Glossary of Infertility Terms
AMA (Advanced Maternal Age)
Any infertility patient 35 years or older has this diagnosis. Also referred to as advanced reproductive age (ARA).
“Incorrect pairing.” Trisomy 21 is an example of aneuploidy. When we use PGD to test for aneuploidy, we look at chromosomes 13, 15, 16, 18, 21, 22, X, Y.
One stage of embryo development requires the embryo to break through an outer shell (zona pellucida). If recommended by 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.
Absence of sperm in the ejaculate.
beta Human Chorionic Gonadotropin. Also referred to as hCG. Pregnancy hormone produced by
endometrium/placenta; acts to support corpus luteum (pregnancy depends on progesterone produced by corpus luteum until 7th week of pregnancy). At 14 days post start of progesterone (whether IVF or FET), we like to see hCG levels at about 50 mIU/ml. This number should double every two or three days until the 6th week of pregnancy.
5 day-old embryo which has many cells surrounding a cystic cavity.
Congenital Absence of the Vas Deferens. Often seen in male carriers of CF gene.
CCCT (Clomid Challege)
Clomiphene Citrate Challenge Test. Often part of initial infertility work-up to screen for low ovarian
reserve (poor fertility potential/poor egg quality). Click here to learn more.
The process of cooling and storing cells at a temperature below the freezing point (-196 C) that provides high survivability when thawed.
A menstrual cycle which begins on the first day (designated as "day 1") of menstrual bleeding.
An appointment that takes place after an unsuccessful IVF cycle. It is approximately 30 minutes
with your physician. 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 prior to attempting another cycle. 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. GIVF has one of the world’s oldest and largest Donor Egg IVF programs.
The female gamete contained in a small sphere called a follicle, located in the ovary. Upon retrieval, eggs are classified based on appearance and stage:
- Mature: usable in IVF, may be used for ICSI if also intact.
- Immature: IVF, not able to be used for ICSI unless mature within 2 hours.
- Post-mature: Suitable for IVF only, not able to be used for ICSI.
- Atretic: dead
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 original 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.
Frozen Embryo Transfer cycle. 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. We can monitor the menstrual cycle and transfer the embryos 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.
- CED FET: The lining of the uterus is thickened, using a combination of 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.
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.
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 GIVF, 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.
Also known as 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.
Once fertility medication has been administered during a treatment cycle, the cycle is said to have been initiated. Some cycles may be cancelled prior to this point and are not included in these calculations. GIVF’s cycle cancellation rate is lower than most programs, so more of our initiated cycles proceed to retrieval than other programs.
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.
Combination of blood work and or sonogram to evaluate patient’s hormones, ovaries, and uterus in order to determine whether it is appropriate to start an IVF cycle or to evaluate how the patient is responding to medications during an IVF cycle. On average, patients are monitored 5-6 times during
the approximately 2 week time period that is the IVF cycle. Hours for monitoring are Monday through Friday from 7:00 am to 9:00 am, weekends and holidays from 7:30 am to 9:00 am. While monitoring visits are relatively quick, it is extremely important that you make every attempt to arrive at your scheduled time. In order to process all of the results for that day, to determine medication adjustments and to contact all of the patients, we must conclude monitoring by 9:00 am to ensure same day results.
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. It therefore may be more useful to patients than “the 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 and are the result of a not wholly understood third-space shift of fluid. OHSS occurs in 1-3% of IVF patients.
OHSS is associated with large numbers of follicles and elevated E2’s, thus close monitoring is a key to prevention. At GIVF, any patient who receives hCG with an E2 greater than 4000 will receive prophylactic treatment. These patients are encouraged to drink balanced fluids such as Gatorade and eat additional protein for the next few weeks.
Patients who present with symptoms are scanned for abdominal fluid. As determined by a physician, patients may then undergo transvaginal culdocentesis. This is performed at GIVF. Nonpregnant
patients will usually recover within 7-10 days; pregnant patients may take up to 3 weeks for resolution. Please note that many other IVF practices will not perform the culdocentesis procedure. Out-of-town patients at risk are encouraged to monitor for symptoms and understand they may be
hospitalized for treatment.
Polycystic Ovarian Syndrome. A problem of persistent anovulation associated with large numbers of small ovarian follicles. May also be associated with other endocrine disorders.
Premature Ovarian Failure. Indicated by anovulation and poor CCCT outcome.
Two successive rising blood pregnancy tests (beta) following an embryo transfer indicate a pregnancy.
Pregnancy Rate per Transfer
The percentage of pregnancies that result per embryo transfer.
Preimplantation Genetic Diagnosis (PGD)
A method using DNA analysis to determine genetic information on an embryo before replacement.
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.