ART, ICSI, PGS, oh my!…IVF’s TLAs and more

I am yours to keep

In 2006, the International Committee for Monitoring Assisted Reproductive Technologies (ICMART) published a first glossary of 53 terms and definitions. In 2009 ICMART together with WHO published a revised version expanded to 87 terms, which defined infertility as a disease of the reproductive system, and increased standardization of fertility treatment terminology.

Since 2009, twenty-five professionals, from all parts of the world and representing their expertise in a variety of sub-specialties, were organized into five working groups. Out of this came a consensus-based and evidence-driven set of 283 terminologies used in infertility and fertility care that was generated to harmonize communication among health professionals and scientists as well as the lay public, patients, and policymakers.

IVF and fertility care is an acronym-rich field and just when you think you have memorized them all, more are added! We have listed the most common used terms that we encounter with our Intended Parents here at Egg Donation, Inc. from ASRM’s International Glossary on Infertility and Fertility Care, 2017

Assisted Reproductive Technology (ART): All interventions that include the in vitro handling of both human oocytes and sperm or of embryos for the purpose of reproduction. This includes, but is not limited to, IVF and embryo transfer ET, intracytoplasmic sperm injection ICSI, embryo biopsy, preimplantation genetic testing PGT, assisted hatching, gamete intra fallopian transfer GIFT, zygote intra fallopian transfer, gamete and embryo cryopreservation, semen, oocyte and embryo donation, and gestational carrier cycles. Thus, ART does not, and ART-only registries do not, include assisted insemination using sperm from either a woman’s partner or a sperm donor.

Blastocyst: The stage of preimplantation embryo development that occurs around day 5–6 after insemination orICSI. The blastocyst contains a fluid filled central cavity (blastocoele), an outer layer of cells(trophectoderm) and an inner group of cells (inner cell mass).

Canceled [ART] cycle: An ART cycle in which ovarian stimulation or monitoring has been initiated with the intention to treat, but which did not proceed to follicular aspiration or in the case of a thawed or warmed embryo did not proceed to embryo transfer.

Cryopreservation: The process of slow freezing or vitrification to preserve biological material (e.g. gametes, zygotes, cleavage-stage embryos, blastocysts or gonadal tissue) at extreme low temperature.

Diploidy/euploidy: The condition in which a cell has two haploid sets of chromosomes. Each chromosome in one set is paired with its counterpart in the other set. A diploid embryo has 22 pairs of autosomes and two sex chromosomes, the normal condition.

Disomy: The normal number of chromosomes characterized by 22 pairs of autosomal chromosomes and one pair of sex chromosomes (XX or XY). The chromosome number in human cells is normally 46.

Embryo: Repository of cryopreserved embryos stored for future use.

Embryo donation: An ART cycle, which consists of the transfer of an embryo to the uterus or Fallopian tube of a female recipient, resulting from gametes that did not originate from the female recipient or from her male partner, if present.

Embryo transfer (ET): Placement into the uterus of an embryo at any embryonic stage from day 1 to day 7 after IVF or ICSI.Embryos from day 1 to day three can also be transferred into the Fallopian tube.

Endometriosis: A disease characterized by the presence of endometrium-like epithelium and stroma outside the endometrium and myometrium. Intrapelvic endometriosis can be located superficially on the peritoneum (peritoneal endometriosis), can extend 5 mm or more beneath the peritoneum (deep endometriosis) or can be present as an ovarian endometriotic cyst (endometrioma).

Euploidy: The condition in which a cell has chromosomes in an exact multiple of the haploid number; in the human this multiple is normally two. Thus, a normal embryo that is euploid is also diploid.

Fertility: The capacity to establish a clinical pregnancy.

Freeze-all cycle: An ART cycle in which, after oocyte aspiration, all oocytes and/or embryos are cryopreserved and no oocytes and/or embryos are transferred to a woman in that cycle.

Frozen-thawed embryo transfer (FET) cycle: An ART procedure in which cycle monitoring is carried out with the intention of transferring to a woman, frozen/thawed or vitrified/warmed embryo(s)/blastocyst(s). Note: A FET cycle is initiated when specific medication is provided or cycle monitoring is started in the female recipient with the intention to transfer an embryo.

Germinal vesicle (GV): The nucleus in an oocyte at prophase I.

Gamete intrafallopian transfer (GIFT): An ART procedure in which both gametes (oocytes and spermatozoa) are transferred into a Fallopian tube(s)

Gestational carrier: A woman who carries a pregnancy with an agreement that she will give the offspring to the intended parent(s). Gametes can originate from the intended parent(s) and/or a third party (or parties). This replaces the term ”surrogate.”

In vitro fertilization (IVF): A sequence of procedures that involves extracorporeal fertilization of gametes. It includes conventional in vitro insemination and ICSI.

Infertility: A disease characterized by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity to reproduce either as an individual or with his/her partner. Fertility interventions may be initiated in less than 1 year based on medical, sexual and reproductive history, age, physical findings and diagnostic testing. Infertility is a disease, which generates disability as an impairment of function.

Intended parent(s): A couple or person who seek(s) to reproduce with the assistance of an egg donor, gestational carrier or traditional gestational carrier.

Intracytoplasmic sperm injection (ICSI): A procedure in which a single spermatozoon is injected into the oocyte cytoplasm.

Intra-uterine insemination (IUI): A procedure in which laboratory processed sperm are placed in the uterus to attempt a pregnancy.

Microsurgical epididymal sperm aspiration/extraction (MESA/MESE): A surgical procedure performed with the assistance of an operating microscope to retrieve sperm from the epididymis of men with obstructive azoospermia. In the absence of optical magnification, any surgical procedure to retrieve sperm from the epididymis should also be registered as MESE.

Oocyte: The female gamete (egg).

Oocyte aspiration: Ovarian follicular aspiration performed with the aim of retrieving oocytes.

Oocyte bank: Repository of cryopreserved oocytes stored for future use.

Oocyte donation: The use of oocytes from an egg donor for reproductive purposes or research.

Oocyte donation cycle: An ART cycle in which oocytes are collected from an egg donor for reproductive purposes or research.

Oocyte cryopreservation: The freezing or vitrification of oocytes for future use.

Ovarian reserve: A term generally used to indicate the number and/or quality of oocytes, reflecting the ability to reproduce. Ovarian reserve can be assessed by any of several means. They include: female age; number of antral follicles on ultrasound; anti-Mullerian hormone levels; follicle stimulating hormone and estradiol levels; clomiphene citrate challenge test; response to gonadotropin stimulation, and oocyte and/or embryo assessment during an ART procedure, based on number, morphology or genetic assessment of the oocytes and/or embryos.

Ovarian stimulation (OS): Pharmacological treatment with the intention of inducing the development of ovarian follicles. It can be used for two purposes: 1) for timed intercourse or insemination; 2) in ART, to obtain multiple oocytes at follicular aspiration.

Polycystic ovary syndrome (PCOS): A heterogeneous condition, which requires the presence of two of the following three criteria: (1)Oligo-ovulation or anovulation; (2) Hyperandrogenism (clinical evidence of hirsutism, acne, alopecia and/or biochemical hyperandrogenemia); (3) Polycystic ovaries, as assessed by ultrasound.

Pre-implantation embryo: An embryo at a stage of development beginning with division of the zygote into two cells and ending just prior to implantation into a uterus.

Preimplantation genetic testing (PGT): A test performed to analyze the DNA from oocytes (polar bodies) or embryos (cleavage stage or blastocyst) for HLA-typing or for determining genetic abnormalities. These include: PGT for aneuploidies (PGT-A); PGT for monogenic/single gene defects (PGT-M); and PGT for chromosomal structural rearrangements (PGT-SR).

Preimplantation genetic diagnosis (PGD) and screening (PGS): These terms have now been replaced by preimplantation genetic testing PGT. 

Recipient (ART): A person or couple who receives donated eggs, sperm or embryos for the purposes of initiating a pregnancy with the intention of becoming a legally recognized parent.

Secondary female infertility: A woman unable to establish a clinical pregnancy but who has previously been diagnosed with a clinical pregnancy.

Severe ovarian hyperstimulation syndrome (OHSS): A systemic response as a result of ovarian stimulation interventions that is characterized by severe abdominal discomfort and/or other symptoms of ascites, hemoconcentration (Hct > 45) and/or other serious biochemical abnormalities requiring hospitalization for observation and/or for medical intervention (paracentesis, other).

Single embryo transfer (SET): The transfer of one embryo in an ART procedure. Defined as elective (eSET) when more than one embryo of sufficient quality for transfer is available.

Testicular sperm aspiration/extraction (TESA/TESE): A surgical procedure involving one or more testicular biopsies or needle aspirations to obtain sperm for use in IVF and/or ICSI.

Thawing: The process of raising the temperature of slow-frozen cell(s) from the storage temperature to room/physiological temperature.

Traditional gestational carrier: A woman who donates her oocytes and is the gestational carrier for a pregnancy resulting from fertilization of her oocytes either through an ART procedure or insemination. This replaces the term “traditional surrogate.”

Zygote intrafallopian transfer (ZIFT): An ART procedure in which one or more zygotes is transferred into the Fallopian tube

At Egg Donation Inc., we are proud to play a small role in helping you accomplish your reproductive goals; whether you are looking to start or grow your family. As the largest and oldest egg donation program in Southern California, we have worked with only the best and most seasoned IVF Clinics as well as belonging to the industry’s top organizations. Having helped more than 15,000 families in our 30+ years in business, assisting our donors and recipients through every step of the process, and supporting your family dreams, is just some of the free services we offer. Contact us today to learn more!