Glossary of Fertility Terms

Understanding infertility can be difficult and overwhelming. The GIVF care team believes that providing the best resources and information to our patients is crucial in helping them make the best decisions for their path to parenthood. Here is an essential glossary of fertility terms.

AMA (advanced maternal age)

Any infertility patient 35 years or older has this diagnosis. Also referred to as advanced reproductive age (ARA).

aneuploidy

An “incorrect number” of chromosomes. Cells should have a total of 46 chromosomes (or 23 pairs) which includes the sex chromosome X and Y. Down Syndrome or Trisomy 21 is an example of aneuploidy where there is an extra (third) chromosome 21. When we use PGT to test for aneuploidy in an embryo, we look at all 23 chromosome pairs to check for any additional or missing copies. An embryo with a normal number of chromosomes is called “euploid”.

assisted hatching

One stage of embryo development requires the embryo to break through an outer shell (zona pellucida). If recommended by the physician, an embryologist nicks the zona just before embryo transfer, thereby assisting the hatch. Assisted hatching may be indicated in cases of advanced maternal age, previous failed IVF cycles, or the appearance of a thickened zona.

azoospermia

Absence of sperm in the ejaculate.

bHCG / beta

beta Human Chorionic Gonadotropin. Also referred to as “beta”. Pregnancy hormone produced by endometrium/placenta; acts to support corpus luteum (pregnancy depends on progesterone produced by corpus luteum until the seventh week of pregnancy). At 14 days post start of progesterone (whether IVF or FET), hCG levels at about 50 mIU/ml are optimal. This number should double every two or three days until the sixth week of pregnancy.

blastocyst

An advanced stage of embryo development (usually reached at Day 5-7 after egg retrieval) where the embryo has many cells and forms different compartments including a fluid filled cystic cavity, an inner cell mass which will develop into the fetus, and a trophectoderm lining around its periphery which will develop into the placenta.

CAV

Congenital Absence of the Vas Deferens. Often seen in male carriers of CF gene.

Clomid Challenge Test (CCCT)

A medical evaluation designed to see how efficiently the ovaries are working. This CCCT is no longer used, as it has been replaced by more modern tests.

cryopreservation

The process of cooling and storing cells at a temperature below the freezing point (-196 C) that provides high survivability when thawed.

cycle

A menstrual cycle which begins on the first day (designated as “day 1”) of menstrual bleeding.

cycle review

An appointment with your physician that takes place after an unsuccessful IVF cycle. If you do not achieve pregnancy as a result of an IVF cycle, it is necessary to review that cycle with your physician and discuss different options for proceeding before attempting another. The cycle review can be conducted over the phone or in person.

donor egg IVF

A donor egg IVF cycle is an IVF cycle in which the eggs from a donor (either anonymous or known) are used instead of a patient’s own eggs. Donor eggs may be combined with a male partner’s sperm or with donor sperm. Donor egg IVF is extraordinarily successful in overcoming age-related infertility, diminished ovarian reserve, and other infertility problems. Genetics & IVF Institute has one of the world’s oldest and largest donor egg IVF programs.

eggs: ova

The female gamete contained in a small sphere called a follicle, located in the ovary. Upon retrieval, eggs are classified based on appearance (morphology) and stage of maturity:

• Mature: Desired stage appropriate for conventional IVF or ICSI.
• Immature: Not able to be used for ICSI unless becomes mature within 2 hours.
• Atretic: Dead

embryo transfer

There are two types of embryo transfers: fresh and frozen. A fresh embryo transfer takes place as a result of a full IVF cycle, and the embryo has not been cryopreserved (frozen) and thawed.

A frozen embryo transfer refers to the transfer of an embryo that has been cryopreserved (frozen) and thawed for transfer into the uterus. This procedure can take place weeks, months, or years after the initial IVF or Donor Egg IVF cycle. Some patients may, therefore, have only one full IVF cycle, but produce enough embryos to achieve more than one successful pregnancy through frozen embryo transfer cycles, which are much easier to undergo than full IVF. GIVF has extensive expertise in embryo freezing.

FET (frozen embryo transfer)

Patient prepares uterus for transfer using one of the cycles outlined below.

• Natural FET – In a normal menstrual cycle, the body develops a thickened uterine lining without using medication. The menstrual cycle is monitored, and the embryos are transferred at the point of ovulation. The body does not discriminate between embryos that are introduced via embryo transfer and an embryo that is conceived in the fallopian tube.
• Medicated FET: The lining of the uterus is thickened, using a combination of medications, such as Lupron and Estradiol. When the lining is mature, progesterone is added, and embryo transfer takes place days later. The entire cycle takes 4–6 weeks.

fibroid (myoma)

Benign growth in the uterine wall. Only fibroids approaching or encroaching upon the uterine cavity may need to be removed, as they may prevent implantation of an embryo.

hysterosalpingogram (HSG)

Diagnostic test of the uterus and fallopian tubes (salpinges) wherein radio-opaque dye is injected into the uterus and X-rays are taken to evaluate the uterine lining and to determine tubal patency. This procedure is not performed at Genetics & IVF Institute, but at a radiological center. This procedure must be performed between days 5–12 of the menstrual cycle or at any time while the patient is on birth control pills. Patients are instructed to take 600–800mg of ibuprofen or 400mg naproxen one hour prior to the procedure.

hysterosonogram (HYS) / saline infused sonohysterogram (SIS)

Also known as saline infused sonohysterogram. Ultrasound test of the uterus, often ordered for patients in the early stages of infertility diagnostics. Using a special catheter, saline solution is injected into the uterus. A transvaginal ultrasound probe is used to evaluate the uterine lining and walls, looking for abnormalities such as polyps or fibroids. This test does not evaluate the fallopian tubes (see hysterosalpingogram). This procedure must be performed between days 5–12 of the menstrual cycle or at any time while the patient is on oral contraceptives. Patients are instructed to take 600–800mg of ibuprofen or 400mg naproxen one hour prior to the procedure.

intracytoplasmic sperm injection (ICSI)

A laboratory procedure in which a single sperm is injected directly into an egg cell for the purpose of achieving fertilization.

intrauterine insemination (IUI)

A relatively simple clinical procedure in which a sperm sample is inserted through the natural opening of the uterus (cervix) and deposited directly into the uterus using a fine insemination catheter for the purpose of attaining fertilization and pregnancy.

in vitro fertilization (IVF)

A laboratory procedure in which fertilization is attempted by placing many sperm cells in a media droplet with unfertilized eggs. The resulting embryos can subsequently be transferred into the uterus or cryopreserved for future use.

morning monitoring

Combination of blood work and/or sonogram to evaluate a patient’s hormones, ovaries, and uterus in order to determine whether it is appropriate to start a treatment cycle or to evaluate how the patient is responding to medications during a treatment cycle. On average, patients are monitored five to six times during the approximately 2-week time period that is the IVF cycle. IUI or FET cycles usually require less monitoring (but can be variable depending on protocol and patient characteristics).

ongoing & delivered pregnancy rate per embryo transfer

The ongoing and delivered pregnancy rate per transfer provides a good indication of the likelihood of actually bringing a baby home. Therefore, it may be more useful to patients than “pregnancy per embryo transfer” statistic, which reflects pregnancies at an early stage but does not indicate whether they continue.

ovarian hyperstimulation syndrome (OHSS)

Potential serious side effect of ovarian stimulation. Patients with OHSS may present with symptoms of severe abdominal bloating, weight gain, nausea, vomiting, diarrhea, constipation, abdominal pain, shortness of breath, easier breathing in an upright position. Symptoms usually appear within a week after egg retrieval. OHSS occurs in 1-3% of IVF patients.

PCOS (polycystic ovarian syndrome)

A problem of persistent anovulation associated with large numbers of small ovarian follicles. May also be associated with other endocrine disorders.

POF (premature ovarian failure)

Indicated by anovulation.

pregnancy

Indicated by two successive blood pregnancy tests (beta) following an embryo transfer.

pregnancy rate per transfer

The percentage of pregnancies that result per embryo transfer.

preimplantation genetic testing (PGT)

A method using DNA analysis to determine genetic information on an embryo before transfer.

reproductive endocrinologist

Infertility specialist. A physician with advanced specialized training in all forms of advanced reproductive techniques.

X chromosome-bearing or X-bearing

Sperm cells that contain the X (female) chromosome and will subsequently result in a female offspring after fertilization.

Y chromosome-bearing or Y-bearing

Sperm cells that contain the Y (male) chromosome and will subsequently result in a male offspring after fertilization.