fertility Blog

When most think of problems with fertility, they tend to attribute the cause to the female partner. However, male infertility is responsible, directly or indirectly, for 60% of fertility-related issues in reproductive-age couples. Even considering this statistic, male infertility is still often under-evaluated or dismissed. Evaluating the male partner for infertility improves the precision of infertility diagnoses and the results of subsequent treatment and management.       

Do men need to get their semen analyzed? Evaluating male fertility is a key piece in determining the best treatment path for acouple struggling to get pregnant. One of the important fertility tests for infertile couples is a semen analysis test. Also referred to as a sperm count test, a semen analysis encompasses more information than just a sperm count.   

What Causes Male Infertility?

The main indicator of male infertility is the inability to impregnate a partner. There may be no other obvious symptom or sign. If you and your partner have not conceived a child after a year of regular, unprotected intercourse, it's time to visit a reproductive specialist who could identify underlying problems, such as hormonal imbalances, dilated veins around the testicles, or possible inherited disorders. Certain conditions or events may be associated with male infertility.

• History of genital infections or inflammation of the prostate
• Early or late onset puberty
• Hernia repair
• Injury to or torsion (twisting) of the testicles
• Genitals exposed to high temperatures
• Undescended testicles

Certain prescription medications may also place a male at risk. Discuss any new medications with a pharmacist.  

How Is a Semen Analysis Done?

The steps involved in a Semen Analysis include:

• Collection of Semen: The patient provides a semen sample by masturbating into a sterile container. The sample should be collected after 2-7 days of sexual abstinence.
• Preparation of the Sample: The semen sample is allowed to liquefy for about 30 minutes at room temperature. The liquefied sample is then mixed to ensure that the sperm are evenly distributed.
• Evaluation of Quantity: The quantity of semen is measured by using a calibrated pipette. The volume of the semen is usually between 1.5 and 5 milliliters.
• Evaluation of Quality: The quality of the sperm is evaluated by examining the sample under a microscope. The sperm are assessed for their motility, morphology, and concentration.
• Motility Assessment: The motility of the sperm is evaluated by measuring the percentage of sperm that are moving and the quality of their movement.
• Morphology Assessment: The morphology of the sperm is evaluated by examining the shape and size of the sperm. Abnormalities in the shape of the sperm can affect fertility.
• Concentration Assessment: The concentration of the sperm is evaluated by counting the number of sperm in a specific volume of semen. A low sperm count can affect fertility.
• Other Tests: In some cases, additional tests may be performed, such as testing for the presence of white blood cells in the semen or testing for infections.

A semen analysis may need to be repeated to ensure accuracy and to monitor changes in sperm parameters over time. If there are any abnormalities in the initial semen analysis, a repeat test may be necessary.

• Information Learned Through Semen Analysis

Analysis of a semen sample involves more than just counting the number of sperm present. In fact, a semen sample normally contains less than 5% sperm. It includes mucus and other fluids that make up the healthy environment for the survival of the sperm within the male's ejaculate. A sperm analysis test usually provides the following information.

Sperm Concentration

The number of sperm found in one milliliter of semen is the sperm concentration number. There should usually be approximately 15,000,000 sperm/milliliter in a healthy sample. A low sperm concentration number may show an overall low sperm count and may indicate an unusually high ejaculate volume.   

Sperm Motility

Motility is the percentage of sperm in a sample that moves. If the sperm are incapable of swimming up the female reproductive tract to meet the egg, fertilization will not take place. A healthy semen sample should include about 40  of the sperm capable of moving. A scale of zero to four measures movement rate, which should be a three or higher if showing proper movement quality.       

Viability or Vitality

Semen analysis reveals the percentage of live sperm in the sample. This is sperm viability or vitality. If sperm motility is low, it is especially important to determine viability. There should be at least 50% of the sperm cells which are viable, but if more than half are immotile, it may require further testing to determine viability.

Morphology

Morphology speaks to the shape of sperm cells. The three portions of the sperm — the head, the midsection, and the tail — are measured, and the proportions between each are recorded. For the sperm to swim effectively and fertilize, at least 4% of sperm need to have a normal shape.      

Liquefaction

Ejaculated semen is normally thick and gelatinous, which helps it adhere to the female cervix. It should liquefy in about 20 minutes to enable sperm to swim effectively. If there is a delay in the liquefaction, more testing is generally indicated. SSemen pH

This analysis measures how alkaline or acidic the semen is. A balanced solution is ideal, with seminal vesicle fluid being more alkaline and prostate fluids being more acidic. If the semen is too acidic, it may kill the sperm or impair fertilization. The pH of the semen sample should be between 7.2 to 7.8. Low semen pH usually goes hand-in-hand with other abnormal measurements, such as a low sperm count or a low volume of semen.    

Diagnosing Male Infertility Through Semen Analysis

Any male with one or more health issues that lower the chances of his partner becoming pregnant may need evaluation for infertility. While there are many causes for infertility in men that can be hard to diagnose, most often, the problem is with sperm delivery or sperm production. 

Diagnosis begins with a physical exam and a full history. An exam usually includes blood work and semen analysis, along with a visual and tactile exam of the male sex organs. The results of baseline blood work will determine the need for more tests.

Semen analysis is most often done at least twice. Abnormal sperm numbers or compromised motility may necessitate further sampling. Semen analysis does not test for sperm function but is the cornerstone of baseline laboratory evaluation for male infertility. Analysis of the semen may provide useful data from which a fertility prognosis or a diagnosis of infertility can be determined.

Low sperm numbers or even no sperm production doesn't indicate irreversible or permanent infertility. It may only illustrate a problem with the growth or delivery of sperm. More testing may further define the problem and suggest possible treatments.

Plan Your Semen Analysis Today 

Sometimes all that's needed are lifestyle changes to improve sperm health, viability and increase sperm count. A few examples include:

• Get plenty of exercise and sleep
• Maintain a healthy weight

• If you smoke, stop
• Enjoy alcohol in moderation
• Support a diet rich in antioxidants with vitamin D and calcium supplements

Avoid underestimating the possibility of male infertility. A correct diagnosis is imperative when determining the best path to building your family. A detailed, precise medical history, physical examination, semen analysis, and other lab work are key to nailing down a diagnosis. 

If twelve consecutive months of trying to conceive have been unsuccessful, it's time to see an endocrinologist specializing in reproduction. The doctors at Reproductive Gynecology & Infertility can diagnose and treat male infertility. Give them a call today!

‍

We get tons of questions regarding the costs of fertility treatments. At RGI, costs for an IVF cycle vary as each personalized treatment plan is created for our patients’ unique journeys. However, to give our patients a better understanding of what they might expect, we’ve created this general guide for IVF treatment cost ranges. 

‍

IVF costs vary, averaging from $12,000 and $30,000 for a single IVF cycle. When comparing cost information from different fertility practices, it's crucial to understand what is included in their pricing as this can vary widely and leave patients to incur unsuspected costs.

Here's a breakdown of the average fees.

IVF Cycle Costs Before the Procedure:

• IVF Cycle fee: $12,000 to $14,000
• Can vary across different providers but typically includes monitoring appointments, bloodwork, egg retrieval, embryo development, embryo transfer, Intracytoplasmic Sperm Injection, and follow-up care.
• Assessing fertility: $250 to $500
• Semen analysis: $200 to $250
• IVF Cycle Medications (injection): $3,000 to $6,000

Embryo Creation and Fresh Embryo Transfer Costs:

• Retrieving eggs: Most include this cost in the IVF cycle fee.
• Anesthesia services: Most include up to $725 in the IVF cycle fee.
• Donor sperm: $300 to $1,600
• Intracytoplasmic Sperm Injection (ICSI): Often, this is included in the IVF cycle fee (up to $2,000).

Frozen Embryo Transfer Costs:

• Embryo cryopreservation: $1,000 to $2,000
• Embryo storage: $350 to $600 yearly
• Genetic testing: $1,800 to $6,000
• Frozen embryo transfer (FET): Typically, the embryo transfer is included in the IVF cycle fee (up to $6,400).
• FET medication: $300 to $1,500

Gestational Carrier or Surrogate Costs:

• When using a Gestational Carrier, patients can expect to pay medical fees and legal fees. A typical Gestational Carrier (surrogacy)  journey can range in cost from $60,000 to $150,000.
• Costs to look out for:    
• Gestational Carrier Compensation
• Agency fees are typically assessed (if applicable)
• Any additional medical costs and legal fees

Currenthly, there are nineteen states that require employer-provided insurance to cover fertility benefits, but this varies from state to state.
‍

If you're ready to start your journey to parenthood, connect with our team today.

‍

If you are currently planning to start in vitro fertilization (IVF), you may feel overwhelmed by the decisions you have to make. Your physician and you (and perhaps a partner) will discuss IVF protocols, the fertilization method, and what to do with any surplus embryos. Another important decision you’ll need to make is whether to do preimplantation genetic testing (PGT). 

PGT is a procedure that spot screens for abnormalities in embryos to help identify the best embryo to transfer and hopefully decrease the risk of an unsuccessful transfer. In addition, it can be used to screen for genetic diseases in patients who are at risk of transmitting a genetic disease (like BRCA, a breast cancer gene) to a child. 

PGT includes three genetic screening tests for embryos. They are usually referred to by their acronyms. Here’s what you need to know about PGT to decide if it’s the right choice for your fertility journey.

What Is PGT?

PGT is an umbrella term covering three main subsets of genetic testing. They include preimplantation genetic testing for aneuploidy (PGT-A), preimplantation genetic testing for monogenetic/single-gene diseases (PGT-M), and preimplantation genetic testing for structural chromosomal rearrangements (PGT-SR). PGT-A is the most common genetic test for those going through fertility treatments like IVF.

By understanding what each of these tests does, you can speak to your fertility specialist and see if they might be right for you.

PGT-A

PGT-A screens for chromosome abnormalities in embryos. It counts the 46 chromosomes in an embryo and detects whether there is an extra or missing chromosome – this is clinically referred to as aneuploidy. This can reduce the risk of implanting an embryo with a genetic condition such as Down syndrome (where there is an extra chromosome), and it can help predict which embryos will implant most successfully during IVF, resulting in pregnancy.

PGT-M

Formerly known as preimplantation genetic diagnosis (PGD), PGT-M (monogenic/single gene defect) is a screening tool used for couples who may be at an increased risk of having a child with a specific single gene disorder. Those who may benefit from PGT-M include couples who are carriers of the same autosomal recessive condition, such as Cystic fibrosis. 

When patients (and their partners) know this information before IVF, they are encouraged to undergo screening for recessive conditions. For these conditions, if an embryo inherits one mutated gene copy from each parent, the child would be affected by the disease. PGT-M can detect mutations from parents with inherited genetic diseases, such as Huntington’s disease, or a genetic cancer risk like the BRCA gene.

PGT-SR

PGT-SR is performed when a patient (or their partner) is known to have a chromosomal rearrangement – pieces of chromosomes are missing, duplicated, or rearranged. Individuals with chromosomal rearrangements may experience recurrent pregnancy loss or have a child affected by a chromosomal rearrangement. Many times these patients are healthy and would otherwise not show any signs or symptoms. 

Patients with recurrent pregnancy loss (two or more clinical pregnancy losses) should have a karyotype to screen for a chromosomal rearrangement prior to starting IVF. By detecting the chromosomal rearrangement in an embryo, PGT-SR can reduce the risk of having a child affected by a chromosomal abnormality and the risk of another pregnancy loss. 

By working closely with a fertility specialist who understands your fertility process and health history, they’ll be able to confidently recommend whether a specialized test like PGT-SR can help in addition to a more commonly used screening tool like PGT-A.

The Pros and Cons of PGT-A

Here are some factors to remember as you discuss PGT-A with your partner and fertility specialist.

Pro: Optimal Embryo Selection

One of the main goals of PGT-A is to ensure that your IVF is successful. By screening the embryos before implantation, the doctor is able to identify the embryos with a higher chance of a successful pregnancy. Since pregnancy rates are higher with embryos that have undergone PGT-A, only one embryo is transferred. Single embryo transfer is preferred since pregnancy complications increase in pregnant patients with more than one fetus.

Pro: Sex Selection

PGT-A screens all 46 chromosomes, which means information on embryo sex is also available. Some patients prefer not to know the sex of the embryos. Others may be interested for the purpose of family balancing or for rare situations in which a genetic disease is inherited based on embryo sex.

Pro: Reduce Stressful Decisions

The most common cause of pregnancy loss is a chromosomal abnormality in the developing fetus. Some chromosomal abnormalities can increase the risk of stillbirth, shorten lifespan, or cause significant medical problems. By screening embryos for chromosomal abnormalities, some of these tragic situations can be avoided. By screening embryos with PGT-A, hopefully, the risk of miscarriage will decrease, and the number of embryo transfer cycles needed to become pregnant will also decrease.

Con: Extra Cost

IVF is expensive, and additional testing like PGT-A can add cost. Your insurance also may not cover PGT-A with your fertility treatment. However, it’s worth noting that with PGT-A, you may not need multiple embryo transfer cycles to conceive, helping to negate that cost. Together with your fertility specialist, you can discuss the expense of both IVF and PGT-A to your options and how much extra testing may cost.

Con: Embryo Damage

All genetic screening tests require embryologists to remove cells (usually five-seven) from the trophectoderm – which are the cells that become the placenta. This testing is usually performed on a day five embryo (blastocyst) when the embryo is less likely to be impacted by removing a small number of cells. Cells from the inner cell mass are not disturbed as these cells will develop into the fetus. In labs that are routinely performing PGT-A, the risk of damage to the embryo is very low because of the expertise and experience of the embryologists. Your fertility specialist will help you decide if this testing is the best choice for you and will also discuss the genetic screening options that are available after you conceive. 

Con: False Results

Just like with any type of testing, there is a chance that a PGT-A test can deliver a false negative or positive, meaning that healthy embryos may go unused when they could have been transferred, or an embryo with a chromosomal abnormality is transferred based on test results. 

This test is also not a diagnostic test but a screening test. This is because the biopsied cells come from the cells that become the placenta and not the cells that become the fetus. This is not unique to embryo testing as early genetic screening in pregnancy – such as noninvasive pregnancy testing (NIPT), which is offered at 10-12 weeks is also screening the DNA from the placenta. The earliest testing that can be done on the DNA of the fetus is at 15 weeks of pregnancy via an amniocentesis. 

In addition, sometimes embryos contain 2 different cell lines – these are called mosaic embryos. Mosaic embryos can implant and result in a live birth but do so at a lower rate than chromosomally-normal embryos. Mosaic embryo results require individualized counseling between the physician and patient before making the decision to transfer. 

Talk to your fertility specialist about the risk of a false PGT-A result so that you can factor this into your decision-making process.

Is PGT-A the Right Choice for Me?

Many personal factors come into play when deciding to do PGT-A testing on your embryos. This includes:

• Age: Women who are older who are undergoing IVF to create embryos have an increased risk of chromosomal abnormalities in those embryos. Therefore, women 35 years or older may want to use PGT-A to select the embryo that has the highest chance of pregnancy.
• Health history: If you’ve had a history of recurrent miscarriages, unsuccessful embryo transfer cycles, or have had abnormal genetic testing results in the past, PGT-A may offer you peace of mind before an IVF transfer.
• The number of embryos: It is important to note that not every fertilized egg will develop into a blastocyst (day five embryo). There is a risk that no embryos develop to day five or that no embryos are chromosomally normal. Thus, some patients who proceed with PGT-A may not have a viable embryo to transfer.
• Time: After the embryos are biopsied on day five, the embryos are cryopreserved until embryo transfer. The results from the genetic testing of the embryo may take as long as two weeks. Therefore, patients who test the embryo will usually transfer the embryo the next month. Studies have also shown that for some patients, a frozen embryo transfer has a higher live birth rate than a fresh transfer.

This is just a glimpse of the considerations when thinking about PGT-A testing. To make the best-informed decision, consult with a fertility specialist regarding your situation. They will be able to go over your health history and fertility journey and answer any questions you may have to help you confidently reach your decision.

At RGI, we offer an IVF 100% Success Guarantee Plan to qualifying patients because we’re confident in our experience and technology to help you get the family of your dreams. For some patients, an important part of that will include PGT-A testing. Schedule a consultation with a fertility specialist today and learn more about your fertility and the available treatment options.

Some couples may experience challenges conceiving or giving birth despite previous successful pregnancies. These obstacles typically hinder partners from reaching their family size easily and early. Secondary infertility is the inability to conceive or to deliver a baby where there has been previous successful delivery of at least one child after trying for 12 months before age 35 years and after six months after age 35 years.

Secondary infertility affects at least 11% of couples in the United States. Male and or female causative factors are responsible for secondary infertility. Medical conditions or diseases that impair ovulation and fertilization or damage the male or female reproductive tracts can cause secondary infertility.

In this article, you will learn more about the male and female causes of secondary infertility and the available treatment options.

Causes of Secondary Infertility in Females

Medical disorders and diseases that affect the female reproductive system and hormones are causes of secondary infertility in females. Here are common causes of female secondary infertility.

Ovulation Disorders

Ovulation disorders include anovulation, which is the inability of the ovaries to release a matured egg during the menstrual cycle. Females with anovulation may not get pregnant because fertilization cannot occur without a matured egg. Oligo-ovulation is ovulation at irregular intervals, often unpredictable, resulting in irregular menses.

Ovulatory disorders account for approximately 25% of female infertility cases. Polycystic ovarian syndrome (PCOS) is the most common ovulation disorder and causes 80% of anovulation infertility. PCOS inhibits the normal cyclical hormone regulatory processes that control ovulation, affecting a female’s ability to get pregnant.

Fallopian Tube Blockage

The sperm fertilizes the egg in the ampulla region of the fallopian tubes. Hence, damage or blockage of the tube hinders the sperm from reaching the egg for fertilization. Infections of the fallopian tubes trigger inflammatory reactions that can damage and block the fallopian tube, especially in chronic pelvic inflammatory diseases. Another risk factor for tubal infertility is a history of pelvic surgery, potentially leading to scar tissue.

Uterine Disorders

Chronic infections and procedures such as dilation and curettage predispose the uterine wall to form scars and adhesions that impair the implantation of the fertilized egg. Also, uterine fibroids, especially the submucous types, may impair implantation and lead to secondary infertility.

Genital Tract Infections

The Centers for Disease Control (CDC) reports that approximately 1 out of 8 women with a history of pelvic inflammatory diseases experience difficulties getting pregnant. Chronic or poorly treated Chlamydia or Gonococcal infections of the genital tract are major causes of female secondary infertility.

Endometriosis

Endometriosis is a medical disorder in which the cells lining the uterus, called the endometrium, are found outside the uterine cavity. These external endometrial cells may trigger inflammation that affects the reproductive process in the uterus and fallopian tubes necessary for fertilization and successful implantation.

Causes of Secondary Infertility in Males

Male factors account for approximately 20-30% of infertility cases. Here are common male factor causes of secondary infertility.

Hormonal Disruption

Some medical conditions may alter the blood level of testosterone, the reproductive hormone responsible for sperm production. Also, brain injury or trauma could damage the pituitary gland or hypothalamus in the brain, which may affect the release of regulatory hormones that control testosterone production.

Genital Tract Infections

Chronic genital infections, such as sexually transmitted diseases, cause inflammatory changes that form scars blocking the sperm transport tubules in the male reproductive tract. This blockage halts the transport of sperm from the testis to the vas deferens for storage.

Damage to Sperm Transport Tubules

After sperm production in the testicles, special transport tubules move matured sperm cells to the vas deferens (the tube that connects the testicle to the penis). However, these transport tubules are at risk of damage in males with previous testicular trauma or pelvic surgeries.

Medical Disorders

Some medical disorders interrupt the blood supply to the testis, affecting the quality and quantity of sperm cells the testes produce. Examples of medical conditions that could affect the testicular blood supply include :

•      epididymitis

•      hydrocele

•      testicular torsion

•      varicocele

•      orchitis

Medications

Medications, such as chemotherapy drugs or steroids, affect sperm production and increase the risk of male secondary infertility.

Exposure to Toxic Environmental chemicals

Prolonged exposure to toxic environmental chemicals and radiation damages the testes and affects sperm formation. Examples include some pesticides and heavy metals like lead.

Lifestyle and Unhealthy Habits

An unhealthy lifestyle typically affects the formation and quality of sperm produced in the testes. Hence, males who engage in unhealthy habits such as alcohol and tobacco intake are more prone to secondary infertility than those who avoid these habits.

When to Seek Treatment for Secondary Infertility

If you suspect you or your partner may have secondary infertility, consult a fertility doctor for evaluation.

During your visit to the fertility clinic, the doctor will take your clinical history, conduct a clinical examination, and order tests for diagnostic purposes.

For females, the doctor will take the following clinical history:

•      duration of infertility

•      your last menstrual period

•      menstrual cycle length and frequency

•      past pregnancies and their outcomes

•      history of medical disorders, including STDs and past pelvic surgeries

•      intake of medications such as birth control pills, etc

•      sexual history

Subsequently, your doctor may conduct a pelvic examination and ultrasound to evaluate your reproductive organs.

While for males, your doctor may take the following clinical history:

•      testicular trauma

•      history of infections such as orchitis or mumps

•      use of medications or previous testicular surgeries

•      exposure to toxic chemicals

•      use of tobacco, alcohol, and illicit drugs

Thereafter, your doctor may perform a pelvic exam to examine your male reproductive organs.

Tests for Secondary Infertility

Your doctor will typically order some tests to identify the underlying cause of secondary infertility and to select the most appropriate therapeutic intervention.

For females, here are some of the common fertility tests:

•      hormone profile test

•      pelvic ultrasound

•      specialized X-ray called Hysterosalpingography to outline the uterus and to check for blocked fallopian tubes

For males, semen analysis is the primary fertility test your doctor will order to assess the following:

•      sperm count

•      sperm volume

•      sperm viability

•      sperm morphology to assess any defects in shape

•      chemical properties such as pH, etc

Also, your doctor may request other tests based on the clinical history and examination findings. For example, your doctor may request a scrotal ultrasound scan if the examination reveals a varicocele. Also, serum testosterone level is crucial for suspected cases of hormone imbalance as the cause of secondary infertility.

Treatment and Fertility Options for Secondary Infertility

There are various treatment modalities for secondary infertility, and your fertility doctor has the medical expertise to decide the most suitable intervention. Generally, identifying the underlying cause and administering the specific treatment may help resolve secondary infertility. Here are the major treatment options for secondary infertility.

Medications

Your doctor will use fertility drugs to optimize the sexual hormones and other specific medications depending on the cause. In females, fertility experts use drugs to induce the ovulation of 1 or more eggs.

Clomiphene citrate is common medication doctors use in fertility clinics. It inhibits the negative feedback effect of serum estrogen in the hypothalamus and pituitary gland. This inhibition enables the pituitary gland to continue secreting gonadotropin hormones that aid the ovulation process and eventually release 1 or more matured eggs.

For males, doctors can prescribe hormone replacement medications in cases of low testosterone blood levels.

Also, your doctor may prescribe antibiotics in clinical cases of chronic genital tract infections.

Surgery

Surgical procedures may be the most suitable therapy for specific causes of secondary infertility in males and females. For instance, in females with uterine fibroids or severe endometriosis, surgery may be an effective remedy for these medical disorders.

In some clinical cases, your doctor may perform a minimally invasive surgical procedure using laparoscopic techniques— surgeries are done using a laparoscope which is a special tube with an attached camera.

For males with varicocele, a doctor may recommend surgical intervention to repair the dilated testicular veins.

Assisted Reproductive Technology

Assisted reproduction technology (ART) is a fertility-based treatment that involves the manipulation of eggs or embryos to aid conception. The two most common types of ART are in-vitro fertilization and intracytoplasmic sperm injection (ICSI).

After stimulation of the ovaries with injectable medications, ART involves obtaining eggs from the ovaries through a small outpatient procedure. 

In vitro fertilization involves the exposure of each egg to several sperm in the laboratory, eventually resulting in a fertilized egg, now called an embryo. Intracytoplasmic sperm injection (ICSI) is an alternative method of aiding fertilization, involving the injection of a single sperm directly into each egg in the laboratory resulting in an embryo. After the creation of the embryo through either IVF or ICSI, the embryo grows in the laboratory, and then eventually, the embryo may be transferred to the uterus to achieve pregnancy.

Do you Need Help with Secondary Infertility?

Secondary infertility in males and females is due to various causative factors. Hence, it is essential to seek help from qualified fertility experts to help you identify the specific cause and proffer the appropriate solution.

Our team of experts at Reproductive Gynecology & Infertility are qualified fertility specialists with a track record of helping couples with infertility cases. To expand and reach your family size early, seek help from Reproductive Gynecology & Infertility today.

‍

Infertility treatment in modern medicine allows so many individuals and couples to realize their dreams of parenthood. Like most medical fields, fertility treatment has its own language, often complicated or highly technical. Acronyms are also a favorite in today's infertility medical lingo. To help decipher the terminology of 21st-century infertility medicine, we've compiled an "old school" favorite: A glossary of common terms and acronyms.

Glossary of Infertility Terms and Acronyms

We've listed the items here in alphabetical order. Acronyms appear in their commonly used form, followed by the full term the set of letters represents.

Agglutination

Describes an event in which sperm clump together, making it difficult for them to swim easily. Sperm agglutination is a possible indication of immunological infertility, which makes it an important factor to consider in forming an infertility diagnosis.

AI (Artificial Insemination)

A procedure that deposits sperm near the cervix in the vagina or directly into the uterus using a catheter.

Amenorrhea

The complete absence of menstrual periods.

Anovulation

A complete absence of ovulation.

ART (Assisted Reproductive Technologies)

ARTs are various procedures used to combat infertility in which conception occurs without sexual intercourse.

ART Cycle

A process that includes an ART procedure, stimulation of the ovaries, or frozen embryos that are thawed for transfer into a woman. This process starts when a woman begins fertility medications or monitors her ovaries for follicle production.

BBT (Basal Body Temperature)

A temperature reading taken every day that can be used to chart ovulation.

Beta HCG Test

This blood test detects very early pregnancies and can help evaluate embryonic development.

Cryopreservation

This freezing process preserves embryos, sperm, and other tissues at very low temperatures. When embryos are not utilized in an ART cycle, they can be cryopreserved for potential use in the future.

DEIVF (Donor Egg In Vitro Fertilization)

An in vitro fertilization procedure in which the egg used is procured from a donor.

Donor Egg

Also known as egg donation, this term describes the donation of an egg from one woman to another. The goal is to become pregnant by in vitro fertilization (IVF).

Donor Embryo

Describes an embryo donated by a couple who previously had ART treatment that resulted in the creation of extra embryos. When donated, all parental rights of the donor couple are relinquished.

Embryologists

Professionals who specialize in advanced laboratory techniques to prepare and provide the conditions necessary for the fertilization of eggs. These specialists facilitate the development, growth, maturation, and preservation of embryos.

Fertility Specialist

A physician who specializes in treating fertility problems. These physicians receive certification in a subspecialty for OB-GYNs from the American Board of Obstetrics after obtaining extra training in reproductive endocrinology and infertility.

Gestation

This term refers to the period of development the fetus undergoes in the uterus from conception to birth, usually 40 weeks' duration.

Gestational Surrogate / Gestational Carrier / Gestational Surrogacy

Arrangement in which a woman agrees to carry a pregnancy on behalf of another individual or couple (the intended parents). In Gestational Surrogacy, embryos are created using the egg of the intended parent (or an egg donor) and the sperm of an intended parent (or a sperm donor). Gestational Carriers (surrogates) do not have any biological relation to the resulting baby.

HCG (Human Chorionic Gonadotropin)

A hormone produced in early pregnancy that's released from the placenta after implantation. It can be employed via injection to trigger ovulation after certain types of fertility treatments. In men, it can stimulate testosterone production.

‍ICSI (Intracytoplasmic Sperm Injection)

This procedure retrieved eggs and sperm from both partners. In a laboratory, a single sperm is injected directly into the egg, and the fertilized egg is then implanted into the woman's uterus.

Idiopathic Infertility

A term applied when the cause of infertility remains unexplained.

Implantation

This occurs when a fertilized egg embeds itself in the uterus lining.

Infertility

Inability to conceive following a year of unprotected intercourse, or six months in women over age 35.

IUI (Intrauterine Insemination)

Less frequently, it can stand for intra-uterine injection or intra-uterine infection. Intra-uterine insemination is a procedure for treating infertility. The sperm is washed, then concentrated before being placed directly in the uterus when the ovary releases one or more eggs.

IVF (In Vitro Fertilization)

A complex procedure for treating infertility in which mature eggs are retrieved from ovaries and fertilized by sperm in a lab.

Microinsemination

In this laboratory procedure, sperm is injected next to an egg cell surface in a laboratory dish. This is done to increase the chances of fertilization.

PGT (Preimplantation Genetic Testing)

A screening technique used to evaluate the chromosomal makeup of an IVF embryo and whether the embryo contains genetic abnormalities.

Postcoital Test

In this standard fertility test, a sample of cervical mucus is taken from the woman after intercourse to determine the number and behavior of sperm. Cervical mucus is an accurate reflection of the ovarian cycle, the PC test is an invaluable indicator of the endocrine preparation of the female reproductive system.         

Reproductive Endocrinologist

Highly trained Obstetrician-Gynecologist with advanced education, research, and skills in reproductive endocrinology and infertility. 

Secondary Infertility

Infertility lasting six months or more in a couple who previously had a successful pregnancy and birth.

Sperm Bank

A facility that specializes in the collection and freezing of sperm, preserving it to be used later by a couple or donated for use in assisting others with infertility.

Sperm Count

The number of active sperm in an ejaculate sample. Normally, the sperm count ranges from 15 million sperm to more than 200 million sperm.

Sperm Motility

The percentage of sperm in an ejaculate that moves forward.

Surrogacy

Traditional Surrogacy

Traditional surrogacy is sometimes called "straight surrogacy," "partial surrogacy," or "genetic surrogacy." It involves a legal agreement between the intended parents and the surrogate. In this scenario, the surrogate is the biological mother of the baby. The surrogate's own eggs are fertilized using a sperm donor or the intended father. Intended mothers do not have a genetic link to the baby in traditional surrogacy. IHR does not work with traditional surrogates, only gestational surrogates. 

Gestational Surrogacy

A gestational surrogate carries and delivers a baby for another person or couple. Gestational surrogate pregnancies are achieved through IVF. In this procedure, an embryo is created in a lab using the egg and sperm from the intended parents, or donor eggs and sperm may be used. The embryo is then transferred to the uterus of the gestational surrogate. Because the gestational carrier carrying the pregnancy doesn't provide an egg, there is no genetic connection between the child and the surrogate.       

TTC (Trying to Conceive)

Considered slang, this acronym is generally used as a form of shorthand in notes, in online communities, and on social media. Often seen as a hashtag: #TTC.

Ultrasound

A testing procedure that uses high-frequency sound waves to view the ovaries, uterus, and the developing fetus.

Vaginal Ultrasound

This procedure is performed through a probe inserted into the vagina. It allows the viewing of the follicles, fetus, and other soft tissues by using sound waves. Imaging the structures in the pelvis with ultrasound can identify abnormalities and help diagnose conditions.

Make the Call

Are you ready to explore the possibilities for growing your family? Request a consultation with the specialists at Reproductive Gynecology & Fertility, your premiere source for comprehensive, advanced, experienced fertility care. 

‍

For the millions of couples who face the challenges of infertility, many factors come into play from both partners. Men’s issues account for approximately 50 percent of all infertility cases, but there are indicators that tell doctors if a woman requires further testing. Two general signs are:

• A woman under 35 has not become pregnant after one year of trying (with regular, unprotected intercourse
• A woman over 35 has not become pregnant after 6 months of trying

If your doctor recommends fertility testing, it’s important to know what to expect.

A complete guide to fertility testing for women

Many women who struggle to get pregnant have multiple problems contributing to their infertility, which is why there are many kinds of fertility tests available. What fertility test(s) a woman undergoes depends entirely on her unique situation. Still, there is a basic order of testing that doctors follow to pinpoint the source of infertility:

• Initial fertility appointment – When you first meet with your fertility doctor, he or she will review your birth controluse, menstrual and pregnancy history, current and past sexual practices, medications used and other health issues. Your doctor will also ask about your lifestyle and work/living environments.
• Physical exam – In addition to a Pap smear and pelvic exam, the doctor will examine areas such as your thyroid, breasts and hair growth.
• Blood tests – Initial tests may be conducted to evaluate thyroid hormone levels, prolactin levels (the hormone that makes you produce milk after giving birth), testosterone levels, and to screen for diseases like HIV or hepatitis.
• Ovulation testing – To confirm ovulation, the doctor may use a range of techniques, including reviewing your temperature charts, ovulation predictor kitsand 3D ultrasound.
• Hormone testing – During the ovulation portion of your workup, levels for follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, inhibin B and other hormones may be examined.
• Cervical mucus tests – These involve post coital tests (PCT) to help determine if the sperm can penetrate and survive in the cervical mucus. It also includes a bacterial screening.

If the above testing is inconclusive, more procedures may be recommended, including reproductive organ tests and genetic testing.

Excellence in fertility testing and complete reproductive care is close to home

If your purpose in life is to become a parent, yet that purpose remains unfulfilled, hope is just around the corner. With locations in Akron, Columbus, Canton and Youngstown, all the expertise, advanced technology, compassion and dedication it takes to help you have the baby you’ve always wanted is within reach.

Our team of reproductive endocrinology and infertility nurses, embryologists and onsite laboratory technicians surround you with support and expertise. They’re led by our board-certified physicians, who bring decades of combined experience, a wealth of innovative diagnostics and treatments, and a genuine passion for helping you realize the dream of parenthood.

To learn more or to schedule an appointment, click here to see the phone numbers for each office, or to use our online form.

In vitro fertilization (IVF) is the process of fertilization by extracting eggs, retrieving a sperm sample and manually combining the two in a laboratory. Once the eggs are fertilized, they are transferred back into the woman’s uterus in hopes of having a successful pregnancy.

IVF hormone injections and the retrieval process

Daily hormone injections are required to control the menstrual cycle and encourage multiple eggs to grow simultaneously. A fertility specialist will perform an ultrasound to determine when the eggs are mature and ready for retrieval. When the eggs are ready, the woman is placed under twilight sleep or IV sedation for the retrieval procedure.

IVF fertilization process

Once the eggs are collected, sperm from a male partner or sperm donor is collected, analyzed and washed from the semen. Next, the best quality sperms are injected into the best quality eggs. The fertilized eggs, or embryos, will grow in a laboratory for three to five days and be closely monitored by a skilled specialist.

IVF implantation process

Once the embryos are growing well, one or two are implanted inside the female’s uterus. A period of rest is usually recommended following the implantation procedure to increase the chance of the embryo implanting itself to the uterine wall.

IVF injections

Depending on your specific situation, IVF can be a four- to six-week commitment that requires daily injections and regular visits to Reproductive Gynecology & Infertility for blood work. The blood work, which comes after the transfer procedure, measures HCG levels. HCG is a hormone made when a women becomes pregnant that can be detected even before a missed period. If an IVF implantation is successful, HCG levels will double every two to three days. Progesterone injections may be required for many weeks after implantation, up to the first trimester. The egg retrieval process during IVF removes the cells that would naturally create progesterone after ovulation. Progesterone injections are needed to help thicken the uterine lining and prepare the woman’s body to support the embryo.

If you are under the age of 35 and have been trying to conceive for 12 consecutive months or are over the age of 35 and have been trying to conceive for 6 consecutive months, it’s important to know your options. To learn more about getting started with IVF, contact the reproductive specialists at Reproductive Gynecology & Infertility today at 866-537-2461. We are here to help you build your long-awaited family.