Decoding the language of fertility
Understanding these terms is essential to make informed decisions and effectively communicate with your healthcare providers. Let’s dive in!ÂAnti-Mullerian Hormone (AMH):Â
A blood test that measures the level of a hormone produced by ovarian follicles. AMH levels can provide insight into a woman’s ovarian reserve, which is the number of eggs remaining in her ovaries. This information can be helpful in predicting a woman’s response to fertility medications and estimating her chances of conceiving. How it’s measured:Â- Blood Draw: A simple blood test is performed to measure the level of AMH in the bloodstream.
- Timing: The test is typically done on the third day of the menstrual cycle for accurate results.
- Interpretation: The AMH level is analyzed to estimate ovarian reserve. Higher levels may indicate a larger ovarian reserve, while lower levels may suggest a smaller reserve.
Assisted Hatching (AH):Â
A procedure used in conjunction with in vitro fertilization (IVF) where a laser is used to create a tiny opening in the outer shell of the embryo, known as the zona pellucida. This can help the embryo implant in the uterine lining more easily, increasing the chances of a successful pregnancy. Assisted hatching is often recommended for women who have experienced multiple failed IVF cycles or have other factors that may hinder implantation. How it works:Â- Embryo Development: Embryos are created through IVF and allowed to develop for a few days.
- Zona Pellucida Thinning: A laser is used to create a small opening in the zona pellucida, the outer shell of the embryo.
- Embryo Transfer: The embryo is then transferred to the uterus, where it has a better chance of implanting and developing into a pregnancy.
Assisted Reproductive Technology (ART):Â
A collection of medical procedures used to help individuals or couples achieve pregnancy when unassisted conception is either not possible or more challenging. These techniques involve manipulating sperm and eggs outside of the body, such as in vitro fertilization (IVF), intrauterine insemination (IUI), and intracytoplasmic sperm injection (ICSI).Cryopreservation:Â
A technique used to preserve embryos, eggs, or sperm at extremely low temperatures for future use. This process involves freezing the biological material in liquid nitrogen, which effectively stops all biological activity. Cryopreservation offers couples the option to preserve their fertility for future use, whether due to personal reasons, medical conditions (such as a cancer diagnosis), or age-related fertility decline. How it works:Â- Collection: Embryos, eggs, or sperm are collected using procedures like IVF or egg retrieval.
- Freezing: The biological material is then frozen using a specialized technique called vitrification, which involves rapid freezing to minimize ice crystal formation.
- Storage: The frozen material is stored in liquid nitrogen tanks at very low temperatures.
- Thawing: When ready for use, the frozen material is thawed and prepared for transfer or use in a fertility procedure.
Egg Donor (ED):Â
A woman who donates eggs to be used in assisted reproduction procedures, such as in vitro fertilization (IVF), for intended parents who cannot produce their own eggs or have difficulty conceiving. How it works:Â- Screening: Potential egg donors undergo a thorough medical and psychological evaluation to ensure they meet the necessary health criteria.
- Hormone Stimulation: The egg donor undergoes hormone stimulation to stimulate the development of multiple follicles containing eggs.
- Egg Retrieval: Eggs are retrieved from the ovaries through a minimally invasive procedure called transvaginal ultrasound-guided aspiration.
- Fertilization: The retrieved eggs are fertilized with sperm in a laboratory setting.
- Embryo Transfer: The resulting embryos can be transferred to the intended recipient’s uterus or frozen for future use.
Frozen Embryo Transfer (FET):Â
A procedure involving the thawing and transfer of previously frozen embryos into the uterus with the intent of achieving pregnancy. How it works:Â- Embryo Freezing: Embryos are typically frozen during an IVF cycle or after egg retrieval.
- Thawing: The frozen embryos are carefully thawed prior to transfer.
- Hormone Preparation: The recipient undergoes hormone therapy to prepare the uterine lining for a potential pregnancy.
- Embryo Transfer: The thawed embryos are transferred into the uterus using a thin catheter.
- The Two-Week Wait: After the transfer, the recipient waits for a pregnancy test to determine if the embryo has implanted.
Follicle Stimulating Hormone (FSH):Â
A hormone produced by the pituitary gland that plays a crucial role in female reproductive function. FSH stimulates the growth and development of follicles in the ovaries, which contain eggs. By measuring FSH levels, doctors can assess a woman’s ovarian reserve, which is the number of eggs remaining in her ovaries. How it’s measured:Â- Blood Test: A simple blood test is performed to measure the level of FSH in the bloodstream.
- Timing: The test is typically done on the third day of the menstrual cycle to get an accurate assessment of ovarian function.
- Interpretation: The FSH level is analyzed to estimate the number of follicles developing in the ovaries. A higher FSH level may indicate a lower ovarian reserve, while a lower FSH level may suggest a higher ovarian reserve.
Gestational Carrier:Â
A gestational carrier is a woman who carries a pregnancy for another person or couple, often due to the intended mother’s inability to carry a pregnancy herself. The gestational carrier is not genetically related to the child, and legal agreements are in place to establish the intended parents’ rights and responsibilities. Gestational carriers receive prenatal care and support throughout the pregnancy. Gestational carrier arrangements can be a complex process, requiring careful planning and coordination between all parties involved. It’s essential to work with qualified fertility specialists and legal professionals to ensure a smooth and successful experience for both the intended parents and the gestational carrier. How it works:Â- Screening: Potential gestational carriers undergo a thorough medical and psychological evaluation to ensure they are healthy and suitable for carrying a pregnancy.
- Egg Donation (Optional): If the intended parents cannot provide their own eggs, an egg donor may be used.
- Fertilization: Sperm and eggs (either the intended parents’ or donor eggs) are fertilized in a laboratory to create embryos.
- Embryo Transfer: The embryos are transferred into the gestational carrier’s uterus with the goal of implantation and pregnancy.
- Pregnancy and Delivery: The gestational carrier carries the pregnancy to term and delivers the baby.
Traditional Surrogate:Â
A traditional surrogate is a woman who carries a pregnancy using her own eggs and sperm from the intended father. This differs from a gestational carrier, who carries a pregnancy using someone else’s eggs and sperm.Intrauterine Insemination (IUI):Â
A procedure used to assist in fertilization by placing prepared sperm directly into a woman’s uterus, bypassing the vagina and cervix. This technique is often used when male infertility is a factor or when there are unexplained fertility issues. IUI is often a less invasive and less expensive option compared to in vitro fertilization (IVF). However, its success rates are generally lower, particularly for women with severe fertility challenges. How it works:Â- Ovulation Monitoring: The woman’s menstrual cycle is monitored to determine the optimal time for ovulation.
- Sperm Preparation: Sperm is collected and prepared for insemination. This may involve washing and concentrating the sperm to improve its quality.
- Insemination: The prepared sperm is inserted into the uterus using a thin catheter. This procedure is typically performed in a doctor’s office and is relatively painless.
- Monitoring: After the procedure, the woman may be monitored for signs of pregnancy.
In Vitro Fertilization (IVF):Â
A complex fertility treatment involving the fertilization of an egg with sperm outside of the body. IVF is a more invasive and expensive procedure compared to other fertility treatments, but it often has higher success rates, especially for women with severe fertility issues. How it works:Â- Hormone Stimulation: The woman undergoes hormone therapy to stimulate the development of multiple follicles containing eggs.
- Egg Retrieval: Eggs are retrieved from the ovaries through a minimally invasive procedure.
- Sperm Collection: The male partner provides a sperm sample.
- Fertilization: The eggs and sperm are combined in a laboratory dish to allow fertilization to occur.
- Embryo Development: The fertilized eggs, now called embryos, are cultured in a laboratory for several days.
- Embryo Transfer: One or more embryos are transferred into the woman’s uterus with the goal of implantation and pregnancy.
- Pregnancy Test: A pregnancy test is performed a few weeks after the embryo transfer to determine if implantation has occurred.
Intracytoplasmic Sperm Injection (ICSI):Â
A specialized technique used in assisted reproduction where a single sperm is injected directly into an egg to facilitate fertilization. ICSI is often used in conjunction with in vitro fertilization (IVF) to improve the chances of fertilization when male factor infertility is a concern—such as when sperm count is low, motility is poor, or there are structural abnormalities. How it works:Â- Egg Retrieval: The woman undergoes hormone stimulation to produce multiple eggs, which are then retrieved through a minimally invasive procedure.
- Sperm Preparation: The male partner provides a sperm sample, which is prepared for ICSI.
- Injection: A single sperm is injected directly into the egg under a microscope.
- Embryo Development: If fertilization occurs, the embryo is cultured in a laboratory for several days.
- Embryo Transfer: The embryo is transferred into the woman’s uterus with the goal of implantation and pregnancy.
Intended Parent (IP):Â
A person or couple who desires to have a child and is actively seeking fertility treatments or alternative family-building options. They may be undergoing fertility treatments themselves or exploring options like adoption, surrogacy, or egg donation.Luteinizing Hormone (LH ):Â
A hormone produced by the pituitary gland that plays a crucial role in female reproduction. LH triggers ovulation, releasing a mature egg from the ovary, and also stimulates the development of the corpus luteum, a temporary endocrine structure essential for pregnancy support. How it’s measured:Â- Ovulation Predictor Kits: These kits typically involve urine testing to detect the LH surge.
- Timing: Tests are usually performed daily around the expected time of ovulation.
- Positive Result: A positive result on an ovulation predictor kit indicates that ovulation is likely to occur within the next 24-36 hours.
Ovarian Hyperstimulation Syndrome (OHSS):Â
A medical condition that can occur after fertility treatments, such as in vitro fertilization (IVF), when the ovaries are stimulated to produce multiple eggs. OHSS occurs when the ovaries overreact to the stimulation hormones, leading to the development of numerous follicles and fluid accumulation in the abdomen. Prevention and management:Â- Careful Monitoring: Fertility specialists closely monitor patients undergoing fertility treatments for signs of OHSS.
- Hormone Adjustments: The dosage of stimulation hormones may be adjusted to reduce the risk of OHSS.
- Fluid Management: In severe cases, hospitalization and fluid management may be necessary.
Preimplantation Genetic Diagnosis (PGD):Â
Preimplantation Genetic Diagnosis (PGD) is a specialized genetic testing procedure used in IVF to identify embryos with specific genetic or chromosomal disorders before they are transferred to the uterus. This can help couples with a known genetic disorder have a healthy child by preventing the transmission of the disease. PGD can also be used for carrier screening, where both parents are carriers of a recessive genetic disorder. PGD is a complex procedure that requires careful consideration and discussion with a fertility specialist. It can provide couples with valuable information to make informed decisions about their family-building journey. How it works:Â- IVF Cycle: The couple undergoes an IVF cycle to create embryos.
- Embryo Biopsy: A single cell is removed from each embryo for genetic testing.
- Genetic Analysis: The removed cell is analyzed for the presence of the specific genetic or chromosomal disorder of interest.
- Embryo Selection: Only embryos without the genetic disorder are selected for transfer.
- Embryo Transfer: The unaffected embryos are transferred to the uterus with the goal of implantation and pregnancy.
Preimplantation Genetic Screening (PGS):
Preimplantation Genetic Screening (PGS) is a diagnostic tool used in IVF to assess embryos for chromosomal abnormalities. By identifying embryos with the correct number of chromosomes, PGS can potentially increase pregnancy rates, reduce miscarriage risk, and improve IVF outcomes. Unlike PGD, which focuses on specific genetic diseases, PGS is a general screening for chromosomal abnormalities. While PGS can provide valuable information, it’s important to consider its limitations and additional costs associated with IVF treatment. Consulting with a fertility specialist is crucial to determine if PGS is a suitable option for your family-building journey. How it works:Â- IVF Cycle: The couple undergoes an IVF cycle to create embryos.
- Embryo Biopsy: A few cells are removed from each embryo at a specific stage of development.
- Genetic Analysis: The removed cells are analyzed through techniques like chromosomal microarray analysis (CMA) to identify any numerical chromosomal abnormalities.
- Embryo Selection: Embryos with the correct number of chromosomes (euploid) are considered chromosomally healthy and prioritized for transfer.
