Glossary

 

A
Alpha Fetal Protein: A protein secreted by fetal tissue that can be present in the mother’s bloodstream. If present in high levels, it can be associated with congenital fetal anomalies such as neural tube defects.

AMH (Anti-Mullerian Hormone): AMH is a hormone that is produced by some cells in ovarian follicles.  The levels of AMH detected in a woman’s blood are thought to reflect the egg supply remaining in the woman’s ovary. The level of AMH is the most predictive of currently available markers of ovarian reserve, but even this test will not provide precise prediction of response.

Antisperm Antibodies: Antibodies directed against sperm. If directed against the head of the sperm, they can interfere with normal fertilization.

Artificial Uterine Insemination: The process of depositing washed sperm inside the uterine cavity.

Assisted Hatching: The process of helping an embryo to hatch by making a surgical slit in the zona pellucida or “shell”, or by digesting this “shell” with special enzymes.

Assisted Reproductive Technologies (ART) : Infertility treatment procedures such as IUI, GIFT, ZIFT, and TET, that require laboratory handling of sperm and /or eggs.

Azoospermia: The complete absence of sperm. It can result from obstruction of the vas deferens (the duct that carries the sperm from the testicles to the urethra) or from failure of the testes to produce sperm.

B
Basal Body Temperature BBT): Indirect evidence of ovulation can be obtained with the basal body temperature chart.

Blastocyst: An embryo that has undergone multiple cellular divisions with the formation of a cavity within it. A fertilized egg reaches the blastocyst stage usually 4 to 5 days after fertilization.

C
Cervical Mucus: Cervical mucus is secreted by glandular cells that are present in the cervix. This mucus protects the uterus from invasion by bacteria present in the vagina.  A thick and dense mucus could prevent the passage of sperm through the cervix.

Cervix: The part of the uterus that opens into the vagina. It is the segment that is checked for abnormal cells by a Pap smear.

Chemical Pregnancy: A pregnancy in its earliest stages that was detected by blood hormone levels but a gestational sac never developed.

Chlamydia: A bacteria responsible for a sexually transmitted infection that can affect the tubes by causing permanent damage and thus infertility. Often occurs without significant symptoms.

Chromosome: The genetic nuclear structure of every living cell. Abnormalities of chromosomes can result in miscarriages or congenital abnormalities. Age affects the quality of chromosomes in an egg and that is why infertility and miscarriages are more common in older women.

Clinical Pregnancy: A pregnancy that has advanced to a stage where a gestational sac and/or a fetus can be seen by ultrasound.

Corpus Luteum: A follicle that releases an egg at the time of ovulation is subsequently called the corpus luteum. This is initially a partially collapsed cystic space and is very active in hormone secretion. Its major product is progesterone.

Cryopreservation: The process of freezing reproductive cells or embryos in extremely low temperatures (-196°C).

 

E
Ectopic Pregnancy: When implantation occurs outside the cavity of the uterus, an ectopic pregnancy ensues. Such an abnormal pregnancy can be located in the tubes, the ovaries, the cervix or inside the abdomen.

Egg: Lay term for oocyte. The largest cell in the human body. Unites with the sperm to make a zygote and eventually a baby.

Egg Donation: This process involves the stimulation of a women’s hormones with fertility drugs, the retrieval of her eggs, the subsequent fertilization with the sperm of the recipient’s partner, and the transfer of the resultant embryos to the uterus of the recipient.
Egg Retrieval: The process of introducing a long needle through the vagina and into the ovaries to aspirate the follicles that contain the eggs. It is done under ultrasound guidance.

Embryo: A fertilized egg that has begun the cycle of cell division.

Embryo Transfer: The process of depositing embryos inside the uterus. This often occurs 3 to 5 days following egg retrieval.

Endometrial Biopsy: A procedure that involves taking a small sample of tissue from the inside lining of the uterus (called the endometrium).

Endometriosis: The presence and growth of tissue resembling the endometrium outside the uterus. Typical locations include over the tubes, the ovaries, the uterus, the peritoneal lining of the pelvis, the bowel and other unusual areas. The disease is benign but usually progressive. In advanced stages it causes severe scarring of the ovaries and/or tubes which can result in infertility.

Endometrium: The inside lining of the uterus where implantation of the embryo occurs.

Endoscopy: A surgical procedure to view the pelvic organs (laparoscopy) or the uterine cavity (hysteroscopy) via a small, fiber-optic telescope. Therapeutic surgery may also be performed during these procedures.

Epididymis: Sperm travels from the testicles through a tubular structure called the epididymis into the vas deferens and through the urethra and penis. Sperm undergoes advanced maturation during its stay in the epididymis.

Estrogen (or Estradiol – E2): The major female hormone secreted by the ovaries. The follicle secretes estrogen as it grows. The level of this hormone peaks at the time of ovulation.

F
Fallopian Tubes: A hollow muscular tubular organ that is connected to the uterus at one end, and opens inside the abdomen close to the ovaries at the other. The latter part pick up the ovulated egg from the surface of the ovary.

Fertilization: The unification of sperm and egg to form an embryo and then a fetus.  A sperm or an egg contains half of the genetic make-up of its species.

Fetus: A fertilized egg is called a zygote. Further cellular division and differentiation yields an embryo. Once organic differentiation occurs, i.e., the embryo acquires human-like features, it is called a fetus.

Fibroid Tumors (or Myomas): Benign tumors of the muscle of the uterus. Fibroids develop in one of every four women at some point during their lifetime. If present inside the uterine cavity, they can interfere with implantation. Fibroids can also cause problems if they become large in size and impinge or put pressure on the uterine lining. They are treated by surgical removal, either via laparoscopy, hysteroscopy, or a major abdominal surgery.

Follicle: A fluid-filled space present inside the ovary that contains and nourishes the egg. Very early in the cycle, many small minute follicles containing immature eggs are recruited. Only one of these follicles will mature and grow. This leading follicle will increase and be ready for ovulation roughly 2 weeks after the start of the menstrual cycle. The follicle will then burst with ovulation and release the egg that is picked up by the fallopian tube. The collapsed follicle will become the corpus luteum.

Follicle Stimulating Hormone (FSH): A hormone secreted by the pituitary gland; FSH stimulates the growth and development of ovarian follicles. It is the main hormone present in the gonadatropin medications. The blood level of FSH assists us in determining the ideal dosage and regimen of fertility agents necessary to initiate proper ovarian stimulation.

G
Gamete: The reproductive cell – the female egg and the male sperm.

Gestational Surrogacy: In gestational surrogacy, the gestational carrier does not contribute any genetic materials since the egg and the sperm come from prospective parents.

GIFT: Gamete Intrafallopian Tranfer is a procedure that involves introducing sperm and egg (also called gametes) inside the fallopian tube. This is accomplished by laparoscopic surgery. It can only be performed when the individual has normal tubes. In most good IVF centers, success rates with GIFT are lower than IVF. Since it is an invasive procedure (requiring laparoscopy) and is more costly, its indications are limited.
GnRH: Gonadotropin releasing hormone is the single most important hormone controlling ovarian function. It is secreted by the hypothalamus and controls LH and FSH secretion by the pituitary gland, which in turn directly controls ovarian function.

GnRH-Agonist: A synthetic hormone similar to GnRH. When administered in a continuous fashion, this hormone will actually suppress pituitary and ovarian function. The benefit of this suppression is that it allows us to control the ovaries ourselves without interference from the hypothalamus or the pituitary.

Gonadatropins: Follicle Stimulating Hormone (FSH) and Lutenizing Hormone (LH) are pituitary hormones that stimulate egg production, ovulation, and estrogen and progesterone production.

H
HCG:  Human Chorionic Gonadotropin is the major hormone secreted by the placenta. Studies have shown that after administering HCG intramuscularly, ovulation occurs 38 to 40 hours afterwards. This is why, during simple ovulation induction with Clomiphene or Gonadatropins, HCG is sometimes given to trigger ovulation.

Hydrosalpinx: A hydrosalpinx is a fallopian tube that is filled with fluid.

Hysterosalpingography: An HSG is an x-ray dye test used to visualize the uterus and tubes. It involves the injection of a radio-opaque dye through the cervix and into the uterus and tubes. A series of x-rays is taken and the contour and patency of the uterus and tubes are assessed.

Hysteroscopy: This is a procedure that involves the introduction of a thin telescope-like instrument through the cervix into the uterine cavity. It enables the direct visualization of the uterine cavity and its lining, thereby providing an opportunity to diagnose abnormalities such as polyps, fibroids or adhesions.

Hysterosonogram: As a diagnostic procedure, the hysterosonogram is equal to the hysteroscopy procedure in identifying polyps or fibriods in the uterine cavity. Under vaginal ultrasound visualization, a small amount of sterile saline solution is placed into the uterine cavity. If there are any polyps or fibroids in the cavity, they can be easily seen by contrast ultrasound.

I
ICSI: Intra-Cytoplasmic Sperm Injection is a micromanipulation technique whereby a single sperm is injected into the cytoplasm of an egg by the embryologist in the laboratory.  The procedure involves grasping a single sperm with a very fine needlepoint pipette and then gently inserting it inside the egg, under microscope.

Implantation: The process by which an embryo burrows within the endometrial lining of the uterus.

Infertility: .Infertility is the result of a disease (an interruption,cessation,or disorder of body functions, systems,or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry
a pregnancy to delivery.

Inhibin: A substance produced by granulosa cells in the ovaries in females and the testes in males. It signals the pituitary gland to slow down the release of follicle stimulating hormone (FSH).

Intrauterine Insemination (IUI): The process of depositing processed sperm inside the uterine cavity.

In vitro fertilization (IVF): A method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division,the resulting embryo is transferred into the woman’s uterus where it will hopefully implant in the uterine lining and further develop. IVF bypasses the fallopian tubes and is usually the treatment choice for women who have badly damaged or absent tubes.
K
Karyotype: The karyotype of a cell is the presence, as well as the specific arrangement and form, of the cell’s chormosomes. The test is also referred to as a karyotype because the shape, size and presence of of chromosomes from the cell are analyzed.

 

L
Laparoscopy: This is a procedure that involves the introduction of a thin telescope-like instrument through the belly button and into the pelvis for direct visualization of the pelvic organs. Physician use laparoscopy for a variety of reasons: to diagnose and treat problems such as infertility, blocked or damaged tubes, scarring, endometriosis, ovarian tumors and uterine fibroids.

Laparotomy: A procedure in which the abdomen is opened with an incision to expose its contents.

Luteinizing hormone (LH):  In women,the pituitary hormone that triggers ovulation and stimulates the corpus luteum of the ovary to secrete progesterone and androgens during the second half of the menstrual cycle.

M
MESA: Microsurgical Epididymal Sperm Aspiration (MESA) is a surgical procedure to remove sperm from the epididymis in men who have azoospermia. Unlike the TESE procedure, millions of sperm can usually be obtained and excess sperm are frozen for subsequent IVF cycles if needed.

Menopause: The period in a woman’s life when menstruation stops, the ovaries stop producing eggs and estrogen levels decline. The average age of menopause is 50.

Miscarriage: The naturally occurring expulsion of a nonviable fetus and placenta from the uterus; also known as spontaneous abortion or pregnancy loss.

Morphology: The form, structure,and shape of sperm.

Motility: The percentage of all moving sperm in a semen sample. Normally 50% or more are moving rapidly.

Micromanipulation: Advanced techniques used to manipulate gametes, i.e. eggs and sperm, to enhance successful fertilization and implantation. Intracytoplasmic sperm injection is one form of micromanipulation.

Morula: An early phase of a growing embryo that resembles a mulberry. The cells cannot be count anymore.

N
Nucleus: Structure in the cell that contains the chromosomes.

O
Oocyte: The largest cell in the human body. Released from the ovary during ovulation, unites with the sperm to make a zygote and eventually a baby.

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: The process by which a mature egg is released from the surface of an ovary.

Ovarian reserve: A woman’s fertility potential in the absence of specific pathophysiologic changes in her reproductive system. Diminished ovarian reserve is associated with depletion in the number of eggs and worsening of oocyte quality.

Ovulation Induction: Stimulation of the ovaries by fertility drugs to produce and release one or more eggs.

Ovarian Hyperstimulation: Complication of taking fertility drugs resulting in gross enlargement of the ovaries. Hyperstimulation occurs when the ovaries produce excess eggs in response to stimulation by fertility drugs.

P
Pelvic Inflammatory Disease (PID):  Infection of the pelvic organs that may result in scarring of the fallopian tubes and /or pelvic adhesions.

Placenta: The organ that is responsible in the nourishment of the developing embryo. Abnormalities in the placenta can result in abnormal fetal growth and death.

Polyp: Benign growth of the lining of the uterus or the endometrium. It can interfere with normal implantation and cause infertility, abnormal bleeding and, theoretically, miscarriages.

Postcoital Test: A test to check the quality of the cervical mucus and the sperm in it. It is performed up to 12 hours after intercourse. A small sample of the cervical mucus is taken and is examined under the microscope. A good test will show ample mucus and contain many moving sperm.

Preimplantation Genetic Diagnosis (PGD): An advanced technique that involves checking the cells of a developing embryo for genetic and chromosomal abnormalities and thus helping to prevent serious transmissible genetic diseases. Due to the expense and potential damage to embryos from this procedure, it is currently used only for couples at risk for having children with genetic diseases.

Pituitary gland: A small hormone-producing gland just beneath the hypothalamus in the brain which controls the ovaries,thyroid,and adrenal glands. Ovarian function is controlled through the secretion of follicle
stimulating hormone (FSH) and luteinizing hormone (LH).

Premature ovarian failure (POF): Cessation of menstrual periods due to depletion of ovarian follicles before age 40. Also known as early menopause.

Progesterone: A female hormone secreted by the corpus luteum after ovulation during the second half of the menstrual cycle (luteal phase). It prepares the lining of the uterus (endometrium) for implantation of a fertilized egg.

Prolactin: A hormone secreted by the pituitary gland. Its major role is to control milk production. Excess secretion can interfere with normal ovulation.

R
Recipient:  A woman who receives the fertilized eggs from an egg donor. In some cases, the husband’s sperm are used to fertilize the eggs. In other cases, donor sperm are selected for fertilization.

S
Selective Reduction: Also known as “multiple pregnancy reduction”. A procedure that is performed to reduce a high order multiple pregnancy such as quadruplets or triplets, to twins or singleton.

Semen analysis: The microscopic examination of semen (the male ejaculate) to determine its volume,the number of sperm, their shapes (morphology),and their ability to move (motility) in addition to other parameters.

Sperm: The male reproductive cells produced by the testes that fertilize a woman’s egg. The sperm head carries genetic material (chromosomes),the midpiece produces energy for movement,and the tail wiggles to
propel the sperm.

Superovulation: A procedure to facilitate fertilization. The woman is given ovulation inducing drugs which cause
her ovaries to produce multiple eggs.

Sperm Antibodies: Substances in either partner that may attach to sperm and interfere with fertilization.

Spontaneous Abortion: A naturally occuring miscarriage.

T
TESE: A Testicular Sperm Extraction (TESE) is a minor surgical procedure in which the doctor removes a piece of testicular tissue to collect sperm. Usually only low numbers of sperm are obtained and are available only for IVF with ICSI on the same day as the TESE.

Testicles (Testes): The two male reproductive glands present in the scrotum that are responsible for producing the male gametes (sperm). The testicles also secrete many of the male hormones, such as testosterone.

Testosterone: The main hormone secreted by the testicles. The effects of testosterone—such as beard growth, an increase in muscle mass, a deepening voice and sperm maturation—can be easily recognized in men.
Testosterone is also produced in small quantities by the ovaries in women.

TSH: A hormone secreted by the pituitary gland that controls the thyroid gland. Elevated levels imply abnormally low thyroid function. The level of this hormone in blood is checked in most women with infertility because certain thyroid diseases may be associated with infertility.

U
Ultrasonography: One of the most common imaging techniques. Almost all ultrasound examinations performed for purposes of monitoring/diagnosing women with infertility issues are currently carried out by means of a vaginal transducer (a small probe inserted into the vagina). It is commonly used to diagnose the presence of ovarian cysts, tumors, uterine fibroids, and pregnancies. It is also used routinely to follow the growth and development of ovarian follicles during ovulation induction with fertility drugs in patients who are undergoing treatment.

Uterine Septum: The presence of a thick membrane that separates the uterine cavity either partially or completely into two distinct parts. A septum can interfere with normal implantation and cause recurrent miscarriages.

Uterus: A hollow muscular organ present in the pelvis. It is connected to the vagina by the cervix and to the abdominal cavity by the fallopian tubes. Its main function is to contain and nourish the fertilized egg through its stages of development from an embryo to a fetus. A layer of specialized glandular cells, called the endometrium, lines the uterus.

V
Varicocele: An abnormal dilatation of the veins surrounding the testes. A varicocele, present in 25% of infertile males, causes blood to pool in the veins of the testes. This pooling presents a problem for some men because the presence of excess blood raises testicular temperature, which can be detrimental to sperm. The surgical correction of a varicocele is performed in order to ligate the dilated vessels or veins. However, the success of treatment is controversial.

Vas Deferens: The segment of the tube that connects the epididymis to the urethra in males.

Vasectomy: A surgery to ligate the vas deferens in males, thus blocking the transport of sperm to the urethra. It is a very effective form of male contraception.

Z
ZIFT: The transfer of a zygote into the fallopian tube.

Zona Pellucida: A translucent noncellular layer, which surrounds the egg and embryo. Just prior to implantation the zona will be broken and the embryo released to implant in the endometrium. In some women, the zona is thicker. Assisted hatching is then employed to help the embryo in this process..

Zygote: A fertilized egg.