Fertility 101: Common terms in the fertility clinic
Somewhere along your fertility journey, you have probably consulted Dr. Google to find support, advice, and community. In doing so, you may have picked up some slang and common abbreviations related to fertility and conception. You might be familiar with common Internet acronyms, such as AF (Aunt Flo, referring to menstruation), BFN (big fat negative), BFP (big fat positive) and TWW (two-week wait).
As fertility specialists, we have abbreviations of our own, and the terms we use in the clinic might be quite unfamiliar to you. That’s why we’ve created this handy glossary of acronyms commonly used in the fertility world, so that you, as a patient, can better understand what at times might seem like an overwhelming amount of jargon.
Tests and diagnoses
Here are some terms related to common infertility tests and diagnoses that your fertility doctor might discuss with you.
This is the term that Friends character Chandler Bing was so worried about. MF stands for “male factor” and refers to issues with sperm quantity and/or quality. The good news is that the fertility clinic will likely be able to provide details about what is causing these difficulties, which can often be treated.
ARA stands for advanced reproductive age. Don’t worry, we’re not calling you old! More women these days are postponing having a family until later in life. Biologically, however, the optimal time for pregnancy is in your 20s and early 30s.
A recurrent pregnancy loss is often defined as two consecutive miscarriages prior to 20 weeks. No matter how you phrase this diagnosis, it can be a tough one to hear. We encourage you to talk to your fertility doctor about what options you have going forward.
You can’t grow your garden if you don’t have enough seeds. This is how you can think about diminished ovarian reserve. Women are born with all of the eggs they will ever have, and over time this store of eggs slowly depletes. Some women have a lower ovarian reserve than others. In working with the amount of eggs you do have, fertility doctors will often recommend more aggressive treatments, such as fertility meds plus IUI or IVF. One of the ways to assess an ovarian reserve is to look at AFC or AMH levels (see below).
Think of bilateral tubal obstruction as trying to drive on the highway when a lot of construction is happening. For whatever reason, a blockage in the fallopian tubes might be preventing the sperm and egg from meeting. Approximately 20% of female infertility cases can be attributed to tubal causes.
Your fertility doctor might recommend any one of several “investigations” to determine the cause of infertility. Here are some of the acronyms you might hear.
A hysterosalpingogram tests whether the fallopian tubes are open. It’s quite the mouthful to say, but it’s a quick test to perform. The test involves injecting contrast dye into the uterine cavity in order to detect whether the fallopian tubes are open or blocked. X-rays are done to track the flow of the dye and to determine whether you have a BTO.
A sonohysterogram is a saline infusion sonogram. This noninvasive procedure tests whether the fallopian tubes are open, and it also detects irregularities in the uterus, including fibroids, polyps, and scar tissue. An SHG might sound very similar to an HSG, but they are different procedures!
AMH stands for anti-mullerian hormone. (As if learning about the hormones estrogen and progesterone wasn’t enough!) Cells within the ovarian follicle produce this hormone, and high levels of AMH correlate with a better response to ovarian stimulation for IVF and more eggs retrieved.
Remember the I Spy books, in which you had to count 15 buttons on the page? Well, an antral follicle count is a bit like that. This is an ovarian reserve test performed by transvaginal ultrasound. It allows your doctor to count how many follicles in your ovaries can be stimulated to produce an egg in response to fertility medication.
A semen sample under a microscope can tell the doctor a lot of things about a male patient’s fertility. A semen analysis often looks at various parameters, such as sperm count, sperm motility (how they swim), sperm morphology (how they look), and volume.
Now let’s talk about some techniques commonly used in reproductive medicine.
In vitro fertilization might sound like something you heard in the latest sci-fi blockbuster, but that’s because it’s one of the most advanced procedures available in reproductive care. In IVF, an egg is fertilized by a sperm outside of the uterus, in an embryology laboratory. After fertilization occurs, the embryo is transferred back into the uterus.
Intracytoplasmic sperm injection is, honestly, just as cool as it sounds. The embryologist chooses individual sperm that have a higher likelihood of achieving fertilization, and injects them directly into the egg. There’s no guesswork about which sperm will win the “race”. Embryologists select the most normally shaped, moving sperm, with all of the right parts to fertilize each egg (or oocyte).
Preimplantation genetic testing is an umbrella term for any test involving the genetics within the embryo. You might also hear the terms PGD and PGS used interchangeably with PGT. With this technique, cells from the embryo are taken and tested for any genetic defects at the chromosomal level, prior to implantation in the uterus.
This term might conjure in your mind the classic turkey-baster scenario, but IUI in a clinical setting is a bit different than that. Intra-uterine insemination is a technique in which sperm is placed in the uterus (bypassing the vagina and cervix). The goal is to increase the number of sperm that are reaching the fallopian tubes, in order to maximize the likelihood of fertilization.
Hopefully, this list has given you some insight into the many acronyms tossed around in the fertility world. Understanding what they all mean will give you the grounding to better communicate with your fertility doctor, FTW (for the win)!