity. Intrauterine insemination in commonly used in conjunction with medications that increase the number of eggs per cycle and triggering of ovulation. The goal is to have more targets for the sperm, combined with better sperm delivery and timing.
A fiber optic telescope is inserted into the female’s abdomen to look for endometriosis, scarring, adhesions, and other pelvic disease. This allows the doctor to diagnose and remove edometriosis, as well as re-open blocked fallopian tubes, amongst other things. Since the incision is so small the patient has a rapid recovery.
A synthetic form of GnRH (gonadotropin releasing hormone- secreted by the hypothalamus) used to suppress ovarian function.
Luteal Phase Deficiency (LPD) :
A deficiency of progesterone in the second half of the menstrual cycle when a pregnancy begins. Treatment involves supplementation with progestrone and other measures. Also known as luteal phase defect.
Luteinizing Hormone (LH):
A hormone produced and released by the pituitary gland. In females it is responsible for ovulation and the maintenance of the corpus luteum. In males it stimulates testosterone production and is important to the production of sperm cells.
Fluid containing nutritive growth substances that enable cells to survive in an artificial environment.
The end of a woman’s menstrual periods. A natural part of aging that occurs when the ovaries stop making hormones called estrogen. This will cause a woman’s estrogen levels to drop which leads to the end of monthly menstrual periods. (Average age for menopause is 51)
A period. A monthly flow of blood signifying ovulation, but failure to achieve pregnancy. The start of bleeding is considered cycle day one. The purpose of a natural menstrual cycle is to produce one follicle and ovulation per month, each and every month that pregnancy is not achieved.
Human FSH that is prepared in an injectable form for ovarian stimulation.
The name of a group of lab techniques that allow sperm eggs, and embryos to be performed under the guidance of a microscope.
The female reproductive cell, also referred to as an egg.
The female sex gland with both a reproductive function (releasing eggs) and a hormonal function (the production of estrogen and progesterone).
The release of a mature egg from the surface of the ovary.
Ovulation Induction :
The stimulation of ovulation by medication. This can be used to trigger oocyte release from relatively mature ovarian follicles.
A screening test to determine the presence of cervical cancer. It is done by gently touching a swab to the cervix in order to collect cells for examination by a pathologist.
A purified extract of LH and FSH, the hormones secreted from the pituitary gland which stimulate the ovary. It is a commercial preparation used by injection to facilitate development of multiple follicles in reproductive treatment cycles.
A small organ at the base of the brain that secretes many hormones, including LH and FSH in response to signals from the hypothalamus.
Polycystic Ovary Syndrome, also known as PCOS is a condition in which the ovaries accumulate tiny cysts or little follicles (2-5mm in diameter which contain an egg) instead of follicles growing and then ovulating, they stall and secrete male hormone into the blood. There is a long history of women who have PCOS having irregular periods and an increase in facial and body hair caused by more than the normal amount of male hormones in the blood.
An overgrowth of the glandular surface of the endometrium. Polyps are often removed by hysteroscopic surgery in order to remove any impediments to implantation.
An abnormal condition where the oocyte is fertilized by more than one sperm.
Post Coital Test (PCT):
The microscopic analysis of a sample of vaginal and cervical secretions that have been collected after sexual intercouse. This test allows the doctor to see if sperm survive in one’s reproductive tract. It has largely been superceded by the semen analysis.
Pre-Implantation Genetic Diagnosis (PGD):
A technique used to identify genetic defects in embryos formed through in vitro fertilization before pregnancy. PGD is used specifically when one or both genetic parents has a known genetic abnormality and testing is performed on an embryo to determine if it also carries genetic abnormaility.
A hormone produced by the ovary which prepares the uterus for implantation and supports early pregnancy.
A hormone occasionally overproduced by the brain, interfering with normal reproductive function.
A specialized stage of the oocyte adn the sperm nucleus before they join to create a genetically unique embryo. After this union the conceptus is then referred to as a zygote.
The examination of the male ejaculate under the microscope to determine the number of sperm. their motility, and their shapes (morphology). A semen analysis in vital for the evaluation of couples experiencing infertiltiy. The sperm counts, motility, and morphology all provide important information about how the sperm will perform during treatment cycles.
Single Embryo Transfer (SET) or Elective Single Embryos Transfer (eSET):
is a specific definition of only 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 in 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 cebters in the USA.
Also known as a saline infusion sonography (SIS) is an ultrasound test done after a saline solution has been injected into the uterus. The saline solution distends the uterus and acts as a contrast to the internal structure. This procedure is done during days 5-10 of one’s menstrual period, before ovulation occurs.
Sperm Antibody Test:
In some couples blood, semen and/or cervical mucus contain substances which hinder sperm action through an allergic or immune reaction
Pregnancy loss by any cause before 20 weeks of gestation
An arrangement in which a woman carries and delivers a child for another person/couple. A child born of a surrogate would have the surrogate’s genetics along with sperm donor’s genetics.
Testicular Epididymal Sperm Aspiration (TESA):
The surgical removal of sperm directly from the testis or the epidiymis using a needle for aspiration. This procedure is used for men who have no sperm in their ejaculates, or men who have had vasectomies in the past. Sperm obtained through TESE requires ICSI to ensure fertilization of the oocyte.
Another way to say; through the vagina.
The lack of obstruction of the fallopian tubes.
High frequency sound waves that can be used painlessly, safely, and without radiation, to view the internal portions of the body. Ultrasounds are especially usefuls for visualizing the female reproductive organs and pregnancies.
The inability to identify the cause of infertility despite complete evaluations of semen, ovarian reserve, ovulation, endocrinologic disorders, and pelvic anatomy.
The reproductive organ that houses, protects, and nourishes the developing embryo and fetus. The uterus consists fo the cervix, the endometrium, and the muscular layer that comprises the body of this reproductive organ. Also known as the womb.
A varicose vein around the ductus deferens and the testes. This may be the cause of low sperm counts, motility, or morphology, leading to male infertility.
A conceptus in which the genetic material of the egg and the sperm have united.
Zygote Intra-Fallopian Tube Transfer (ZIFT):
Oocytes are aspirated, fertilized in the lab, and surgically transferred into the fallopian tubes before cell division. This procedure has largely been replaced by in vitro fertilization.