Glossary

For those of you who are interested in learning about the IVF process and/or may be unfamiliar with some of the terminology, I have created this Glossary (with abbreviations) that I've compiled from various Internet resources (cited at the bottom).

Assisted Hatching (AH): Placing a small opening in the “shell” that surrounds every embryo. This assists the embryo in breaking out of this shell and extruding itself to implant in the endometrium. This is done my embryologists in the laboratory prior to embryo transfer in IVF cycles.


Azoospermia: The absence of sperm in semen that is sometimes caused by blockages.


Blastocyst: An embryo that has been developed in the laboratory for five or six days after insemination, in contrast to conventional IVF which involves transferring embryos to the womb two to three days after egg collection and insemination (Day 2 or 3 transfer).


Cryopreservation: Controlled freezing and storage. This may be employed for sperm, embryos and oocytes (eggs).

Egg Retrieval: The procedure during an IVF cycle where the eggs are harvested through a minimally-invasive surgical procedure. This is done under light anesthesia so that patients are sleeping during the entire process. Typically takes about 30 minutes total. 

Embryo: The term used to describe the early stages of fetal growth. Strictly defined from the second to the ninth week of pregnancy but often used to designate any time after conception. 

Embryo Transfer: The procedure of transferring embryos back in to the endometrial cavity (womb) of a patient during an IVF cycle. It occurs on the third or fifth day after an egg retrieval.


Follicle: A fluid-filled pocket in the ovary that houses the microscopic egg. Each ovary has many follicles within it. Follicles start out extremely small and then grow larger under the influence of hormones (and the medications that mimic these hormones). Follicles are lined with granulosa cells which produce estrogen and nourish the oocyte (egg). Each Follicle contains a single oocyte. 

Follicle Stimulating Hormone (FSH): A hormone produced by the pituitary gland in the brain that stimulates the ovarian follicles to grow and develop. FSH is measured in the blood at specialized times during the menstrual cycle to help measure ovarian reserve.

Frozen Embryo Transfer (FET): A cycle in which the frozen embryos from a previous fresh IVF cycle are thawed and then transferred back into the woman’s uterus.

Gonadotropin Releasing Hormone (GnRH): Hormone produced by the hypothalamus in the brain that stimulates the pituitary gland to secrete gonadotropins.

Hysterosalpingogram (HSG): An x-ray procedure to examine whether the fallopian tubes are patent (open) or not. This test helps determine if the tubes are blocking sperm from reaching the ovulated eggs through the fallopian tubes. Special x-ray dye is gently injected through the uterus and then x-ray pictures are taken to see where the dye travels.

Implantation: The attachment and embedding of the conceptus (embryo) into the lining of the uterus. 

Infertility: For women under 35, this means the inability to get pregnant or carry a pregnancy to term when trying to conceive one year, and for women over 35, infertility is the inability to get pregnant or carry a pregnancy to term when trying to conceive for six months.


Insemination: Transfer of sperm for the purpose of establishing a pregnancy. Inseminations are performed by placing a small, soft catheter through the cervix into the uterine cavity and depositing the concentrated and activated sperm. 

Intracytoplasmic Sperm Injection (ICSI): Placement of a single sperm into a single oocyte (egg) by penetrating the outer coatings of the egg. This technique is used in cases where there are very low sperm numbers, motility or morphology. ICSI is also used for patients who have had previous IVF cycles with failed fertilization. 

Intra-Uterine Insemination (IUI): is a technique that transfers sperm directly in to the uterus. It bypasses the vaginal and cervical defense mechanisms of the female reproductive tract and allows better sperm delivery to the fallopian tubes. This allows the sperm and egg to interact in close proximity. It is a very common treatment for mild and moderate deficits in the semen analysis. IUI is typically used in conjunction with medications that increase the number of eggs per cycle and triggering of ovulation. The goal is to have more targets for the sperm (eggs), perfect timing and better sperm delivery. 

In Vitro Fertilization (IVF): A powerful procedure to help patients conceive pregnancies. IVF entails stimulating your ovaries to develop multiple follicles. This is achieved with injectable medications. The goal of IVF is to produce a large number of growing follicles, then harvest the eggs inside the follicles through a short surgical procedure performed in our office. The eggs are then inseminated with sperm in the laboratory, sometimes using ICSI, in order to create embryos that can then be transferred back to the endometrial cavity (the womb) of the patient. The name in vitro fertilization refers to the fact that the oocyte is fertilized by the sperm in the laboratory, rather than inside the female reproductive tract.

Lupron™: A synthetic form of GnRH (gonadotropin releasing hormone- secreted by the hypothalamus) used to suppress ovarian function. 

Luteal Phase: The menstrual cycle is divided up into two main parts- the follicular phase and the luteal phase. This refers to the second half of the cycle, usually the last fourteen days of an ovulatory. It begins from the time of ovulation to the onset of menses, but is prolonged during pregnancy cycles. It is associated with progesterone production from the corpus luteum that facilitates implantation of embryos and supports early pregnancies. 

Luteinizing Hormone (LH): A hormone produced and released by the pituitary gland. In the female it is responsible for ovulation and the maintenance of the corpus luteum. In the male it stimulates testosterone production and is important in the production of sperm cells.

Male-factor Infertility: Infertility due to male health or anatomic reasons.


Menses: A “period.” Cyclic (monthly) flow of blood (menstruation) signifying ovulation, but failure to achieve pregnancy. Onset of bleeding is considered cycle day 1. The purpose of a natural menstrual cycle is to produce one follicle and ovulation per month, each and every month that pregnancy is not achieved.

Preimplantation Genetic Diagnosis (PGD): A technique for identifying genetic or chromosomal information about embryos before transferring them back to a patient’s endometrial cavity (the womb). It entails taking a biopsy of the embryo on day three after egg retrieval. PGD can be employed to identify embryos that carry a genetic disease that may be asymptomatically carried by the parents, or it may be used to identify explanations for Recurrent Pregnancy Loss and improve pregnancy outcomes in selected patients.

Preimplantation Genetic Screening (PGS): This refers to removing one or more cells from an in vitro fertilization embryo to test for chromosomal normalcy. PGS screens the embryo for a normal chromosome number.

Secondary Infertility: Infertility that occurs after a couple have had a successful pregnancy and/or live birth.


Semen Analysis (SA): Examination of the male ejaculate under the microscope to determine the number of sperm, their ability to move forward (motility) and their shapes (morphology). The semen analysis is a cornerstone of the evaluation of couples experiencing infertility. The sperm counts, motility and morphology all provide important information about how the sperm will perform in treatment cycles. 

Single Embryo Transfer (SET) or Elective Single Embryos Transfer (eSET) – is a specific definition of only transferring a single embryo at the culmination of an IVF cycle. This is different from the conventional practice of transferring more than one embryo. Traditional embryo transfer strategies include the idea of transferring as many embryos as is deemed safe in your age group. This ensures the highest pregnancy rates, but also exposes you to the possibility of having more than one baby, such as twins or more.

Testicular Sperm Extraction (TESE) or Microsurgical Testicular Sperm Extraction (mTESE): A surgical sperm retrieval procedure used in fertility treatment for men who have no sperm in their ejaculate.


Ultrasound: High-frequency sound waves used to monitor pregnancy and observe images of internal body parts to detect any abnormalities (also called sonogram). 


Unexplained Infertility: When no reason or cause can be found for a couple’s infertility problems. 


Urologist
: A doctor who specializes in urinary and urogenital medicine.


Resources: Advanced Fertility Center of ChicagoCARE FertilityIntegraMed AmericaRMA of ConnecticutShady Grove FertilitySims IVF