Fertility Glossary

A

Adhesions

Fibrous bands that form between tissues and organs, often as a result of injury during surgery. They may be thought of as internal scar tissue that connects tissues not typically connected.

Andrologist

A medical doctor or PhD who specializes in the study of male reproduction and performs laboratory evaluations of male fertility. They are usually affiliated with a fertility treatment center that performs Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF).

Anovulation

A condition in which a woman does not ovulate (produce and release eggs). This can occur with or without menstruation.

Anti-Mullerian Hormone (AMH)

The AMH hormone gives an estimate of a woman’s remaining egg quantity, or ovarian reserve. Normal range is one to three. Less than one mean a low number of eggs remain. If a woman has a high AMH it could mean she has an increased number of eggs that remain due to Polycystic Ovarian Syndrome (PCOS). If left untreated PCOS can lead to serious health problems, such as diabetes and heart disease.

Assisted Hatching

An embryology laboratory procedure that helps create a small hole in the 'shell' of the embryo to help it hatch out to implant. Assisted hatching may help the embryo along in this naturally occurring process.

Assisted Reproductive Technology (ART)

Any procedure that involves the removal of eggs from a woman prior to fertilization, such as in vitro fertilization.

Asthenozoospermia

A medical term for reduced sperm motility in which less than 50 percent of the sperm are capable of movement.

Azoospermia

The absence of sperm in the seminal fluid. This is usually caused by a blockage or an impairment of sperm production. Men with azoospermia typically have normal sexual function and will be able to find sperm with a testicular biopsy.

B

Basal Body Temperature

The body temperature of a woman, immediately upon awakening, before any activity. It may be evidence of ovulation and is used to time intercourse to increase the likelihood of conception.

Beta HCG Test (BhCG)

A blood test to determine pregnancy. If a woman is pregnant it gives a positive reading of Human Chorionic Gonadotropin (hCG). The level of hCG is around 50-100 at the time of a missed period.

Biochemical Pregnancy

A very early pregnancy miscarriage where the Human Chorionic Gonadotropin (hCG) blood test is positive but bleeding occurs and results in an early pregnancy loss.

Blighted Ovum (EGG)

An early miscarriage when the embryo (fertilized egg) implants in the uterus, but does not develop.

Bromocriptine (Parlodel)

When the hormone prolactin is elevated this oral medication is used to lower it.

C

Cancelled Cycle

The discontinuation of an assisted reproductive technology (ART) cycle. This is usually a result of poor response to hormone therapy, no egg recovery or failed fertilization.

CBC (Complete Blood Count)

One of the most commonly ordered blood tests to give information regarding infection and anemia.

Cervical Mucus

Secretions produced by the cervix. The thickness of this mucus varies according to the phase of the menstrual cycle. In the days just before ovulation, the mucus becomes thin and slippery, like egg white, which is easily penetrable by sperm.

Cervix

The lower section and opening of the uterus that protrudes into the vagina. Sperm pass through the cervix into the uterus during intercourse. It dilates during labor to allow the passage of the infant.

Chemical Pregnancy

A very early pregnancy detectable only by a blood test for hCG. The hCG level in the blood rises high enough to yield a positive pregnancy test, but then stops rising and does not lead to a clinical pregnancy, but may result in a very early miscarriage.

Clinical Pregnancy

A pregnancy with fetal cardiac activity within the uterus detectable only by ultrasound five weeks after egg retrieval.

Clomiphene Citrate (Clomid/Serophene)

A synthetic hormone, taken orally, to help women ovulate by producing extra natural Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). It is often used to treat milder forms of ovulation failure or Polycystic Ovarian Syndrome (PCOS). Men also use this medicine to help sperm production.

Congenital

A condition existing at or before birth, it may be hereditary or acquired during gestation.

Corpus Luteum

The ovulated follicle cyst, which is the container where the egg used to be in the ovary. After ovulation it releases progesterone, a hormone that preserves the uterine lining and prepares the body for pregnancy.

Cryopreservation

A freezing procedure used to preserve and store embryos, sperm and eggs.

Cycle

The period of time, about one month, when an infertility treatment is initiated and continuing until the treatment is halted or completed. It begins with the onset of one menstrual period and ends with the onset of the following period.

D

Donor Egg

The use of someone else’s eggs to achieve pregnancy. The eggs might be fresh (collected and immediately fertilized and transferred) or frozen (collected and frozen for later use). The donor is usually anonymous but can be known.

Donor Sperm

The use of someone else’s sperm to achieve pregnancy. The donor is usually anonymous but can be known.

Dysfunctional Uterine Bleeding

Irregular vaginal bleeding that may be caused by hormone imbalance or by something structural like a fibroid or polyp.

E

Ectopic Pregnancy

A pregnancy in which the embryo implants outside the uterine cavity (usually in the fallopian tube, the ovary or the abdominal cavity). May require surgical intervention or use of medications (Methotrexate) to stop growth.

Egg and Embryo Vitrification

Recent cryo-technique which 'flash freezes' eggs and embryos, preventing crystals, which may hamper results.

Egg Donation

See Oocyte Donation.

Egg Retrieval

See Oocyte Retrieval.

Embryo

The developing baby in the earliest stages of growth, from the point of conception to the eighth week of pregnancy.

Embryo Freezing

See Cryopreservation.

Embryologists

Professional scientists trained in advanced laboratory techniques that prepare and provide the necessary conditions for the fertilization of eggs with sperm resulting in embryos. They also facilitate the growth, development, maturation and preservation of embryos.

Endocrinologists

See Reproductive Endocrinologists.

Endometriosis

The presence of endometrial tissue (the uterine lining) in areas outside of the uterus such as the tubes, ovaries and peritoneal cavity. This condition can cause painful menstruation and infertility. Sometimes it can be seen by ultrasound or felt by a physical exam but surgery may be required to identify endometriosis.

Endometrium

The velvety soft glandular membrane lining of the uterus. This tissue grows thicker in response to the hormones of the menstrual cycle, which allows the embryo to implant. Eventually, the placenta will form during pregnancy starting at approximately seven weeks. With each menstruation, this lining is shed to allow a new lining to form the next month.

Epididymis

The elongated tube in the male that lies above and behind the testicles. It contains a highly convoluted canal four to six meters in length where sperm are stored, nourished and ripened for several months.

Estradiol Level (E2 Level)

The amount of estradiol, a form of estrogen, in the blood produced by the follicle where the egg is growing for that month. The mature follicle produces about 200-300 pg/ml of estradiol.

F

Fallopian Tube

Either of a pair of tubes that allow for the eggs to travel from an ovary to the uterus. The egg ovulates and is released into the tubal opening. Once in the tube, the egg waits for the sperm to arrive and fertilize it. The fertilized egg, now an embryo, must travel back to uterus within a certain amount of time and then implant in the uterine cavity.

Female Factor Infertility

The condition when a couple’s infertility is attributed to the woman.

Fertilization

Penetration of an egg by a sperm and the fusion of genetic material.

Fetal Reduction (or Selective Reduction)

A medical procedure to decrease the number of fetuses in a multiple gestation. For example, reducing quadruplets to a twin or singleton pregnancy.

Fetus

The developing baby after the embryo stage, from the ninth week of pregnancy to the moment of birth.

Fibroid/Myoma

A non-cancerous tumor found within the wall of the uterus and present in one-third to one-half of all women.

Follicle

A normal fluid-filled cyst (like a bubble) within the ovary that usually contains a ripening egg. The follicle can release an egg at ovulation. A physician can retrieve the egg from the follicle during an ART treatment cycle.

Follicle Stimulating Hormone (FSH)

Produced in the anterior pituitary gland it stimulates the ovary to grow a follicle, which gets it ready for ovulation. It can be injected under the skin to stimulate development and maturation of follicles.

Follicular Phase

The portion of the menstrual cycle when ovarian follicle development takes place, usually the first 14 or so days after menses begins.

G

Gamete

A sperm or an egg.

Gamete Intra-Fallopian Tube Transfer (GIFT)

A surgical procedure in which a sperm/egg mixture is transferred into the fallopian tubes where natural fertilization may occur.

Ganirelix

An injectable medication in the form of a subcutaneous injection that is a Gonadotropin Releasing Hormone (GnRH) antagonist used to suppress ovulation during an In Vitro Fertilization (IVF) cycle.

Gestation

The period of fetal development in the uterus from conception to birth, usually 40 weeks in humans.

Gestational Carrier

A woman who becomes pregnant through In Vitro Fertilization (IVF) with the eggs of the intended mother and sperm of the intended father. Donor eggs or sperm may also be used. The gestational surrogate has no biological connection to the child and will only carry the pregnancy. After delivery, the intended parents will have custody of the child.

Gonadotropin

A hormone that can stimulate the testicles to produce sperm or the ovaries to produce an egg.

GnRH (Gonadotropin Release Hormone)

A hormone that controls the synthesis and release of the pituitary hormones FSH and LH. GnRH is produced by the hypothalamus.

H

Hormonal Assay

Also known as the blood hormone tests. These include tests for levels of Estradiol, FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone), DHEA-S (dehydroepiandresterone), sulfate, prolactin, progesterone, estrogen and hCG.

Hormone

A chemical substance produced by one organ in the body that regulates the activity of another organ.

Human Chorionic Gonadotropin (hCG)

A hormone secreted during the pregnancy by the placenta to help prolong the life of the corpus luteum and stimulate progesterone production. A pregnancy test is positive when hCG is detected. It can be administered therapeutically (Pregnyl or Profasi) to act like Luteinizing Hormone (LH) and mature the egg, as well as, cause ovulation.

Human Menopausal Gonadotropin (hMG)

A natural product containing both human FSH and LH (sold as Pergonal, Repronex and Humegon). It is used to treat both male and female infertility and to stimulate the development of multiple eggs. These hormones are extracted from the urine of postmenopausal women.

Humegon

See Human Menopausal Gonadotropin (hMG).

Hydrocele

A fluid-filled swelling in the scrotum.

Hydrosalpinx

A dilated, fluid-filled tube, usually caused by a previous tubal infection and is often a blocked tube.

Hysterectomy

The removal of the uterus. A partial hysterectomy removes the uterus including, in some cases, the cervix. A total hysterectomy also removes the ovaries and fallopian tubes.

Hysterosalpingogram (HSG, Hysterogram, Tubogram)

An X-ray procedure used to determine whether the fallopian tubes are open and capable of functioning properly. The physician injects dye into the uterus through the cervix. The dye passes through the tubes if they are open. An HSG can also reveal information such as the configuration of the uterus, irregularities and the presence of fibroids.

Hysteroscopy

A surgical procedure in which a telescope-like device is inserted through the cervix to view the inside of the uterus. This procedure may also be performed in conjunction with a laparoscopy.

I

Idiopathic Infertility (Unexplained Infertility)

The term is used when even after an infertility work-up is done, including semen analysis in the man and assessment of ovulation and fallopian tubes in the woman, no reason can be found to explain the cause of a couple’s infertility.

Immunological Response

Condition when either a man or a woman produces antibodies, which may cause infertility.

Implantation

The embedding of the fertilized egg (embryo) in the lining of the uterus.

Infertility

The inability of a couple to achieve a pregnancy after a considerable amount of time (usually one year for females under the age of 35 or six months for a female over the age of 35) of regular unprotected sexual relations. Infertility also includes a woman being unable to carry a pregnancy to live birth.

Intracytoplasmic Sperm Injection (ICSI)

A laboratory procedure in which a single sperm is directly inserted into an individual egg.

Intrauterine Insemination (IUI)

The introduction of specially prepared sperm directly into the uterus through the cervix.

In Vitro Fertilization (IVF)

A procedure in which one or more eggs, each removed from a ripe follicle, is fertilized by a sperm outside the human body.

J

K

Karyotype

A number of containers called chromosomes which house the DNA of a person. A normal woman has 46 chromosomes, the last pair being XX. A normal man has 46 XY chromosomes.

L

Laparoscopy

A surgical procedure in which a telescope-like device is inserted through a small incision near the navel to view the pelvic cavity, the ovaries, fallopian tubes and uterus.

Leuprolide Acetate

See Lupron.

LH

See Luteinizing Hormone.

LH Surge

A spontaneous release of large amounts of Luteinizing Hormone (LH) during a woman’s menstrual cycle. This normally results in the release of a mature egg from a follicle (ovulation). Ovulation predictor kits (OPKs) measure LH in the urine.

Lupron

A hormonal medication that can create a pseudo menopause. A chemical similar to GnRH, it first stimulates the female hormones, then suppresses a woman’s secretion of FSH and LH. Concurrent treatment with Lupron tends to increase the number of follicles, oocytes (eggs) and embryos during a cycle, decreasing the risk of a cancelled cycle.

Lupron 'Down Regulation' Long Protocol

A treatment with Lupron that takes advantage of the suppression of natural hormone (LH and FSH) secretions. Used before injection of gonadotropins to stimulate follicular development for In Vitro Fertilization (IVF).

Lupron Flare

A treatment with Lupron that takes advantage of the initial rise or 'flare' of the woman’s Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) levels. This means Lupron is given during the menstrual period.

Luteal Phase

The days of a menstrual cycle following ovulation and ending with menses (usually lasting between 12 and 14 days).

Luteinizing Hormone (LH)

The anterior pituitary gland secretes LH, a hormone that causes the ovary to release a mature egg (ovulation). In the male, LH stimulates testosterone production. In the female, LH stimulates progesterone production after ovulation has occurred.

M

Male Factor Infertility

The condition when a couple’s infertility is attributed to the man.

Microinsemination

A laboratory technique in which sperm are injected next to the egg cell surface to increase the likelihood of fertilization.

Micromanipulation

Procedure in which a sperm, egg or embryo is manipulated under a microscope (includes Intracytoplasmic Sperm Injection (ICSI)), assisted hatching and embryo biopsy for Preimplantation Genetic Diagnosis (PGD).

Morphology

A branch of biology dealing with the study of form and structure of organisms and their specific structural features. It is used to describe eggs, sperm and embryos. See Sperm Morphology.

Motility

A term used when a man has a semen analysis to determine the health of his sperm or the percentage of all moving sperm in a semen sample. Grade 1 swimming is poor and barely shaking. Grade 2 is moving in circles but without forward progression. Grade 3 is moving forward at a good speed. Grade 4 motility is moving forward at an excellent speed. Normally, 50 percent or more sperm in a sample move or swim rapidly. See Sperm Motility

Multiple Birth

The birth of two or more offspring produced in the same gestational period.

Multiple Gestation or Multiple Pregnancy

The conception of two or more fetuses in the same woman at the same time, whether or not they result in live births.

Myomectomy

The surgical removal of non-cancerous fibroid tumors originating from the wall of the uterus.

N

O

Oligo-Ovulation

Irregular ovulation where ovulation is not happening often.

Oligozoospermia

A condition in which the number of sperm in a semen sample are abnormally low.

Oocyte

The egg cell produced in the ovaries. Also called the ovum or gamete.

Oocyte Donation

The process in which eggs are removed from the ovaries of one woman and donated for use by another.

Oocyte Retrieval

A surgical procedure, usually under twilight sedation, to collect the eggs contained within the ovarian follicles before ovulation. The physician inserts a needle into the follicle under vaginal ultrasound guidance and draws out the follicle’s fluid and egg through the needle. The fluid and egg are then placed into a dish for identification by the embryologist.

Ovarian Hyperstimulation

The effect of medically induced follicular development to prepare someone for ovulation, Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF) where more than one follicle is produced in a controlled fashion.

Ovarian Hyperstimulation Syndrome (OHSS)

A possible side effect of medically induced follicular development to prepare someone for ovulation, Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF). It is characterized by swollen ovaries and, in some cases, the accumulation of fluid in the abdomen and chest. At times, it can require a 'tap' where fluid is removed to help healing occur more quickly.

Ovarian Reserve

A term used to refer to the quantity and quality of eggs in the ovaries. It can be determined by several tests, including day three Follicle Stimulating Hormone (FSH), estradiol, antral follicle count, ovarian volume and Anti-Mullerian Hormone (AMH). The lower the ovarian reserve, the lower the chance for pregnancy.

Ovulation

Release of a mature egg from a follicle at the surface of the ovary. Usually the egg is trying to find its way to the fallopian tube.

Ovulation Induction

The therapeutic use of drugs or female hormones to stimulate egg development and release. Useful hormones and hormone-based medications include clomiphene citrate, Pergonal, Humegon, Repronex, Follistim, Gonal F, Bravelle and hCG (Pergonol, Pregnyl or Ovidrel).

P

Papanicolaou Smear (Pap Smear)

A screening test to evaluate the cells of the cervix to determine whether they are normal or cancerous. The physician or nurse removes some cells from the cervical canal with a brush or spatula, usually a painless process, then smears them onto a glass plate or places them in liquid. A pathologist examines the cells under a microscope.

Pelvic Inflammatory Disease (PID)

An inflammatory disease of the pelvis, often caused by infection or inflammation, which can lead to infertility by damaging the fallopian tubes.

Pergonal

See Human Menopausal Gonadotropin (hMG).

Post-Coital Test (PCT)

Microscopic study of samples of vaginal and cervical secretions taken several hours after sexual relations and examined for live, moving sperm. Also known as the Sims-Huhner Test.

Pregnyl

See Human Chorionic Gonadotropin (hCG).

Preimplantation Genetic Diagnosis (PGD)/Preimplantation Genetic Screening (PGS)

Chromosomal abnormalities on embryos created during an IVF cycle. This is a delicately precise micro-manipulative procedure, in which embryologists remove either necessary DNA from the egg shortly after fertilization (polar body biopsy) or a single cell from a three-day old embryo (embryo biopsy). Molecular biologists examine cells for genetic abnormalities.

Premature Ovarian Failure (POF)

The occurrence of menopause when a woman experiences the loss of ovarian function before the age of 40, associated with high levels of hormones called gonadotropins (high Follicle Stimulating Hormone (FSH) and low Anti-Mullerian Hormone (AMH) and low levels of estrogen. The ovary may intermittently produce an egg (mature follicle) and ovulate.

Profasi

See Human Chorionic Gonadotropin (hCG).

Progesterone

The hormone produced after ovulation by the ovary’s corpus luteum. It prepares the lining of the uterus to accept implantation of a fertilized egg, the embryo. It is released in pulses, so the amount in the bloodstream is not constant. The placenta also produces it during pregnancy.

Prolactin

A hormone produced by the pituitary gland. This gland plays an important role during pregnancy, preparing the breasts for nursing. An inappropriate elevation at times other than pregnancy may interfere with normal ovulation.

Q

R

Recurrent Pregnancy Loss (RPL)

Defined as two or more consecutive miscarriages in the first trimester of pregnancy. Medical evaluation is beneficial and treatment is often possible.

Reproductive Endocrinologists (RE)

Physicians trained in obstetrics and gynecology that further specialize and are certified to treat infertility with surgical procedures and technologies associated with physician-assisted reproduction.

Rubella Titer

A blood test that determines if the patient is immune to rubella (German measles), a viral disease that can cause severe birth defects. If a woman is not immune to rubella, she may be advised to have a rubella vaccination, wait one month before attempting pregnancy, and then re-test for immunity.

S

Secondary Infertility

The inability to conceive or carry a pregnancy after having conceived and carried one or more pregnancies.

Selective Reduction

See Fetal Reduction.

Semen

The sperm and seminal secretions ejaculated during orgasm.

Semen Analysis (SA)

A microscopic examination of freshly ejaculated semen to evaluate the number of sperm (count), the percentage of moving sperm (motility) and the size and shape of the sperm (morphology).

Sims-Huhner Test

See Post-Coital Test.

Sperm Antibodies (Immunological Response)

Entities that may attack and destroy sperm cells. These antibodies can be produced by women, or by men against their own sperm, often seen in men who have had a vasectomy.

Sperm

A sperm is the male 'gamete' or sex cell. It combines with the female 'gamete,' called an ovum, to form a zygote. The formation process is called 'fertilization.' See oocyte and zygote.

Sperm Morphology

An important component of a complete semen analysis that determines the percentage of sperm cells that have a normal appearance under magnification. The sperm morphology may be evaluated using either World Health Organization (WHO) criteria, where normal is 30 percent or more. A Strict or Kruger criteria is used to assess shape, where 14 percent is less than normal.

Sperm Wash

A technique for separating sperm from seminal fluid.

Split Ejaculate

A method of collecting a semen specimen so that the first portion of the ejaculate is caught in one container and the rest in a second container. In most men the first specimen will contain the vast majority of the sperm.

Spontaneous Abortion

A miscarriage or the unintended termination of a pregnancy before the twentieth week.

Sterility

The total inability to reproduce. Not to be confused with infertility. There are options for someone who is sterile to conceive but it may require donor egg, donor sperm or gestational surrogacy.

Stimulation

Administration of hormones that induce development of multiple ovarian follicles.

Surrogate

A woman who becomes pregnant through insemination with the sperm of the partner of an infertile woman, and then following delivery, turns the child over for adoption by the couple. Also called Traditional Surrogate.

Swim-Up Test

A technique that separates motile sperm from non-motile sperm and cellular debris in a semen sample. The most motile sperm will 'swim up' and are more easily separated for insemination.

T

Testicles

The two male sexual glands contained in the scrotum. They produce the male hormone testosterone and produce the male reproductive cells, the sperm.

Testicular Biopsy

A small excision of testicular tissue to determine the ability of the cells to produce normal sperm and/or to obtain sperm to use for In Vitro Fertilization (IVF). Testicular Epididymal Sperm Extraction (TESE) where the sperm is carefully removed for In Vitro Fertilization (IVF).

Testosterone

The most potent male sex hormone. It is produced in the testes, and to a lesser extent, by the ovaries.

Therapeutic Insemination (TI)

A procedure in which sperm from a male partner or from a donor (Therapeutic Donor Insemination — TDI) are placed into a woman's vagina or cervix. Also called artificial insemination, but distinct from intrauterine insemination.

Traditional Surrogate

A woman who becomes pregnant through insemination or In Vitro Fertilization (IVF) with her own eggs and the sperm of the male partner of an infertile woman. The traditional surrogate will carry the pregnancy and after delivery, the male partner and infertile woman (who only have one biological link to the child) will have custody of the child through adoption.

Tubal Embryo Transfer (TET)

A surgical procedure in which a fertilized and divided egg is transferred to the fallopian tubes.

U

Ultrasound

A technique used to view the follicles in the ovaries or the fetus in the uterus. It can be performed transvaginally or transabdominally. See also Vaginal Ultrasound.

Unexplained Infertility

See Idiopathic Infertility.

Uterus

The hollow, muscular organ in the woman that holds and nourishes the fetus until the time of birth, also known as the womb.

V

Vaginal Ultrasound

Technique used to view the follicles, fetus and other soft tissues by projecting sound waves through a probe inserted into the vagina. A baseline ultrasound shows the ovaries in their normal state. A follicular ultrasound shows egg follicle maturation. A pregnancy ultrasound shows if a pregnancy is in the uterus or in a fallopian tube (an ectopic pregnancy). Ultrasound pictures can be used to measure growth.

Varicocele

A collection of varicose veins in the scrotum, which may be associated with poor sperm quality. Blood flows in an abnormal direction in these veins towards the testicles.

Vas Deferens

A pair of thick-walled tubes about 45 cm long in the male that lead from the epididymis to the ejaculatory duct in the prostate. During ejaculation, the ducts make wavelike contractions to propel sperm forward.

Vitrification

An alternative cryopreservation (freezing) method to traditional cryopreservation involving a rapid cooling method that helps prevent formation of ice crystals that cause damage to the cell. May be used to freeze embryos and oocytes as well as sperm.

W

X

Y

Z

Zygote

A fertilized egg or embryo, in the early stages of development.

Zygote Intrafallopian Transfer (ZIFT)

The surgical transfer of a zygote, or fertilized egg, into a fallopian tube one day after fertilization.