Glossary of Terms

Understanding infertility and treatment options can be confusing. Right now you're dealing with a number of emotions. And you may not understand all the medical jargon coming your way. Refer to our glossary of terms. It will give you a solid understanding of infertility problems and treatments. Contact us with any questions you may have.

Agglutination: The aggregation of cells or particles into clumps or masses. Especially the clumping together by the action of a specific antibody directed against a surface antigen. In fertility, the clumping together of sperm is associated with the presence of anti-sperm antibodies. Amenorrhea: Absence of menstruation.

Anti-sperm Antibodies: It's common in men with vasectomy reversals or other testicular surgery or injury. Anti-sperm antibodies are created when there is contact between sperm and immunocompetent lymphocytes in the blood. Sperm can enter the blood stream as a result of trauma, surgery, or infection. These lymphocytes attack the sperm by creating anti-bodies against it. The antibodies remain in the blood stream. They're able to freely pass the blood-sperm barrier in the testis and attack the waiting sperm. Once attached to the sperm, these antibodies appear to interfere with penetration through cervical mucus and with penetration of the egg. Women may also develop antibodies to sperm. IVF/ICSI is indicated in cases of high levels of agglutination and/or anti-sperm antibodies.

ART: Assisted Reproductive Technologies refers to any therapy directed towards improving the chance of pregnancy in an infertile couple. ART describes the most sophisticated infertility treatments. This is where eggs and sperm are united outside the body and transferred back to the female partner when appropriate. In-Vitro Fertilization (IVF) is the most common of the ART procedures.

Assisted Hatching: The purpose of assisted hatching is to create a small opening in the zona of an embryo, so that it may easily exit or "hatch" when it has developed sufficiently.

Asthenospermia: Describes sperm showing poor movement in speed and forward progression. There's no clear explanation for this abnormality. This is assuming the specimen was collected properly and wasn't exposed to harmful environmental conditions. Asthenospermic men have little hope of conceiving naturally. The reason is their sperm moves so slowly they may not reach their destination.

Azoospermia: Refers to a complete absence of sperm in ejaculation.

Basal Body Temperature: In infertility, monitoring one's temperature over the course of a cycle and recording the results. Evidence of ovulation is signaled by an increase in a temperature level of 0.50 F for several days.

Blastocyst: Late developmental stage of the pre-implantation embryo. It's made clear by the formation of a central fluid-filled cavity called a blastocoel. It's followed by an increase in overall size and thinning of the zona pellucid. This happens as it readies itself for hatching and. subsequent implantation.

Blastomere: Refers to one of the cells of an early stage embryo resulting from the cellular division (or cleavage) of a fertilized egg. Capacitation: The process where sperm become capable of fertilizing an egg. This process involves major biochemical and biophysical changes in the sperm. It happens some time after the sperm have been ejaculated, usually while in the female reproductive tract. Capacitation can also be induced under laboratory conditions.

Chlamydia: A sexually transmitted disease with often very mild symptoms, it is often called the silent STD. Victims of Chlamydia may not be aware they have the disease. They may not notice until symptoms and getting the disease, happens. In males who do have symptoms, there's usually a painful urination and a watery discharge from the penis.

Women may suffer itching and burning in the genital area. And there are other symptoms. These include an odorless, thick, yellow-white vaginal discharge, dull abdominal pain, and bleeding between menstrual periods. The bacteria, causing Chlamydia is responsible for about 50% of all pelvic inflammatory disease. Symptoms can appear from 1-5 weeks after exposure to the bacteria. And almost all sexual contacts become infected. If left untreated, Chlamydia can cause scarring in the fallopian tubes and lead to infertility and tubal pregnancies. Chlamydia infection can be effectively treated with antibiotics like tetracycline or doxycycline.

Clomiphene Citrate: An infertility medication which works as an anti-estrogen by blocking the effects of estrogen (or estradiol) in the body. During an ovulatory cycle, rising estradiol causes the pituitary gland to decrease FSH output. This causes most of the egg-containing follicles to stop developing. Clomiphene Citrate essentially "hides" circulating estradiol from the pituitary gland. It causes it to think there are still low levels of estradiol present in the body. As a result, the pituitary gland thinks the ovarian follicles are not being stimulated enough and increases its output of FSH. The hope is to prolong follicular development to the point of ovulation.

Congenital: Present and existing at the time of birth.

Conventional IVF: Refers to the IVF procedure where sperm are placed in a dish with an egg. Sperm are allowed to attempt fertilization on their own as opposed to an unconventional IVF. Unconventional IVF involves mechanically injecting a sperm into an egg through a process called ICSI. Corpus luteum: A yellow glandular mass in the ovary formed by a follicle which has matured and ovulated. The corpus luteum secretes progesterone which helps prepare the uterine lining for implantation.

Cryopreservation: The process of freezing tissue or organs to maintain their viability by storing at low temperatures. In the field of infertility, this involves the freezing of sperm or embryos for eventual thaw and use.

Cytoplasm: The essential component of a cell which describes the thick, fluid-like area of a cell in which the various organelles and genetic material are housed.

Ectopic Pregnancy: Also called a tubal pregnancy. It's a pregnancy where an embryo becomes implanted outside the uterus (almost always in the fallopian tube) instead of in the wall of the uterus. There's a present danger that the fetus will continue to grow large enough to burst the tube. The pregnancy will sometimes resolve on its own. But usually requires some intervention to remove the pregnancy either through medication or surgery.

Embryo: An embryo describes an organism's earliest stage of development. This is in between the time of fertilization of an egg, and until the beginning of the third month. After the third month it's called a fetus.

Endocrine: Pertaining to internal secretions; hormonal. The endocrine system involves organs or groups of cells that secrete hormones into the circulatory system. Hormonal activity is mostly concerned with regulating metabolic activities by controlling the rates at which chemical reactions take place within cells, the transport of substances across the cell membrane, and the activities related to growth and reproduction.

Endometriosis: A condition where tissue perfectly resembling Endometrium happens in various locations in the pelvic cavity. The condition includes growing in and on the fallopian tubes and ovaries. Endometriosis can be debilitating. The cause of endometriosis is not clearly known. It may involve the expulsion of endometrial tissue during menstruation upward through the fallopian tubes, and into the pelvic cavity where it's able to implant and grow on the ovaries and elsewhere. It may involve a hormonal change or other event triggering undifferentiated tissue in the pelvis to transform into endometrial tissue. Left unchecked, endometriosis can lead to complete infertility or cancer.

Endometrium: The membrane lining the uterus.

Estradiol: The most potent naturally occurring estrogen in humans secreted by the ovaries during follicular development. Pre-ovulatory levels provide a measure of follicular maturation. Determination of estradiol measurements are important in the diagnosis of amenorrhea, ovulatory disorders, and in the monitoring of ovulation induction.

Fertilization: The human reproductive process where the male's sperm meets the female's egg, or ovum.

Fetus: The developing offspring in the uterus in the post-embryonic period. The process takes 7-8 weeks after fertilization, until birth.

Follicle: A sac or pouch-like depression or cavity. In a reproductive setting, an ovarian follicle describes the egg and its surrounding cells.

Follicular Phase: The part of the ovulatory cycle from the start of menses until ovulation. The term follicular phase derived from the development of one or more follicles during this time.

FSH: Follicle stimulating hormone is a gonadotropin normally produced by the pituitary gland. It initiates the growth and development of ovarian follicles. FSH can be administered by injection to supplement or increase the level of follicular development. Circulating levels of estradiol secreted by developing follicles control the production of FSH through a negative feedback mechanism on the pituitary gland. As estradiol levels rise, FSH production declines. In menopause, there is decreased ovarian function and estradiol secretion. This creates an imbalance in the negative feedback mechanism. It happens, because with diminished estradiol, FSH production is not controlled and circulating FSH levels become significantly increased.

Gamete: Term used to describe one of the two reproductive cells. One is the sperm in the male. The second is the egg or ovum in the female.

Gestational Host: Term used to describe a woman who agrees to have another couple's embryos transferred to her uterus with the desire to carry the pregnancy for the genetic mother. It may be necessary because of a uterine factor preventing the genetic mother from carrying the pregnancy herself. Although technically the same meaning, the term "gestational host" is used rather than "surrogate" since the term "surrogate" implies that the woman is providing the service in exchange for money. At the Gyft Clinic, "gestational hosts" are always a relative or close friend providing the service out of love, not money.

GnRH: Gonadotropin Releasing Hormone is a hormone produced by the hypothalamus. It's necessary to keep the pituitary gland functioning. Some women fail to ovulate because the hypothalamus fails to produce sufficient stimulation to the pituitary gland. During intervals of high physical or psychological stress, the hypothalamus may not secrete GnRH. And the pituitary gland stops producing gonadotropins FSH and LH, necessary for egg development and ovulation. In these instances, GnRH can be directly administered into the blood stream by injection with a high incidence of restoring pituitary function.

GnRH Agonist: Medication administered to prevent the secretion of GnRH from the hypothalamus. This turns off the secretion of FSH and LH from the pituitary gland. It may be beneficial in various infertility treatments. This medication is especially effective in cases where super ovulation is desired.

Gonorrhea: A highly contagious bacterial infection of the genital and urinary tracts. Gonorrhea is usually contracted through sexual transmission. Symptoms usually develop within 3 weeks but many infected persons are asymptomatic. In men showing symptoms, inflammation of the genital tract causes a painful burning sensation when urinating. And there's discharge of a whitish fluid from the penis. Symptomatic women may feel pain in the lower abdomen. They may have or not have a burning sensation when urinating, or a whitish discharge from the vagina. If the infection is allowed to reach other organs of the reproductive system, the ovaries and tubes may become inflamed or damaged resulting in sterility. Antibiotics are an effective treatment once gonorrhea is diagnosed.

Growth medium: One of the physiological media used in the culture of IVF embryos. Growth medium is formulated to provide the proper developmental environment for embryonic growth from the zygote to 8-cell stage.

Haploid: Having half the number of chromosomes in a cell. In reproduction, two haploid gametes (the egg and the sperm) join to restore the full complement of genetic material. The material represents each subsequent cell division during development of the conceptus.

HCG: Human Chorionic Gonadotropin is a hormone usually only found in the blood during pregnancy. It's secreted by the placental tissue almost from the time of implantation. It supports the corpus luteum during the early weeks of pregnancy. Its measurement is of great value in the detection and management of pregnancy. Medicinal HCG is also often used as a "surrogate" LH since it has the same stimulatory effects on the ovary that LH does. And it can be administered by injection to trigger ovulation.

Hepatitis: One of a number of strains of viral infections. Hepatitis is classified as A, B or C. It causes inflammation of the liver. Hepatitis A is transmitted primarily through the oral-fecal route. Hepatitis A is especially common in environments where there's poor sanitation and overcrowding. It doesn't usually cause lasting damage to the liver. Hepatitis A can produce profound fatigue, fever, and aching for weeks. Bed rest is typically the only treatment recommended. Hepatitis B is qualified as a sexually transmittable disease. Unlike Hepatitis A, it can persist in the body fluids for years or a lifetime. Carriers of Hepatitis B are a threat to others and at risk for chronic hepatitis, cirrhosis of the liver and liver cancer. Symptoms of Hepatitis B can vary in their intensity. Many infected individuals are not aware they have the disease. Symptoms can vary from asymptomatic to jaundice, rash, joint pain, etc. There is a vaccine that can be used to provide immunity against Hepatitis B to protect high-risk people. Hepatitis C is similar to that of Hepatitis B, but currently has no available vaccination to protect from it.

HIV: Human Immunodeficiency Virus: A sexually transmitted disease which can lead to the onset of AIDS, or Acquired Immune Deficiency Syndrome. HIV attacks a person's immune system making it less able to fight diseases and infections. It can take as long as six months after infection to detect the virus. Symptoms may not show for years. HIV may show itself years later when the victim may develop swollen lymph nodes. As the HIV infection progresses to AIDS, severe symptoms may show. Symptoms include……

• Severe weight loss
• Headaches and dizziness
• Nausea and fever
• Discolored growths on the skin
• Continual coughing
• Coated tongue
• Unexplained bleeding and bruising

Not all persons infected with HIV will develop AIDS. There is currently no treatment to destroy HIV in the human body. There's no treatment to restore the immune system once it is infected with HIV. However, there are new therapies being researched and used that seem to delay the onset of HIV/AIDS symptoms.

HOS: The Hypo osmotic swelling test is a very simple procedure. It's used in conjunction with the seminal fluid analysis. This allows us to measure the ability of the sperm to transport fluid, essential in the fertilization process. Sperm are placed in a Hypo osmotic environment. Sperm having a functional fluid transport membrane will result in a distention or curling of the tail.

HSG: A Hysterosalpingogram is a commonly used method for determining whether or not an obstruction or blockage exists in the fallopian tubes. Your doctor or referred Radiologist injects a liquid dye (which is visible on x-ray) into the portion of the tube where it connects to the uterus. It observes if the fluid is able to freely spill through to the opposite end of the tube (near the ovary). If not, a blockage is usually the culprit. Your doctor will determine whether or not it can or should be removed. In some cases, the simple act of flushing dye through the tubes during the HSG is enough to clear minor blockages and restore fertility.

Hypothalamus: Located in the posterior portion of the forebrain, this gland influences endocrine activity and many somatic functions. Other somatic functions include regulation of water balance, body temperature, sleep, thirst, and hunger. It also influences the development of secondary sex characteristics. The Hypothalamus also influences the release and inhibition of pituitary hormones. As a result the hypothalamus indirectly plays an important role in other functions. It provides regulation of protein, fat, and carbohydrate metabolism. Other influences include body fluid volume, electrolyte content and internal secretion of endocrine hormones.

ICSI: Intracystoplasmic sperm injection is the micromanipulatory process of mechanically injecting a single sperm into a mature oocyte. The hope is to achieve fertilization. ICSI is often indicated in male factor patients. Their sperm are so dysfunctional they can't adequately fertilize an oocyte on their own.

Immobilization: A part not capable of moving. In ICSI, injected sperm are stopped from swimming by immobilizing the sperm's tail.

Implantation: The attachment and embedding of the fertilized ovum or embryo into the uterine lining.

In-Vitro: Within a glass. In-Vitro happens in an artificial or laboratory environment.

In-Vivo: Within the living body.

Injectable Gonadotropins: Often referred to as "fertility drugs". These medications are primarily composed of the gonadotropin FSH. They're given by direct injection to supplement or replace the FSH, normally produced by the pituitary gland. By using Injectable gonadotropins, it is possible to attain sufficient levels of FSH. The right FSH levels stimulate follicular development, oocyte maturation, and ovulation in a vast majority of patients. It can induce super ovulation in patients undergoing more advanced infertility treatments like IVF.

IVF: In-Vitro Fertilization is the process where fertilization takes place in the laboratory as a treatment for infertility. The treatment involves the following steps.

Step 1: Induction of ovulation with "fertility drugs" to produce multiple eggs
Step 2: Retrieval of the eggs from the ovaries by transvaginal ultrasound aspiration
Step 3: Placing the recovered eggs with appropriate sperm in a laboratory controlled environment
Step 4: Culturing the resulting embryos for 3-6 days
Step 5: Transferring the embryos, by catheter to the patient's uterus.

LH: Luteinizing hormone is a gonadotropic hormone produced by the pituitary gland. Along with FSH, LH causes the ovulation of mature follicles and secretion of estrogen by the ovary.

LH Surge: At the midpoint of the ovulatory cycle, the pituitary gland is signaled to release a surge of LH which triggers a follicle to release its egg. Ovulation predictor kits can be used to detect this surge in urine. Since ovulation should be expected to occur sometime in the 24-48 hours following the surge, intercourse can be more effectively timed to improve the chance of pregnancy.

Luteal Phase: The Luteal phase refers to the presence of the corpus luteum. It's the portion of the menstrual cycle following ovulation until the start of menstruation (if not pregnant).

Menstruation: The periodic discharge from the vagina of blood and tissues from a non-pregnant uterus at the culmination of the menstrual cycle. Menstruation occurs every 28 days or so between puberty and menopause. Menstruation doesn't happen during pregnancy. The flow lasts about 5 days with the times varying from woman to woman.

Micromanipulation: Refers to any procedure where gametes or embryos are physically and individually "operated on". Delicate microscopic tools are used to achieve specific outcomes.

Miscarriage: Term used to designate loss of the fetus before it is viable. A miscarriage is also called a spontaneous abortion. Morphology: The science of the forms and structure of organisms. In infertility morphology is the analysis of the shape and structure of the reproductive cells. This pertains to sperm, eggs, and embryos.

Motility: Term used to describe the percentage of moving sperm in an ejaculate. Sperm are evaluated on the basis of quantitative and qualitative motilities. Quantitative motility is the percentage of swimming sperm out of the total number of sperm in a semen sample. Qualitative motility ranks the degree of speed and forward progression of the swimming sperm.

OHSS: Ovarian hyper stimulation syndrome is almost unique to ovulation induction cycles. It's especially unique in women who develop a large number of follicles (usually 20 or more), in response to Injectable gonadotropins. This fairly rare condition is characterized by significant enlargement of the ovaries, possible fluid retention in the abdomen, and general swelling throughout the body. The syndrome usually begins about a week after ovulation. OHSS usually happens in cycles where the woman winds up pregnant. There may be some unidentified characteristic of pregnancy that helps to trigger the onset of OHSS. The syndrome usually resolves on its own. It can take a few days to a few weeks before the discomfort is gone.

Oligoovulation: The term used to describe the ability to have only very irregular ovulatory cycles.

Oligospermia: The term used to describe a deficiency of spermatozoa in semen, or low sperm count.

Oocyte: The female gamete or egg.

Oolemma: The plasma membrane immediately surrounding an oocyte.

Ooplasm: The cytoplasm of the mammalian oocyte.

Ovulator: A Predictor Kit used like home pregnancy tests. They turn positive when an LH surge is detected in urine. Since ovulation should be expected to occur sometime in the 24-48 hours following the surge, intercourse can be more effectively timed to improve the chance of pregnancy.

Perivitelline Space: The fluid-filled space between the Oolemma and the zona pellucida of a mammalian oocyte.

Placenta: An organ characteristic of mammals during pregnancy, joining the mother and offspring, and providing the exchange of nutrients from the mother's blood into the fetus's blood and waste products from the fetus back to the mother. The placenta secretes both estrogens and progesterone. After birth of the infant the placenta is cast off from the uterus and expelled via the birth canal.

Polar Body: Structure extruded into the Perivitelline space as a result of oocyte maturation, containing a full half of the genetic material of the non-mature oocyte. It creates the necessary haploid gamete in preparation for fertilization.

Pre-implantation Embryo: Describes the stage of a developing embryo prior to implantation. This includes the stages from 2-cell to Blastocyst.

Premature Labor: Expulsion of a viable infant before the normal end of gestation. Premature labor usually applies to the interruption of pregnancy between the 28th and 37th weeks.

Progesterone: Hormone which plays a major part in the menstrual cycle. Produced by the corpus luteum, progesterone is promptly carried to the uterus and works with estrogen to prepare the uterus for possible conception. In pregnancy, progesterone acts in a way that protects the embryo and fosters growth of the placenta. By decreasing the frequency of uterine contractions it helps to prevent expulsion of the implanted ovum. It promotes secreting changes in the mucosa of the fallopian tubes. This provides nutrition for the fertilized ovum as it travels through the tube on its way to the uterus. Diminished secretion of progesterone can lead to menstrual difficulties in non-pregnant women and spontaneous abortion in pregnant women.

Prolactin: Hormone secreted by the pituitary gland that promotes the growth of breast tissue and stimulates and sustains milk production in postpartum mammals. Elevated Prolactin levels may indicate the presence of a pituitary tumor which can inhibit normal ovarian function.

Pronuclei: Structures in a fertilized ovum containing the nuclear material from both the male and female partners. This includes one pronucleus from the sperm and one from the egg. Male and female Pronuclei are usually formed simultaneously following successful fertilization. The Pronuclei may be visible as early as 5-6 hours after insemination. They'll remain visible up to about 20 hours until they fade and the first cleavage stage begins.

Reproductive Endocrine System: Describes the functions of those organs and glands responsible for the secretion of hormones which regulate the activities related to the reproductive process.

Reproductive Endocrinology: The study of the hormonal activity of the reproductive system.

RPR: Stands for the Rapid Plasma Reagin test used in the detection of syphilis.

Rubella: A mild systemic disease caused by a virus and characterized by a fever and a transient rash. Rubella is also called "German Measles". If a pregnant woman contracts rubella, especially during the first trimester, the virus can damage the developing offspring through a number of means. It can be damaged by congenital heart defects, cataract, mental retardation and deafness. A vaccine against rubella is available. The vaccine is given in a single subcutaneous injection to children more than a year old. It is never given to a pregnant woman, or to any woman who might become pregnant in the succeeding 2 months.

Super ovulation: The process where the ovary is stimulated to produce a number of egg-containing follicles (rather than just one) during the same cycle. Super ovulation is valuable in IUI and IVF procedures in order to improve the likelihood of obtaining enough quality oocytes for an increased probability of pregnancy.

Sperm Donor: Someone who donates sperm to a qualified recipient. The donation is done anonymously through a sperm bank or by a known friend or relative. Qualified recipients may be single women, or women whose partners have impaired sperm-producing ability.

Spermatogenesis: The development of mature spermatozoa from undifferentiated male germ cells in the semi-niferous tubules of the testis.

Syphilis: A contagious venereal disease leading to many structural and cutaneous lesions. The first sign of primary syphilis is a painless sore, called a chancre sore. It appears within 9 days to 3 months. Usually a chancre sore appears in 21 days after infection. Even if treatment isn't given, the chancre sore will disappear in 10-40 days. This often leads to the false conclusion the disease is cured.

Primary syphilis can be cured with antibiotics. Secondary syphilis may begin 2-6 months after the primary sore disappears and may last up to two years. A rash is usually one of the first symptoms and may cover any part of the body. The rash often spreads over the entire skin surface, including the palms and soles. Thin white sores in the mouth, throat, or genitalia may appear.

Syphilis is highly contagious in this stage and generally disappears within 3-12 weeks. It may return later if the organisms are still present. Like primary syphilis, secondary syphilis can be cured with antibiotics. Tertiary syphilis is known as "late syphilis" and its symptoms may develop soon after the secondary symptoms have vanished.

They may lie hidden for 15 years or more. Late syphilis is less contagious to others but is extremely dangerous to the person who has it. It may be fatal, particularly if the central nervous system or heart is affected. Cure of late syphilis takes longer. It's harder than primary or secondary syphilis. Late syphilis may be successfully treated with antibiotics.

Teratozoospermia: Describes semen specimens containing a high percentage of abnormally shaped sperm, often referred to as poor morphology.

Tubal Ligation: Commonly used as a method of birth control in females. It's commonly known as having your tubes tied. Tubal ligation involves application of a ligature to the fallopian tubes. It prevents the passage of eggs or sperm through the tubes. This prevents the possibility of a pregnancy.

Thyroid Hormones: Secreted by the thyroid gland in the neck, they influence many metabolic processes. Thyroid hormones stimulate the synthesis of protein, lipids, and coenzymes from vitamins. They regulate many aspects of carbohydrate metabolism.

Ultrasound: Employing the technique of ultrasonography. Ultrasound is used in obstetrics and gynecology to avoid using radiation. It's known as a safe, reliable and fast method. Ultrasound is used to examine the anatomy of female ovaries and the uterus. It's also used to examine the developing fetus and placental position in pregnant women.

Uterine Lining: The membrane lining the uterus. It's also called the Endometrium.

Varicocele: An enlargement of the veins of the testicle particularly in and around the spermatic cord. Varicoceles are usually located in the upper part of the scrotum and have historically been reported to occur in 24-41% of infertile men. The statistic is considered controversial in many circles. It's not well known or proven how a Varicocele produces infertility. It's generally believed to be related to an increase in the temperature of the sperm production centers. This is due to the increased blood flow in the enlarged veins.

Zona Pellucida: The covering that surrounds the oocyte, functioning as the "shell" of the oocyte.

Contact the Gyft Clinic for affordable fertility and gynecology services. Schedule an appointment at 253-777-1964.