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Glossary of Terms
A | B | C | D | E | F | G | H | I | J | K | L | M
N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A
Adhesions: Scar tissue that holds two structures together. Adhesions can be in the pelvis, in which case they are often caused by endometriosis or infection. A frequent cause of infertility. Usually corrected by laparoscopic surgery.
Amenorrhea: Lack of menstrual bleeding. May be primary (never had a period) or secondary (previously had periods). Causes include polycystic ovarian disease, anorexia, menopause, uterine scar tissue and low thyroid function.
Anovulation: Lack of ovulation, resulting in rare or no menstrual periods.
Antral Follicle Count: Testing to count the number of egg follicles at the start of a woman’s menstrual cycle. The fewer follicles, the more likely the patient has a decreased ovarian reserve.
Artificial Insemination: Placement of sperm into the uterus, through the vagina, with a small flexible tube (catheter). Typically used in conjunction with ovulation induction medication.
Assisted Hatching: Thinning of an embryo's outer shell (zona pellucida) prior to embryo transfer. Indicated for couples with advanced maternal reproductive age, elevated FSH levels and lack of success in previous IVF cycles.
Azospermia: Absence of sperm in the ejaculate.
B
Balanced Translocation: Chromosomal abnormality found in two to five percent of couples with recurrent pregnancy losses.
Basal Body Temperature (BBT): A woman measures her temperature orally, each morning before getting out of bed. With ovulation, temperature rises approximately one half degree.
Beta Three (ß3) Integrin: Marker of uterine receptivity. Diminished b3 levels are found in women with endometriosis, blocked fallopian tubes (hydrosalpinges), recurrent pregnancy loss, unexplained infertility and polycystic ovarian disease.
Blastocyst: Well developed embryo, formed five to six days after fertilization. Blastocyst stage embryos hatch out of their "shell," called a zona pellucida, then implant into the uterine wall.
C
Cervical Mucus: Cells within the cervix secrete mucus. At ovulation, the mucus is thin and watery, making it easy for sperm to travel from the vagina to the uterus. At other times in the menstrual cycle, the mucus is thick.
Chlamydia: Common sexually transmitted infection (STI) which can cause pelvic inflammatory disease (PID), damaged fallopian tubes, infertility and an increased risk of ectopic pregnancy.
Clomiphene Citrate: Oral ovulation induction medication.
Clomiphene Citrate Challenge Test: Test of ovarian reserve. Estradiol and FSH are measured at the beginning of a cycle. High FSH levels indicate poor ovarian reserve and a low likelihood of establishing a pregnancy through in vitro fertilization. This is repeated on the tenth day of the cycle, after taking clomiphene citrate.
Congenital Absence of the Vas Deferens: Men with a congenital absence of the vas deferens produce sperm in the testicle, but have a blockage in the tube (vas deferens) that connects to the urethra. Fifty percent of men with congenital absence of the vas deferens are carriers for cystic fibrosis. Pregnancies are easily established with intracytoplasmic sperm injection (ICSI) with sperm that is taken from the testicle.
Corpus Luteum: After ovulation, the dominant follicle transforms into a corpus luteum that makes progesterone, critical for implantation and early pregnancy.
Cryopreservation: Freezing of biologic material for future thaw and use. Embryos can be safely frozen for at least several years. Sperm can be frozen indefinitely. Eggs do not freeze or thaw well, and are not routinely cryopreserved, though there is new technology that may improve results with egg freezing.
D
Donor Egg: Women with diminished ovarian reserve or premature menopause have an extremely low likelihood of establishing a pregnancy. Eggs from a young donor can be retrieved and fertilized with the partner’s (or donor) sperm. Donor egg pregnancy rates at RMA of Philadelphia have been greater than 70 percent per cycle.
Donor Sperm: Donor sperm, which is screened for all known sexually transmitted infections (STIs), is available from many commercial sperm banks. Patients select their own donor for insemination.
E
Ectopic Pregnancy: Pregnancy found in a location outside the uterus. Occurs almost exclusively in the fallopian tube. Can be treated by laparoscopy or with a medication called methotrexate.
Egg: The mature female gamete, also called an oocyte.
Egg Retrieval: Minimally invasive procedure to retrieve eggs for use in an IVF cycle.
Embryo Transfer: Placement of embryos (usually no more than three) in the uterine cavity. The final step in an in vitro fertilization cycle.
Endometriosis: The presence of tissue usually found in the lining of the uterus (the endometrium) in sites outside the uterus. Endometriosis is a frequent cause of infertility, pain with menses (dysmenorrhea), pain with intercourse (dyspareunia) and premenstrual spotting.
Endometrium: The tissue that lines the uterine cavity.
Estradiol: The estrogen produced by the dominant follicle during the first half of the menstrual cycle. Estradiol levels rise prior to ovulation. Estradiol levels are carefully monitored during ovulation induction and IVF cycles.
F
Fallopian Tube: Thin elongated structure running from the uterine cavity to the ovary. Fertilization occurs in the ampullary portion (end) of the fallopian tube. Fallopian tubes may be blocked (hydrosalpinges) as a consequence of sexually transmitted infections.
Fertilization: Fusion of egg and sperm resulting in an embryo.
Fibroids: Also called myomas. Benign tumors found in the muscular wall of the uterus. Fibroids cause uterine enlargement, heavy and abnormal vaginal bleeding, bladder pressure, need for frequent urination and pelvic pain. Fibroids can play a role in infertility and miscarriage.
Folic Acid: Vitamin prescribed during pre-conception, for women of reproductive age, which reduce a fetuses' risk of a neural tube defects by 80 percent.
Follicle: Structure within the ovary that contains an egg. The follicle fills with fluid and makes estrogen as the egg inside gets closer to ovulation.
Follicular Phase: The first half of the menstrual cycle prior to ovulation.
Follicle Stimulating Hormone (FSH): Released by the pituitary gland in response to gonadotropin hormone releasing hormone (GnRH) released by the hypothalamus. Responsible for the selection and growth of follicles and eggs. Women take FSH injections for ovulation induction and IVF.
G
Gonadotropin: The hormones FSH (follicle stimulating hormone) and LH (luteinizing hormone) needed for ovulation and sperm production. FSH and LH are made in the pituitary gland in response to gonadotropin hormone releasing hormone (GnRH) made in the hypothalamus.
Gonorrhea: Common sexually transmitted infection (STI) which can cause pelvic inflammatory disease (PID), damaged fallopian tubes, infertility and an increased risk of ectopic pregnancy.
H
Human Chorionic Gonadotropin (hCG): The hormone produced by the placenta. hCG levels normally double every other day in early pregnancy. Slowly rising hCG levels indicate an impending miscarriage or ectopic pregnancy. hCG is injected to trigger ovulation or egg maturation during ovulation induction and IVF cycles.
Human Menopausal Gonadotropins (hMG): Medication containing follicle stimulating hormone (FSH) and luteinizing; hormone (LH) utilized for ovulation induction and IVF.
Hydrosalpinges: Blocked dilated fallopian tubes that are often caused by chlamydia or gonorrhea infection, prior pelvic surgery and ruptured appendix. Frequently, hydrosalpinges are removed prior to IVF to maximize the likelihood that an embryo will implant in the uterus.
Hypothalamus: Small area of the brain responsible for regulating many different hormones, including luteinizing hormone, follicle stimulating hormone, thyroid stimulating hormone, cortisol and prolactin.
Hysterosalpingogram: Outpatient test performed to asses the shape of the uterine cavity and whether the fallopian tubes are open. A small catheter is placed in the cervix and contrast is used to fill the uterus and fallopian tubes.
Hysteroscopy: Procedure to examine the shape of the uterus. Fibroids and polyps can be identified. Frequently performed in our office using a very small, flexible hysteroscope.
I
Implantation: Invasion of the human embryo (a blastocyst) through the uterine lining and into the muscle of the uterus. The uterus is receptive to implantation approximately one week after ovulation during a normal menstrual cycle.
Infertility: Defined as unprotected intercourse for more than one year without establishing a pregnancy, or multiple miscarriages.
Intracytoplasmic Sperm Injection (ICSI): Direct injection of a single sperm into a single egg.
Intramuscular Injection: Injection into the muscle part of the buttock. Method to administer human menopausal gonadotropins and hCG.
Intrauterine Insemination: Painless office procedure where sperm is placed into the uterus with a small flexible tube (catheter). Indicated for infertile couples with abnormal semen analyses, or in conjunction with ovulation induction.
In Vitro Fertilization (IVF): Fertilization of egg and sperm outside of the body. The most effective form of infertility therapy. Indicated in women and men with a range of diagnoses, including male factor infertility, unexplained infertility, endometriosis or damaged fallopian tubes.
L
Laparoscopy: An out-patient surgical procedure. Very effective method for treating endometriosis, pelvic adhesions, ovarian cysts, blocked fallopian tubes and pelvic pain.
Lupron: A GnRH agonist. This medication is usually started one week after ovulation as a twice daily injection. Lupron is an important medication for in vitro fertilization and in select patients undergoing ovulation induction with injectable FSH.
Luteal Phase: The second half of the menstrual cycle, after ovulation.
Luteal Phase Defect: Inadequate progesterone production or effect that does not allow normal implantation. Can cause recurrent pregnancy loss.
Luteinizing Hormone (LH): Released by the pituitary. Causes ovulation. Elevated in women with polycystic ovarian disease
M
Menopause: Total depletion of eggs resulting in the end of menstrual periods. The average age of menopause in the U.S. is 52 years, and 50 years for smokers.
Menstrual Cycle: Orchestrated sequence of the release of hormones (FSH and LH) produced in the brain that leads to ovulation and ovarian production of estrogen and progesterone. If pregnancy is not established, regular menstrual bleeding occurs.
Microsurgery: Delicate surgery using a microscope or glasses with high magnification. Most commonly needed for repairing fallopian tubes after tubal ligation.
Myoma: Also called fibroid. Benign tumors arising from the muscular wall of the uterus. Fibroids cause uterine enlargement, heavy and abnormal vaginal bleeding, bladder pressure, need for frequent urination and pelvic pain. May interfere with reproduction, especially if pressing into the uterine cavity.
Myomectomy: Surgical removal of fibroids either hysteroscopically or by an abdominal approach.
O
Ovarian Reserve: The number and quality of eggs remaining in a woman. Ovarian reserve diminishes over time, especially in the transition from the late 30s to the early 40s. Ovarian reserve can be assessed by measuring follicle stimulating hormone (FSH), or by the clomiphene citrate challenge test.
Ovary: Pelvic organ where eggs are stored and the hormones estrogen and progesterone are produced.
Ovulation: The release of mature egg from a follicle.
Ovulation Induction: Use of medication to develop multiple eggs. Clomiphene citrate, Lupron and injectable FSH are used for ovulation induction and IVF. Frequently used with intrauterine insemination.
Ovulation Predictor Kit: A way to measure luteinizing hormone in urine. Ovulation occurs 24 to 36 hours after detection of a change in the ovulation predictor kit.
P
Pelvic Inflammatory Disease (PID): Infection of the fallopian tubes and ovaries by gonorrhea or chlamydia. Characterized by fever and lower abdominal pain. Frequently requires hospitalization. Can cause infertility and increased risk of ectopic pregnancy.
Pituitary: The master gland of hormonal regulation. Releases luteinizing hormone, follicle stimulating hormone, thyroid stimulating hormone, prolactin and other important hormones.
Polycystic Ovarian Syndrome (PCOS): Characterized by infrequent menstrual periods, excess facial hair growth, obesity and infertility. Recent studies have shown that insulin plays a central role in the development of PCOS. Most women with PCOS ovulate with clomiphene citrate. A drug that lowers insulin levels can be prescribed for women who don't respond to clomiphene citrate alone.
Post-Coital Test: A small sample of cervical mucus is looked at under the microscope within 12 hours of intercourse.
Preimplantation Genetic Diagnosis (PGD): A single cell from an embryo created with in vitro fertilization (IVF) is tested for genetic disorders. PGD may be considered for women with multiple prior miscarriages, advanced maternal age, and for women with many prior failed IVF cycles. In addition, couples with known histories of inherited genetic diseases can also be tested, and normal embryos transferred.
Premature Ovarian Failure: Menopause occurring before the age of 40. Occurs in one percent of the general population.
Primary Infertility: Lack of pregnancy after one year of unprotected intercourse, for a woman who has never been pregnant before.
Progesterone: Hormone produced by the corpus luteum after ovulation. Progesterone is often supplemented either orally or by vaginal gel in the second half of the menstrual cycle after ovulation induction or in vitro fertilization.
Prolactin: Pituitary hormone that regulates breast milk production. When prolactin levels are elevated, ovulatory dysfunction may result.
R
Recombinant FSH: Injectable gonadotropin used for ovulation induction and in vitro fertilization. Results in recruitment and growth of many follicles and eggs.
Recurrent Pregnancy Loss: Two or three consecutive miscarriages.
S
Secondary Infertility: Lack of pregnancy after one year of unprotected intercourse, for a woman who has been pregnant before.
Semen Analysis: Evaluation of the male ejaculate for volume, count, motility and appearance (morphology).
Sperm: The mature male gamete.
U
Ultrasound: Method for measuring ovarian follicle growth and uterine lining thickness during ovulation induction and IVF.
Uterine Receptivity: The ability of the uterus to allow for an embryo to implant. Uterus is receptive only during the window of implantation, from six to 10 days after ovulation. Markers of uterine receptivity, such as the b3 integrin, have been extensively researched by Dr. Castelbaum and colleagues.
W
Window of Implantation: The time during the menstrual cycle when the uterus will allow implantation of an embryo. The uterus is only receptive from six to 10 days after ovulation.
Z
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