2013Appendix B

Glossary of Terms APPENDIX B: GLOSSARY OF TERMS

American Society for Donor egg cycle. An embryo is formed from (ASRM). Professional society whose affiliate the egg of one woman (the donor) and then organization, the Society for Assisted Reproductive transferred to another woman (the recipient). Technology (SART), is composed of clinics and The donor relinquishes all parental rights to any programs that provide ART. resulting offspring. ART (assisted reproductive technology). All Donor embryo. An embryo that is donated by a treatments or procedures that include the handling patient or couple who previously underwent ART of human eggs or embryos to help a woman treatment and had extra embryos available. become pregnant. ART includes but is not limited Ectopic . A pregnancy in which the to in vitro fertilization (IVF), gamete intrafallopian fertilized egg implants in a location outside of the transfer (GIFT), zygote intrafallopian transfer —usually in the , the , (ZIFT), tubal , egg and embryo or the abdominal cavity. Ectopic pregnancy is a , egg and , and dangerous condition that must receive prompt gestational . medical treatment. ART cycle. An ART cycle starts when a woman Egg. A female reproductive cell, also called an begins taking fertility drugs or having her oocyte or ovum. monitored for follicle production. If eggs are produced, the cycle progresses to egg retrieval. Egg/Embryo banking cycle. An ART cycle started Retrieved eggs are combined with sperm to create with the intention of freezing (cryopreserving) all embryos. If fertilization is successful, at least one resulting eggs or embryos for potential future use. embryo is selected for transfer. If implantation Egg retrieval (also called oocyte retrieval). A occurs, the cycle may progress to clinical procedure to collect the eggs contained in the pregnancy and possibly live birth. ART cycles ovarian follicles. include any process in which (1) an ART procedure is performed, (2) a woman has undergone ovarian Egg transfer (also called oocyte transfer). The stimulation or monitoring with the intent of having transfer of retrieved eggs into a woman’s fallopian an ART procedure, or (3) frozen embryos have tubes through laparoscopy. This procedure is used been thawed with the intent of transferring them to only in GIFT. a woman. Embryo. An egg that has been fertilized by a sperm Canceled cycle. An ART cycle in which ovarian and has undergone one or more divisions. stimulation was performed but the cycle was Embryo transfer. Placement of embryos into a stopped before eggs were retrieved or, in the case woman’s uterus through the after IVF: in ZIFT, of frozen embryo cycles, before embryos were zygotes are placed in a woman’s fallopian tube. transferred. Cycles are canceled for many reasons: eggs may not develop, the patient may become ill, . A medical condition that involves or the patient may choose to stop treatment. the presence of tissue similar to the uterine lining in abnormal locations. Cryopreservation. The practice of freezing eggs or embryos from a patient’s ART cycle for potential eSET (elective single embryo transfer). Elective future use. single embryo transfer is a procedure in which one embryo, selected from a larger number of available Diminished ovarian reserve. This diagnosis embryos, is placed in the uterus or fallopian tube. means that the ability of the ovary to produce eggs The embryo selected for eSET might be a frozen is reduced. Reasons include congenital, medical, or (cryopreserved) embryo from a previous IVF cycle surgical causes or advanced age. or a fresh embryo selected from a larger number of fresh embryos yielded during the current fresh IVF cycle.

527 Female factor . Infertility due to ovulatory ICSI (intracytoplasmic sperm injection). A disturbances, diminished ovarian reserve, pelvic procedure in which a single sperm is injected abnormalities affecting the reproductive tract, or directly into an egg; this procedure is commonly other abnormalities of the reproductive system. used to overcome problems. Success Rate and Certification Implantation rate. A measurement of ART success Act of 1992 (FCSRCA). Law passed by the United when the ART cycle results in an intrauterine States Congress in 1992 requiring all clinics clinical pregnancy, defined as the larger of performing ART in the United States to annually either the number of maximum fetal hearts by report their success rate data to the Centers for ultrasound or maximum infants born, including Disease Control and Prevention. live births and stillbirths, out of the total number of embryos transferred. Fertilization. The penetration of the egg by the sperm and the resulting combining of genetic Induced or therapeutic . A surgical or material that develops into an embryo. other medical procedure used to end a pregnancy. Fetus. The unborn offspring from the eighth week Infertility. In general, infertility refers to the inability after conception to the moment of birth. to conceive after 12 months of unprotected intercourse. Women aged 35 and older unable to Follicle. A structure in the ovaries that contains a conceive after 6 months of unprotected intercourse developing egg. generally are considered infertile. Fresh eggs, sperm, or embryos. Eggs, sperm, or IUI (intrauterine insemination). A medical embryos that have not been frozen. Fresh embryos, procedure that involves placing sperm into a however, may have been conceived using either woman’s uterus to facilitate fertilization. IUI is not fresh or frozen sperm. considered an ART procedure because it does not Frozen embryo cycle. An ART cycle in which involve the manipulation of eggs. frozen (cryopreserved) embryos are thawed and IVF (in vitro fertilization). An ART procedure that transferred to the woman. involves removing eggs from a woman’s ovaries Gamete. A reproductive cell, either a sperm or and fertilizing them outside her body. The resulting an egg. embryos are then transferred into a woman’s uterus through the cervix. Gestational age. The deviation of time from estimated last menstrual period (LMP) to birth. LMP Live birth. The delivery of one or more infants with is estimated using the date of retrieval or transfer. any signs of life. Gestational carrier (also called a gestational Male factor infertility. Any cause of infertility surrogate). A woman who gestates, or carries, an due to low sperm count or problems with sperm embryo that was formed from the egg of another function that makes it difficult for a sperm to fertilize woman. The gestational carrier usually has a an egg under normal conditions. contractual obligation to return the infant to its Miscarriage (also called spontaneous abortion). intended parents. A pregnancy ending in the spontaneous loss of the Gestational sac. A fluid-filled structure that embryo or fetus before 20 weeks of gestation. develops within the uterus early in pregnancy. In Multifetal pregnancy reduction. A procedure a normal pregnancy, a gestational sac contains a used to decrease the number of fetuses a woman developing fetus. carries and improve the chances that the remaining GIFT (gamete intrafallopian transfer). An ART fetuses will develop into healthy infants. Multifetal procedure that involves removing eggs from reductions that occur naturally are referred to as the woman’s ovary and using a laparoscope to spontaneous reductions. place the unfertilized eggs and sperm into the Multiple factor infertility, female and male. woman’s fallopian tube through small incisions in A diagnostic category used when one or more her abdomen. female cause of infertility and male factor infertility are diagnosed.

528 Multiple factor infertility, female only. A Pregnancy (clinical). A pregnancy documented diagnostic category used when more than one by ultrasound that shows a gestational sac in female cause of infertility but no male factor the uterus. For ART data reporting purposes, infertility is diagnosed. pregnancy is defined as a clinical pregnancy rather than a chemical pregnancy (i.e., a positive Multiple-fetus pregnancy. A pregnancy with two pregnancy test). or more fetuses, determined by the number of fetal hearts observed on an ultrasound. Singleton. A single infant. Multiple-infant birth. A pregnancy that results in Society for Assisted Reproductive Technology the birth of more than one infant. (SART). An affiliate of ASRM composed of clinics and programs that provide ART. NASS (National ART Surveillance System). Web-based data collection system used by all Sperm. The male reproductive cell. ART clinics to report data for each ART procedure Spontaneous abortion. See Miscarriage. to CDC. Stillbirth. The birth of an infant that shows no sign Oocyte. The female reproductive cell, also called of life after 20 or more weeks of gestation. an egg. Stimulated cycle. An ART cycle in which a Other causes of infertility. These include woman receives oral or injected fertility drugs to immunological problems, chromosomal stimulate her ovaries to develop follicles that contain abnormalities, cancer chemotherapy, and mature eggs. serious illnesses. Thawed embryo cycle. Same as frozen embryo Ovarian hyperstimulation syndrome. A possible cycle. complication of ovarian stimulation or that can cause enlarged ovaries, a Tubal factor infertility. A diagnostic category used distended abdomen, nausea, vomiting, and/or when the woman’s fallopian tubes are blocked diarrhea, fluid in the abdominal cavity and/or chest, or damaged, making it difficult for the egg to be breathing difficulties, changes in blood volume fertilized or for an embryo to travel to the uterus. and/or viscosity, and diminished kidney perfusion Ultrasound. A technique used in ART for visualizing and function. the follicles in the ovaries, the gestational sac, or Ovarian monitoring. The use of ultrasound and/or the fetus. blood or urine tests to monitor follicle development Unknown cause of infertility. A diagnostic and hormone production. category used when no cause of infertility is found Ovarian stimulation. The use of drugs (oral or in either the woman or the man. injected) to stimulate the ovaries to develop follicles Unstimulated cycle. An ART cycle in which the and eggs. woman does not receive drugs to stimulate her Ovulatory dysfunction. A diagnostic category ovaries to produce more follicles and eggs. Instead, used when a woman’s ovaries are not producing follicles and eggs develop naturally. eggs normally. It is usually characterized by Uterine factor infertility. A structural or functional irregular menstrual cycles reflective of ovaries that disorder of the uterus that results in reduced fertility. are not producing one mature egg each month. It includes polycystic ovary syndrome and multiple ZIFT (zygote intrafallopian transfer). An ART ovarian cysts. procedure in which eggs are collected from a woman’s ovary and fertilized outside her body. A PGD (preimplantation genetic diagnosis). laparoscope is then used to place the resulting A technique combining advances in molecular zygote into the woman’s fallopian tube through a genetics and ART. PGD allows physicians to identify small incision in her abdomen. various genetic diseases in the embryo (fertilized egg with several divisions) prior to implantation, Zygote. A fertilized egg before it begins to divide. that is, before the pregnancy is established. It is of special value for those who are at risk of having children with serious genetic problems.

529