Glossary of terms

AIDS - (Acquired Immune Deficiency Syndrome) - a number of symptoms and infections in humans resulting from the specific damage of the immune system caused by the Human Immunodeficiency Virus (HIV).

Andrologist - An MD/PhD. who specializes in the study of male reproduction.

Aneuploidy – Numerical assessment of chromosome number. Aneuploidy is the most frequently observed type of cytogenetic abnormality.

Anovulation - The total absence of ovulation (menses may still occur).

Assisted hatching - Reduce the thickness or open the zona pellucida of oocyte or embryos

Assisted Reproductive Technology (ART) – Treatments and procedures involving the handling of human eggs and sperm for the purpose of establishing a pregnancy. Types of ART include IVF, ICSI, assisted hatching, embryo transfer, gametes cryo preservation and donation etc…

Asthenozoospermia - Very weak mobility of spermatozoa or none at all in the seminal fluid.

Azoospermia - The absence of spermatozoa in the seminal fluid (secretory or excretory), either due to a hypothalamus-pituitary insufficiency or to congenital (chromosome anomalies or ectopic testicle) or acquired (mumps, chemotherapy) factors.

Beta hCG test (BhCG) - A blood test by which the level of the hormone BhCG is evaluated to determine pregnancy.

Biochemical pregnancy - See chemical pregnancy.

Blighted ovum (egg) - A general term used to mean a fertilized egg that fails to survive after implantation in the uterus.

Cancelled cycle - Discontinuation of the cycle due to one of the following: poor response, no oocyte recovery, or failed fertilization.

CBC (Complete Blood Count) - A routine preoperative blood test that gives information regarding infection and anaemia.

Cervical mucus - Secretions produced by the cervix which vary in viscosity according to the phase of the menstrual cycle, and become penetrable by sperm in the days preceding ovulation.

Cervix - The lower section of the uterus which protrudes into the vagina and dilates during labour to allow the passage of the infant.

Chemical pregnancy - A positive hCG level in the blood that fails to continue to rise and does not lead to a clinical pregnancy.

Chlamydia - A genus of bacteria. Chlamydia trachomatis is a common sexually transmitted bacterial pathogen. The most common manifestation is nongonococcal urethritis in males. The cervix is the most commonly infected site in women. Ascending infections can occur in either sex, resulting in epididymitis in males or endometritis and salpingitis in females. Chlamydia infection of the fallopian tube can cause late consequences such as infertility and ectopic pregnancy, even though the earlier infection is asymptomatic. The infant passing through the infected birth canal can acquire the infection and may develop either conjunctivitis or pneumonia. A more invasive form of C. trachomatis causes a systemic sexually transmitted disease called lymphogranuloma venereum.

Cytomegalovirus (CMV) – A member of the herpes virus family. Active infection produces enlarged cells enclosing foreign matter. It is transmitted by sexual contact or infected body fluids. It can also be transmitted from mother to foetus. It rarely causes serious illness in healthy adults; however, it can lead to serious consequences, including blindness, in those with depressed immune systems. In newborns, even without spleen and liver enlargement (10% of cases), CMV is the most common infection and a major cause of congenital deafness; it may also induce retardation and blindness.

Congenital - A characteristic or defect present at birth, acquired during pregnancy, but not necessarily hereditary.

Cryopreservation (Embryo Freezing) - A freezing procedure used to preserve and store embryos or sperm for transfer at a later date.

Cycle - Refers to the period in between the beginning and the completion of one infertility treatment.

Cystic fibrosis - inherited disorder of the exocrine glands, affecting children and young people. It is caused by a genetic abnormality in the CF transmembrane conductance regulator (CFTR) gene that results in the disruption of chloride transfer across cell membranes and affecting mainly the pancreas, respiratory system, and sweat glands.

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

Egg retrieval – Using a needle to puncture the wall of the vagina while a patient is under sedation, the physician enters the ovaries to retrieve the ripened eggs.

Ectopic pregnancy - A pregnancy in which the fertilized egg implants outside the uterine cavity (usually in the fallopian tube, the ovary or the abdominal cavity).

Embryo - The term used to describe the early stages of foetal growth, from fertilization by a sperm until the eighth week of pregnancy.

Embryology – A specialty focusing on embryo development.

Embryo transfer – A procedure in which the physician passes a catheter into the woman’s uterus, discharging the embryos.

Endometriosis - The presence of the normal uterine lining (endometrial tissue) in areas outside of the uterus such as the tubes, ovaries and peritoneal cavity.

Endometrium - The mucous membrane lining the uterus.

Epididymis - The elongated organ in the male lying above and behind the testicles. It contains a highly convoluted canal four to six meters in length where, after production, sperm are stored, nourished and ripened for a period of several months.

Estradiol level (E2 level) - A form of oestrogen measured to determine follicular maturation prior to ovulation.

Estrogens - A class of female hormones responsible for the development of secondary sexual characteristics. Oestrogen is produced mainly by the ovaries from the onset of puberty until menopause.

Fallopian tube - Either of a pair of tubes that conduct eggs from the ovary to the uterus. Normal fertilization takes place within this structure.

Fertilization – The process during which sperm penetrates an egg, fusion of genetic material occurs and an embryo develops.

Florescence In Situ Hybridization (FISH) -

Foetal reduction - A medical procedure to decrease the number of foetuses in a multiple gestation.

Foetus - The developing human organism after the embryo stage, from the ninth week of pregnancy to the moment of birth.

Fibroid / Myoma - A no cancerous tumour found within the wall of the uterus.

Follicle - Fluid-filled structure on the ovary which contains the ripening egg, from which the egg is released at ovulation or retrieved during the treatment cycle.

Follicle Stimulating Hormone (FSH) - A hormone produced in the anterior pituitary gland that stimulates the ovary to ripen a follicle for ovulation.

Follicular phase - The portion of the menstrual cycle when ovarian follicle development takes place.

Gametes - reproductive cells carrying a haploid number of chromosomes. Human gametes, a mature sperm or egg, carry 23 chromosomes in their nucleus instead of 46 chromosomes that are found in the somatic cells. When fertilization occurs, the two nuclei of sperm and egg fuse, to produce a zygote carrying 46 chromosomes.

Gamete Intra-Fallopian Tube Transfer (GIFT) - A procedure where a sperm - egg mixture is transferred by laparoscopy into the fallopian tubes where natural fertilization may occur.

Gestation - The period of foetal development in the uterus from conception to birth, usually considered to be 40 weeks in humans.

Gestational carrier - A woman, who is not the genetic parent, carries the pregnancy to term, and then gives the child to the responsible parents.

GnRH (Gonadotropin release hormone; LHRH) - A hormone released from the hypothalamus that controls the synthesis and release of the pituitary hormones FSH and LH.

Gonadotropin - A hormone capable of stimulating the testicles or the ovaries to produce sperm or and egg respectively.

Gonorrhoea - A common sexually transmitted disease caused by the bacterium Neisseria gonorrhoeae. Local epithelial cell destruction usually occurs, but the organisms may spread to adjacent organs or disseminate via the bloodstream. In women, local complications include inflammation of the uterine lining (endometritis), inflammation of the fallopian tube (salpingitis), inflammation of the abdominal wall (peritonitis), and inflammation of Bartholin's glands (bartholinitis); in men, periurethral abscess and inflammation of a duct connected to the testes (epididymitis).

Hepatitis B - Also called serum hepatitis. It is spread by the exchange of body fluids or blood transfusions and from mother to baby at birth. Some infected individuals, particularly children, become chronic carriers of the virus. Hepatitis B can progress to chronic liver disease and is associated with an increased risk of developing liver cancer. A vaccine, available since 1981, is recommended for all infants and others at risk for the virus.

Hepatitis C – formerly called non-A, non-B hepatitis, is also transmitted by contaminated blood transfusions and by sharing of needles among drug abusers, although in many cases no source can be identified. Many of those infected have no symptoms but become carriers, and the virus may eventually cause liver damage. Blood banks routinely screen for hepatitis C.

HIV - A retrovirus that causes acquired immune deficiency syndrome (AIDS). It is transmitted by the exchange of body fluids or blood transfusions.

Hormonal assay - Also known as hormone tests. These include: FSH (follicle stimulating hormone), LH (luteinizing hormone), DHEA-S (dehydroepiandresterone), prolactin and progesterone. A hormone is a chemical substance that is produced in the body by an organ or cells of an organ which has a specific regulatory effect on the activity of another organ.

Human Chorionic Gonadotropin (hCG) - A hormone secreted by the placenta during pregnancy that prolongs the life of the corpus luteum, stimulates progesterone production and thus preserves the pregnancy. This hormone accounts for a pregnancy test being positive. It may also be administered therapeutically for some infertility problems.

Human Menopausal Gonadotropin (hMG) - A natural product containing both human FSH and LH. These hormones are extracted from the urine of postmenopausal women. As a drug is used to treat both male and female infertility and to stimulate the development of multiple oocytes in the female.

Hysterectomy - The removal of the uterus which can be total (including removal of the ovaries and tubes) or partial (just the uterus and sometimes including the cervix).

Hysterosalpingogram (HSG, hysterogram, tubogram) - An x-ray procedure during which dye is introduced into the uterus through the cervix and passed through the tubes to determine if they are open. This also shows the configuration of the uterus (any irregularities, fibroids, etc.)

Hysteroscopy - A surgical procedure where a fibre optic scope is inserted through the vagina and cervical canal, to allow visualization of the inside of the uterus. This procedure is sometimes performed in conjunction with a laparoscopy.

Idiopathic infertility (unexplained infertility) - The term used when no reason can be found to explain the cause of a couple's infertility despite a comprehensive evaluation.

Implantation - The embedding of the fertilized egg in the lining of the uterus.

Infertility - The inability of a couple to achieve a pregnancy after one year of regular unprotected sexual relations, or the inability of the woman to carry a pregnancy to live birth.

Intra Cytoplasmic Sperm Injection (ICSI) - A micro insemination procedure where a single sperm is directly inserted into an individual egg.

IntraUterine Insemination (IUI) - The introduction of specially prepared sperm (washed and separated from the seminal fluid) directly into the uterus through the cervix.

Inversion – The case where one or more breaks occur in a chromosome and the in between fragment is inverted and rejoined.

In Vitro Fertilization (IVF) - IVF is the procedure during which an egg is removed from ripe follicle and is combined with sperm in a laboratory dish to facilitate fertilization.

Karyotype – Is an organised profile of a person’s chromosomes. In a karyotype chromosomes are arranged and numbered by size, shape and their characteristic banding pattern. This arrangement helps scientists identify chromosomal alterations that may result in a genetic disorder.

Laparoscopy - A procedure where a telescope-like surgical instrument is inserted through a small incision near the navel in order to visualize the pelvic cavity, the ovaries, fallopian tubes and uterus.

Leuprolide acetate (Lupron) - A GnRH analogue which stimulates the female hormones initially, then suppresses a woman's secretion of FSH and LH, thus creating a pseudo menopause. Lupron has been extensively used in the United States and has been found to increase the number of follicles, oocytes (eggs), and embryos obtained, with a decreased chance of cancellation of the cycle.

LH (Luteinising hormone) - A hormone secreted by the anterior pituitary that causes the mature egg to be released by the ovary (ovulation). In the male, LH stimulates testosterone production.

LH surge - A spontaneous release of large amounts of luteinising hormone (LH). This normally results in the release of a mature egg (ovulation).

Lupron "down regulation" - A treatment cycle in which Lupron is used to suppress a woman's internal hormone secretion before injection of hMG to stimulate follicular development.

Lupron "flare" - This stimulation takes advantage of the initial rise or "Flare" of gonadotrophins (LH & FSH) which occurs 24 hours after the start of Lupron administration. This "flare" response is then augmented by giving other fertility agents.

Luteal phase - The days of a menstrual cycle following ovulation and ending with menses.

Male factor infertility - The term or diagnosis used to describe the condition when the couple's infertility is attributed to the male partner.

Meiosis – the process of cell division in sexually reproducing organisms that reduces the number of chromosomes in reproductive cells from diploid to haploid, leading to the production of gametes.

Metrodin - A preparation of FSH used to stimulate development and maturation of follicles.

Micro insemination - A laboratory technique whereby sperm are injected next to the egg cell surface to increase the likelihood of fertilization.

Micromanipulation – The mechanical manipulation of eggs, sperm or embryos under a microscope. Intracytoplasmic sperm injection (ICSI), assisted hatching and embryo biopsy are all forms of micromanipulations.

Microsurgical sperm aspiration – Procedures using an operating microscope to obtain sperm that can be used in conjunction with intracytoplasmic sperm injection (ICSI) in certain cases of male infertility.

Microsurgical Epididymal Sperm Aspiration (MESA) – A microsurgical procedure to extract fluid and sperm directly from an epididymal tubule, where sperm is stored. The sperm is prepared in the laboratory for use with intracytoplasmic sperm injection (ICSI).

Mosaic – An organism that has more than one genetically distinct population of cells.

Motility - The percentage of all moving sperm in a semen sample. Normally 50% or more are moving rapidly.

Multiple birth - The birth of two or more offspring produced in the same gestational period.

Myomectomy - The surgical removal of fibroid tumours from the wall of the uterus.

Mycoplasma - Is a genus of small bacteria which lack cell walls. Several species are pathogenic in humans, including M. genitalium, which causes non-chlamydial non-gonococcal urethritis (NCNGU) in men. It is sexually transmitted and associated with urogenital diseases of women.

Non disjunction – The failure of paired chromosomes or sister chromatids to separate and go to different cells during meiosis.

Ovarian Hyperstimulation Syndrome (OHSS) - A possible side effect of medically induced ovulation, characterized by swollen, painful ovaries and, in some cases, the accumulation of fluid in the abdomen and chest.

Oligozoospermia - A condition in which the number of sperm in semen sample is abnormally low (lower than 20 millions per millilitre of semen). Oligozoospermia is considered severe when the sperm count is lower than 5 millions per millilitre.

Oocyte - The egg cell produced in the ovaries. Also called the ovum or gamete.

Oocyte donation - Eggs that are removed from the ovaries of one woman for use by another.

Oocyte retrieval - A surgical procedure, usually under sedation, to collect the eggs contained with the ovarian follicles. A needle is inserted into the follicle; the fluid and egg are aspirated into the needle and then placed into a culture medium - filled dish.

Ovulation - Release of a mature egg from its follicle.

Ovulation induction – A type of female infertility treatment that uses hormone therapy to stimulate oocyte development and release.

Papanicolaou smear - Also known as Pap Smear. This is a screening test to evaluate the cells of the cervix to determine if they are normal. It is done by using a cyto-brush and a wooden spatula in the cervical canal. A pathologist then examines the cells under a microscope.

Pelvic Inflammatory Disease (PID) - Inflammatory disease of the pelvis, often caused by infection.

Preimplantation Genetic Diagnosis (PGD) - Combines two technically advanced procedures: in vitro fertilization or IVF and genetic analysis of single human embryo cells to identify the genetic disorders which occur naturally in embryos. PGD is of benefit to couples known to be at risk of passing an inherited disorder to their children and possibly in improving the likelihood of a successful pregnancy and birth following IVF.

Progesterone - A hormone secreted by the corpus luteum of the ovary after ovulation has occurred, that prepares the lining of the uterus for implantation of a fertilised egg. Also produced by the placenta during pregnancy and helps sustain pregnancy.

Prolactin - A hormone produced by the pituitary. Measurement of blood level of prolactin is useful in providing an index of functional disorder within the hypothalamic-pituitary axis that may lead to failure to ovulate properly.

Rubella titer - A blood test which determines if the patient is immune to rubella (German measles). If immunity is not present the patient may be advised to have a rubella vaccination, wait three months before attempting pregnancy, and then re-test for immunity.

Secondary infertility - The inability to conceive or carry a pregnancy after having conceived and carried one or more pregnancies.

Semen - The sperm and seminal secretions ejaculated during orgasm.

Semen analysis - Freshly ejaculated semen is observed under a microscope to evaluate the number of sperm (count), the percentage of moving sperm (motility), and to assess the size and shape of the sperm (morphology).

Sperm antibodies (immunological response) - Antibodies against sperm cells which may attack and destroy them. These antibodies can be produced either by men against their own sperm or by the woman.

Sperm bank – It is a facility that collects and stores (cryopreservation) human sperm from donors, primarily for the purposes of artificial insemination. Donors are constantly tested and monitored and all sperm is stored for a minimum of 6 months without being released for sale to ensure that the donor is healthy. Donors are subject to tests for diseases such as human immunoviruses HIV-1 and HIV-2, Syphilis, Chlamydia, Gonorrhoea, Hepatitis B, Hepatitis C, Cytomegalovirus (CMV), Cystic fibrosis, Karyotyping 46, XY.

Sperm wash - Technique for separating sperm from seminal fluid.

Spontaneous abortion - A miscarriage or an unintended termination of a pregnancy before the twentieth week.

Sterility - The total inability to reproduce. Not to be confused with infertility.

Stimulation - Administration of hormones which induce development of multiple ovarian follicles.

Surrogate - A woman, who becomes pregnant through insemination with the sperm of the husband of an infertile woman, and then following delivery, turns the child over for adoption by the couple.

Swim-up test - This technique separates motile sperm from non-motile sperm and cellular debris in a semen sample. The most motile sperm will "swim-up" in a small volume of media so they can be more easily separated for insemination.

Syphilis - A chronic infectious disease caused by a spirochete (Treponema pallidum), either transmitted by direct contact, usually in sexual intercourse, or passed from mother to child in uterus, and progressing through three stages characterized respectively by local formation of chancres, ulcerous skin eruptions, and systemic infection leading to general paresis.

Teratozoospermia - Teratozoospermia refers to a spermocytogram with less than 40% sperm of normal morphology.

Testicles - The two male oval-shaped sexual glands contained in the scrotum beneath the base of the penis. They produce the male hormone testosterone and the male reproductive cells, the sperm.

Testicular biopsy - A procedure to remove a small sample of tissue from one or both testicles and examined under a microscope to evaluate a man's ability to father a child.

Testosterone - The most potent male sex hormone; produced in the testes.

TET (Tubal Embryo Transfer) - A process where a fertilized and divided egg is transferred to the fallopian tubes.

TI - Therapeutic or artificial insemination. During this procedure sperm from a male partner or from a donor (TDI) is placed into a woman's vagina or cervix.

Translocation – Is a chromosomal abnormality which occurs when chromosomes break and the fragments rejoin to other chromosomes. There are many structurally different types of translocations. There is no loss of genetic material, although the breakpoint can cause disruption of critical gene or juxtapose of two genes to create a fusion gene that induces cancer. In general however, the problem with translocations occurs during meiosis and is manifest as reduction in fertility due to increased risk of producing abnormal gametes.

Trisomy – When having three chromosomes of a particular type.

Ultrasound - Technique for visualizing the follicles in the ovaries and the fetus in the uterus, allowing the estimation of size.

Ureoplasma - A genus of no motile bacteria that are close “relatives” with Mycoplasma. It can cause disease, including non-specific urethritis (NSU), infertility, chorioamnioitis, stillbirth, premature birth, and in the perinatal period, pneumonia or meningitis.

Uterus - The hollow, muscular organ in the woman that holds and nourishes the fetus until the time of birth.

Vaginal ultrasound - Visualization of soft tissue by projecting sound waves through a probe which is inserted into the vagina. A baseline ultrasound shows the ovaries in their normal state. A follicular ultrasound shows egg follicle maturation. A pregnancy ultrasound shows if a pregnancy is intrauterine or tubal and measures growth.

Vas deferens - a pair of thick-walled tubes about 45cm long in the male that lead from the epididymis to the ejaculatory duct in the prostate. During ejaculation, the ducts make wave-like contractions to propel sperm forward.

Zygote - An embryo in the early stages of development.

Zygote IntraFallopian Transfer (ZIFT) - The transfer of a zygote, or fertilized egg into a fallopian tube one day after fertilization.