Glossary of Terms

A | B | C | D | E | F | G | H | I | K | L | M | N | O | P | R | S | T | U | V | Z

H

Hysterosalpingography

An HSG is an x-ray dye test used to visualize the uterus and tubes. It involves the injection of a radio-opaque dye through the cervix and into the uterus and tubes. A series of x-rays is taken and the contour and patency of the uterus and tubes are assessed. The procedure can be somewhat uncomfortable, and may result in some cramping which often lasts for a few hours after the procedure. The likelihood of this occurring can be diminished or lessened by taking Ibuprofen or other pain medications, one hour before the test. In a small percentage of cases an HSG can cause tubal infection. This is more common in women who have one or more blocked tubes. If this is the case, the individual should immediately contact her infertility specialist to be placed on antibiotics for a week.

Hysteroscopy

This is a procedure that involves the introduction of a thin telescope-like instrument through the cervix into the uterine cavity. It enables the direct visualization of the uterine cavity and its lining, thereby providing an opportunity to diagnose abnormalities such as polyps, fibroids or adhesions. It is best performed 2 to 7 days following the end of menstruation. Diagnostic hysteroscopy can be performed with general anesthesia in the doctor's office. The procedure is relatively risk free and is significantly less painful than a hysterosalpingogram. All patients suspected of having surface lesions involving the inner lining of the uterus should have a diagnostic hysteroscopy performed.

Hysterosonogram

As a diagnostic procedure, the hysterosonogram is equal to the hysteroscopy procedure in identifying polyps or fibroids in the uterine cavity. It is performed in the doctor's office or in a hospital radiology department and does not require anesthesia. Ibuprofen is sometimes taken prior to the procedure to decrease the incidence of cramping. A small tube with a tiny balloon is placed into the cervix. Under vaginal ultrasound visualization, a small amount of sterile saline solution is placed into the uterine cavity. If there are any polyps or fibroids in the cavity, they can be easily seen by a doctor, who can then perform a hysteroscopy to remove the lesion(s).

I

ICSI

Intra-Cytoplasmic Sperm Injection is a technique whereby a single sperm is injected into the cytoplasm of an egg by the embryologist in the laboratory. This technique, also called "Sperm Injection," is performed when a man has a very low sperm count or when his sperm show very poor motility. It is also recommended for individuals who have experienced poor fertilization of eggs in a previous IVF cycle. The procedure involves grasping a single sperm with a very fine needlepoint pipette and then gently inserting it inside the egg and releasing the sperm.

Implantation

The process by which an embryo burrows within the endometrial lining of the uterus.

In Vitro Fertilization

See IVF.

Intracytoplasmic Sperm Injection

See ICSI.

IUI

Intrauterine Insemination: The process of placing washed sperm into the uterine cavity. Using a thin plastic catheter, concentrated sperm is gently placed high in the cavity, moving the sperm sample past the potential barrier of the cervical mucus and getting a higher concentration of motile sperm much closer to the egg(s).

IVF

Literally "fertilization in glass," IVF comprises several basic steps: the woman is given fertility drugs that stimulate her ovaries to produce a number of mature eggs; at the proper time, the eggs are retrieved by suction through a needle that has been inserted into her ovaries; the eggs are fertilized in a glass Petri dish, or in a test tube, in the laboratory with her partner's or donor sperm; and subsequently the embryos are transferred back into the body.

IVF with a Gestational Carrier (or "Surrogate")

The prospective parents' eggs and sperm are used to create embryos, which are then transferred into the uterus of another woman—known as the carrier (or surrogate)—via in vitro fertilization. It is the job of the gestational carrier to "carry" the pregnancy to term.

K

Karyotype

The word karyotype can be used in two different ways. The karyotype of a cell is the presence, as well as the specific arrangement and form, of the cell's chromosomes. A normal human cell has 46 chromosomes. Abnormalities of certain chromosomes, such as an extra chromosome, can be detected by doing a test in which a photograph is taken of the chromosomes from a single cell. This test is also referred to as a karyotype because the shape, size and presence of chromosomes from the cell are analyzed. This test is done for couples who suffer from recurrent miscarriages, in order to look for a specific chromosomal abnormality called "translocation", which can result in the loss of important genetic material therefore causing miscarriages. In men with severe male factor infertility or azoospermia, there is an increased chance that they have a genetic abnormality. A karyotype of their blood is often recommended.

L

Laparoscopy

This is a procedure that involves the introduction of a thin telescope-like instrument through the belly button and into the pelvis for direct visualization of the pelvic organs. Dye is sometimes injected through the cervix, and its flow traced through the fallopian tubes. Physician use laparoscopy for a variety of reasons: to check for suspected problems such as infertility, blocked or damaged tubes, scarring, ovarian tumors and uterine anomalies such as fibroids; to diagnose and treat endometriosis; to lyse (cut) adhesions that result from scarring; to remove fibroids, ovarian cysts or tumors. Laparoscopy is conducted under general anesthesia. The majority of patients do not have to stay overnight in the hospital. Mild abdominal discomfort for 1 or 2 days after the procedure is common; however, most women resume their normal activities as early as the day following the procedure. There are risks associated with laparoscopy, but they are considered minimal and/or uncommon. These risks include the following: infection, bleeding, damage to nearby organs (such as the bowel), and reaction to anesthesia. Very rarely is abdominal surgery required post-procedure, in order to take care of a complication that developed as a result of the laparoscopy.

Laparotomy

A procedure in which the abdomen is opened with an incision to expose its contents.

Letrozole

A medication that lowers the levels of the enzyme that produces estrogen, thereby temporarily lowering estrogen levels. Can be useful for inducing ovulation in women that do not ovulate regularly. 

LH

The luteinizing hormone (LH) is secreted by the pituitary gland involved in the control of ovulation. The role of LH is to trigger ovulation and help prepare the endometrial lining for implantation. The level of this hormone starts to rise roughly 24 hours prior to expected ovulation. We can check this by using a home ovulation predictor kit, such as Clear Blue Easy. When the test color matches the control, this signifies the presence of elevated levels of LH in the blood. The individual then can plan intercourse or IUI within 24 hours of that positive test. 

Lupron

Known medically as a GnRH-agonist (see GnRH), Lupron is a commonly used medication in IVF, and also for the treatment of severe endometriosis or large uterine fibroids. Lupron taken continuously either by daily subcutaneous (under the skin) injections or monthly intramuscularly depot injections will suppress the pituitary-ovarian axis. Simply stated, it will make the ovaries "go to sleep" and stop functioning, therefore stopping the secretion of hormones such as estrogen and progesterone. Lupron is frequently used in IVF to prevent premature ovulation.

Luteinizing Hormone

See LH.

M

Meiosis

The cellular division that occurs in sexual gonads (ovaries and testicles) to reduce the number of chromosomes in the egg and the sperm by half (from 46 down to 23 chromosomes). After fertilization, when the egg and sperm unite, the normal complement of 46 chromosomes is re-established in the new embryo. Errors in the process of meiosis occur frequently in human eggs and may be one of the major causes of implantation failure and miscarriage in humans.

Menopause

The period in a woman's life when menstruation stops. The average age of menopause in the United States is 51. The few years prior to menopause, also called the climacteric or peri-menopause, menstrual cycles become irregular in many women. 

MESA

Microsurgical Epididymal Sperm Aspiration (MESA) is a surgical procedure to remove sperm from the epididymis in men who have an obstruction of the vas deferens or epididymis (or congenital absence of the vas deferens). This procedure is also used for obtaining sperm from men who have had a prior vasectomy. Unlike the TESE procedure, millions of sperm can usually be obtained and excess sperm are frozen for subsequent IVF cycles if needed. The sperm are then injected into the female partner's eggs (see ICSI).

Metformin

An oral medication used to treat insulin-resistance associated with Polycystic Ovarian Syndrome.

Micromanipulation

Advanced techniques used to manipulate gametes, i.e. eggs and sperm, to enhance successful fertilization and implantation. Intracytoplasmic sperm injection is one form of micromanipulation. (See ICSI). Embryo biopsy for pre-implantation genetic diagnosis and assisted hatching are other micromanipulation techniques.

Mitosis

The replication of cells by equal division. Soon after fertilization, the zygote undergoes successive mitoses and thus yields an embryo. All organs in the body that regenerate do so by mitosis.

Morula

An early phase of a growing embryo that resembles a mulberry. This stage is the typical stage for a Day 4 embryo. 

N

Nucleus

Structure in the cell that contains the chromosomes.

O

Oocyte

See Egg.

Ovarian Hyperstimulation

Complication of taking fertility drugs resulting in gross enlargement of the ovaries. In other words, hyperstimulation occurs when the ovaries produce excess eggs in response to stimulation by fertility drugs. This complication can be accompanied by an accumulation of fluid in the abdomen and lungs, and abnormal blood tests. However, hyperstimulation occurs in this severe form, requiring medical intervention, less then 1% of the time. Additionally, we monitor the body's response to fertility drugs, which allows us to see which patients are at risk in order to take the proper steps to prevent any problems from occurring.

Ovarian Reserve

As a woman gets older, the number of viable, healthy eggs remaining in her ovaries diminishes. While a woman continues to ovulate monthly from her late 30s until menopause, the eggs she produces are increasingly at risk for genetic abnormalities such as Down syndrome. Ovarian reserve is a term used to refer to a woman's "reproductive potential"; i.e., the chances that a woman will have a successful pregnancy with her own eggs. In order to evaluate ovarian reserve, doctors use tests such as the FSH and Estradiol level on Cycle Day 2 or 3, AMH (Anti-Mullerian Hormone) level, and Antral Follicle Count. 

Ovary

The small oval organs measuring 2 by 1.5 inches present in a woman's pelvis and responsible for making eggs.

Ovulation

The process by which a mature egg is released from the surface of an ovary.

Ovulation Induction

Stimulation of the ovaries by fertility drugs to produce and release one or more eggs.

Ovulation Predictor Kit

See Ovulation.

Ovum Donation

See Egg Donation.

P

Pituitary Gland

A small gland present at the base of the brain. It receives instructions from a specialized area of the brain just above it called the hypothalamus. The pituitary secretes many important hormones, such as FSH, LH, TSH and Prolactin. FSH and LH control the ovaries. TSH controls the thyroid gland and Prolactin controls milk production.

Placenta

The organ that is responsible in the nourishment of the developing embryo. Abnormalities in the placenta can result in abnormal fetal growth, pre-eclampsia and death.

Polycystic Ovarian Syndrome (PCOS)

A genetic condition that results in women with ovulation problems and menstrual irregularity. Can be associated with excess male hormones and insulin resistance. Women with PCOS often require Clomid or other ovulation-inducing medications to stimulate ovulation.

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