Hormones
Estrogen
A primary female hormone, produced by the ovaries, placenta, and adrenal glands.
Testosterone
The primary male hormone, which influences the production and maturation of sperm.
FSH—Follicle Stimulating Hormone
A hormone (gonadotropin) produced by the pituitary gland that stimulates the growth of the follicle surrounding an egg. FSH may also be given by injections during IVF.
LH—Luteinizing Hormone
A hormone produced by the pituitary gland, which normally causes ovulation and eggs to mature.
GnRH—Gonadotropin Releasing Hormone
A hormone produced by the hypothalamus that prompts the pituitary gland to release FSH and LH into the bloodstream.
hCG—Human Chorionic Gonadotropin
A hormone produced by the placenta measured in pregnancy tests. It may also be injected to stimulate ovulation and maturation of eggs.
Testing
BBT—Basal Body Temperature Chart
Daily charting of temperature to help determine ovulation, due to the rise of progesterone after ovulation and the drop at or just before menstruation, when both estrogen and progesterone levels fall.
FSH Test
Blood taken on day 3 of the menstrual cycle. FSH indicates ovarian reserve–egg viability. The higher the FSH, the less reserve.
HSG—Hysterosalpingogram
X-ray procedure that determines if the fallopian tubes are open and if there are abnormalities in the uterus.
CCCT—Clomiphene (Clomid) Challenge Test
Clomid, a synthetic hormone in pill form, is given on days 5-9 to induce ovulation. A blood test measures FSH on days 3 & 10 of the menstrual cycle. Used by a minority of fertility clinics.
Laparoscopy
A surgical procedure that may be used for diagnostic evaluation, as well as reparative surgery (i.e., endometriosis) and other fertility procedures.
Pregnancy Test
Blood or urine test, which determines a clinical pregnancy: confirmed pregnancy = high HCG level; chemical pregnancy = low HCG level which suggests the possibility of a pregnancy, but needs further testing to confirm.
RE–Reproductive Endocrinologist
Physicians who often specialize in fertility testing, diagnosis, and ART–often referred to as IVF docs.
Fertility Issues
Female Factor
When infertility is related to the woman.
Male Factor
When infertility is related to the man.
OHSS–Ovarian Hyper-Stimulation Syndrome
A potential risk of IVF due to the ovaries being over-stimulated by the hormone injections. Enlargement of the ovaries, fluid retention and weight gain can result. IVF clinics closely monitor the cycle through ultrasound to avoid what can become a potentially life-threatening risk, albeit extremely small.
Endometriosis
Endometrium grows outside the uterus, resulting in scarring, pain, and heavy bleeding, often damaging fallopian tubes and ovaries.
Fibroid Tumors
A tumor in the uterus, which may prevent implantation or cause miscarriage.
PCOS–Polycystic Ovary Syndrome
The most common endocrine disorder in reproductive age women with prevalence 5-10%. Ovaries contain many small follicles or cysts that may not grow normally and regress before the time of ovulation. There are many possible symptoms; among these are menstrual irregularities and impaired fertility. In women with PCOS, failure to ovulate is the most common reason for not conceiving.
Autoimmune Factors
Immune factors that may decrease or impair fertility such as thyroid disorders and antibodies to sperm—substances in the male or female blood and in reproductive secretions that reduce fertility by causing sperm to stick together, coating their surface, or killing them.
Treatments
Intrauterine Insemination (IUI)
Sometimes referred to as artificial insemination, the sperm is washed free of seminal fluid to increase the chance of fertilization, and then inserted directly into the uterus. Clomid and injectables (stimulating hormones) may be added to further enhance fertility.
Assisted Reproductive Technology (ART)
Assisted Reproductive Technology (ART)
Advanced medical treatment that involves handling human eggs or embryos. The most recognized treatment is IVF.
In Vitro Fertilization (IVF)
Stimulating hormones (injectables) are used to stimulate multiple egg production, scans (ultrasounds) monitor response of ovaries to hormones, mature follicles are then retrieved (egg retrieval) and fertilized with sperm in the IVF clinic lab (fertilization) with resulting embryos transferred into the uterus (embryo transfer) 3 days post retrieval. Sometimes blastocysts (day 5 embryos) are transferred. Under ideal conditions, clinics quote a 50% success rate on the first attempt.
Fresh Cycle
When embryos/blastocysts are transferred a few days after retrieval from an IVF cycle.
Frozen Cycle
When embryos/blastocysts that have been frozen from a fresh IVF cycle are thawed for a later transfer.
ICSI–Intracytoplasmic Sperm Injection
An IVF related procedure in which a single sperm is injected directly into an egg to enable fertilization. Used as treatment for poor sperm motility.
PGD–Preimplantation Genetic Diagnosis
An IVF related procedure in which one or two cells are removed from an embryo and screened for genetic abnormalities. This reduces potential miscarriage rate and passage of genetic problems to offspring.
Selective Reduction
Reduces a multiple pregnancy (high risk) typically to twins prior to completion of the third month of pregnancy, through injection of a chemical under ultrasound guidance.
Medication
Clomid–Clomiphene Citrate
An oral synthetic hormone to induce ovulation of more than one egg. Often used to enhance fertility in IUI’s and to regulate cycle for PCOS.
Heparin
A drug sometimes used during an IVF cycle to prevent blood clotting within the fluid that harbors the egg.
Metformin
An oral diabetic agent used to treat PCOS. Improves insulin sensitivity.
