INTERNATIONAL GLOSSARY OF INFERTILITY AND FERTILITY CARE

The spontaneous loss of two or more clinical pregnancies prior to 22 completed weeks of gestational age.

Spontaneous loss of a clinical pregnancy before 22 completed weeks of gestational age, in which the embryo(s) or fetus(es) is/are nonviable and is/are not spontaneously absorbed or expelled from the uterus.

The spontaneous loss of an intra-uterine pregnancy prior to 22 completed weeks of gestational age.

Intentional loss of an intrauterine pregnancy, through intervention by medical, surgical or unspecified means. (See induced embryo/fetal reduction.)

A membrane-bound structure covering the anterior of the sperm head that contains enzymes necessary to penetrate the zona pellucida of the oocyte.

The process by which an oocyte is activated to undergo development in the absence of fertilization.

A form of endometriosis marked by the presence of endometrium-like epithelium and stroma outside the endometrium in the myometrium.

Bands of fibrous scar tissue that may bind the abdominal and pelvic organs, including the intestines and peritoneum, to each other. They can be dense and thick or filmy and thin.

Clumping of spermatozoa in the ejaculate.

A procedure that involves the separation of sperm through centrifugation and resuspension in culture media. It can be used to remove seminal plasma and infectious agents before IUI and ART procedures. This procedure has been shown to be effective in the removal of HIV. It may also be effective in removing other infectious particles but clinical safety and efficacy have to be established for each particular infection. This term is sometimes referred to as ‘sperm washing’.

A description of the ejaculate to assess function of the male reproductive tract. Characteristic parameters include volume, pH, concentration, motility, vitality, morphology of spermatozoa and presence of other cells.

The medical practice dealing with the health of the male reproductive system.

An abnormal number of chromosomes in a cell. The majority of embryos with aneuploidies are not compatible with life.

Two or more aneuploidies involving different chromosomes in the embryo. When autosomes are involved, this condition is not compatible with human life.

A congenital anomaly that requires surgical repair of a defect, is a visually evident or life-threatening structural or functional defect, or causes death.

Structural or functional disorders that occur during intra-uterine life and can be identified prenatally, at birth or later in life. Congenital anomalies can be caused by single gene defects, chromosomal disorders, multifactorial inheritance, environmental teratogens and micronutrient deficiencies. The time of identification should be reported.

Antibodies that recognize and bind to antigens on the surface of the spermatozoon.

A professional intervention with the intention to mitigate the physical, emotional and psychosocial consequences of infertility.

Ovarian follicular aspiration performed with the aim of retrieving oocytes.

A surgical procedure in which a needle is introduced percutaneously into the epididymis with the intention of obtaining sperm.

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.

A surgical procedure involving one or more testicular biopsies or needle aspirations to obtain sperm for use in IVF and/or ICSI.

Reduced percentage of motile sperm in the ejaculate below the lower reference limit. When reporting results, the reference criteria should be specified.

The absence of spermatozoa in the ejaculate.

The provision of reproductive health services in a different jurisdiction or outside of a recognized national border within which the person or persons legally reside.

The absence, at birth, of both duct systems (vas deferentia) that connect the testes to the urethra and may be associated with cystic fibrosis transmembrane conductance regulator (CTFR) gene mutation. Although the testes usually develop and function normally, men present with azoospermia.

A condition in which a person, voluntarily or involuntarily, is not a legal or societally-recognized parent to a child, or has had all children die.

A condition in which a person has never delivered a live child, or has never been a legal or societally- recognized parent to a child.

A condition in a person with a child wish, who has never delivered a live child, or has never been a legal or societally-recognized parent to a child. A major cause of primary involuntary childlessness is infertility.

A condition in a person with a child wish, who has previously delivered a live child, or is or has been a legal or societally-recognized parent to a child. A major cause of secondary involuntary childlessness is infertility.

Absence of spermatozoa in the ejaculate due to lack of production of mature spermatozoa.

Absence of spermatozoa in the ejaculate due to occlusion of the ductal system.

A condition in which fewer than four follicles and/or oocytes are developed/obtained following ovarian stimulation with the intention of obtaining more follicles and oocytes.

Repository of cryopreserved embryos stored for future use.

Repository of cryopreserved oocytes stored for future use.

Repository of cryopreserved sperm stored for future use.

The presence of two nuclei in a blastomere (cell).

Fluid-filled central region of the blastocyst.

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

A cell in a cleavage stage embryo.

A medical or pharmacological method to prevent the release of gonadotropins (FSH, LH) from the pituitary gland.

The process of raising the temperature of a vitrified cell or cells from the storage temperature to room/ physiological temperature.

Type of testicular cell located in the interstitial space between the seminiferous tubules, that secretes testosterone.

The non-germinal cell type in the seminiferous tubule that mediates the actions of testosterone and FSH in the testis, provides nutrients and proteins to the developing spermatogenic cells, creates the blood- testis barrier, and secretes Mullerian-inhibiting hormone.

The innermost cells of the cumulus oophorus.

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.

An ART procedure in which cycle monitoring is carried out with the intention of fertilizing thawed/ warmed oocytes and performing an embryo transfer.

An ART cycle in which a woman receives zygote(s) or embryo(s) from donor(s) or a partner.

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.

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

An ART cycle in which a woman’s uterus is prepared to receive one or more cleavage stage embryos/ blastocysts, resulting from gametes that did not originate from her or from her male partner, if present.

A MAR cycle in which a woman receives spermatozoa from a person who is not her sexually intimate partner. In the case of ART registry data, a sperm recipient cycle would only include data from cycles using ART procedures.

An ART cycle in which a woman receives oocytes from a donor, or her partner if in a same sex relationship, to be used for reproductive purposes.

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.

An ART cycle in which one or more fresh or frozen/thawed embryos at cleavage or blastocyst stage are transferred into the uterus or Fallopian tube.

A cycle in which the woman receives specific medication for ovarian stimulation or in which cycle monitoring is carried out with the intention to treat, irrespective of whether or not insemination is performed, follicular aspiration is attempted in an ovarian stimulation cycle or whether egg(s) or embryo (s) are thawed or transferred in a frozen embryo transfer (FET) cycle.

An ART procedure in which one or more oocytes are collected from the ovaries during a menstrual cycle without the use of any pharmacological compound.

An ART procedure in which one or more oocytes are collected from the ovaries during a spontaneous menstrual cycle. Pharmacological compounds are administered with the sole purpose of blocking the spontaneous LH surge and/or inducing final oocyte maturation.

A single cell resulting from fertilization of a mature oocyte by a spermatozoon and before completion of the first mitotic division.

Surgical procedures performed to diagnose, conserve, correct and/or improve reproductive function in either men or women. Surgery for contraceptive purposes, such as tubal ligation and vasectomy, are also included within this term.

The process during which tight junctions form between juxtaposed blastomeres resulting in a solid mass of cells with indistinguishable cell membranes.

The (measure of the) number of spermatozoa in millions per 1 ml of semen.

The understanding of reproduction, fecundity, fecundability, and related individual risk factors (e.g. advanced age, sexual health factors such as sexually transmitted infections, and life style factors such as smoking, obesity) and non-individual risk factors (e.g. environmental and work place factors); including the awareness of societal and cultural factors affecting options to meet reproductive family planning, as well as family building needs.

The canal that passes through the prostate just lateral to the verumontanum where the vas deferens and the duct from the seminal vesicle coalesce.

A cryopreservation procedure in which the temperature of the cell(s) is lowered in a step-wise fashion, typically using a computer controlled rate, from physiological (or room) temperature to extreme low temperature.

The freezing or vitrification of oocytes for future use.

The process of slow-freezing or vitrification of tissue surgically excised from the ovary with the intention of preserving reproductive capacity.

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.

Testis not in scrotal position within the neonatal period and, up to but not limited to, 1 year post birth. If the testis has not descended into the scrotum, this condition can cause primary testicular failure and increased risk of testicular cancer development.

The small bodies containing chromosomes segregated from the oocyte by asymmetric division during telophase. The first polar body is extruded at telophase I and normally contains only chromosomes with duplicated chromatids (2c); the second polar body is extruded in response to fertilization or in response to parthenogenetic activation and normally contains chromosomes comprising single chromatids (1c).

Interventions that include fertility awareness, support and fertility management with an intention to assist individuals and couples to realize their desires associated with reproduction and/or to build a family.

A poorly defined abnormality of the endometrium presumably due to abnormally low progesterone secretion or action on the endometrium.

A measure of the mass/volume ratio (specific gravity) for spermatozoa.

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

An intervention intended to induce an oocyte in vitro or in vivo to resume meiosis to reach maturity (i.e. to reach metaphase II).

Failure of germ cells to progress through specific stages of spermatogenesis at onset or during meiosis.

These terms have now been replaced by preimplantation genetic testing PGT. (See term PGT and its definitions.)

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.

Inability to have and/or sustain an erection sufficient for intercourse.

A histological finding in which spermatogenesis is present with few cells in the seminiferous tubules, resulting in a decreased number or absence of sperm in the ejaculate.

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.

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.

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

An ART procedure in which the zona pellucida of an embryo is either thinned or perforated by chemical, mechanical or laser methods.

The process by which an embryo at the blastocyst stage extrudes out of, and ultimately separates from, the zona pellucida.

The age of an embryo or fetus calculated by the best obstetric estimate determined by assessments which may include early ultrasound and the date of the last menstrual period and/or perinatal details. In the case of ART, it is calculated by adding two weeks (14 days) to the number of completed weeks since fertilization. Note: For frozen-thawed embryo transfer (FET) cycles, an estimated date of fertilization is computed by subtracting the combined number of days an embryo was in culture pre-cryopreservation and post-thaw/-warm, from the transfer date of the FET cycle.

A pregnancy diagnosed only by the detection of beta hCG in serum or urine.

A pregnancy diagnosed by ultrasonographic or clinical documentation of at least one fetus with a discernible heartbeat.

A pregnancy diagnosed by ultrasonographic visualization of one or more gestational sacs or definitive clinical signs of pregnancy. In addition to intra-uterine pregnancy, it includes a clinically documented ectopic pregnancy.

A pregnancy documented by a positive human chorionic gonadotropin (hCG) test without visualization of pregnancy by ultrasound. This condition exists only after circulating hCG concentration is compatible with ultrasound visualization of a gestational sac.

A pregnancy outside the uterine cavity, diagnosed by ultrasound, surgical visualization or histopathology.

Concurrent pregnancy involving at least one embryo implanted in the uterine cavity and at least one implanted outside of the uterine cavity.

A state of reproduction in which an embryo has implanted in the uterus.

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.

The biological organism resulting from the development of the zygote, until eight completed weeks after fertilization, equivalent to 10 weeks of gestational age.

Embryos beginning with the 2-cell stage and up to, but not including, the morula stage.

Co-ordinated contractions of the vas deferentia, seminal vesicles, and ejaculatory ducts leading to deposition of semen into the urethral meatus prior to ejaculation.

A convoluted, highly coiled duct that transports the spermatozoa from the testis via the efferent ducts to the vas deferens.

The space between the cytoplasmic membrane enclosing the oocyte and the innermost layer of the zona pellucida. (This space may contain the first and second polar bodies and extracellular fragments.)

The mature male reproductive cell produced in the testis that has the capacity to fertilize an oocyte. A head carries genetic material, a midpiece produces energy for movement, and a long, thin tail propels the sperm.

A permanent state of infertility.

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.

A protocol in which the ovaries are stimulated with gonadotropins, and/or other pharmacological compounds, with the intention of limiting the number of oocytes following stimulation for IVF.

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.

A surgical procedure using an operating microscope to identify seminiferous tubules that may contain sperm to be extracted for IVF and/or ICSI.

A condition in which semen is released sooner than desired.

A condition in which it takes a man an extended period of time to reach orgasm and ejaculation.

A condition resulting in an inability to ejaculate during vaginal intercourse.

A condition that causes the semen to be forced backward from the ejaculatory ducts into the bladder during ejaculation.

Co-ordinated contractions of the genitourinary tract leading to the ejection of spermatozoa and seminal fluid.

The probability of a pregnancy, during a single menstrual cycle in a woman with adequate exposure to sperm and no contraception, culminating in a live birth. In population-based studies, fecundability is frequently measured as the monthly probability.

Clinically defined as the capacity to have a live birth.

The capacity to establish a clinical pregnancy.

The capacity to establish a clinical pregnancy.

A sequence of biological processes initiated by entry of a spermatozoon into a mature oocyte followed by formation of the pronuclei.

A sequence of procedures that involves extracorporeal fertilization of gametes. It includes conventional in vitro insemination and ICSI.

The stages of development of an organism from eight completed weeks of fertilization (equivalent to 10 weeks of gestational age) until the end of pregnancy.

The process during which one or more blastomeres shed membrane vesicles containing cytoplasm and occasionally whole chromosomes or chromatin.

A pregnancy with three or more embryos or fetuses.

A pregnancy with more than one embryo or fetus.

The condition in which a cell has one set of each of the 23 single chromosomes. Mature human gametes are haploid, each having 23 single chromosomes.

Significant bleeding, internal or external, after oocyte aspiration retrieval requiring hospitalization for blood transfusion, surgical intervention, clinical observation or other medical procedure.

A distally occluded, dilated, fluid-filled Fallopian tube.

High volume of ejaculate above the upper reference limit. When reporting results, the reference criteria should be specified.

Histopathologic description of reduced production of spermatozoa in the testes.

Gonadal failure associated with reduced gametogenesis and reduced gonadal steroid production due to reduced gonadotropin production or action.

Low volume of ejaculate below the lower reference limit. When reporting results, the reference criteria should be specified.

The photographic recording of microscope image sequences at regular intervals in ART, referring to gametes, zygotes, cleavage-stage embryos or blastocysts.

The attachment and subsequent penetration by a zona-free blastocyst into the endometrium, but when it relates to an ectopic pregnancy, into tissue outside the uterine cavity. This process starts 5 to 7 days after fertilization of the oocyte usually resulting in the formation of a gestation sac.

Pharmacological treatment of women with anovulation or oligo-ovulation with the intention of inducing normal ovulatory cycles.

A woman who has never been diagnosed with a clinical pregnancy and meets the criteria of being classified as having infertility.

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

Infertility caused primarily by female factors encompassing: ovulatory disturbances; diminished ovarian reserve; anatomical, endocrine, genetic, functional or immunological abnormalities of the reproductive system; chronic illness; and sexual conditions incompatible with coitus.

Infertility in couples with apparently normal ovarian function, Fallopian tubes, uterus, cervix and pelvis and with adequate coital frequency; and apparently normal testicular function, genito-urinary anatomy and a normal ejaculate. The potential for this diagnosis is dependent upon the methodologies used and/ or those methodologies available.

A man who has never initiated a clinical pregnancy and meets the criteria of being classified as infertile.

A man who is unable to initiate a clinical pregnancy, but who had previously initiated a clinical pregnancy.

Infertility caused primarily by male factors encompassing: abnormal semen parameters or function; anatomical, endocrine, genetic, functional or immunological abnormalities of the reproductive system; chronic illness; and sexual conditions incompatible with the ability to deposit semen in the vagina.

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.

The process of placing laboratory processed sperm or semen from a man into the reproductive tract of a woman who is not his intimate sexual partner, for the purpose of initiating a pregnancy.

The co-incubation of oocytes with sperm in vitro with the goal of resulting in extracorporeal fertilization.

A procedure in which laboratory processed sperm are placed in the cervix to attempt a pregnancy.

A procedure in which laboratory processed sperm are placed in the uterus to attempt a pregnancy.

A procedure whereby semen, collected from a non-lubricated condom or similar method, is deposited into the vaginal cavity of a female. An intervention that can be self-administered by a woman attempting pregnancy.

A condition characterized by hypergonadotropic hypogonadism in women younger than age 40 years (also known as premature or primary ovarian failure). It includes women with premature menopause.

Damage to testicular function after radiation, chemotherapy or hormone treatment; or devascularization

as a consequence of hernia surgery.

A procedure in which a single spermatozoon is injected into the oocyte cytoplasm.

A high number of white blood cells in semen above the upper reference limit. When reporting results, the reference criteria should be specified.

The process whereby proteolytic enzymes degrade proteins causing seminal plasma to liquefy.

The number of perinatal deaths per 1000 total births (stillbirths plus live births).

An ultra-rapid cryopreservation procedure that prevents ice formation within a cell whose aqueous phase is converted to a glass-like solid.

Lack of external ejaculation.

The absence of spermatozoa in the ejaculate.

The multi-layered mass of granulosa cells surrounding the oocyte.

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).

Describes spermatozoa with a reduced or absent acrosome.