Throughout your care in our office, many medical terms and abbreviations relating to infertility will be used by your care providers. Although you may understand many of the terms already, we are providing definitions for the more frequent terms you may encounter. As always, if you have questions, please seek clarification from the care provider. We are here to provide you with understanding and compassionate care.
Antibodies – Molecules made by the body to fight or attack foreign substances entering the body. Normally they prevent infection; however, when they attack the sperm or fetus, they cause infertility. Sperm antibodies may be made by either the man or the woman.
Antimullerian Hormone (AMH) – A hormone produced by the granulosis cells of the ovary in the ovarian follicle that correlates with ovarian reserve.
Antisperm 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 their ability to fertilize.
Antral Count – An ultrasound assessment of the number of antral follicles (< 1 cm) in the ovary and day 1-3 of the cycle. Correlates with ovarian reserve. (see Ovarian Reserve).
Artificial Insemination – The depositing of sperm in the vagina near the cervix or directly into the uterus with the use of a catheter and syringe instead of by intercourse. This technique is used to circumvent sperm-mucus interaction problems, to maximize the potential for poor semen, to overcome sexual performance problems and when using donor sperm.
Autoimmune Antibodies – Patients with recurrent pregnancy loss may have autoantibodies including anticardiolipin antibodies, antinuclear antibody or lupus anticoagulant. These may be a cause of the pregnancy loss and can be treated with medication during pregnancy to decrease the risk.
Baseline Ultrasound – The baseline ultrasound is performed using vaginal ultrasound at the start or “baseline” of a cycle. A vaginal ultrasound probe that is smaller and usually more comfortable than a speculum is used for gynecologic exams. The lining of the uterus is measured as are any cysts that may appear on your ovaries. Cysts are usually from follicles that formed in previous cycles and usually resolve spontaneously.
Cervical Mucus – A viscous fluid plugging the opening of the cervix. Most of the time this thick mucus plug prevents sperm and bacteria from entering the womb. However, at midcycle, under the influence of estrogen, the mucus becomes thin, watery, and stringy to allow sperm to pass into the womb.
Chemical Pregnancy – A chemical pregnancy is the clinical term used for a very early miscarriage. In many cases, the positive pregnancy test was achieved before the woman’s period was due but a miscarriage occurred before a gestational sac was able to be seen on an ultrasound.
Chromosome – The structures in the cell that carry the genetic material (genes); the genetic messengers of inheritance. The human has forty-six chromosomes, twenty-three coming from the egg and twenty-three coming from the sperm.
Clomiphene Citrate, Clomid – An oral tablet commonly used to treat ovulatory problems. It acts by signaling the brain to trigger release of the hormones responsible for development and release of the egg.
Corpus Luteum – The yellow-pigmented glandular structure that forms from the ovarian follicle following ovulation. The gland produces progesterone, which is responsible for preparing and supporting the uterine lining for implantation. Progesterone also causes the half-degree basal temperature elevation noted at midcycle during an ovulatory cycle. If the corpus luteum functions poorly, the uterine lining may not support a pregnancy. If the egg is fertilized, a corpus luteum of pregnancy forms to maintain the endometrial bed and support the implanted embryo. A deficiency in the amount of progesterone produced (or the length of time it is produced) by the corpus luteum can mean the endometrium is unable to sustain a pregnancy. This is called Luteal Phase Defect (LPD).
D&C (Dilation and Curettage) – A procedure used to dilate the cervical canal and scrape out the lining and contents of the uterus. The procedure can be used to diagnose or treat the cause of abnormal bleeding, to remove abnormal pregnancy tissue from the uterus and to terminate an unwanted pregnancy.
Dysmenorrhea – Painful menstruation. This may be a sign of endometriosis.
Ectopic Pregnancy – A pregnancy outside of the uterus, usually in the fallopian tube. Such a pregnancy can rarely be sustained, and often leads to decreased or complete loss of function in the affected tube. Methotrexate may be used to stop the pregnancy to minimize major damage to the tube. A surgical procedure may also be required (laparoscopy).
Egg Retrieval – A procedure used to obtain eggs from ovarian follicles for use in in vitro fertilization. Most egg retrievals are performed non-surgically through the vagina using a guided needle and ultrasound to locate the egg sac in the ovary. The procedure may rarely be performed during laparoscopy.
Endometrial Biopsy – A test to check for luteal phase defect. A procedure during which a sample of the uterine lining is collected for microscopic analysis. The biopsy results will confirm ovulation and the proper preparation of the endometrium by estrogen and progesterone stimulation. Endometrial biopsy can also be used to diagnose cancer or endometrial hyperplasia.
Endometriosis – A condition where endometrial tissue is located outside the uterus. The tissue may attach itself to the reproductive organs or to other organs in the abdominal cavity. Each month the endometrial tissue bleeds with the onset of menses. The resultant irritation can cause adhesions in the abdominal cavity and in the fallopian tubes. Endometriosis may also interfere with ovulation and with the implantation of the embryo.
Epididymis – A coiled, tubular organ attached to and lying on the testicle. Within this organ the developing sperm complete their maturation and develop their powerful swimming capabilities. The matured sperm leave the epididymis through the vas deferens.
Estradiol (E2) – The female hormone produced in the ovary. Responsible for formation of the female secondary sex characteristics such as breast enlargement; supports the growth of the follicle and the development of the uterine lining. At mid cycle the peak estrogen level triggers the release of the LH spike from the pituitary gland. The LH spike is necessary for the release of the ovum from the follicle. Fat cells in both obese men and women can also manufacture estrogen from androgens (male sex hormones) and interfere with fertility.
Fertilization – The combining of the genetic material carried by sperm and egg to create an embryo. Normally occurs inside the fallopian tube (in vivo) but may also occur in a petri dish (in vitro). See also In Vitro Fertilization.
Follicle Stimulating Hormone (FSH) – A pituitary hormone that stimulates ovarian follicular development and sperm production. In the man FSH stimulates the Sertoli cells in the testes and supports sperm production. In the woman FSH stimulates the growth of the ovarian follicle. Highly elevated FSH levels are indicative of gonadal failure in both men and women. Highly elevated levels may suggest a lower number of follicles (containing eggs) or decreased sperm production (see Antral Count).
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. This follicle reaches approximately one inch in size when ready to ovulate.
Follistim – Drug given by intramuscular (IM) or subcutaneous (SUB-Q) injection. It contains only purified FSH and is produced in the lab using recombinant DNA technology. See also Bravelle and Gonal-F.
Glucophage – An oral medication usually used to treat diabetes mellitus. Glucophage prevents the release of glucose (sugar) from the liver, thus lowering blood sugar and insulin levels. Glucophage is also commonly used to promote ovulation in women with polycystic ovarian syndrome (PCOS). Women with PCOS are frequently anovulatory and often have high blood insulin levels (hyperinsulinemia). Glucophage is often used in combination with Clomid tablets in anovulatory infertility patients.
Hamster Test – See Sperm Penetration Assay (SPA).
Hyperinsulinemia – Elevated blood insulin levels often seen in women with PCOS. May indicate insulin resistance and an increased risk of developing diabetes mellitus later in life.
Hyperstimulation – A potentially life-threatening side effect of gonadotropin ovulation induction treatment. Arises when too many follicles develop and hCG is given to release the eggs. May be prevented by withholding the hCG injection when ultrasound monitoring indicates that too many follicles have matured.
Implantation – The embedding of the embryo in to 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.
Insemination (IUI) – The procedure where either a prepped sample of the husband’s sperm (or donor sperm if indicated) is introduced into the woman’s uterus at the time of ovulation.
In Vitro Fertilization (IVF) – In vitro fertilization involves stimulation of multiple egg development in the woman’s ovaries with ovulation-inducing medication, monitoring with sonar and blood tests, followed by transvaginal egg retrieval using mild sedation. Eggs and sperm are combined in the laboratory followed by transfer of two (usually) resulting embryos to the woman’s uterus through the cervix.
Lupron – A synthetic drug that mimics the naturally occurring gonadotropin releasing hormone (GnRH). GnRH stimulates the release of FSH and LH which cause follicular maturation and egg release. This, in turn, causes estrogen and progesterone production in the female. Lupron possesses greater potency than GnRH and inhibits its release. This ceases the production of FSH and LH and, therefore, decreases the estrogen and progesterone level and prevents ovulation unless gonadotropins (FSH and/or LH) are given.
Luteal Phase – Post-ovulatory phase of a woman’s cycle. The corpus luteum produces progesterone, which causes the uterine lining to thicken to support the implantation and growth of the embryo.
Luteal Phase Defect – A condition that occurs when the uterine lining does not develop adequately because of inadequate progesterone stimulation or because of the inability of the uterine lining to respond to progesterone stimulation. LPD may prevent embryonic implantation or cause an early abortion.
Menopur – Injectable drug (can be given intramuscular [IM] or subcutaneous [SUB-Q]) to stimulate ovulation. It contains the hormones FSH and LH which are responsible for stimulating the growth and maturation of ovarian follicles and eggs. See also Repronex and HMG.
Mycoplasma (See Ureaplasma).
Myomectomy – Surgery performed to remove fibroid tumors.
Ovarian Reserve – An estimate of available follicles (which may contain eggs) in the ovary. Decreased with the age of the woman, ovarian damage by endometriosis infection or smoking and other toxins. (see Antral Count, Antimullerian Hormone, FSH, Inhibin).
Ovulation Induction – The therapeutic use of female hormones to stimulate egg development and release. Useful hormones and hormone-based medications include Clomiphene Citrate, Follistim, Gonal-F, Bravelle, Menopur or Repronex.
Pituitary Gland – The master gland; the gland that is stimulated by the hypothalamus and controls all hormonal functions. Located at the base of the brain just below the hypothalamus, this gland controls many major hormonal factories throughout the body including the gonads, the adrenal glands, and the thyroid gland.
Polycystic Ovarian Syndrome (PCOS) – A common condition affecting 5-10% of reproductive aged women characterized by: 1) irregular periods and/or a lack of ovulation; 2) elevated male hormone levels (androgens) in the blood, which may cause acne or bothersome male-pattern hair growth (hirsutism); and 3) polycystic-appearing ovaries on ultrasound. In addition to infertility, women with PCOS are frequently obese and have an increased risk of developing diabetes mellitus, hypertension, high cholesterol levels and endometrial cancer. They may have elevated insulin levels in fasting blood tests (see Glucophage).
Preimplantation Genetic Diagnosis (PGD) – Involves genetic testing of embryos in couples undergoing in vitro fertilization (IVF). PGD can be used to screen for diseases caused by a single defective gene (such as cystic fibrosis) and conditions caused by chromosomal rearrangements (translocations).
Progesterone – A hormone produced by the corpus luteum, which acts directly on the lining of the uterus to enhance its integrity. This helps prevent uterine contractions and bleeding. It is indicated in patients with a luteal phase defect, a history of spontaneous miscarriages, or episodes of bleeding during pregnancy. It is administered by intramuscular injection, vaginal suppository, vaginal capsule and occasionally by mouth. Progesterone support is routinely prescribed after several types of infertility treatment, such as IVF and gonadotropin therapy.
Repronex – Injectable drug (can be given intramuscular [IM] or subcutaneous [SUB-Q]) to stimulate ovulation. It contains the hormones FSH and LH which are responsible for stimulating the growth and maturation of ovarian follicles and eggs. See also Menopur.
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 may also refer to the entire ejaculate, including the sperm.
Septate Uterus – A normally shaped uterus divided into right and left halves internally by a wall of tissue (septum). Women with a septate uterus have an increased chance of early pregnancy loss and premature birth. May be repaired in an outpatient procedure.
Sonar Insufflation Study (SIS) – This procedure is performed in our office by placing a catheter in the uterus and injecting saline liquid into the uterine cavity so that the uterine cavity and muscle can be evaluated during ultrasound.
Sonogram (Ultrasound) – Use of high-frequency sound waves for creating an image of internal body parts. Used to detect and count follicular growth (and disappearance) in many fertility treatments. Also used to detect and monitor pregnancy.
Sperm Antibodies – See Antisperm Antibodies.
Sperm Morphology – A semen analysis factor that indicates the number or percentage of sperm in the sample that appear to have been formed normally. Abnormal morphology includes sperm with kinked, doubled, or coiled tails. There should be at least 30% of sperm with normal morphology.
Sperm Penetration Assay (SPA) – A laboratory test which assesses the ability of the sperm to penetrate specially prepared hamster eggs and correlates with the ability to penetrate human eggs. This is often called the Hamster Test. This test is an indicator of an increased “time to pregnancy” in general (lower pregnancy rate per cycle of the female). IVF with ICSI compensates for most problems with sperm penetration and results in a normal pregnancy rate per retrieval. Therefore, pregnancy rate will primarily correlate with the age of the woman and her ovarian reserve.
Tracking Cycle – The monitoring of a monthly cycle. It generally involves using an ovulation monitoring kit to determine when ovulation is likely to occur, followed by an ultrasound scan to detect the egg sac formation after the surge, as well as checking hormonal blood levels. A post-coital test is conducted within 24 hours of a surge.
Ultrasound – See Sonogram.
Zona Pellucida – The soft shell around the embryo.