The Berry Fertility Glossary.

An agonist (also know as a GnRH agonist) is a type of medication taken during IVF and egg freezing. Agonists bind to GnRH receptors in the brain and cause an initial surge of FSH and LH from the pituitary, which is known as a flare. Shortly, after the flare of hormones, the FSH and LH levels dramatically drop off, which causes suppression. Agonists can be used to both jump start stimulation with the flare and also to suppress ovulation prior to the egg retrieval. Lupron is an example of an agonist

Aneuploid refers to an embryo that is chromosomally abnormal (too many or too few chromosomes) in the preimplantation genetic testing or embryonic tissue after a miscarriage.

Anovulation is when ovulation does not occur during a menstrual cycle. Anovulation, often associated with PCOS, is a common cause of infertility.

Antagonists (also known as GnRH antagonists) are medications used in IVF and egg freezing to prevent premature ovulation during ovarian stimulation. They work by inhibiting the GnRH receptors and causing immediate suppression of the production of FSH and LH. The lack of LH surge prevents the ovulation of the developing follicles. Examples of antagonists are Ganrelix and Cetrotide.

A hormone that is released by the cells surrounding each immature egg cell in the ovaries. The level of this hormone corresponds with the amount of eggs remaining in the ovaries, a patient's ovarian reserve. This value is tested through a blood test. The result is especially high in younger people and patients with PCOS and declines as they approach menopause.

An antral follicle is a tiny fluid-filled sac most likely containing one immature egg. Antral follicles are visualized and counted by ultrasound on cycle day 2 or 3 of the menstrual cycle. The number of antral follicles corresponds with the ovarian reserve.

Basal body temperature is the body’s lowest temperature taken when the body is fully at rest. This is most accurate when you first wake up in the morning before any activity. The basal body temperature rises after ovulation. If the basal body temperature is tracked daily, it can help confirm when ovulation occurred. 

Birth control pills are made of either estrogen and progesterone or progesterone only. They are taken daily to prevent follicle development, ovulation, and ultimately pregnancy from occuring. In fertility treatments, they can be taken to manipulate the menstrual cycle to assist in scheduling the start of treatment.

Blastocyst is the stage in embryonic development where the multi-celled embryos are best suited to be biopsied for genetic testing, frozen, and thawed for transfer. Typically it takes an embryo 5 to 7 days of culturing in the lab to reach this stage.  

Bloodwork is often referred to as "BW".

In terms of a semen analysis, concentration refers to the number of sperm per milliliter of semen.

A cryobank is a business that collects, freezes, and stores sperm samples both for individuals and for donor sperm. Donor sperm vials can be purchased through a cryobank for use in fertility treatment.

A cycle day is the numerical name given to each of the days in your menstrual cycle. Cycle day 1 is categorized as the first day of full flow where you need to change a pad or tampon frequently throughout the day. Spotting before the start of your period does not count as a cycle day. To begin a fertility treatment cycle, the initial baseline appointment is typically scheduled on the second or third day of full flow or “cycle day 2 or 3”

Days post ovulation is often abbreviated as “DPO”

The one follicle the body selects each month to grow, mature, and ovulate.

Donor sperm is sperm that comes from an outside source other than the patient or patient’s partner. The sperm can be donated from someone the patient knows, which is called a known donor, or from a sperm bank from an anonymous donor. 

The egg retrieval is a minor surgical procedure done at the end of each IVF or egg freezing cycle. It is preformed vaginally using a needle guided by ultrasound to remove each egg from the ovary in order to deliver them to the lab to be frozen or fertilized depending on the treatment plan.

An embryo is the result of the fertilization of the egg by a singular sperm. The embryo is the stage of human development prior to becoming a fetus.

Embryologists are scientists specializing in the growth and development of embryos. They work within the lab at the fertility clinic and are responsible for the fertilization, culture, freezing, and thawing of embryos.

The lining of the uterus that grows each month in order to support the possible implantation of an embryo. If no implantation occurs, the endometrial lining is shed in the form of a menstrual period. 

An ERA is a test that assesses a sample of the endometrial lining for markers indicating that the lining is receptive to the implantation of an embryo. The ERA results indicate whether the lining is pre-receptive, receptive, or post-receptive and using that information it makes recommendations as far as how to adjust the start of progesterone and the timing of the embryo transfer.

The lining of the uterus that grows each month in order to support the possible implantation of an embryo. If no implantation occurs, the endometrium is shed in the form of a menstrual period.

eSET stands for an elective single embryo transfer. An eSET means that a person chooses to have one embryo transferred into their uterus, when multiple embryos are available for transfer.

Estrogen is a hormone produced by growing follicles in the ovary. As the follicle or follicles grow, the estrogen level in the blood rises. The presence of estrogen causes the endometrial lining to grow thicker in preparation for implantation of an embryo.

Euploid refers to an embryo that is chromosomally normal (46 chromosomes) in the preimplantation genetic testing or tissue after a miscarriage. Transferring a euploid embryo can result in higher pregnancy rates.

The fallopian tubes are tubes on either side of the uterus. They have an opening adjacent to the ovary on one end and the other end is open to the interior of the uterus. During ovulation, the mature egg is released into the fallopian tube where it can potentially be fertilized if sperm is present. If so, the fertilized egg will make its way down the rest of the fallopian tube and into the uterus for implantation.

Fertilization is the process by which a single-celled egg from a female is penetrated by a singular sperm from a male to create an embryo. Fertilization happens within the fallopian tubes or can be facilitated in the IVF lab.

A tiny fluid-filled sac in the ovary that contains an egg. As the egg matures in response to hormone changes, the follicle grows in size.

Follicle Stimulating Hormone is produced by the body to cause the dominant follicle to grow and an egg to grow to maturity in order to reach ovulation. Synthetic FSH (Gonal-F/Follistim) is used as an injection medication during IVF cycles to stimulate multiple eggs to mature.

A frozen embryo transfer is when an embryo from a previously completed IVF cycle is thawed and transferred into the uterus with the goal of creating a pregnancy.

Hirsutism is excess hair growth in females, often seen on the face and torso.

A home pregnancy test is a pregnancy test that checks for the presence of the pregnancy hormone hCG in the urine. It is often abbreviated “HPT”.

Human chorionic gonadotropin is a hormone naturally produced in the body during pregnancy. HCG blood testing is used to confirm early stage pregnancies. HCG is also used as a trigger shot to initiate the final maturation of the egg(s) to prepare for IUI insemination or IVF egg retrieval.

A hysterosalpingogram is a procedure where the uterus and fallopian tubes are filled with contrast dye and examined using X-ray. The dye allows the doctor to visualize the anatomy of the uterine wall as well as confirm that the fallopian tubes are free of any blockages.

A hysteroscopy is a procedure where the doctor enters through the cervix and into the uterine cavity using tiny instruments guided by a camera to visualize the interior of the uterus and cervix. Typically the procedure is done to remove a polyp, fibroid, or scarring from the cervix or uterine wall to prevent it from interfering with embryo implantation and pregnancy.

In vitro fertilization is the process by which the ovaries are stimulated using medications to grow eggs (more than one) to maturity in order to be retrieved and ultimately fertilized in a lab to create embryos.

Intended parents are the patient(s) that use a sperm or egg donor and/or a gestational carrier to have children. The intended parents have sole parental rights over any children born from the donors or gestational carriers.

Intracytoplasmic sperm injection is a technique used in the embryology lab to inject one sperm into each egg. ICSI is used to overcome fertility issues stemming from sperm with poor motility or very low sperm count.

An injection using a 1 or 1.5 inch needle that is administered into the muscle tissue. These injections are often performed in the muscle of the buttocks.

Intrauterine adhesions are pieces of scar tissue that develop in the uterus as a result of uterine surgeries or procedures.

An IUD (Intrauterine device) is a form of long term birth control that consists of a small T-shaped device placed inside of the uterus by a medical provider. IUDs are either copper or hormonal and each work in a different way to prevent pregnancy.

An IUI involves the placement of a concentrated sperm sample through the cervix and into the uterus at the time of ovulation using a thin, flexible catheter. An IUI can use medications to induce ovulation or be timed alongside a patient’s natural ovulation.

In terms of fertility treatment, IV anesthesia is a light anesthetic that is administered intravenously. It is very short acting, which works perfectly for the short duration of the egg retrieval. This type of anesthetic allows the patient to be comfortable and unaware of the procedure taking place all while breathing on their own and not requiring a long recovery time at the clinic following the procedure.

A laparoscopy is a minimally invasive surgical technique that uses a few small incisions in the abdominal wall to view the inside of the abdominal cavity and perform surgery. During the laparoscopic surgery, an instrument called a laparoscope that contains a camera and light is inserted through one of the incisions and is used to guide the use of the surgical instruments that are inserted through the other small incisions.

Last menstrual period, often referred to as LMP, is used to calculate menstrual cycle length and regularity as well as due date and gestational age during pregnancy.

The live birth rate for IVF is the percentage of IVF ovarian stimulation cycles that result in at least 1 baby born alive.

Luteinizing hormone is the hormone that triggers the ovary to ovulate the egg within the dominant follicle. Ovulation typically occurs within 24-36 hours after the LH surge.

The LH surge is the spike in the production of luteinizing hormone (LH) by the pituitary gland. The LH surge is triggered by elevated estrogen levels associated with mature follicle(s) in the ovaries. The surge of LH is what triggers the body to ovulate.

Medicated embryo transfer cycles use estrogen medications to grow a uterine lining in preparation for the embryo. Progesterone medication is introduced to make the lining receptive to embryo implantation. The embryo is thawed and transferred back into the uterus and the potential pregnancy is supported using the continued administration of the estrogen and progesterone.

The menstrual cycle is the cycle of hormonal changes in a female body that allows for an egg to develop and ovulate, making pregnancy possible. The average menstrual cycle lasts 24 to 35 days, beginning on the first day of one period and ending on the first day of the next period. 

MII stands for metaphase II. MII is the stage of cell division that an egg must be in to be able to be fertilized. In egg freezing cycles, only eggs in the MII stage are frozen for future use.

Mini IVF uses lower doses of stimulation medications (sometimes oral, sometimes injectable, and sometimes a combination of both). The thought behind mini IVF is that the patient can save money by using much smaller doses of injectable medication or by using oral medication instead. Mini IVF does result in fewer mature eggs being retrieved at the egg retrieval, so there are fewer chances to create a normal embryo for transfer. Some doctors and clinics claim that mini IVF may result in higher quality eggs, but there currently is no research to confirm this thought. 

Mixing needles are usually 22 or 23 gauge needles that are 1 to 1.5 inches long. They are used only for mixing or reconstituting medication prior to injecting. The mixing needle is removed and swapped for an injecting needle prior to administering the medication.

Monogenetic disorders are medical conditions that are caused by the presence of or an issue with a single gene.

In terms of semen analysis, morphology refers to the shape and size of the sperm (head and tail). Issues with morphology can cause the sperm to not be able to swim correctly, not be able to swim at all, or not be able to penetrate the egg for fertilization.

In terms of a semen analysis, motility refers to the sperms’ ability to swim.

Natural frozen embryo transfers allow your body to grow a follicle and uterine lining as it normally would during the follicular phase of your menstrual cycle. After either detecting natural ovulation or triggering it with hcg, progesterone supplements are started to boost the body's natural progesterone prior to thawing and transferring an embryo back into the uterus.

An NSAID (non-steroidal anti-inflammatory drug) is a medication that is used to reduce inflammation, fever, and pain. One of the most common examples of an NSAID is ibuprofen.

Oral contraceptive pills is another name for birth control pills.

There are many types of ovarian cysts. A typical cyst is a remnant of the previous cycle’s dominant follicle that remains in the ovary following the start of the next menstrual cycle. The cyst often is still producing hormones that will interfere with the body’s ability to respond to IVF stimulation medications. This type of ovarian cyst usually resolves spontaneously over time.

OHSS is the multitude of severe symptoms that is most commonly associated with medicated cycles as result of an exaggerated response to the hormone stimulation of the ovaries. It is less likely during IUI or egg freezing. It typically occurs in patients with high egg counts and very elevated estrogen levels. OHSS is characterized by serious symptoms that include weight gain of 1 pound or more in a 24 hour period, shortness of breath, extreme abdominal bloating, abdominal pain, and in some cases nausea and vomiting.

Ovarian reserve is considered to be the estimated amount of eggs remaining in the ovaries. Ovarian reserve is typically estimated based on hormone blood tests (AMH, FSH) and AFC ultrasound. These values are used to determine if the ovarian reserve is considered low, average, or high for a person’s age. Ovarian reserve is strictly related to egg quantity and not egg quality.

Ovaries are the two walnut-sized structures on either side of the female pelvis that house all of the eggs in the body. In a regular menstrual cycle, one egg on one side or the other is selected to mature and then ovulate.

Ovulation is the process where the mature egg is released from the dominant follicle into the fallopian tube. This release is triggered by the presence of luteinizing hormone in a natural cycle. Each cycle, usually only one egg is ovulated from either the left or right ovary.

Ovulation predictor kits are at home urine tests that detect the presence of luteinizing hormone (LH). LH detected in the urine indicates the beginning of the ovulation window.

Preimplantation genetic testing is optional testing completed on blastocyst stage embryos that analyzes the chromosomal makeup of each embryo. The testing is completed by removing a few cells from the outer portion of the embryo and examining them to confirm that all of the chromosomes are present (23 pairs of chromosomes) and in the right number (2 of each chromosome). 

Priming the needle is the process by which air is removed from a syringe prior to doing an injection. To prime a needle, the syringe is held with the needle facing up towards the ceiling and the plunger is gently and slowly pressed up until a drip of medication is seen at the tip of the needle. This indicates that the air is removed and only medication remains to be injected.

A prior authorization is a request to your insurance company for coverage of certain medications or medical procedures. During the process, your health insurance company will review the medical necessity of the medication or procedure. It can take up to seven business days for an insurance company to review the paperwork and make a determination.

Reciprocal IVF is a type of in vitro fertilization for same sex female couples where one female partner provides the eggs to create embryos and that are then transferred into the uterus of the other female partner, who will carry the pregnancy. RIVF is a way for both partners to physically participate in the IVF and family building process. This form of IVF is also known as Co-IVF, Partner IVF, or co-maternity.

In terms of fertility medications, reconstitute refers to mixing the provided liquid with the powdered medication to turn it into an injectable liquid form. Menopur is an example of a medication that needs to be reconstituted before injecting.

An OB/GYN physician that has completed a fellowship to specialize in reproductive medicine.

A saline sonogram is a procedure that uses a thin catheter threaded through the cervix to place a small volume of saline inside of the uterus. The doctor will then use an ultrasound to visualize the interior uterine wall for abnormalities, like fibroids or polyps, that can contribute to infertility.

A semen analysis is an evaluation of a semen sample and sperm within that sample. Some of the main categories of the analysis are volume, concentration, motility, morphology, and total motile count. 

An injection using a short, thin needle that is administered in the fatty layer of tissue just below the skin. The typical locations for these injections are the upper thigh, belly, or the back of the upper arm. 

When you are ready to use frozen eggs or embryos, the embryology lab will remove the tissue from the liquid nitrogen tank where it was stored while frozen. The tissue will be mixed with compounds that help to stabilize the cells as they thaw. The tissue is slowly warmed in the lab until it is thawed and ready for use in fertilization, biopsy, or embryo transfer.

Timed intercourse cycles are a low intervention fertility treatment where a patient coordinates intercourse with a natural cycle or takes medication to induce follicle growth and ultimately ovulation under the guidance of a fertility specialist. The patient will plan to have intercourse once ovulation is detected through either at-home ovulation predictor kits or ultrasound and bloodwork at a fertility clinic.

The total motile count is the total number of swimming sperm present in the entire specimen provided for a semen analysis.

A long, slender ultrasound probe is inserted into the vagina in order to most clearly view the anatomy of the uterus and ovaries. This technique is used to count and measure follicles in the ovaries as well as to measure the thickness of the uterine lining throughout fertility treatment.

The trigger shot is the final injection done at the end of an IVF, Egg Freezing, or IUI cycle that initiates the final maturation of the eggs to prepare them for the egg retrieval or IUI insemination. The trigger shot can be either lupron or hCG. The clinic will provide a very precise day and time to administer the injection.

Trying to conceive is often abbreviated as “TTC”.

The two week wait, or TWW, is the 2 weeks between ovulation and the start of the next menstrual period. Two weeks after ovulation is also the recommended time to take a pregnancy test when trying to conceive.

During fertility treatments ultrasounds are often abbreviated “US”.

A uterine fibroid is a mass that can grow anywhere within the uterus. Fibroids are benign, but depending on size and placement, they can contribute to abdominal discomfort, painful and heavy periods, vaginal bleeding between periods, recurrent miscarriages, and infertility.

A uterine filling defect is an abnormal result on an HSG or saline sonogram that needs further assessment to determine its classification. A uterine filling defect is  typically determined to be a polyp, scarring, or a fibroid.

A uterine polyp is a small benign growth on the interior wall of the uterus. Polyps can interfere with the ability to grow a uterine lining that can support a pregnancy and can cause irregular vaginal bleeding. Typically, polyps will be removed through a procedure called a hysteroscopy. 

The fist-sized muscular reproductive organ in the pelvis of a female that is able to support the implantation, growth, and birth of offspring.