Glossary

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abortion, habitual:

a term referring to a condition where a woman has had two or more miscarriages.

 

abortion, missed:

a failed pregnancy where the fetus dies in the uterus but there is no bleeding or cramping (and the pregnancy is not miscarried). an intervention will be needed to remove or abort the remaining pregnancy tissue.

 

acth:

a hormone produced by the pituitary gland that stimulates the adrenal glands. excessive levels may lead to fertility problems.

 

adhesion:

scar tissue occurring in the abdominal cavity, fallopian tubes, or inside the uterus. adhesions can interfere with transport of the egg and/or implantation of the embryo in the uterus.

 

adrenal androgens:

male hormones produced by the adrenal gland which, when found in excess, may lead to fertility problems in both men and women. excess androgens in the woman may lead to the formation of male secondary sex characteristics and the suppression of pituitary gland hormones such as lh and fsh. elevated levels of androgens may be found in women with polycystic ovaries or in those with a tumor in the pituitary gland, adrenal gland, or ovary. adrenal androgen excess may also be associated with abnormally elevated levels of another hormone called prolactin.

 

amenorrhea:

refers to the absence of a menstrual bleed or period.

 

androgens:

male sex hormones.

 

andrologist:

a scientist who specializes in the study of male reproduction and performs laboratory evaluations of male fertility. he or she may hold a ph.d. degree instead of an m.d. the andrologist is usually affiliated with a fertility treatment center that performs in-vitro fertilization.

 

aneuploidy:

refers to a condition in which an abnormal number of chromosomes are found in an embryo or pregnancy. there may be missing or extra chromosomes present.

 

anovulation:

a condition in which a woman does not release mature eggs on a regular basis. menstrual (vaginal) bleeding may still occur.

 

antiperm antibodies:

antibodies are produced by the immune system to fight off foreign substances, like bacteria. antisperm antibodies attach themselves to sperm and inhibit movement and the sperm’s ability to fertilize an egg.

 

artificial insemination:

a procedure in which sperm are introduced into a woman’s uterus through clinical means instead of through sexual intercourse to increase the likelihood that sperm will reach and fertilize an egg. artificial insemination is also called “intrauterine insemination” or iui.

 

asherman’s syndrome:

a condition where the uterine walls adhere to one another. this is usually caused by uterine inflammation.

 

assisted hatching:

an in-vitro (laboratory) procedure in which the zona pellucida (protective outer shell) of an embryo (usually at the eight-cell stage or the blastocyst stage) is perforated by chemical, mechanical, or laser-assisted methods. this can assist with separation of the embryo from its zona pellucida and may increase the chance of embryo implantation during ivf.

 

assisted reproductive technology (art):

medical treatments aimed at helping women, men, and couples with fertility obstacles conceive and give birth to a healthy child. in-vitro fertilization (ivf), intracytoplasmic sperm injection (icsi), and assisted hatching are examples of fertility treatments used to help begin successful pregnancies.

 

asthenozoospermia:

low sperm motility.

 

azoopermia:

the absence of sperm in the seminal fluid, usually caused by a blockage or an impairment of sperm production.


basal body temperature:

the body temperature of a woman, immediately upon awakening, before any activity. when the temperature is recorded daily on a graph, a jump in temperature (about 0.5 °f) may be evidence of ovulation. a drop in temperature may be evidence of imminent menses or miscarriage.

 

beta hcg test (bhcg):

a blood test, often referred to as “the beta”, to determine if pregnancy took place. it gives a positive reading if human chorionic gonadotropin (hcg) is present.

 

bicornuate uterus:

a congenital malformation of the uterus where the upper portion (called “horn”) is duplicated.

 

blastocyst:

an embryo with a fluid-filled blastocele cavity (usually developing by five or six days after fertilization).

 

blighed ovum (egg):

a fertilized egg that implanted in the uterus but did not develop into a baby.

 

bromocriptine (parlodel):

an oral medication used to lower the blood level of a hormone called prolactin when it is inappropriately elevated.


cancellation:

stopping a cycle of ovarian stimulation following initiation of medication prior to egg retrieval or iui when there is an inadequate response to the fertility medication.

 

cervical mucus:

secretions produced by the cervix. the thickness of the mucus varies according to the phase of the menstrual cycle. in the days just before ovulation, the mucus becomes thin and watery and is easily penetrable by sperm.

 

cervical stenosis:

a blockage of the cervical canal from a congenital defect or from complications of surgical procedures.

 

cervix:

the lower section and opening of the uterus that protrudes into the vagina. sperm pass through the cervix into the uterus following intercourse. it dilates during labor to allow passage of the newborn baby.

 

cervix, incompetent:

a weakened cervix, which opens up prematurely during pregnancy and can cause the loss of the fetus. a cervical cerclage is a procedure in which a stitch is put around the cervix to prevent its opening prematurely. it is usually removed when the pregnancy is full term.

 

chromosome:

the structures in the cell that carry the genetic material (genes); the genetic messengers of inheritance. humans have forty-six chromosomes, twenty-three coming from the egg and twenty-three coming from the sperm.

 

clinical pregnancy:

a pregnancy is “clinical” when a pregnancy (gestational) sac is visualized in the uterus using ultrasound imaging techniques.

 

clomiphene citrate:

a fertility drug which causes a woman’s body to mature an egg-containing follicle. it comes in tablet form and is usually taken for five days.

 

congenital adrenal hyperplasia:

a congenital (from birth) condition characterized by elevated androgens which suppress the pituitary gland and interfere with spermatogenesis or ovulation. women may have ambiguous genitalia from excessive male hormone production.

 

controlled ovarian hyperstimulation (coh):

medical treatment to induce the development of multiple ovarian follicles to obtain multiple oocytes (eggs).

 

corpus luteum:

structure on an ovary that is a remnant of a follicle after ovulation. it releases progesterone, a hormone that prepares the uterine lining for embryo implantation. the corpus luteum should persist into the first trimester of pregnancy if a pregnancy does indeed occur.

 

cryopreservation:

a procedure used to preserve and store, by freezing, sperm, eggs, and/or embryos.


d&c (dilation and curettage):

a procedure used to dilate (open) the cervical canal and scrape out the lining and contents of the uterus.

 

donor insemination (di):

artificial insemination with donor sperm.

 

doxycycline:

a tetracycline derivative; an antibiotic that inhibits many of the microorganisms associated with infections of the reproductive tract. often used for treating ureaplasma infections. many physicians find routine treatment with this antibiotic more cost-effective than performing multiple cultures on both the man and women in an attempt to identify an infection.


ectopic pregnancy:

a pregnancy in which the embryo implants outside the uterine cavity, most often in the fallopian tube. less frequently, it can implant on the ovary or in the abdominal cavity. treatment usually requires surgical intervention and/or methotrexate therapy.

 

egg donor:

a woman who provides eggs or “ova” to another person who “needs” eggs. the other person can be a male in a male/male relationship, or can be another woman with poor quality or quantities of eggs. donated eggs will be fertilized in the laboratory to create embryos, after which the embryo is implanted in the uterus of the infertile woman or a surrogate.

 

egg retrieval (er):

an attempt to obtain eggs from the ovary under a type of anesthesia. this is done with a long, thin needle, through the vagina, under ultrasound imaging guidance.

 

embryo:

an early stage of human development; the undifferentiated beginnings of a baby, from the point of conception to the eighth week of pregnancy.

 

embryo transfer (et):

a process where an embryo or embryos is/are transferred into the uterus using a thin tube called a catheter.

 

embryologists:

scientists trained in advanced laboratory techniques who prepare and provide the necessary conditions for the fertilization of eggs. they also facilitate the growth, development, maturation, and preservation of sperm, eggs, and embryos.

 

endometrial biopsy:

a procedure during which a sample of the uterine lining is collected for microscopic analysis. the biopsy results can confirm ovulation and the proper preparation of the endometrium by estrogen and progesterone stimulation.

 

endometriosis:

the presence of endometrial tissue (the uterine lining) growing in areas outside of the uterine cavity. these locations can include the fallopian tubes, ovaries, and the peritoneal cavity. this condition often causes infertility and painful menstruation.

 

endometrium:

the tissue lining the inside of the uterus. this tissue responds to the cyclic production of ovarian hormones and permits implantation of the placenta during pregnancy. its upper layers are shed with menstruation.

 

epididymis:

a coiled, tubular organ attached to and lying on the testicle. within this organ, the developing sperm complete their maturation and develop their swimming capabilities. the mature sperm leave the epididymis through a tube called the vas deferens.

 

estradiol level (e2 level):

the amount of estradiol, a form of estrogen, in the blood.

 

estrogens:

a group of female hormones responsible for the development of female secondary sexual characteristics during puberty. estrogen also plays an important role in stimulating the endometrium. estrogen is produced mainly by the ovaries, starting with the onset of puberty and continues until menopause.


fallopian tube:

either of a pair of tubes that acts as a conduit for eggs to traverse from an ovary to the uterus. natural fertilization normally takes place here as an egg travels through the fallopian tube.

 

fertility specialist:

a physician specializing in the practice of fertility. the american board of obstetrics and gynecology certifies a subspecialty for ob-gyns who receive extra training in reproductive endocrinology (the study of hormones) and infertility.

 

fertilization:

the combining of the genetic material carried by sperm and egg to create an embryo. this normally occurs inside the fallopian tube (in vivo) but may also occur after manipulation of sperm and egg in a petri dish (in vitro).

 

fetus:

a term used to refer to a baby during the period of gestation between eight weeks and full term.

 

fibroid (myoma or leiomyoma):

a benign tumor of the uterine muscle and its connective tissue.

 

follicles:

fluid-filled sacs in the ovary which contain the eggs released at ovulation. each month an egg develops inside the ovary in a fluid-filled pocket called a follicle.

 

follicle stimulating hormone (fsh):

a pituitary gland hormone that stimulates spermatogenesis (in males) and follicular development (in females). in the man, fsh stimulates the sertoli cells in the testicles and supports sperm production. in the woman, fsh stimulates the granulosa cells in the ovaries to support the growth of the egg-containing ovarian follicle. elevated fsh levels may indicate poor gonadal function or failure in both men and woman.

 

follicular phase:

the pre-ovulatory portion of a woman’s menstrual cycle during which a follicle grows and high levels of estrogen cause the lining of the uterus to thicken and proliferate. this normally lasts between 12 and 14 days.


gametes:

sex cells that contain half of a person’s genetic information. male gametes are called sperm; female gametes are called eggs, ova, or oocytes.

 

gestational carrier:

a woman who carries a pregnancy resulting from fertilization with third-party sperm and oocytes. she carries the pregnancy with the intention or agreement that the offspring will be parented by one or both of the persons who produced the gametes.

 

gestational sac:

a fluid-filled structure containing an embryo that develops early in pregnancy, usually within the uterus.

 

gonadotropins:

potent fertility drugs that provide the patient with the hormones lh and/or fsh.

 

gonadotropin release hormone (gnrh):

a hormone that controls the synthesis and release of the pituitary hormones follicle stimulating hormone (fsh) and luteinizing hormone (lh). gnrh is produced by a structure in the brain called the hypothalamus.

 

gonadotropin release hormone agonists (gnrh agonists):

fertility medications used to prevent the pituitary gland from releasing the hormones fsh and lh. it can take up to seven days for the agonists to block the release of fsh and lh.

 

gonadotropin release hormone antagonists (gnrh antagonists):

fertility medications that, like gnrh agonists, suppress ovulation. the gnrh antagonists effectively prevent lh release within hours of injection.


hirsutism:

the overabundance of male-type body hair found in women with excess androgens.

 

hormone:

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

 

host uterus:

also called a “gestational mother.” a couple’s embryo is transferred to another woman who carries the pregnancy and returns the baby to the genetic parents immediately after birth.

 

human chorionic gonadotropin (hcg):

the hormone produced in early pregnancy that maintains production of progesterone from the corpus luteum. hcg is also used via injection to trigger ovulation after some fertility treatments, and it is used in men to stimulate testosterone production as well.

 

human menopausal gonadotropins (hmg):

a combination of the hormones fsh and lh, used to grow and mature follicles in some fertility treatments.

 

hypothalamus:

a part of the brain, often referred to as the hormonal regulation center, located adjacent to and above the pituitary gland. in both the man and the woman, this tissue secretes hormones such as gnrh.

 

hysterosalpingogram (hsg):

an x-ray procedure used to determine whether the fallopian tubes are open and of normal caliber. the physician injects contrast (“dye”) into the uterus through the cervix. the dye passes through the tubes if they are open. an hsg can also reveal information about the configuration of the uterus such as irregularities of the cavity and the presence of polyps or fibroids.

 

hysteroscopy:

a minor surgical procedure in which a telescope-like device is inserted through the cervix to view the inside of the uterus. this procedure is sometimes performed in conjunction with a laparoscopy.

 

hysterosonogram:

a specialized type of ultrasound used to visualize the uterine cavity. unlike a “regular ultrasound examination”, a liquid is instilled into the uterine cavity during the procedure to help determine if the uterine cavity is normal.


implantation (embryo):

the embedding of the embryo into body tissue so it can establish contact with the mother’s blood supply for nourishment. implantation usually occurs in the lining of the uterus; however, in an ectopic pregnancy, it may occur elsewhere in the body.

 

infertility:

the inability to conceive or to achieve a successful pregnancy over a considerable period of time (typically after one year for a female under the age of 35 or after six months for a female over the age of 35) despite determined attempts by intercourse without the use of contraception.

 

initiated cycles:

medication initiated to stimulate the ovaries to produce multiple follicles.

 

intracytoplasmic sperm injection (icsi):

a laboratory procedure in which a single sperm is directly inserted into an oocyte (egg cell) under a high powered microscope.

 

in vitro fertilization (ivf):

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


karyotyping:

a test performed to analyze chromosomes for the presence of certain genetic defects.


laparoscopy:

a surgical procedure during which a laparoscope, a slender tool with an attached camera and light source, enables a physician to see the inside of the body. infertility specialists perform laparoscopy to view a woman’s reproductive organs. laparoscopy can be used for diagnostic purposes or to perform surgical procedures such as removing damaged tissue and ovarian cysts.

 

lh surge:

a spontaneous or induced 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).

 

lupron:

a hormone medication that can create a pseudo-menopause. a drug similar to gnrh, it first stimulates, and subsequently suppresses, the release of fsh and lh from the pituitary gland. lupron may improve the response to stimulation with gonadotropin medications, may prevent premature ovulation, and may decrease the risk of a cancelled ivf stimulation cycle. it may also be used to treat uterine fibroids or endometriosis.

 

lupron “down regulation”:

a treatment with lupron that takes advantage of the suppression of the natural hormones lh and fsh. down regulation is typically used before starting injections of gonadotropins and stimulation of follicular development.

 

luteal phase:

the days of a menstrual cycle following ovulation and ending one day before the onset of menses. this usually lasts between 12 and 14 days.

 

luteinizing hormone (lh):

a pituitary gland hormone that causes the ovary to produce testosterone which is subsequently changed into estrogen. lh also helps to release a mature egg (ovulation). in the male, lh stimulates testosterone production in the testis.


micromanipulation:

procedure in which an egg, sperm, or embryo is manipulated under the microscope. manipulative procedures include icsi, assisted hatching, and embryo biopsy for pgs or pgd.

 

microsurgical epididymal sperm aspiration (mesa):

a procedure in which spermatozoa are obtained from the epididymis by either aspiration or surgical excision.

 

miscarriage:

loss of a clinical pregnancy prior to 20 weeks gestation.

 

motility:

the percentage of all moving sperm in a semen sample. normally, 50% or more sperm in a sample move rapidly.

 

multiple gestation/pregnancy:

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


ovarian failure:

the failure of the ovary to respond to fsh stimulation from the pituitary. this can result from multiple causes such as damage to the ovary, interruption of the blood supply to the ovary, malformation of an ovary, genetic abnormalities in the woman, or natural menopause. diagnosis may be made by measuring an elevated fsh level in the blood.

 

ovarian hyperstimulation syndrome (ohss):

a possible side effect of medically induced ovarian stimulation and/or ovulation from fertility drug treatments, characterized by swollen, painful ovaries and, in some cases, the accumulation of fluid in the abdomen and chest.

 

ovaries:

female sex organs that release mature eggs and produce the hormones estrogen and progesterone. the ovaries also produce low amounts of testosterone and other hormones.

 

oligo-ovulation:

irregular and/or infrequent ovulation.

 

oligospermia:

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

 

oocyte:

the egg cell produced in the ovaries. also called the ovum or female gamete.

 

ovulation:

release of a mature egg from a follicle at the surface of the ovary.

 

ovulation induction:

the therapeutic use of female hormones or other fertility medications to stimulate egg development and release.


papanicolaou smear (pap smear):

a screening test to evaluate the cells of the cervix to determine whether they are normal, pre-cancerous, or cancerous.

 

pelvic inflammatory disease (pid):

an infection of the pelvic organs that may lead to blockage of the fallopian tube(s) and pelvic adhesions (scar tissue). while many practitioners associate pid with severe illness, high fever, and extreme pain, pid can actually occur without symptoms.

 

percutaneous epididymal sperm aspiration (pesa):

a procedure in which a needle is used to remove sperm from the epididymis (a long coiled tube above each of the testes.

 

pituitary gland:

the master gland in the brain; the gland that is stimulated by the hypothalamus and controls many hormonal functions. located at the base of the brain, just below the hypothalamus, this gland controls other body processes including functions of the gonads, the adrenal glands, and the thyroid gland.

 

polycystic ovarian syndrome (pcos):

a condition found in women who don’t typically ovulate regularly, characterized by excessive production of androgens (male sex hormones) and the presence of small cysts in the ovaries. some of the more common signs and symptoms of pcos include obesity, acne, excessive male-type hair growth, irregular menstrual periods, and infertility.

 

post-coital test (pct):

microscopic study of samples of cervical secretions taken several hours after sexual relations. the mucus secretions are then examined for live, moving sperm. most reproductive endocrinologists (infertility specialists) consider this test to be antiquated and not predictive of fertility success.

 

preimplantation genetic testing (pgt):

screening of cells from embryos for the detection of genetic and/or chromosomal disorders before embryo transfer.

 

premature ovarian failure (pof):

the loss of ovarian function associated with high levels of fsh and low levels of estrogen before age 40. the ovary may intermittently produce mature follicles. some experts call this condition ovarian insufficiency since the ovary may still occasionally function and may not be in true “failure”.

 

progesterone:

the hormone produced by the ovarian corpus luteum during the second half of a woman’s menstrual cycle. it prepares the lining of the uterus to accept implantation of a fertilized egg. progesterone is released in bursts, or pulses, so the amount in the bloodstream is not constant.

 

prolactin:

a hormone produced by the pituitary that plays an important role in preparing the breasts for breast feeding during pregnancy. an inappropriate elevation at times other than pregnancy may interfere with normal ovulation and fertility.


recipient:

in an art cycle, this refers to the woman who receives a donated oocyte or embryo from another woman.

 

rubella igg titer:

a blood test that determines if a 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 retest for immunity.


secondary infertility:

the inability to conceive or carry a pregnancy after having conceived one or more pregnancies. this is in contrast to primary infertility, a condition in which a woman has not previously been pregnant.

 

semen:

the fluid portion of the ejaculate consisting of secretions from the seminal vesicles, prostate gland, and several other glands in the male reproductive tract. the semen provides nourishment and protection for the sperm and a medium in which the sperm can travel to the woman’s vagina. semen sometimes refers to the entire ejaculate, including the sperm, although this is technically incorrect.

 

semen analysis (sa):

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

 

sonogram (ultrasound):

use of certain frequency sound waves to create an image of internal body parts. used to detect, count, and measure follicles (growth and disappearance) in many fertility treatments. also used to detect and monitor pregnancy.

 

sperm:

male sex cells, or gametes. sperm, medically referred to as spermatozoa, are mobile, mature, haploid cells that fertilize eggs. sperm cells provide the genetic information that determines an embryo’s sex (gender).

 

stimulation:

administration of hormones or fertility drugs that induce development of multiple ovarian follicles.

 

superovulation:

stimulation of multiple follicles using with fertility drugs with the goal of ovulating more than one egg; also known as controlled ovarian hyperstimulation (coh).


testicular sperm aspiration (tesa):

a procedure in which spermatozoa are obtained directly from the testicle by aspiration.

 

testicular sperm extraction (tese):

a sperm removal or retrieval method in which a small section of tissue from one or both of the testicles is removed through one or more short incisions in the scrotum. sperm are then extracted from the tissue by an embryologist who injects a sperm into an egg using a micro-needle (called intracytoplasmic sperm injection, or icsi) in order to fertilize the egg in a laboratory. tese may be applicable to a man who does not have mature sperm in his epididymis.

 

testicles:

the two male sexual glands contained in the scrotum. they produce the male hormone testosterone as well as sperm, the male reproductive cells.

 

testicular biopsy:

a small excision of testicular tissue to determine the ability of the cells to produce or contain normal sperm.

 

testosterone:

the male hormone responsible for the formation of secondary sexual characteristics as well as the sex drive (libido). testosterone is also necessary for spermatogenesis (sperm production).

 

thyroid gland:

the endocrine gland in the front of the neck that produces thyroid hormones that regulate the body’s metabolism.


urethra:

the tube that allows urine to pass between the bladder and the outside of the body. in the man, this tube also carries semen from the prostate gland to the outside.

 

uterus:

the hollow, muscular structure that carries and protects a growing fetus. the uterus, often referred to as the womb, is connected to the vagina through the cervix.


vagina:

the canal leading from the cervix to the outside of the woman’s body; the birth passage.

 

vaginal ultrasound:

technique used to view follicles, a fetus, or 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 is done to demonstrate maturation of the egg-containing follicle. 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 and show fetal viability.

 

varicocele:

a collection of varicose (dilated) veins in the scrotum which may be associated with poor sperm quality.

 

vitrification:

an alternative cryopreservation (freezing) method to traditional cryopreservation. it involves a rapid cooling method that helps to prevent formation of ice crystals that cause damage to cells. may be used to freeze oocytes (eggs) and embryos.


zygote:

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