“When one door of happiness closes, another opens but often we look so long at the closed door that we do not see the one that has been opened for us.”
Adenomyosis. A benign (non-cancerous) invasion of endometrial tissue into the uterine wall.
Adhesions. Bands of fibrous scar tissue that may bind the pelvic organs and/or loops of bowel together. Adhesions can result from infections, endometriosis, or previous surgeries.
Androgens. Hormones produced by the testes, ovaries, and adrenal glands responsible for encouraging masculine characteristics. Often referred to as “male” hormones. Androgens are produced in males and females, but males have much higher levels.
Antimüllerian hormone (AMH). A hormone measurement that reflects your ovaries’ capability for producing eggs.
Antral follicle count (AFC). A transvaginal ultrasound machine is used to determine the number of pre-stimulated follicles in the ovary during the first 3-4 days of the menstrual cycle.
Assisted hatching (AH). A procedure in which the zona pellucida (outer covering) of the embryo is partially opened, usually by application of an acid or laser, to facilitate embryo implantation and pregnancy.
Assisted reproductive technologies (ART). All treatments that include laboratory handling of eggs, sperm, and/or embryos. The most common examples of ART are in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), preimplantation genetic testing (PGT), frozen embryo transfer (FET), donor egg, and donor embryo transfer.
Biochemical pregnancy. When a woman's pregnancy test is initially positive but becomes negative before a gestational sac is visible on ultrasound.
Biopsy. The removal of a tissue sample for microscopic examination. The term also refers to the tissue removed.
Blastocyst. An embryo that has formed a fluid-filled cavity and the cells have begun to form the early placenta and embryo, usually 5 days after ovulation or egg retrieval.
Cervix. The narrow, lower part of the uterus that opens into the vagina. The cervical canal runs through the cervix and connects the vagina with the uterine cavity. The cervix produces mucus through which sperm must swim before entering the uterine cavity and then the fallopian tubes.
Clinical pregnancy. A pregnancy confirmed by an increasing level of hCG and the presence of a gestational sac detected by ultrasound.
Corpus luteum. A yellow body in the ovary that forms from a follicle after ovulation; the follicle has matured, ruptured, and released its egg. The corpus luteum produces progesterone and estrogen during the second half of a normal menstrual cycle.
Cortisol. A hormone produced by the adrenal glands, which are located on top of the kidneys in the area of the back near the waistline. Cortisol is responsible for maintaining the body’s energy supply, blood sugar, and control of the body’s reaction to stress.
Cryopreservation. Freezing at a very low temperature, such as in liquid nitrogen (-196°C) to keep embryos, eggs, or sperm viable.
Dehydroepiandrosterone (DHEA). A hormone naturally made by the adrenal glands. The body turns it into other hormones such as estrogen and testosterone. DHEA sold as a “natural” supplement is made from plant chemicals and is not regulated by the FDA. It often is marketed as an antiaging medication, but its safety and effectiveness are controversial.
Dilation and curettage (D&C). An outpatient surgical procedure during which the cervix is dilated and the lining of the uterus is scraped out. The tissue is often microscopically examined for the presence of abnormality or pregnancy tissue.
Dysmenorrhea. Painful menstrual cramps.
Dyspareunia. Painful intercourse; sometimes a symptom of endometriosis.
Ectopic pregnancy. A pregnancy that implants outside of the uterus, usually in the fallopian tube. The tube may rupture or bleed as the pregnancy grows and present a serious medical situation.
Egg donation. The process of fertilizing eggs from a donor with the male partner’s sperm in a laboratory dish and transferring the resulting embryos to the female partner’s uterus. The female partner will not be biologically related to the child, although she will be the birth mother on record. The male partner will be biologically related to the child.
Egg retrieval. The procedure in which eggs are obtained by inserting a needle into the ovarian follicle and removing the fluid and the egg by suction. Also called oocyte aspiration.
Embryo culture. Growth of the embryo in a laboratory (culture) dish.
Embryo transfer. Placement of an embryo into the uterus.
Endometrial biopsy. The removal of a small sample of endometrium (lining of the uterus) for microscopic examination.
Endometrioma. A blood-filled “chocolate” cyst that can occur when endometriosis tissue develops in the ovary.
Endometriosis. A condition where endometrial-like tissue (the tissue that lines the uterus) develops outside of the uterine cavity in abnormal locations such as the ovaries, fallopian tubes, and abdominal cavity. This tissue can grow with hormonal stimulation and cause pain, inflammation, and scar tissue. It may also be associated with infertility.
Endometrium. The lining of the uterus that is shed each month during menstruation
Epididymis. The duct between testes and vas deferens where sperm are stored and mature.
Estradiol. The predominant estrogen (hormone) produced by the follicles on the ovary.
Estrogen. A hormone produced mainly by the ovaries. Estrogen largely is responsible for stimulating the endometrium to thicken and prepare for pregnancy during the first half of the menstrual cycle.
Fallopian tubes. A pair of hollow tubes attached one on each side of the uterus through which the egg travels from the ovary to the uterus.
Fibroids. Benign (non-cancerous) tumors of the uterine muscle wall that can cause abnormal uterine bleeding, pelvic pain, and interfere with pregnancy.
Fimbriae. The flared (finger-like) end of the fallopian tube that sweeps over the surface of the ovary and helps to direct the egg into the tube.
Follicle. A fluid-filled sac located just beneath the surface of the ovary, containing an egg (oocyte) and cells that produce hormones. The sac increases in size and volume during the first half of the menstrual cycle and at ovulation, the follicle matures and ruptures, releasing the egg. As the follicle matures, it can be visualized by ultrasound.
Follicle stimulating hormone (FSH). In women, FSH is the pituitary hormone responsible for stimulating follicular cells in the ovary to grow, stimulating egg development and the production of the female hormone estrogen. In the male, FSH is the pituitary hormone which travels through the bloodstream to the testes and helps stimulate them to manufacture sperm. FSH can also be given as a medication.
Gestational carrier. A woman who carries a pregnancy for another couple. The pregnancy is derived from the egg and sperm of the couple. Although she carries the pregnancy to term, she does not have a genetic relationship to the resulting child.
Gonadotropin releasing hormone (GnRH). Hormone secreted by the hypothalamus, a control center in the brain, which prompts the pituitary gland to release FSH and LH into the bloodstream.
GnRH agonists (Lupron). A GnRH analog that initially stimulates the pituitary gland to release LH and FSH, followed by a delayed suppressive effect. GnRH agonists are also used to help stimulate follicle growth when started at the beginning of an IVF cycle.
GnRH antagonists (Ganarelix, Cetrotide). Synthetic hormones similar to the naturally occurring gonadotropin releasing hormone used to prevent premature ovulation. These medications have an immediate suppressive effect on the pituitary gland.
Hirsutism. The growth of long, coarse hair on the face, chest, upper arms, and upper legs of women in a pattern similar to that of men. Hirsutism may be due to excess levels of androgens.
Hormones. Substances formed in one organ of the body, such as the pituitary or adrenal glands, and carried by a body fluid to another organ or tissue where they have a specific effect.
Human chorionic gonadotropin (hCG). A hormone produced by the placenta; its detection is the basis for most pregnancy tests. Also refers to the medication used to induce ovulation and during the final stages of egg maturation.
Human menopausal gonadotropin (hMG) (Menopur). An ovulation drug that contains follicle stimulating hormone (FSH) and luteinizing hormone (LH) derived from the urine of postmenopausal women. hMG is used to stimulate the growth of multiple follicles.
Hysteroscopy. A procedure in which a lighted scope (hysteroscope) is inserted through the cervix into the uterus to enable the physician to view the inside of the uterus to diagnose and treat problems within the uterine cavity.
Hydrosalpinx. A term used to describe a fallopian tube which is swollen or dilated and often filled with fluid. This fluid usually results from a previous infection of the fallopian tube. A hydrosalpinx may be detected by ultrasound, HSG, or by laparoscopy.
Hysterosalpingogram (HSG). An x-ray procedure in which a special media (dye) is injected into the uterus to demonstrate the inner contour of the uterus and degree of openness (patency) of the fallopian tubes.
Implantation. The process whereby an embryo embeds in the uterine lining in order to obtain nutrition and oxygen. Sometimes, an embryo will implant in areas other than the uterus, such as in a fallopian tube. This is known as an ectopic pregnancy.
Intracytoplasmic sperm injection (ICSI). A micromanipulation technique used in conjunction with IVF that involves injecting a sperm directly into an egg in order to facilitate fertilization. The fertilized egg is then transferred to the uterus.
Intrauterine insemination (IUI). The process whereby sperm are injected directly into the uterine cavity in order to bypass the cervix and place the sperm closer to the egg. The sperm are usually washed first in order to remove chemicals that can irritate the uterine lining and to increase sperm motility and concentration.
In vitro fertilization (IVF). A method of assisted reproduction that involves surgically removing eggs from the woman’s ovaries, combining them with sperm in the laboratory and, if fertilized, replacing the resulting embryo into the woman’s uterus.
Laparoscope. A thin, lighted, telescope-like viewing instrument that is usually inserted through the navel into the abdomen to examine the contents of the pelvic and abdominal cavities. Other small incisions may also be made, and additional instruments inserted to facilitate diagnosis and allow surgical correction of pelvic abnormalities. The laparoscope can be used as both a diagnostic and operative instrument.
Laparoscopy. A diagnostic procedure in which a surgeon inserts a laparoscope through a small incision below the navel and visually inspects the uterus, uterine ligaments, fallopian tubes, ovaries, and abdominal organs. Other incisions may also be made to allow insertion of additional instruments to facilitate diagnosis and treatment of pelvic disease.
Laparotomy. A procedure in which a surgeon makes an incision in the abdomen, usually several inches long, in order to treat conditions such as extensive endometriosis.
Luteal phase. The second half of the ovarian cycle when the corpus luteum produces large amounts of progesterone. This progesterone is important in preparing the endometrium to receive a fertilized egg (embryo) for implantation.
Luteinizing hormone (LH). The hormone that triggers ovulation and stimulates the corpus luteum to secrete progesterone.
Methotrexate. A medication that destroys pregnancy-related tissue and hastens re-absorption of this tissue in a woman with an ectopic pregnancy.
Micromanipulation. The IVF laboratory process whereby the egg or embryo is held with special instruments and surgically altered by procedures such as intracytoplasmic sperm injection (ICSI), assisted hatching, or embryo biopsy.
Miscarriage. The naturally occurring expulsion of a nonviable fetus and placenta from the uterus, also known as spontaneous abortion or pregnancy loss.
Multifetal pregnancy reduction. Also known as selective reduction. A procedure to reduce the number of fetuses in the uterus. This procedure is sometimes performed on women who are pregnant with multiple fetuses who are at an increased risk of late miscarriage or premature labor. These risks increase with the number of fetuses.
Oocyte. The female sex cell; the egg.
Ovary. One of the two female sex glands in the pelvis, located on each side of the uterus. The ovaries produce eggs and hormones including estrogen, progesterone, and androgens.
Ovarian drilling. A laparoscopic procedure, using laser or electrocautery, to destroy the androgen-producing tissue in the ovaries. This procedure is usually a last resort for ovulation induction in PCOS patients who have not responded to hormonal treatments.
Ovarian hyperstimulation syndrome (OHSS). A condition that may result from ovulation induction characterized by enlargement of the ovaries, fluid retention, and weight gain.
Ovarian reserve. Refers to a woman’s fertility potential in the absence of any problems in the reproductive tract (fallopian tubes, uterus, vagina). It mainly depends on the number and quality of eggs in the ovaries and how well the ovarian follicles are responding to the hormonal signals from the brain.
Ovulation. The release of a ripened egg from its follicle in the outer portion of the ovary. Ovulation usually occurs on day 14 or 15 of a 28-day cycle or 14 days prior to the first day of the next period.
Peritoneum. The lining of the abdominal cavity.
Pituitary gland. A small gland just beneath the hypothalamus in the brain that secretes follicle stimulating hormone (FSH) and luteinizing hormone (LH).
Polycystic ovary syndrome (PCOS). A condition in which the ovaries contain many cystic follicles associated with chronic anovulation (lack of ovulation) and overproduction of androgens (male hormones). The cystic follicles exist because the eggs are not expelled at the time of ovulation. Symptoms may include irregular menstrual periods, excessive growth of body hair in a male-like pattern (hirsutism), and infertility. Also called polycystic ovarian syndrome and Stein-Leventhal syndrome.
Polyps. A general term that describes any mass of tissue that bulges or projects out or upward from the normal surface level.
Preimplantation genetic testing (PGT). Procedures used in conjunction with IVF. Five to six days after the embryo is formed to a blastocyst stage, a few cells from the embryo are removed in order to run special genetic tests. These tests vary and can include counting the number of chromosomes on each embryo or looking specifically for a genetic illness carried by the couple or in the couple’s family.
Progesterone. A female hormone secreted by the corpus luteum after ovulation during the second half of the menstrual cycle (luteal phase). It prepares the lining of the uterus (endometrium) for implantation of a fertilized egg and also allows for complete shedding of the endometrium at the time of menstruation. In the event of pregnancy, the progesterone level remains stable beginning a week or so after conception.
Pronuclei. The nuclei of the male and female gametes (sperm and egg) seen in the one-cell embryo (zygote).
Prostaglandins. Hormone-like chemicals produced in large amounts by endometrial cells. They stimulate the uterine muscles to contract and are largely responsible for menstrual cramps.
Retroverted uterus. A uterus that is tilted backwards. This is found in approximately 10% of normal women.
Salpingectomy. An operation in which one or both of the fallopian tubes are removed.
Salpingostomy. A surgical procedure in which the wall of the fallopian tube is opened and the ectopic pregnancy is removed. The tubal incision heals spontaneously.
Semen analysis. The microscopic examination of semen to determine the number of sperm, their shapes, and their ability to move.
Septum, uterine. A band of fibrous tissue present from birth that forms a wall within the uterine cavity. A septum may increase the risk of miscarriage and other pregnancy complications.
Sexually transmitted infection (STI). An infection, such as chlamydia or gonorrhea, that is transmitted by sexual activity. In the female, some STIs can cause pelvic infections and lead to infertility by damaging the fallopian tubes and increasing the risk of ectopic pregnancy. In the male, STIs can cause blockage of the ductal system that transports sperm.
Spironolactone. A steroid hormone that directly blocks the effect of androgens on the skin. It initially was used as a diuretic or water pill to increase urine output. A brand name is Aldactone®.
Steroids. Hormones that are derived from cholesterol. Categories of steroids include sex steroids (estrogens, androgens, progestogens), glucocorticoids (hormones that closely resemble cortisol), and mineralocorticoids (hormones related to aldosterone and involved in fluid and electrolyte control). Man-made steroids closely resemble cortisol, a hormone naturally produced by the adrenal glands. Steroids decrease inflammation, reduce immune system activity, and are used to treat a variety of inflammatory diseases and conditions.
Superovulation. Treatment with clomiphene, letrozole, human menopausal gonadotropin, or follicle-stimulating hormone injections to cause more than one egg to develop and release during ovulation.
Testicular sperm extraction (TESE). Operative removal of testicular tissue by a urologist in an attempt to collect living sperm for use in an IVF-ICSI procedure.
Transvaginal ultrasound. An imaging technique in which a smooth cylindrical probe that uses sound waves to view organs on a video screen is placed in the vagina.
Uterus (womb). The hollow, muscular organ in the pelvis where an embryo implants and grows during pregnancy. The lining of the uterus, called the endometrium, produces the monthly menstrual blood flow when there is no pregnancy.
Varicocele. A varicose or dilated vein within the scrotum that can cause infertility in some men.
Vas deferens. The two muscular tubes that carry sperm from the epididymis to the urethra.
Vitrification. An ultra-rapid method of freezing eggs and embryos that may offer certain advantages compared with traditional types of cryopreservation.
Zona pellucida. The egg’s outer layer that a sperm must penetrate in order to fertilize the egg.
Zygote. A fertilized egg before cell division (cleavage) begins.