Glossary of terms used in reproductive medicine
AMH - Anti-Mullerian Hormone | Artificial Insemination | Assisted Hatching | Azoospermia | Blastocyst | Blastocyst Culture | Carcinoma | Cryopreservation | Egg Donation | Ejaculate | Embryo | Embryo Transfer | Endometrium | Endometriosis | Follicle | Follicular Puncture | Hashimoto's Thyroiditis | Hysteroscopy | ICSI | Implantation | IMSI | Infertility | Insemination | ISME-T | IVF | Karyogram | Miscarriage | OHSS | Oocyte | Ovarian Stimulation | Ovary | Ovarian Insufficiency | PCOS | PGD | PGS | Progesterone | Social Freezing | Sperm Donation | Spermiogram | TESE | Fallopian tubes | Uterus | Vitrification | Zygote |
AMH - Anti-Mullerian Hormone
AMH stands for "Anti-Mullerian Hormone". There is only a finite number of eggs available to each woman throughout her lifetime. In this context, medical experts advocate for the additional determination of serum levels of specific hormones, including, inter alia, FSH, LH, estradiol. The level of AMH is considered to be an indicator of a woman's ovarian reserve. Along with female age, the response to ovarian stimulation and mainly the AFC (Antral Follicle Count = smaller follicles visible by ultrasonography) it allows clinicians to obtain an overall picture.
Artificial Fertilization
Couples who have been trying to conceive for quite some time, but have so far failed to achieve a pregnancy often seek medical help and may opt for "artificial insemination". This colloquially used term covers the diagnostic and therapeutic options in medically assisted procreation (reproductive medicine).
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Assisted Hatching
The outer layer of the oocyte (zona pellucida) is sometimes so tough that the embryo cannot break through on its own. The hatching of the embryo is supported by creating a small opening into the zona pellucida. Different methods are used for this purpose: mechanical (glass micropipettes), chemical and laser techniques.
Azoospermia
Azoospermia is defined as the complete absence of spermatozoa from the ejaculated semen. Azoospermia may occur because of blocked testicular tubes. However, the condition may also be due to past testicular inflammation resulting in the destruction of precursor cells (e.g. mumps in adolescent males).
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Blastocyst
Stage of embryonic development on the fourth up to the sixth day after fertilization (=embryo capable of implantation).
Blastocyst Culture
In medically assisted reproduction, the fertilization of the egg with the sperm takes place outside the female body in the laboratory. The fertilized eggs are transferred into a special culture medium and placed in an incubator, where they grow into embryos that are capable of implantation (blastocysts). This procedure is referred to as blastocyst culture.
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Carcinoma
Cancer of epithelial origin, beginning in the membranous tissues that line the surface of the body.
Cryopreservation
Cryopreservation means the freezing and "storing" of human cells and tissues at low temperatures (-196°C) using liquid nitrogen. Specific cryopreservation techniques (e.g. vitrification) are used in reproductive medicine in order to cryopreserve spermatozoa, oocytes, fertilized ova, embryos at various stages of development (e.g. at the blastocyst stage), ovarian tissue as well as testicular tissue.
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Egg Donation
Is the process by which a fertile woman (donor) provides one or several oocytes to another woman (recipient) undergoing IVF treatment.
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Ejaculate
The typical result of male orgasm is the discharge of semen (ejaculation). The seminal fluid is also known as ejaculate or semen.
Embryo
Following the union of two germ cells (egg and sperm), the resulting zygote begins to divide. Or, put another way, the oocytes grows into an embryo which travels down the fallopian tube into the womb to implant itself into the uterine lining. This is referred to as the early stages of embryonic development. Some people, however, confuse the two terms 'embryo' and 'fetus'. The term 'fetus' is used from around the 9th week of pregnancy. At this stage of development, the inner organs have already formed.
Embryo Transfer
Transfer of the embryo (fertilized oocyte) into the uterine cavity (womb) as part of IVF treatment. A thin and flexible tube (embryo flushing catheter) is inserted through the vagina and cervix into the uterus. Using this catheter, the embryo is gently deposited into the uterine cavity. This is ideally done on the fifth day following egg collection.
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Endometrium
Mucous membrane lining the inner cavity of the womb. The endometrium is the layer in which the fertilized egg implants.
Endometriosis
Benign chronic disorder affecting the female reproductive organs. Endometriosis is a condition in which endometrial or endometrial-like tissue also grows in places other than the uterine cavity. The often painful proliferation of endometriosis lesions can result in female sub-fertility, i.e. endometriosis is not associated with infertility per se, but women who suffer from the disorder are more likely to have trouble getting pregnant.
Follicle
Small fluid-filled sac in the ovary that contains the developing egg cell.
Follicular Puncture
Collection of egg cells during IVF treatment. The follicles are imaged by means of 3D ultrasound and the eggs contained therein are retrieved by transvaginal aspiration.
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Hashimoto's Thyroiditis
Hashimoto's thyroiditis is an autoimmune disease that causes inflammation of the thyroid gland (the thyroid plays a key role in our endocrine system). Instead of protecting it, the immune system attacks the thyroid gland and damages thyroid cells. The disease typically progresses in stages. The patients might show symptoms such as weight gain in spite of normal eating habits, hair loss, depressive moods, decreased libido and abnormal menstrual cycles.
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Hysteroscopy (uterine endoscopy)
Hysteroscopy allows for a direct visualization of the endometrial cavity via the vagina involving the use of an endoscope (med. instrument featuring an integrated micro camera). This enables any pathological changes in the uterine wall to be detected, e.g. polyps or myomas. Where appropriate, the procedure offers the possibility of immediately treating such conditions following diagnosis, i.e. by endoscopic removal.
ICSI
ICSI stands for "Intracytoplasmic Sperm Injection". This procedure used for fertilization of an egg during IVF treatment involves the direct injection of a single sperm into the cytoplasm of an egg.
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Implantation
Implantation is the process in which an embryo at the blastocyst stage (in both natural and medically assisted procreation) implants into a receptive uterine lining (endometrium). This is a very complex phenomenon that follows precisely regulated processes on both the molecular and cellular level.
IMSI
IMSI stands for "Intracytoplasmic Morphologically selected Sperm Injection". Advanced microscopy such as IMSI can help further improve the assessment of sperm quality during IVF treatment. Using a high-resolution special microscope, the spermatozoa are analyzed at 6.000-12.000 x magnification. This allows a considerably more accurate evaluation and selection of the sperm, in particular as regards their shape and structure.
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Infertility
Infertility (synonymous terms: sterility, impotence) in women and men describes the inability to conceive and reproduce. Couples trying to conceive but fail to achieve a pregnancy after one year of regular unprotected sexual intercourse should consider having a detailed infertility work-up.
Insemination
Refers to a treatment method in reproductive medicine. In the case of insufficient sperm production or reduced sperm motility, special laboratory techniques are used to concentrate the sperm sample obtained and deposit it directly into the uterine cavity at the moment of ovulation or, respectively, the semen specimen is placed in the Petri dish after oocyte retrieval.
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ISME-T
ISME-T stands for "Implantation Support Medium Transfer" and describes a procedure in fertility treatment by which certain messenger substances are introduced into the uterus two days prior to embryo transfer in order to improve endometrial receptivity.
IVF
IVF - abbreviation of "In Vitro Fertilization", also called "artificial insemination" in colloquial English. It is an ART procedure in which the retrieved eggs and the sperm sample are mixed in a Petri dish (in vitro, Latin for "in the glass") in the laboratory (i.e. outside the female body) in order for fertilization to occur.
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Karyogram
Karyotyping can be done on a blood sample. A karyotype is a picture of a human's chromosomes arranged in pairs by size and shape. More precisely, the visualization of the chromosome pairs helps confirm or exclude the presence of numerical and/or structural chromosome aberrations. Karyotyping can be used, for example, to determine the causes of hereditary diseases.
Miscarriage
Spontaneous abortion (miscarriage) refers to the unintentional premature termination of a pregnancy (depending on the definition) prior to 20 - 24 weeks pregnant.
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OHSS
OHSS stands for "Ovarian HyperStimulation Syndrome" and means that in the course of ovarian stimulation treatment with follicle stimulating hormone preparations - depending on dosage and the patient's response - the ovaries have become significantly enlarged. However, the swelling is temporary in nature. Ovarian enlargement may cause abdominal pain and lead to extravascular fluid accumulation in the lungs/abdominal cavity associated with shortness of breath and nausea. The attending physician will take all measures necessary to treat severe OHSS.
Oocyte
Ovarian Stimulation
When starting IVF treatment, the female body is prepared for pregnancy by giving precise consideration to the woman's personal situation. During controlled ovarian stimulation, specific hormones are administered to induce the growth of multiple follicles (containing the oocytes) in the woman's ovaries.
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Ovary
The ovaries form part of the female reproductive system. The ovaries are paired organs that lie on either side of the womb.
Ovarian Insufficiency
Both female and male infertility may be caused by a variety of physical problems. So-called primary ovarian insufficiency (premature ovarian failure) refers to a loss of normal ovarian function, involving either the absence of follicles or the early exhaustion of a small ovarian follicle pool. This results in the failure to produce mature eggs, i.e. sufficient amounts of certain hormones.
PCOS
Polycystic Ovary Syndrome (PCOS) is a very complex clinical condition associated with a variety of endocrine disorders, the causes of which are still largely unknown. Such endocrine disruptions can affect a woman's fertility. It is therefore important to undergo detailed medical investigation by a specialist who can help patients decide on adequate therapeutic options, including the use of assisted reproductive technology (ART).
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PGD
PGD stands for "Pre-Implantation Genetic Diagnosis". Where clinically indicated, PGD can be used for genetic analysis during fertility treatment. PGD involves the testing of cell material removed from an oocyte or an embryo before it is transferred to the uterine cavity. The biopsy material is investigated in a targeted manner for the presence of any hereditary genetic diseases. The procedure is aimed at increasing the couple's chances of a successful pregnancy and the birth of a healthy child.
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PGS
PGS stands for "Pre-Implantation Genetic Screening". The technique can be employed for genetic analysis during fertility treatment in cases where such use is clinically indicated. PGS aims at testing cell material removed from an oocyte or an embryo before it is transferred to the uterine cavity. The biopsy material is examined for the presence of any spontaneously occurred, non-hereditary, i.e. de novo chromosomal abnormalities in terms of their number and/or structure. The procedure is aimed at increasing the infertile couple's chances of a successful pregnancy and the birth of a healthy child.
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Progesterone
In the "natural' cycle, the period between ovulation and the beginning of the next menstruation is referred to as luteal phase. In order for pregnancy to happen, the female hormone progesterone is of key importance. During IVF treatment, this hormone is administered in the form of medication, i.e. shortly before and after the embryo transfer.
Social Freezing
Cutting-edge medical procedures offer women the opportunity to opt for the freezing and "storage" of some of their own oocytes while they are still young as a precautionary measure to preserve their fertility. This may help them cope with female age-related fertility decline. The procedure is known as "Social Freezing" and provides an opportunity for women to get pregnant at a later age by undergoing IVF treatment using their own "younger" eggs.
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Sperm Donation
IVF treatment using sperm provided by a donor in order to help a woman (recipient) get pregnant.
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Spermiogram
Semen analysis (spermiogram) helps gain an initial overview of sperm quality in a man and is considered to be an important step in the evaluation of fertility in men. A spermiogram includes the analysis of a male's semen (ejaculate) by means of special methods and technologies in the laboratory. Based on the results obtained, a man's reproductive capacity can be assessed.
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TESE
In IVF treatment, the insemination of eggs with sperm is performed outside the female body in the laboratory. In some cases, a minor surgical procedure is required to extract viable sperm directly from testicular tissue - the so-called TESE - "Testicular Sperm Extraction".
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Fallopian tubes
The fallopian tubes, also known as uterine tubes or oviducts are the female structures, which connect the ovaries to the womb (uterus). In a "natural" cycle, the fusion of egg and sperm usually occurs in the ampulla of the fallopian tube.
Uterus
Uterus is the Latin word for womb. This is where implantation normally takes place following the transfer of fertilized oocytes or embryos at the blastocyst stage. The embryo development continues in fetal development up to the birth of the baby.
Vitrification
In the course of fertility treatment, situations may occur requiring the safe freezing and storing (cryopreservation) of spermatozoa, ova or embryos in different stages of embryonic development. Vitrification is a modern, scientifically-backed technique which is best suited for this purpose. Vitrification (from Latin vitreum, "glass") involves the direct transformation of a liquid into a glassy solid, thus preventing the formation of ice crystals. This is important, since the formation of ice crystals may cause damage to the cell membrane.
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Zygote
Successful fertilization occurs when a sperm penetrates an egg, resulting in the fusion of egg and sperm. On day 1 of embryo development, the egg cell is termed a two-pronuclear zygote (2PN stage). In the early stages of embryonic development, the zygote begins to divide, in a process called cleavage.