A hormone secreted by the cells of the developing antral and pre-antral follicles (or egg sacks) in the ovaries. Once secreted from these growing follicles, AMH stops more immature ones from getting recruited into the maturation process, so that not all the eggs mature all at the same time. Because AMH reflects the number of eggs maturing in the ovaries on their way to ovulation, AMH is a strong indicator of a woman’s ovarian reserve (OR) – the ovaries’ ability to produce good-quality eggs. Using the Roche Elecsys AMH Assay, the median AMH level (pmol/l) for a donor between 20–29 years of age is 13.1 – 53.8.

Assisted Hatching

An embryology laboratory procedure that chemically or physically (by laser) helps create a small hole in the “shell” of the embryo to help it hatch out to implant. The embryo naturally hatches out of its shell to implant into the uterus, but assisted hatching may help the embryo along in this critical process.

Blastocyst

A blastocyst has differentiated and contains two different cell types. The first is called the inner cell mass, which develops into fetal tissue. The second is called the trophoblast or trophoectoderm, and these cells lead to part of the placenta. In order to form a blastocyst, an embryo activates it’s own genes through a process called genomic activation.

A blood test to determine pregnancy which that gives a positive reading if a woman is pregnant by testing the presence or absence of the pregnancy hormone called Human Chorionic Gonadotropin (hCG). The level of hCG is around 50-100 at the time of a missed period.

Discontinuation of an ART cycle in which ovarian stimulation was carried out but which was stopped before eggs were retrieved. usually prompted by poor response to hormone therapy, no egg recovery, or failed fertilization. It may also occur with an over response to medicine (hyperstimulation).

A chemical pregnancy is an early pregnancy loss that occurs shortly after implantation. Chemical pregnancies take place before ultrasounds can detect a fetus, but not too early for a pregnancy test to detect levels of hCG, or human chorionic gonadotropin.

A synthetic hormone, taken orally, to help women ovulate by producing extra natural Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). It is also used to help women who already ovulate to achieve pregnancy by ovulating more than one egg. Men also use this medicine to help sperm production.

A freezing procedure used to preserve and store embryos or sperm and even eggs.

CD refers to the cycle days. The cycle here is the menstrual cycle. CD1, CD2, etc means the first day of your cycle or second day of your cycle. CDs are tracked to ensure that corrective measures are taken at the right time for a successful pregnancy. For example, some hormone needs to be injected in the woman at particular cycle days to ensure a successful pregnancy.

Donor Egg

The use of someone else’s eggs to achieve pregnancy. The donor is usually anonymous but can be known. The eggs might be fresh (collected and immediately fertilized and transferred) or frozen (collected and frozen for later use).

Egg

The female reproductive cell, also called an oocyte. Medically an egg is called an Oocyte.

Egg Donor (ED)

Also known as oocyte or ovum donation, is a process that enables a woman to donate her eggs to another woman who is not able to produce viable eggs on her own, or for couples or individuals in which there is no egg provider. Types of donors include:

Altruistic Donor: Men and women who give their sperm or eggs without needing treatment themselves. In the UK they may receive expenses but not payment.

Anonymous Donor: Donor to whom a donor conceived child or their parents has no right to identifying information. Some non-identifying information may be available. Most of our donors are anonymous.

Egg Share Donor: Egg share donors agree to share their eggs with one or two women.

Identifiable Donor: Donor who is anonymous to the recipient at the time of donation but is willing to be known to the child from age 18.

ID Release Donor: Donor whose identity will be made available at a specified time to the recipient and/or offspring

Known Donor: Donor whose identity is known at the time of donation.

Egg Freezing vs. Embryo Freezing

The egg freezing procedure and the embryo freezing procedure both start the same basic way: with hormone medication, injected over for 8–12 days, that stimulates the ovaries to produce multiple eggs. Once mature, the eggs are collected from the ovaries and frozen to a temperature so low that all activity within the cell—including aging—pauses, freezing them in time

During embryo freezing, the eggs are fertilized using IVF before they are frozen, and develop, over a period of several days, into embryos.

Egg Retrieval

A procedure to collect the eggs contained in the ovarian follicles.

Egg Sharing (Split or Shared Cycles)

Egg sharing involves a woman undergoing in vitro fertilization (IVF) or an egg freezing procedure who then shares some of the eggs retrieved with another individual in need of eggs to achieve pregnancy. The woman who shares her eggs (the sharer) usually receives the IVF treatment or egg freezing procedure for free or at a reduced cost, while the other individual (the recipient) gets the donor eggs required to attempt achieving pregnancy through IVF.

Egg sharing differs from conventional egg donation in that both the donor and recipient are provided an opportunity to have a baby.

Egg Vitrification

The process of cryopreserving your eggs to stop the biological clock, so they can be used in the future. An advancement in egg freezing technology, uses a flash-freezing. With its ultra-rapid freezing process and use of cryoprotectants, egg vitrification prohibits the formation of damaging ice crystals, thus sealing the egg in a glass-like protection.

Embryo

The earliest stages of development of a baby from the point of conception to the eighth week of pregnancy. An embryo begins its growth as a single cell, and then divides every 12-24 hours. By Day 3, it is about 4-8 cells, and is referred to as a multicell embryo. During the early growth of the multicell embryo, all of the energy and chemicals required for cell division come from the mother’s egg. By Day 5, the embryo, now called a blastocyst, is about 70-100 cells.

Embryo Grading

During IVF, the embryos are cultured for up to six days and receive quality grades each day

• Germinal vesicle (GV): The egg has not begun meiosis yet, so it is considered immature.
• Metaphase I (MI): The egg is in the first phase of meiosis; however, it is still not completely mature because it has not entered the second phase of meiosis. This kind of immature egg may mature after a couple of hours of temperature-controlled incubation.
• Metaphase II (MII): The egg is in the second phase of meiosis and is mature. Eggs at this stage of maturity are ready for fertilization.

Embryo Transfer (ET)

Placement of embryos into a woman’s uterus through the cervix after in vitro fertilization (see also fresh embryo transfer or frozen embryo transfer)

Escrow Account/Fund Management

A financial account the intended parent establishes to disperse funds that will be used to pay egg donor expenses.

In 2010, California bill 2426 was signed into law, specifying how funds for surrogacy and egg donation must be managed in the state. California Family Code Section 7961 now requires that client funds for these types of assisted reproduction must be deposited into one of two specific accounts:

(1) An independent, bonded escrow depository maintained by a licensed, independent, bonded escrow company.

(2) A trust account maintained by an attorney.

The surrogacy, egg donation agency, or fertility treatment facility should inform clients about their two options and direct them to deposit funds there for retrieval during the fertility process.

Our agency will inform the escrow agency/fertility attorney how much is to be distributed according to the contract that is drawn up between an egg donor and the intended parents.

Client-trust accounts held by attorneys are regulated by the California State Bar, to which each attorney is accountable. In addition, the California State Bar has created the Client Security Fund, which protects clients against financial losses from dishonest conduct. Law firms have no financial interest in holding accounts for clients; no interest earned off the account may be appropriated by an attorney

Estradiol Level (E2)

The amount of estradiol, a form of estrogen, in the blood. It is produced by the follicle where the egg is growing for that month. The mature follicle (the egg right before ovulation) produces about 200-300 pg/ml of estradiol.

Fertilization

The penetration of the egg by the sperm and the resulting combining of genetic material that develops into an embryo.

Fertility Attorney

An attorney with experience in third-party fertility contracts and parental establishment procedures. This is a specialized area of law where the egg donor contracts are legal, written agreements between the intended parents and the egg donor that state the rights and obligations of both parties throughout the arrangement. They might include such specifications as future contact, travel expenses, timelines for retrieval, anonymity preferences, privacy considerations, or any number of other provisions based on the unique case.

Fertility Clinic/IVF Clinic

IVF Clinic or Fertility Clinic is the location where all of the IVF medical procedures will be completed. The IVF clinic is chosen by the Intended Parents based on the physician they have chosen to work with.

Follicle

A structure in the ovaries that contains a developing egg. A woman’s eggs develop inside fluid-filled cysts (sacs) inside the ovaries, called follicles. During a natural menstrual cycle in which no fertility drugs are taken, several follicles begin to enlarge around the time when the woman is having her period.

However, over the course of the next few weeks, only one of these follicles develops to maturity, ruptures, and releases its egg during the process of ovulation. The other follicles that had begun to develop stop growing and degenerate (dissolve), therefore, only a small percentage of eggs present in the ovaries are ever ovulated during the woman’s reproductive life span. We can “rescue” follicles and eggs that would otherwise degenerate by giving shots of fertility drugs which contain FSH (follicle stimulating hormone).

When the follicles are ready for egg retrieval — generally after eight to 14 days — injections of human chorionic gonadotropin (Pregnyl, Ovidrel) or other medications can help the eggs mature.

Follicle Stimulating Hormone (FSH) Levels

A hormone released by the pituitary gland. FSH stimulates the growth of follicles and has a role in the maturation of oocytes. The measurement of FSH levels in the blood is one of the most widely used tests to assess a woman’s ovarian function and is typically taken on day 2 or 3 of a woman’s menstrual cycle.

Follicle Stimulating Hormones (FSH)

FSH helps a woman produce more than one egg per cycle for the purpose of egg retrieval. It is taken once a day for nearly 10 days. Clomid is a common FSH.

Fresh Embryo Transfer

A fresh embryo transfer is the transfer of a newly formed embryo during an in vitro fertilization (IVF) cycle into a uterus without prior freezing of the embryo. A fresh embryo transfer does not need rigorous hormonal treatment to prepare the uterus for implantation.

Frozen Embryo Transfer (FET)

A frozen embryo transfer (FET) is procedure where embryos that were cryogenically stored (frozen) from a previous IVF or donor egg cycle are a thawed and transferred to a uterus as part of an in vitro fertilization (IVF) cycle.

Genetic Carrier Screening/Testing

A carrier screen is a genetic (DNA) blood test that investigates whether you have (“carry”) recessive gene changes – also called mutations – that could cause certain serious genetic diseases in your children. Genetic testing is a type of medical test that identifies changes in chromosomes, genes, or proteins. In carrier screening your DNA is tested for mutations in a certain number of disease genes. The results can confirm or rule out a suspected genetic condition or help determine a person’s chance of developing or passing on a genetic disorder. While carrier tests will not identify all carriers of all genetic diseases, many carriers will be identified such as: cystic fibrosis, spinal muscular atrophy, hemoglobinopathies, Tay-Sachs disease, and others depending on your ancestry. Expanded carrier screening refers to testing for a large number (generally 100 or more) genetic conditions simultaneously on one test.

This screening is also part of two very different but complementary genetic screening strategies for egg donors: (1) genetic carrier screening, and (2) genetic summary or assessment of the donor’s family history (see below).

The genetic assessment is an important part of egg donor screening, matching, and identifying potential risk factors and disease susceptibilities for children who are donor-conceived. This report is used to help intended parents determine whether or not they will need further genetic tests based on the donor’s family history. The donor will meet with a genetic counselor to discuss her family history and the genetic counselor will create a pedigree, or family tree, of the donor. While the risk assessment evaluates the personal medical history, family history, and carrier screening results of the egg donor, it does not consider the intended parent(s) genetic information, which should be evaluated separately.

This family tree report is also part of two very different but complementary genetic screening strategies for egg donors: (1) genetic carrier screening (see above), and (2) genetic summary or assessment of the donor’s family history.

Gestation

The period of time from conception to birth.

Human Chorionic Gondaotropin (hCG)

An injection of human chorionic gonadotropin triggers ovulation. This is taken the day before the egg retrieval procedure or approximately 36 hours in advance. hCG carries the same side effects as gonadotropins.

ICSI or Intracytoplasmic Sperm Injection (ICSI)

The purpose of ICSI is to assist the fertilization process when a man’s sperm count is abnormal. Whether it is because the number of motile sperm is very low or the morphology is excessively poor, the technique involves the delivery of a single sperm into a single egg. Most clinics will recommend ICSI if there is a fear that poor fertilization may occur by traditional IVF where sperm are merely added to the egg culture dish.

Infectious Disease Screening

All our egg donors are screened for certain infectious diseases, such as HIV and Chlamydia prior to starting their medications. For our frozen egg donors, potentially infectious eggs are stored differently than are other eggs.

Intended Parent(s)/Recipients/IPs

Intended Parents are the recipients of egg donation. They may also be referred to as “IPs” or “Future Parents.” Intended Parents and Recipients are used interchangeably. However, Intended Parents comes about from California Code, Family Code – FAM § 7960 (c) “Intended parent” means an individual, married or unmarried, who manifests the intent to be legally bound as the parent of a child resulting from assisted reproduction.

In Vitro Fertilization (IVF)

An ART procedure that involves removing eggs from a woman’s ovaries and fertilizing them outside her body. The resulting embryos are then transferred into the woman’s uterus through the cervix.

Legal Clearance

This is a document fertility clinic will require prior to the start of medical treatment for an egg donor.  This will be issued directly to the medical facility by the attorneys involved once the contracts have been signed by all parties. Medications cannot begin until Legal has been cleared.

Lupron

This injectable medication is one of the many medications used to prepare your body for the retrieval process. It is also called Gonadotropin Releasing Hormone (GnRH) and antagonist that most commonly stops a menstrual cycle from making a follicle on its own when given in the luteal phase. It can also stimulate the female hormones, then suppress the secretion of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). Lupron trigger can also be given in Gonadotropin Releasing Hormone (GnRH) antagonist cycles in place of a Human Chorionic Gonadotropin (hCG) trigger to induce egg maturation.

Luteinizing Hormone (LH)

A hormone that causes the ovary to release a mature egg (ovulation) and release male hormones. In the male, Luteinizing Hormone (LH) stimulates testosterone production. The anterior pituitary secretes LH.

Medical Screening

During a medical screening, you will take a series of tests to determine that you are healthy enough for egg donation. This includes a physical examination, genetic testing, STD testing and drug/nicotine screening as well as any other testing the chosen IVF clinic deems appropriate in order to medically approve you for egg donation. You must receive “medical clearance” to donate your eggs.

Monitoring Clinic

If the IVF clinic is not near the egg donor’s home, we will help find a local monitoring clinic who will oversee their medication monitoring before traveling for retrieval at the actual IVF clinic.

Multifetal Pregnancy Reduction

A procedure used to decrease the number of fetuses a woman carries and improve the chances that the remaining fetuses will develop into healthy infants.

Oocyte

The female reproductive cell, also called an egg.

Oocyte Retrieval aka “Retrieval” or “Egg Retrieval”

A procedure performed under twilight sedation, to collect eggs contained within the ovarian follicles. The physician gently inserts a small needle into the follicle under vaginal ultrasound guidance and draws out the follicle’s fluid and egg.

Ovarian Hyperstimulation aka “Hyperstim”

The effect of medically induced follicular development to prepare someone for ovulation, Intrauterine Insemination (IUI), or In Vitro Fertilization (IVF) where more than one follicle is produced in a controlled fashion.

Ovarian Hyperstimulation Syndrome (OHSS)

A possible side effect of medically induced follicular development to prepare someone for ovulation, Intrauterine Insemination (IUI), or for In Vitro Fertilization (IVF). It is characterized by swollen ovaries and, in some cases, the accumulation of fluid in the abdomen and chest. At times, it can require a “tap” where fluid is removed to help the healing occur more quickly.

Ovarian Reserve

A term used to refer to the quantity and quality of eggs in the ovaries. It can be determined by several tests, including day three Follicle Stimulating Hormone (FSH), estradiol, antral follicle count, ovarian volume, and Anti-Mullerian Hormone (AMH). The lower the ovarian reserve, the lower the chance for pregnancy.

Polycystic Ovarian Syndrome (PCO, PCOS)

A condition found in women who don’t ovulate regularly, characterized by excessive production of androgens (male sex hormones) and the presence of extra follicle cysts in the ovary. Though PCO can be without symptoms, some include: obesity, acne, excessive hair growth, irregular menstrual periods, and infertility.

Preimplantation Genetic Diagnosis (PGD)

Used to screen for abnormal numbers of chromosomes, broken or damaged chromosomes, and other anomalies such as: Down Syndrome, Trisomy 21, Tay Sachs Disease, Hemophilia A and B, Gaucher’s Disease, Sickle Cell Anemia, and Gender selection

PGD performed on a woman’s embryos for the most common chromosomal problems enables the physician and couple to determine which embryos will most likely result in a healthy, ongoing pregnancy. Additionally, for couples that have failed IVF cycles for unexplained reasons, preimplantation genetic diagnosis (PGD) may provide important information in the determination of the cause(s) of the failures.

Progesterone

The hormone produced after ovulation by the ovary’s corpus luteum during the second half of a woman’s cycle. It prepares the lining of the uterus to accept implantation of a fertilized egg, the embryo. It is released in pulses, so the amount in the bloodstream is not constant.

Psychological Evaluation/Screening

A psychological evaluation is required to ensure that egg donors are ready to handle the donor requirements from a medical and legal perspective. This helps us ensure that you understand the process and procedure involved.

Reproductive Endocrinology (RE)

Reproductive endocrinology is a sub-specialty of Obstetrics and Gynecology that focuses on treating men and women with infertility or reproductive system issues.

Society for Assisted Reproductive Technology (SART)

is the primary organization of professionals dedicated to the practice of assisted reproductive technologies (ART) in the United States.

Sperm

The male reproductive cell.

Trigger Shot

A trigger shot is an injection of synthetic human chorionic gonadotropin (hCG), which is a hormone medication used to stimulate the maturation of follicles and trigger ovulation; usually within 24 hours of the retrieval procedure.

A trigger shot may also be called an hCG trigger shot or by the brand names Ovidrel, Pregnyl or Novarel.

Ultrasound

A technique used in ART for visualizing the follicles in the ovaries and the gestational sac or fetus in the uterus.