A

Adjunctive Treatment / Procedures

adjunctive (in health care)- an additional substance, treatment, or procedure used for increasing the efficacy or safety of the primary substance, treatment, or procedure or for facilitating its performance.

Amenorrhea

Absence of menstruation, diagnosed when a woman does not have a period for three months or more.

Anovulation

A condition in which a woman does not ovulate or rarely ovulates.

Anti-Müllerian hormone (AMH)

AMH predicts a woman's remaining egg supply (ovarian reserve). AMH is produced by the granulosa cells in the ovarian follicles. AMH blood levels indicate the size of the pool of follicles remaining; therefore, as a woman ages, the size of the ovarian follicle pool decreases and the AMH level also decreases, becoming undetectable at the time of menopause.

Artificial reproductive technology (ART)

Technology that improves fertility and promotes pregnancy. This umbrella term covers infertility treatments such as IVF that process the egg and sperm.

Azoospermia

Azoospermia is the complete absence of sperm in a man's semen. It occurs in 5-10% of men who seek fertility treatment.

B

Beta hCG

A beta, or beta pregnancy test, is a blood test for the hormone hCG (human chorionic gonadotropin). Levels of hCG increase steadily in the early stages of pregnancy, showing physicians that a healthy pregnancy is progressing.

Biochemical pregnancy

The medical term used to describe a very early miscarriage, which usually happens in the first couple of weeks after an embryo has been transferred to the womb.

Blastocyst

Five to six days after a zygote is created by the fusing of an egg and a sperm, it becomes a blastocyst, a multi-cell mass, and enters the uterus. This is also the stage at which the embryo is transferred into the uterus during an embryo transfer (day 5) or during a frozen embryo transfer (day 5 or 6).

BMI

Body-mass index - a measure of body fat based on height and weight that applies to men and women.
Underweight = < 18.5
Normal weight = 18.5 - 24.9
Overweight = 25 - 29.9
Obesity = > 30
Morbid obesity = > 40

C

Canadian Compliant

"Canadian Compliant" means that a donor's units meet the Health Canada Standards.
They require donor's units to have some additional testing done including Semen Culture, Gonorrhea, and Chlamydia by DNA on the day of donation.

Chemical pregnancy

Another term to describe a very early miscarriage, which occurs 1-2 weeks after an embryo has been transferred to the womb.

Clinical Pregnancy

A pregnancy that has been confirmed by two things: an ultrasound showing either a heartbeat or gestational sac (a fluid-filled structure in the uterus) and high levels of the pregnancy hormone hCG.

Clomiphene citrate/Clomid (product name)

A fertility drug used to trigger follicle-stimulating hormone (FSH), which can jump-start the ovulation process.

Controlled ovarian stimulation (COS)

The process of stimulating ovulation using fertility drugs (such as Clomiphene citrate or Letrozole, or Gonadotropins).

Corpus luteum

After an egg is released during ovulation, the structure it leaves behind is called the corpus luteum. It produces progesterone, which helps sustain a new pregnancy.

Cryopreservation

The process of freezing eggs or embryos from an ART cycle for potential future use.

Cycle Monitoring

This process occurs during the first half of the menstrual cycle to allow the doctor to follow the development of the follicles and eggs, and measure the hormone levels. It can be done in a natural cycle or while using fertility medication to stimulate the ovaries. It requires ultrasound and/or bloodwork each time the woman comes in.

D

Diminished ovarian reserve

This condition means that the ability of the ovaries to produce eggs is reduced.

Down-regulation

This is sometimes used as one of the first steps in IVF. The woman receives a drug that temporarily "switches off" her ovaries to better control ovulation and egg maturation during treatment. Fertility drugs are used to "switch on" your ovaries later. This process is also called "down regging," and the process is a "down-regulation cycle."

E

Endometrial biopsy or sampling

This is a test done in the doctor's office to study the lining of the uterus (endometrium). A sample of endometrial tissue is removed using a very fine catheter placed in the uterus. This test is usually done late in the menstrual cycle, after ovulation.

Endometriosis

A gynaecological condition in which the tissue that lines the inside of the uterus (endometrium) grows outside of the uterus. This tissue responds to hormones the way it normally would, and can grow on the ovaries causing cysts (called endometriomas), or on other structures within the pelvis. Because it also bleeds during menstruation, scar tissue may form within the pelvis, which can cause pain and distortion of structures. Inflammation usually occurs within the "implants" of endometriosis which affect various aspects of the reproductive process, leading to decreased fertility.

Estrogen (E2)

E2 refers to estradiol, or your level of estrogen. The estrogen level correlates directly with the number of follicles in your ovaries, helping physicians to estimate how many eggs you will have for retrieval during your cycle.

Ectopic pregnancy

A pregnancy in which the fertilized egg implants somewhere other than the uterus.

Egg

A female reproductive cell, also called an oocyte or ovum.

Egg retrieval, Egg collection, Ovum Pick-up (OPU)

An IVF treatment step in which eggs are removed from the ovaries using real-time ultrasound guidance, for use (immediate fertilization) or storage (egg freezing).

Embryo

An embryo is created when the sperm meets, penetrates, fuses with and fertilizes the egg, forming a single cell. The embryo then divides and develops into a multi-cell cluster. Further divisions create a morula and then a blastocyst.

Embryo transfer (ET)

The procedure of placing an embryo into a woman's uterus during in vitro fertilization (IVF).

F

Fallopian tubes

Two hollow tubes on either side of the uterus. The egg and sperm meet in one of the tubes to begin the fertilization process.

Fertilization

The penetration of the egg by the sperm and the combining of genetic material, which may result in pregnancy if the fertilized egg implants in the uterus.

Fetus

The embryo is called a fetus from the eighth week after conception to the moment of birth.

Fibroids

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. They can cause decreased fertility, depending on their location and their size. They can also be associated with pain and heavy bleeding.

Fibroid locations

Follicle

A tiny fluid-filled sac in the ovaries that contains a developing egg.

Follicle-stimulating hormone (FSH)

FSH is released by the brain to stimulate the ovarian follicles (structures within the ovaries, each containing a maturing egg) to grow and develop.

Frozen embryo transfer (FET)

A procedure in which the frozen embryos from a previous fresh IVF or donor egg cycle are thawed and then transferred back into a woman's uterus.

G

Gamete

A reproductive cell, either a sperm or an egg.

Gamete intrafallopian transfer (GIFT)

This ART procedure extracts a woman's eggs, mixes them with sperm and immediately uses a catheter to place them into her fallopian tube to fertilize. It requires laparoscopic surgery and a general anesthetic. This is a rarely used alternative to traditional IVF.

Gestational carrier

A surrogate who carries a baby not genetically related to her; another couple's embryo is transferred to her uterus, she becomes pregnant and she gives birth to the baby.

Gestational sac

A fluid-filled structure that develops within the uterus early in pregnancy. The fetus grows inside the gestational sac.

Gonadotropin-releasing hormone (GnRH)

A hormone that is involved in triggering ovulation.

H

Human chorionic gonadotropin (hCG)

HCG is a hormone produced during pregnancy. Levels of hCG increase steadily in the early stages of pregnancy, showing physicians that a healthy pregnancy is progressing. A beta pregnancy test specifically looks for and measures hCG.

Hysterosalpingogram (HSG)

An exam that determines the condition of the fallopian tubes and uterus. When an HSG is performed, dye is placed through the cervix into the uterus and fallopian tubes. An x-ray determines if the uterine cavity is normal and the tubes are open.

Hysteroscopy (HSC)

A procedure in which a thin, telescope-like instrument is inserted through the cervix into the uterus, allowing the doctor to see and photograph the area. This test is usually done with either a general or local anesthetic.

I

Intercourse

The physical act of sex between two people.

Intracytoplasmic sperm injection (ICSI)

A fertility treatment used when sperm count is too low or sperm quality is too poor to effectively penetrate the egg on its own. An embryologist selects a single healthy sperm and injects it directly into the center of the egg. This has been a highly effective treatment for male factor infertility.

In vitro fertilization (IVF)

A method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg is fertilized and the cells begin to divide, the resulting embryo is transferred into the woman's uterus, where it will hopefully implant in the uterine lining and further develop into a fetus.

Implantation

Within 6 to 7 days after an egg is fertilized, it implants in (attaches to) the lining of the uterus.

Infertility

Medically, if a woman is under age 35, she and her partner are experiencing infertility if they have not conceived after having 12 months of unprotected sex. If the woman is 35 or older, they are diagnosed with infertility after six months of trying.

Intrauterine insemination (IUI)

A procedure involving placing sperm directly into a woman's uterus to facilitate fertilization.

L

Laparoscopy

A procedure that involves insertion of a narrow, telescope-like instrument called a laparoscope through a small incision in the abdomen, allowing doctors to inspect various reproductive organs.

Luteinizing hormone (LH)

LH is produced by the gonadotropin cells in the pituitary gland. In women, the rise of LH (known as the "LH surge") triggers ovulation, or the release of an egg into a fallopian tube.

Luteal phase (LP)

The time between ovulation and menstruation (also called the two-week wait)

LH surge

A surge of luteinizing hormone helps the follicle rupture and the egg break through the surface of the ovary during ovulation. You can use an ovulation predictor kit, which detects the surge in LH in your urine, indicating that ovulation is likely within the next 12 to 24 hours. It can also be measured in your blood, indicating that ovulation is likely to occur within the next 24 - 36 hours.

M

Male factor infertility

When the cause of a couple's infertility is due to problems in the man or when it contributes to existing fertility problems in the woman.

Menstrual cycle

The menstrual cycle is the regular natural change that occurs in the female reproductive system that makes pregnancy possible.

About once a month, females who have gone through puberty will experience menstrual bleeding. This happens because the lining of the uterus has prepared itself for a possible pregnancy by becoming thicker and richer in blood vessels, in response to hormonal changes. If pregnancy does not occur, this thickened lining is shed, demonstrated by bleeding. Bleeding usually lasts for 3-8 days. For most women, menstruation happens in a fairly regular, predictable pattern. The length of time from the first day of one period to the first day of the next period normally ranges from 21-35 days.

Microsurgical testicular sperm extraction (MicroTESE)

This minor surgical procedure removes a small sample of testicular tissue in order to retrieve sperm for use in an IVF cycle.

Miscarriage (also called spontaneous abortion)

A pregnancy ending in the spontaneous loss of the embryo or fetus before 20 weeks of gestation.

N

Natural cycle IVF

An IVF procedure that is done using your natural menstrual cycle, without fertility drugs to influence natural egg production.

O

Oligozoospermia (also oligospermia)

A condition in which a man has very few sperm, causing male factor infertility.

Oocyte

Another term for the female reproductive cell, also called an egg.

Ovulation

The release of eggs from the ovaries. In humans, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized by sperm.

Ovarian hyperstimulation syndrome (OHSS)

A rare complication of ovarian stimulation to create egg growth. OHSS causes a woman to develop fluid in the abdomen and enlarged ovaries.

Ovarian reserve

The capacity of a woman's ovaries to produce healthy eggs.

Ovarian stimulation

The use of medications to stimulate the ovaries to develop eggs.

Ovulation predictor kit or test

The home test strips used to predict ovulation.

Ovum

Another term for the female reproductive cell, also called an egg.

P

Pelvic inflammatory disease (PID)

PID is an infection of the female reproductive organs. It usually occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries. It often does not produce any or only mild signs or symptoms, and therefore may not be detected until much later. The common symptoms include lower abdominal pain, fever, nausea and vomiting, and foul-smelling vaginal discharge. It can cause obstruction of the fallopian tubes if it is untreated.

Progesterone (P4)

P4 is measured to determine the following: if the woman has ovulated, when ovulation occurred, if the woman has/had an ectopic pregnancy or if the woman had a miscarriage. Progesterone levels will surge JUST before ovulation and should continue to rise if you become pregnant.

Prolactin

The pituitary gland hormone that promotes the woman's milk production after giving birth.

Polycystic ovary syndrome (PCOS)

A hormonal disorder common among women of reproductive age. Women with PCOS may have irregular menstrual periods, symptoms of excess male hormones, (such as acne, excess hair growth, hair loss associated with a male pattern of balding, weight gain), and development of numerous small cysts on their ovaries. Often they don't ovulate, or ovulate infrequently, causing decreased fertility.

Preimplantation genetic diagnosis (PGD)

A state-of-the-art procedure used in conjunction with IVF to select embryos for transfer to the uterus that are free of chromosomal abnormalities and specific genetic disorders.

Preimplantation genetic screening (PGS)

Screens embryos for missing or additional chromosomes (aneuploidy), which is a leading cause of implantation failure or miscarriage. PGS aims to identify abnormal embryos so they will not be implanted, leaving chromosomally normal embryos to be transferred in an attempt to achieve a successful pregnancy.

Preconception genetic screening

Tests prospective parents for over 100 different diseases and syndromes. Genetic screening tests for traits that are common in certain ethnic groups, traits that are recessive and traits that may have some likelihood of causing serious diseases in affected offspring.

R

Reproductive endocrinologist (RE)

An obstetrician/gynecologist (ob/gyn) who has taken additional years of training to specialize in reproductive endocrine disorders and infertility.

Retrograde ejaculation

A male condition in which semen enters the bladder during ejaculation instead of leaving the penis.

Round spermatid nucleus injection (RSNI)

An experimental fertilization technique in which immature sperm cells are removed from the testicles and the genetic material is injected into an egg.

Recurrent pregnancy loss (RPL)

Two or more consecutive miscarriages (spontaneous pregnancy losses) that occur before the gestations reach 20 weeks. Recurrent miscarriages can be attributed to a variety of factors, including genetic defects, an abnormally shaped uterus, fibroids, scar tissue, hormonal imbalances or other conditions.

S

Semen analysis (SA)

An examination that assesses a man's sperm count, morphology and motility.

Sonohysterogram (SHG)

This is an ultrasound examination that provides information about the uterus and the fallopian tubes, without using x-rays or an anesthetic. It is done shortly after the end of your period and usually before ovulation. Fluid is inserted into the uterus and ultrasound pictures are taken; then a "dye" is infused in order to outline the fallopian tubes.

Sperm

The male reproductive cell produced in the testes and found in semen.

Sperm DNA Fragmentation

DNA fragmentation refers to the situation in which DNA within the sperm contains breaks. Good quality sperm DNA is crucial for successful fertilization of your partner's egg and the normal development of your embryo. Damage to your sperm DNA can occur during sperm production or while it is being stored in your body. A high level of sperm DNA fragmentation reduces the likelihood of pregnancy and is also linked to recurrent miscarriage.

Sperm Morphology

The size and shape of sperm.

Sperm Motility

Sperm's ability to move.

Sperm washing

The official term for separating individual sperm from semen. This is done with IUI prior to injecting the sperm into the uterus; and for IVF, this is usually performed after the woman has had her eggs collected, in order to use the sperm for fertilization.

T

Testicular epididymal sperm aspiration (TESA)

A simple procedure in which sperm is aspirated from the testicles using a needle. A man may undergo this procedure when his sperm does not exit his penis during ejaculation, or if he has had a vasectomy.

Testosterone

A male sex hormone produced in the testicles that aids in the production of sperm.

Therapeutic Donor Insemination (TDI)

TDI involves placing cryobanked (frozen) sperm from an anonymous or known donor into the uterus, at the time of ovulation.

Thyroid stimulating hormone (TSH)

An important hormone in the human reproductive cycle and therefore of particular interest to ART treatments.

Therapeutic Donor Insemination (TDI)

TDI involves placing cryobanked (frozen) sperm from an anonymous or known donor into the uterus, at the time of ovulation.

Tubal factor infertility

Tubal factor infertility is either a complete or partial blockage and/or scarring of the fallopian tubes, which causes infertility (since either sperm are blocked from meeting the egg or the egg is unable to move to the uterus).

U

Unexplained infertility

A diagnostic category used when a man, woman or couple is experiencing infertility, but no cause of it is found.

Uterus/Womb

The main female reproductive organ. The fetus develops in the womb during gestation.

Ultrasound (US)

The US test assesses ovarian reserve and detects abnormalities of the ovaries, uterus and other structures in the pelvis.

V

Viable Pregnancy

A live pregnancy with a fetal heartbeat detected on ultrasound.

Vitrification

Vitrification is a technology that is used in the embryo and egg freezing process so that they can be stored for later use. When cells are frozen in a lab, the main focus of the process is to avoid ice crystal formation as the fluid in the cell cools to very low temperatures. Ice crystal formation poses 2 significant and deadly problems for cells. First, an ice crystal is very sharp and will easily shred the cell membrane, killing the cell. Second, as water in the cell turns to ice, it expands in volume, rupturing or killing the cell. Therefore vitrification is one of the processes that was developed to allow cells to be frozen while avoiding the formation of ice.

Z

Zygote

The fertilized egg while it is in the fallopian tube in a natural cycle, or immediately after the sperm fertilizes the egg during an IVF cycle.