Absence or discontinuation of menstruation.
Absence of ovulation, a woman can have menstrual cycle without ovulation.
Medical procedures and methods of manipulation with germ cells.
Damaging of outer layer of embryo to assist the implantation, i.e. embryo hatching in the womb.
Absence of sperm in ejaculate.
Removal of a piece of tissue for cytology or histology to confirm or exclude suspected tumour (refer to the tumours morphology).
5-6 days old embryo.
Cell formed by cleavage of a fertilized ovum. Blastomeres intensely divide into cells (this phenomenon is called the zygote division) and produce pluricelular formation (approx. 16 cells) called morula.
Programmed regular gynaecologic check-ups aimed at detecting symptoms of tumour associated alterations (precancerous lesions) or detecting the early stage of malignant tumour (carcinoma) of the cervix. If there are abnormalities of the cervix, considerable health issues or complications are generally not observed, this increases the risk that cervical abnormalities will not be detected on time. The only possible and efficient prevention of the cervical cancer is still the careful and regular monitoring (i.e. exact colposcopy and correctly obtained and evaluated cytology sample are not 100% secure).
Neck of womb or cervix. Bottom narrow part of the womb. Usually cylindrical or cone-like shaped, approximately a half of cervix can be easily examined during standard gynaecological exam.
Medical diagnostic procedure to examine the cervix, using a special device – colposcope – which detects early modifications in the cervix. From female patient’s point of view, colposcopy does not significantly differ from the gynaecologic examination.
Cryopreservation of Embryos
Embryo freezing (cryopreservation) is a method to preserve embryos. Once collected, embryos are stored in special containers preserved in liquid nitrogen at – 196 °C. Two to four embryos are stored together in a special solution which prevents their damage during the freezing. After embryos are defrozen, approximately 60-80% of originally preserved embryos can be used.
Cytological exam- a microscope is used to observe individual cells obtained from the cervical surface (compared with the histology). Cytology does not detect relation of tumour and resistant tissues (i.e., if a carcinoma is concerned, it can be ascertained whether it is a carcinoma in situ or not).
The fetus develops outside the uterus. Abnormal pregnancy, fertilized ovum attaches outside the uterus, usually in one of the oviducts, ovaries or abdomen.
Initial stage in fetus development since the conception until the 8th pregnancy week.
Cultivation technique to store embryos in laboratory (up to 6 days).
Refer to: Embryos Cryopreservation.
Endometriosis is defined as a condition in which parts of endometrium appear outside the uterus. The endometriosis may frequently cause female infertility.
Endometrium, the mucous membrane lining the uterus. During the cycle, the endometrium grows into a thick plethoric layer with glands and tissue and creates an optimum environment for blastocyte (embryo) hatching.
Primarily female reproductive hormones with low concentration in a body of a male too. Estrogens are inter alia contained in certain contraceptive drugs and medicines for women after menopause.
Fluorescent In Situ Hybridization is a cytogenetic technique which uses special colourants (fluorochromes) to colour a chromosome or specific parts thereof. Fluorochromes link to the specific DNA sequence. The preparations are subsequently observed under fluorescent microscope.
Ovarian follicle. A formation with a single oocyte generally (future ovum) and auxiliary follicular cells.
Follicle-stimulating hormone. One of human reproductive hormones shared by both sexes. FSH stimulates follicles growth (ovarian cams). One of the group of human sex hormones occurring in both sexes. As for women, it promotes the growth of follicles (ovarian) in the ovaries and stimulates the formation of estrogen. As for men, it causes the formation of sex cells (spermatogenesis).
Germ cells (sperm, ova).
Any hormones in mammals which stimulate the growth of reproductive organs. Gonadotropin includes follitropin (FSH), lutropin (LH, luteinizing hormone), choriogonadotropin (hCG).
Choriogonadotropin. Human chorionic gonadotropin created after ovum is fertilized and during the embryo development. This hormone is detected in blood 7-9 days after the conception and 1-2 days later also in urea.
X-ray examination to unobstruct the oviducts. It is an outpatient examination without the general anaesthesia. The findings are relatively precise. The simplicity, easy nature and low risks make this medical examination advantageous. The test includes the assessment of the uterus. HSG neither precisely defines the extent of accretions, nor confirms endometriosis.
Minimally invasive surgery, a small camera is used to inspect the womb cavity. Hysteroscopy is applied to examine the reasons of sterility, reasons of irregular bleeding, to localize polyps in the womb cavity and detect defects in womb development.
Sperm is directly injected to the cytoplasm of ripe oocytes. The selected sperm is paralyzed, aspirated to micropipette and inserted to oocytes by micromanipulator.
Unexplained infertility. It is not possible to detect any obvious reason of infertility in 10-15% couples: i.e. semen has a normal quality and there is not an obvious defect in woman’s reproductive system.
Inability to get pregnant.
Medical, biologic term also applied in sectors focusing on organisms and partly in artificial laboratory conditions, Latin equivalent of “in glass”.
In Vitro Fertilization, IVF
The sperm fertilizes ovum outside of woman’s body: one of assisted reproduction methods applied to treat infertility. It consists of the hormonal stimulation of ova to develop and mature, ripe ova are removed from ovaries and fertilized by sperm. Fertilized ovum (zygote) is transferred to the womb.
All chromosomes in the cell nucleus. The number, size and shape of chromosomes in cell nuclei is constant which makes it a genetic attribution. Karyotypes is one the main subjects studied by cytogenetics.
Laparoscopy can be translated as “view of the abdominal cavity”. Nowadays, laparoscopy has an irreplaceable role in the examination and treatment of several impairments. It is a minimally invasive surgery with surgical trocars inserted to the abdominal cavity through abdominal wall. Optic fibres and surgical instruments are inserted to the trocar tubes. Optic fibres and a small camera display the abdominal cavity and organs on a screen. Laparoscopy is used to identify the reason of sterility or if the ectopic pregnancy is suspected.
Luteinizing Hormone (LH)
Luteinizing hormone (Lutropin) enhances the production of reproductive hormones. It develops the production of estrogen and progesterone in women’s ovaries (and corpus luteum). It produces testosterone in men’s testicles.
Meiotic division, reduction division– a cell division which produces cells with reduce the number of chromosomes – this is the basic prerequisite of the reproductive process. These cells (gametes) may either merge with a suitable gamete and create a new individual again composed of a double set of chromosomes (e.g. sperm in ovum).
The ceasing of menstruation after the climacterium occurs. It is a natural process in woman’s life, the function of ovaries ceases, less estrogen and progesterone is produced. The menstrual cycle is absent, so is the fertility – a woman can no longer become pregnant (naturally, there are successful cases of assisted reproduction). The menopause usually concerns ages between 45 to 55. There may be (significant) deviations in the age limits.
If sperm transport is compromised between the epididymis and the urinary tract, it is possible to obtain the sperm using the MESA technique (micro epididymal sperm aspiration) by microsurgical suction of the sperm from the epididymis.
Mitotic division is a cell division, its function is to transmit full genetic information to daughter cells in a uniform manner. The mitotic division of cell is preceded by a complicated division of cell nucleus with the same number of chromosomes in the nuclei of daughter cells.
Irregular menstrual periods, the bleeding starts after an interval longer than 31 days. The irregularity is mainly caused by hormonal disbalance and can be hormonally treated.
Reduced number of sperm cells in the ejaculate, reduced production of sperm.
Cytology has been reputed basic screening (monitoring) method to assess the quality of cervix cells in a specimen. Cytology test should detect any irregularity in cells in terms of precancerous or cancerous alterations. Cytology and colposcopy should form an integral part of preventive medical check-ups of women and targeted examinations of cervical irregularities. With regards to the fact that the cervical carcinoma is the second commonest malignancy of female genitals, these two methods applied by experienced and qualified healthcare personnel form the basis to timely detect any precancerous alterations.
Oocyte Donation Programme helps women with ovaries which are unable to produce quality ova prone to fertilization for whatever reason. This concerns women with premature menopause or both ovaries removed, patients with chromosome anomaly which is systematically transferred to their descendants. Young healthy women donate ova to women in need without asking anything in return.
Oocytes are obtained from ovarian follicles. The follicles are then placed in a container with a cultivating medium and identified under a microscope.
Ova or oocytes are female germ cells. Their development starts in the prenatal period. The production of ripe ova is limited to woman’s fertile years (from teen age to climacterium (menopause)).
Ovarian Hyperstimulation Syndrome (OHSS)
A rare syndrome which may arise if ovulation is aided or an assisted reproduction method is used.
Narrow flexible tube starts in uterus, its cilia ends in the abdominal cavity nearby ovary. There are two oviducts, each links one ovary with the uterus. The oviducts transport ovum to the uterus after the ovulation ends. The ovum is fertilized in the oviduct.
Ripe ovum is released from ovary. Released ovum slowly heads to the oviducts in the uterus – aided by the cilia in the membrane of oviducts. If the ovum comes across sperm, they will merge and fertilize ovum. After the ovulation, ovum disappears within 24 hours.
It is a modified ICSI method (intracytoplasmic sperm injection) in which only ripe sperm is used for fertilization of ovum. Ripe sperm has significantly lower rate of chromosomal abnormality.
Pituitary gland attached to the base of the brain (glandula pituitaria). Central endocrine gland which is largely superior to other glands with internal secretion in the human body. Pituitary inter alia produces FSH, LH and other hormones contributing to the growth and development.
Preimplantation Genetic Diagnostics (PGD)
In certain highly specific cases, there is a high risk that certain diseases will be transferred to descendency (haemophilia, muscular dystrophy, etc.). Isolated cells of embryo and blastomeres are examined. This genetic examination of cells excludes any infection and pathology and insert only healthy embryos to the uterus.
Precancerous = Precancerous Stages
These cell modifications concern only epithelum and cannot metastase. We recognise:
LG lesions (low-grade lesions) – minor modification mostly eliminated by woman’s body without any surgery.
HG lesions (high-grade lesions) – severe modifications which may be easily surgically treated.
After a year or two of unprotected sexual intercourse, a couple cannot achieve pregnancy. The infertility here defines the condition when a woman can get pregnant (sexual intercourse, assisted reproduction), however, she is not able of a birth – i.e. repeated miscarriage.
Prolonged Cultivation (PK) of Embryo
Embryos are stored in a laboratory, the embryotransfer is performed on the 5th cultivation day, which increases the ability to get pregnant. This treatment is recommended to female patients who have undergone several unsuccessful transfers.
Female reproductive hormone secreted by corpus luteum in ovary after ovulation. This process prepares the uterus for pregnancy. Also the placenta produces progesterone throughout the pregnancy. It is also produced in the suprarenal glands or testicles. The production of progesterone decreases during the climacterium.
A luteotropic hormone produced by the pituitary. High levels of this hormone cause hyperprolactinemia – the impairment of ovulation, which may result in infertility or reduced fertility. Certain medicines may cause excessive production of prolactin. The hormone stimulates the growth of the milk gland and the production of milk.
The semen is redirected to the urinary bladder during the ejaculation, instead of being ejaculated through penis to female genitals. Sperm is normal; it may be obtained from urea and used in assisted reproduction techniques.
A condition of a couple, which conceived one or several children, however the woman cannot get pregnant for two years of unprotected sexual intercourse.
Basic laboratory test of ejaculate to assess man’s fertility. There are other special tests to examine the quality of sperm (precise analysis of fertility impairments).
Testicular Sperm Extraction. Operation technique to obtain a piece of tissue from testicles, sperm is extracted under microscope. This technique may be used, if there is only a few or absolutely no sperm in the ejaculate.
Abnormally widened veins which transport blood from testicles. It affects 10 to 22 % of adult men and may be one of the reasons of infertility. It can be treated by a surgery.
Ova freezing, the ova are immersed directly to liquid nitrogen at -196 °C. The main advantage is that crystals of ice are not produced, these could harm the ovum and its cellular structures.
First stage of embryo development – i.e. of fertilized ovum. A cell with complete set of chromosomes.