Glossary of fertility terminology

Amniocentesis.
A procedure in which a small amount of amniotic fluid from the fetal sac is removed through a needle placed in the uterus at about 16 weeks into a pregnancy. The fluid is studied for chromosomal or other abnormalities which may affect fetal development. The fetal loss and infection risk is less than 2%.
Antagonist protocol.
The typical starting protocol for most fertility patients involving taking gonadotropin injections for 10-12 days to stimulate the ovaries in addition to an ovulation blocker followed by oocyte retrieval. Has reduced risk of OHSS.
Anti-müllerian Hormone (AMH).
A hormone which is often measured in a woman during her fertility work-up to help determine her egg, or “ovarian reserve”. It is secreted by small, growing ovarian follicles.
Antral follicle count.
The number of follicles noted by ultrasound at the beginning of the menstrual cycle, usually day 2 or 3 and is a reflection of ovarian reserve.
Asherman’s syndrome.
Scarring of the endometrial cavity which can occur after infection, surgery, extensive manipulation of the uterus. Often results in scant menses and infertility.
Assisted hatching (AH).
A procedure in which the zona pellucida (outer covering) of the embryo is partially thinned, usually by application of an acid or laser, to facilitate embryo implantation and pregnancy.
Assisted reproductive technologies (ART).
All treatments which include the handling of eggs, sperm and/or embryos. Some examples of ART are in vitro fertilization (IVF), Intracytoplasmic sperm injection (ICSI).
Augment.
A novel technique to take a woman’s own energy producing organs (mitochondria) from her ovaries via a surgery (laparoscopy) then inject them into the oocytes during IVF and ICSI to potentially improve embryo quality and IVF success.
Biochemical pregnancy.
When a woman’s pregnancy test is positive on her blood test or urine test, but becomes negative before a gestational sac is visible on ultrasound.
Blastocyst.
An embryo that has formed a fluid-filled cavity and the cells have begun to form the early placenta and embryo, usually 5-6 days after ovulation or egg retrieval.
Cervical canal.
The passageway leading from the vagina into the uterus.
Cervical mucus.
The substance in the cervix through which sperm must swim to enter the uterus and which assists sperm in entering the uterus.
Cervix.
The opening of the uterus.
Clinical pregnancy.
A pregnancy confirmed by an increasing level of hCG and the presence of a gestational sac detected by ultrasound.
Clomiphene citrate challenge test (CCCT).
A test of ovarian reserve in which serum FSH is checked on days three and ten of the menstrual cycle after clomiphene citrate is taken on days five through nine. Clomiphene citrate is an oral antiestrogen medication used to induce ovulation.
Conscious sedation.
General anesthesia applied through an IV during procedures such as office hysteroscopy, D+C, oocyte pickup.
Cryopreservation.
Freezing at a very low temperature, using liquid nitrogen (-196°C) to keep embryos, eggs, or sperm viable. Eggs, sperm and embryos can be kept cryopreserved for many years.
Cryopreserved.
Frozen.
Ectopic pregnancy.
A non-viable pregnancy outside of the uterus, usually in the fallopian tube.
Egg (oocyte).
The female gamete (ovum), produced by the ovary, which, when fertilized by a male’s sperm, produces an embryo.
Egg freezing.
Freezing or cryopreserving oocytes (eggs) after an IVF cycle. Can be done for elective or medical indications.
Egg (oocyte) retrieval.
The procedure in which eggs or oocytes are obtained by inserting a needle into the ovarian follicles and removing the fluid and the eggs by suction, typically under sedation (anesthesia).Also called oocyte aspiration.
Electroejaculation (EEJ).
Procedure to cause ejaculation of sperm, performed by electrical stimulation of tissue in the region of the prostate.
Embryo.
A fertilized egg that has begun cell division.
Embryo culture.
Growth of the embryo in a laboratory (culture) dish.
EmbryoGlue.
A substance made of natural glycoprotein molecules that when placed with the embryo at the time of transfer can enhance implantation success.
Embryo transfer.
Placement of an embryo into the uterus, typically under ultrasound guidance. or, in the case of ZIFT and TET, into the fallopian tube.
Endometrial scratch/biopsy.
A technique whereby the lining of the uterus (endometrium) is sampled prior to an IVF or Frozen embryo transfer cycle to improve potentially improve subsequent implantation of embryos.
Endometriosis.
A disease in which tissue resembling endometrium (the lining of the uterus) grows outside the uterus. It is often associated with infertility and can be associated with pelvic pain.
Epididymis.
The duct between testes and vas deferens where sperm are stored and mature.
Estradiol.
The predominant estrogen (hormone) produced by the follicular cells of the ovary.
Estrogen.
The female hormone largely responsible for thickening the uterine lining during the first half of the menstrual cycle in preparation for ovulation and possible pregnancy. Estradiol (E2) is the main estrogen produced by ovarian follicular cells.
Fallopian tubes.
A pair of tubes attached to the uterus, one on each side, where sperm and egg meet in normal conception and fertilization occurs The fallopian tubes transport the embryo to the uterus.
Fertility preservation.
Freezing eggs, sperm or embryos electively or for medical reasons.
Fertilization.
The fusion of sperm and egg.
Fibroids.
Benign (non-cancerous) tumors of the uterine muscle wall that can cause a variety of symptoms including abnormal uterine bleeding and pain.
Follicle.
A fluid-filled structure in the ovary containing an egg and the surrounding cells that produces hormones. As the follicle matures, the fluid can be visualized by ultrasound.
Follicle-stimulating hormone (FSH).
The pituitary hormone responsible for stimulating the growth of the follicle that surrounds the egg. In addition, it is one of the the hormone in injectable fertility medications that promotes growth of follicles during fertility treatment.
Gamete intrafallopian transfer (GIFT).
The direct transfer of sperm and eggs into the fallopian tube. Fertilization takes place inside the tube.
Gestational carrier.
A woman who carries a pregnancy for another couple. The pregnancy is derived from the egg and sperm of the couple. Although she carries the pregnancy to term, she does not have a genetic relationship to the resulting child.
Gonadotropin releasing hormone (GnRH).
Hormone secreted by the hypothalamus, a control center in the brain, which prompts the pituitary gland to release FSH and LH into the bloodstream.
GnRH agonists.
A GnRH analog that initially stimulates the pituitary gland to release LH and FSH, followed by a delayed suppressive effect. GnRH agonists are also used to prevent ovulation and synchronize follicle growth during an IVF cycle.
GnRH analogs.
Synthetic hormones similar to the naturally occurring gonadotropin releasing hormone used to prevent premature ovulation. There are two types of GnRH analogs: GnRH agonists and GnRH antagonists.
GnRH antagonists.
Synthetic hormones similar to the naturally occurring gonadotropin releasing hormone used to prevent premature ovulation during an IVF cycle. These medications have an immediate suppressive effect on the pituitary gland.
Growth hormone.
A hormone that can be given by injection during an IVF cycle to potentially improve egg and embryo quality.
Human chorionic gonadotropin (hCG).
A hormone produced by the placenta; its detection is the basis for most pregnancy tests. Also refers to the medication used to induce ovulation and during the final stages of egg maturation in a super ovulation or IVF cycle.
Human menopausal gonadotropin (hMG).
An ovulation drug that contains follicle stimulating hormone (FSH) and luteinizing hormone (LH) derived from the urine of postmenopausal women. hMG is used to stimulate the growth of multiple follicles.
Hydrosalpinx.
A blocked, dilated, fluid-filled fallopian tube.
Hysteroscopy.
Telescope evaluation of the uterine cavity under sedation which can be performed in the hospital or office. Uterine lesions such as polyps, fibroids, uterine septum, adhesions can be removed during the procedure.
Intracytoplasmic sperm injection (ICSI).
A micromanipulation procedure in which a single sperm is injected directly into an egg to attempt fertilization, used with male infertility or couples with prior IVF fertilization failure.
Intra-uterine insemination.
Placement of sperm into the uterus or cervix for producing a pregnancy, or adding sperm to eggs in IVF procedures.
In vitro fertilization (IVF).
A process in which an egg and sperm are combined in a laboratory dish to facilitate fertilization and creation of embryos.
IVF culture medium.
A special fluid with nutrients where sperm, eggs and embryos are placed to promote growth and development outside the human body in the laboratory.
Laparoscopy.
A surgical procedure that allows viewing of the internal pelvic organs. During the procedure, a long, narrow, fiberoptic instrument, called a laparoscope, is usually inserted through an incision in or below the woman’s navel. One or more additional incisions may be made for inserting additional instruments. This procedure is done under general anesthesia in the hospital operating room.
Luteinizing hormone (LH).
The pituitary hormone that normally causes ovulation and maturation of the egg. It is present in many injectable fertility medications used for ovulation induction and IVF.
Male factor.
Infertility caused by a problem in the male; for example the inability to ejaculate or insufficient quantity or quality of sperm.
Microepididymal sperm aspiration (MESA).
Outpatient microsurgical procedure used to collect sperm in men with blockage of the male reproductive ducts. Used in conditions such as prior vasectomy or absence of the vas deferens. Sperm can be used in IVF-ICSI procedures either a fresh or frozen sample.
Micromanipulation.
The IVF laboratory process whereby the egg or embryo is held with special instruments and surgically altered by procedures such as intracytoplasmic sperm injection (ICSI), assisted hatching, or embryo biopsy.
Minimal stimulation protocol.
A protocol which uses low doses of gonadotropins (fertility drugs) to potentially achieve better egg and embryo quality, typically used in poor responders.
Miscarriage.
Loss of a pregnancy before 20 weeks gestational age.
Motile.
Moving.
Multifetal pregnancy reduction.
Also known as selective reduction. A procedure to reduce the number of fetuses in the uterus. This procedure can be performed on women who are pregnant with multiple fetuses who are at an increased risk of complications with multiple gestation. These risks increase with the number of fetuses. The procedure is associated with a 4-5% risk of pregnancy loss.
Oocyte.
Medical term for egg, the female gamete. Also called ovum (singular) or ova (plural).
Ovarian hyperstimulation syndrome (OHSS).
A condition that may result from superovulation characterized by enlargement of the ovaries, fluid retention, and weight gain. Mild or moderate cases occur more frequently than severe cases, usually after IVF or gonadotropin/IUI cycles.
Ovarian reserve.
A woman’s fertility potential that is directly correlated with age and prior exposure to ovarian toxins, or ovarian surgeryDiminished ovarian reserve is associated with depletion in the number of eggs and worsening of oocyte quality.
Ovarian stimulation.
See “Ovulation induction.”
Ovary (Ovaries).
The two female sex glands in the pelvis, located one on each side of the uterus. The ovaries produce eggs and hormones including estrogen, progesterone, and androgens.
Ovulation.
Release of an egg from the ovary which occurs during a natural or stimulated cycle.
Ovulation induction.
The administration of hormone medications (ovulation drugs) that stimulate the ovaries to produce multiple eggs. Sometimes called enhanced follicular recruitment or controlled ovarian hyperstimulation.
PCOS.
A triad of long cycles, signs of high male hormones and polycystic appearing ovaries on ultrasound. Often also associated with infertility and sugar intolerance.
Penile vibratory stimulation (PVS).
A procedure to cause ejaculation of sperm, performed by vibratory stimulation of the penis.
Percutaneous epididymal sperm aspiration (PESA).
A sperm aspiration procedure in which a needle is inserted into the epididymis (gland that carries sperm from testicle to vas deferens) in order to retrieve sperm for use in an IVF procedure.
PGS.
A technique where a few cells are removed from the blastocyst and analyzed for the chromosomal component of the embryo. All 23 chromosomes can be analyzed.
Pituitary gland.
A small gland just beneath the hypothalamus in the brain that secretes follicle stimulating hormone (FSH) and luteinizing hormone (LH), as well as prolactin.
Polyps.
A typically benign growth of endometrium within the uterine cavity. Often diagnosed by sonohysterogram or when doing a hysteroscopy (telescope evaluation of the uterine cavity).
Preimplantation genetic diagnosis (PGD).
A test performed by an embryologist in which one or two cells are removed from an embryo. The removed cells are then screened for specific genetic abnormalities. PGD is typically performed in conjunction with IVF.
Premature ovarian failure.
Loss of ovarian function below the age of 40.
Progesterone.
A female hormone secreted during the second half of the menstrual cycle. It prepares the lining of the uterus for implantation of a fertilized egg. Often taken vaginally or via intramuscular injection after IVF or COH.
Pronuclei.
The nuclei of the male and female gametes (sperm and egg) seen in the one-cell embryo (zygote).
Septum, uterine.
A band of fibrous tissue present from birth that forms a wall within the uterine cavity. A septum may increase the risk of miscarriage and other pregnancy complications.
Semen.
The fluid ejaculated by the male containing the male gametes, sperm.
Society for Assisted Reproductive Technology (SART).
A society affiliated with the ASRM and comprised of representatives from assisted reproductive technology programs who have demonstrated their ability to perform IVF.
Sperm.
The male reproductive cells that fertilize a woman’s egg. The sperm head carries genetic material (chromosomes), the midpiece produces energy for movement, and the long, thin tail moves to propel the sperm toward the oocyte within the female reproductive tract.
Sperm preparation.
A method of treating semen to remove the seminal fluid and isolate the sperm cells.
Spina bifida.
A birth defect of the spinal column. Spina bifida is the failure of the spine to close properly during development. Taking folic acid can prevent spina bifida.
Testicular sperm extraction (TESSE).
Operative removal of testicular tissue in an attempt to collect living sperm for use in an IVF-ICSI procedure.
Transvaginal ultrasound aspiration.
An ultrasound-guided technique for egg retrieval whereby a long, thin needle is passed through the vagina into the ovarian follicle and suction is applied to accomplish retrieval.
Ultrasound.
A technology that uses high-frequency sound waves to form an image of internal organs on a monitor screen; used by fertility specialists to monitor the growth of ovarian follicles and to retrieve the eggs from the follicles and evaluate a pregnancy. Also used to evaluate the uterus.
Uterus (womb).
The hollow, muscular female reproductive organ in the pelvis in which an embryo implants and grows during pregnancy. The lining of the uterus, called the endometrium, produces the monthly menstrual blood flow when there is no pregnancy. The endometrium is where the embryo implants during a conception cycle.
Vagina.
The canal in the female that leads to the cervix, and then to the uterus.
Vas deferens.
The two muscular tubes that carry sperm from the epididymis to the urethra.
Vitrification.
An ultra-rapid method of freezing eggs and embryos that may offer certain advantages compared to traditional types of cryopreservation. It is the standard freezing method used in most IVF clinics.
Zona pellucida.
The egg’s outer layer that a sperm must penetrate in order to fertilize the egg.
Zygote.
A fertilized egg before cell division (cleavage) begins.