IVF – Dictionary

In Vitro Fertilization (IVF) comes with many new terms with which you may not be familiar. Here is a partial dictionary of some of those terms.
ART (Assisted Reproductive Technologies):
Treatment and procedures involving the handling of human oocytes, sperm or embryos, with the intent of establishing a pregnancy. This includes IVF +/- ICSI and excludes artificial insemination and ovulation induction.

American Society for Reproductive Medicine (ASRM):
Professional medical society whose members are interested in reproductive medicine.

Assisted Hatching (AH):
The early embryo has a protein shell surrounding it, the zona pellucidae. The embryo must break out of this shell (hatch) before attaching itself to the uterine wall. Assisted hatching involves creating a gap in this outer shell (either chemically or mechanically) to potentially aid in attachment. This is more commonly done in older women or those who have had previously unsuccessful IVF cycles.

Blastocyst transfer:
A blastocyst is an embryo that has developed to the point of having two different cell components and a fluid cavity. The embryo usually reaches this stage by day five after fertilization.

CBAVD (Congenital Bilateral Absence of the Vas Deferens):
The vas deferens is the tube which transports the sperm from the testicle during ejaculation. Occasionally, this is absent. This can be found in patients who carry the gene for cystic fibrosis.

Catheter:
Thin tube of varying lengths and sizes, which is used to insert embryos or sperm into the uterine cavity.

Cervical canal:
Canal which runs through the center of the cervix connecting the vaginal vault on one side to the uterine cavity on the other side.

Cryopreservation:
The freezing of viable sperm, eggs, or embryos that may be used in subsequent cycles.

Egg retrieval:
Process of inserting a needle into ovarian follicles to withdraw mature eggs.

Embryo transfer:
Placement of the embryo into the uterine cavity.

Estrogen:
One of the hormones responsible for the development and thickening of the endometrial cavity.

Estradiol:
A form of estrogen that can be measured in blood. The level rises with normal oocyte growth.

Fallopian tube:
Tube which provides means of transport of the egg from the ovary into uterus. Normal anatomy includes a left and right fallopian tube.

Frozen embryo transfer (FET):
Embryos cryopreserved from a fresh IVF cycle are thawed and then transferred into the uterus or fallopian tube.

Follicle:
A fluid filled sac located just below the surface of the ovary. Attached to the inner wall is the egg. As the egg becomes more mature, the size and volume of the follicle increase.

Follicular Phase:
Phase during which follicles grow and endometrium thickens. Typically occurs cycle days 1-14 of a normal menstrual cycle.

Follicle-stimulating hormone (FSH):
Secreted by the pituitary gland, this is a hormone that stimulates the growth and maturation of follicles on the ovary. This can also be manufactured in a laboratory and given as a medication.

Gonadotropin Releasing Hormone (GnRH):
The natural hormone secreted by the hypothalamus that prompts the pituitary gland to release the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). This in turn stimulates the ovaries to produce estrogen, progesterone and to ovulate.

Human chorionic gonadotropin (hCG):
Hormone produced by the placenta during pregnancy. This hormone level rises in early pregnancy. This can also be manufactured in a laboratory and given as a medication.

Hysterosalpingogram (HSG):
An x-ray of the female reproductive organs used to visualize the inner contour of the uterine cavity and also to determine patency of the fallopian tubes. The x-ray is obtained after a radiopaque liquid is injected into the uterine cavity.

Intracytoplasmic Sperm Injection (ICSI):
A fertilization technique is used in couples with male factor. A single isolated sperm is drawn up into a specially designed pipette. The pipette is inserted into the egg’s center (the cytoplasm) and the sperm is released.

Intrauterine insemination (IUI):
In an attempt to achieve pregnancy, a prepared semen specimen is placed within the uterine cavity at the time of ovulation.

In Vitro Fertilization (IVF):
Process by which the oocyte and sperm are combined in a culture dish in the laboratory. Fertilization and early embryonic development occur outside of the body.

Luteinizing hormone (LH):
A hormone secreted by the pituitary that can trigger ovulation to occur. This can also be manufactured in a laboratory and given as a medication.

Luteal Phase:
Phase of the menstrual cycle that follows the follicular phase, in which the endometrium is accepting of a fertilized egg and growth of the corpus luteum occurs; typically lasts for 10-14 days.

Ovarian Hyperstimulation Syndrome (OHSS):
OHSS is a medical complication that may occur after gonadotropin use as with IVF. In its severest form, OHSS is characterized by ovarian enlargement and a build-up of fluid in the abdomen (ascities), chest cavity (pleural effusion), or around the heart (pericardial effusion). It affects blood electrolyte levels, liver, and kidney function and puts the patient at greater risk for blood clots. Patients may experience abdominal discomfort, nausea, vomiting, weight gain, decreased urine production, shortness of breath, or pelvic pain. If you experience these or have any concerns always contact your physician immediately. Complications of OHSS can be FATAL.

Ovulation:
Release of mature egg(s) ready for fertilization.

Pipette:
Glass or plastic transparent tube used in measuring or transferring small amounts of liquid. Used with ICSI.

Progesterone:
A female hormone produced by the corpus luteum after ovulation and/or by the placenta during pregnancy. It prepares the lining of the endometrium for potential implantation of an embryo.

Reproductive Endocrinologist (RE):
A medical specialist who has completed four years of college followed by four years of medical school. The physician then completes an obstetric and gynecology residency, followed by a two to three year fellowship training in Reproductive Endocrinology. This advanced training includes experience in infertility, laparoscopy and microsurgery, endocrinology, menopausal problems, and endometriosis.

Semen analysis:
A microscopic analysis of semen to determine volume, quantity, movement (motility), shape (morphology) and a number of other factors.

Sonohystogram (SHG):
An ultrasound that is used to visualize the inner contour of the uterine cavity. The ultrasound is performed after saline is injected into the uterus through a catheter placed in the cervical canal.

Ultrasound:
A picture of internal organs produced by high frequency sound waves. These images can be viewed on a computer screen or printed on paper.

Vitrification:
The process of rapidly cryopreserving (freezing) an oocyte or embryo.

 Zygote intrafallopian transfer (ZIFT):
The woman’s eggs are fertilized in the laboratory and then a laparoscope is used to help transfer the fertilized eggs (zygotes) into her fallopian tubes.