Fertility Jargon Buster

Understanding hormones

• AMH: stands for Anti-Mullerian Hormone. This is a protein hormone produced by cells within the ovary. Understanding your AMH level tells you how good your egg reserve is and this gives the doctor an indication of how fertile you are. AMH levels are naturally lower in older women (particularly those over the age of 40) and higher in women with Polycystic Ovaries (PCO) or Polycystic Ovary Syndrome (PCOS). Manchester Fertility are specialists in treating older women.

• FSH: is Follicle Stimulating Hormone. FSH is a hormone produced by the pituitary gland. This stimulates the growth of follicles in the ovary before the release of an egg. A high reading of FSH can be an indication of a poor ovarian reserve.

What we measure

• Blood-flow: The blood flow to your uterus, ovaries and follicles gives you an idea of how good your ovarian-reserve is. A cell in the body that has good blood flow is likely to be a healthy cell; it has received a good supply of oxygen and nutrients. By looking at blood flow, we can see which eggs might be of better quality.
• Egg-reserve/ovarian-reserve: is the term that is used to determine the capacity of the ovary. The ovary houses the egg cells that are most likely to fertilise and result in a healthy pregnancy.
• Follicle count: We count follicles that are between 2-6mm in the ovary. This is because if you have plenty of follicles of this measurement when you come in for your scan, this indicates a good ovarian reserve. We measure each of these in our Fertility Assessment and our Initial Scan and Consultation.

Fertility medications and hormones

• AMH: AMH is Anti-Mullerian Hormone. AMH is a hormone made directly by the ovarian follicle that contains the egg. AMH tells us your ovarian reserve – the number of eggs you have remaining. If you have a very low blood AMH level, it means you don’t have many available eggs. If you have very high AMH levels, this means you have lots of follicles in your ovaries, but this could mean you’re at higher risk of complications such as Ovarian Hyperstimulation Syndrome (OHSS).
• Clomid: Clomid (clomiphene) is an oral medication used to simulate or regulate the ovaries.
• Cyclogest: Cyclogest is a pessary that contains progesterone. You’ll use Cyclogest from the day of egg collection, as it helps your womb lining to prepare for embryo implantation and supports early pregnancy. You’ll continue to use it until the results of your treatment are known.
• FSH: FSH is Follicle Stimulating Hormone. FSH is produced by the pituitary gland and is one of the main hormones responsible for egg production. If your blood test shows a high reading of FSH, this can be an indicator that you have poor ovarian reserve. This is because your body is producing higher levels of FSH than normal in an effort to stimulate your ovaries.
• Gonadotrophins: Gonadotrophins are hormones that are given by injection to stimulate the ovaries to produce eggs ready for IVF. Gonadotrophins include Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH) or a combination of both.
• hCG: Human Chorionic Gonadotrophin is an injectable hormone that helps your eggs to go through the final stage of maturation so they are ready for collection. You’ll receive a hCG injection to ‘trigger’ the final stage just before your egg retrieval procedure.
• LH: LH means Luteinising Hormone. Together with Follicle Stimulating Hormone (FSH), it’s one of the necessary hormones needed for ovulation.

Fertility treatments, procedures treatment phrases and abbreviations

• AI: stands for Artificial Insemination. This is a treatment that involves directly inserting sperm into a woman's womb.

• Blastocyst: A blastocyst is an embryo that has been developed for longer after fertilisation, to day five of development instead of day three. A blastocyst has different cell types – inner mass cells which develop into the foetus, and Trophectoderm cells which become the placenta. If you’re having Pre-Implantation Genetic Screening as part of your IVF cycle, the biopsied cells are Trophectoderm cells.

• DI: is short for Donor Insemination, when donor sperm is inserted into the womb to fertilise the egg.
• Down regulation: ‘Down regulation’ is the term used when your natural ovarian function is ‘switched off’ during your treatment cycle through the use of fertility medications.
• Donor Bank: If you need donor sperm or eggs to have your baby, we can offer you treatment with our own dedicated, UK egg and sperm donor bank.
• Egg Freezing: Egg freezing is a method of fertility preservation, which allows women to freeze eggs for later use when they might like to start a family.
• Embryo Freezing: once the egg and the sperm have successfully fertilised, we can freeze the embryo created. We use a newly developed freezing method called vitrification to rapidly freeze the embryo to ensure the best preservation. This will then be inserted back into the womb later.
• ERA Test: The Endometrial Receptivity Array Test (ERA) is a genetic test and a new method of assessing when the endometrium (the membrane that lines the inside of your uterus) is receptive to the embryo, in order to give a personalised embryo transfer to help evaluate your endometrial receptivity from a molecular perspective.
• Frozen Embryo Transfer: Frozen Embryo Transfer (FET) is a procedure that allows you to use embryos created by a previous IVF cycle. When multiple good embryos are created during your IVF cycle, only one or two of them may be transferred back into your uterus.
• HyCosy: Hysterosalpingo-contrast-sonography (usually called HyCoSy), is a straightforward procedure which is used to look at the fallopian tubes and to check for abnormalities of the uterus and ovaries. This is where a dye is passed into the uterus, and the doctor tracks it using an ultrasound scan.
• Hysteroscopy: Hysteroscopy is a procedure where a very thin telescope camera is used to view the inside of your womb. It is used to investigate different conditions of the uterus such as polyps, fibroids, septum or scarring inside the uterine cavity.
• ICSI: stands for Intracytoplasmic Sperm Injection. This is where an individual sperm cell is inserted directly into the egg cell.
• Induction of Ovulation: involves stimulating your ovaries to produce an egg. This technique is used if you are failing to ovulate, but you have normal fallopian tubes and your partner’s sperm is normal.
• Implantation: after the successful fertilisation of the egg and the sperm, forming an embryo, the embryo is placed back into the womb.
• IUI: IUI involves directly inserting specially washed sperm into a woman’s womb at the most fertile point of her cycle. Doctors use hormone blood tests and monitoring scans to keep track of the cycle and pinpoint the time at which ovulation occurs.
• IVF: stands for In Vitro Fertilisation, it involves the fertilisation of an egg and a sperm outside of the body. ‘In vitro’ means ‘in glass’.
• LH surge: Luteinising Hormone is released naturally just before ovulation. Your ‘LH surge’ indicates when ovulation is about to happen, usually in the next 12 to 24 hours.
• Luteal phase: The luteal phase is the second half of your menstrual cycle. It begins straight after ovulation, and it lasts until you start your next period. The average luteal phase is around 14 days, and during this time your body prepares for the possibility of pregnancy. Progesterone is released to thicken the womb lining ready for a fertilised egg.
• Partner IVF: This is a way for partners in a same-sex relationship to both be part of the treatment cycle. Eggs are collected from one partner and fertilised with donor sperm, the resulting embryo is then implanted into the other partner. So one partner uses her eggs, the other carries and baby and gives birth.
• Modified Natural Cycle IVF: Modified Natural Cycle IVF is where a small dose of medication is given for 3-4 days in order to keep the follicles healthy and growing. This allows us to collect 1-2 eggs from a cycle.
• PGS: Preimplantation Genetic Screening (PGS) is a specialised method of embryo selection we can use for your IVF/ICSI treatment cycle. Through PGS, we can check that your embryos have the correct number of chromosomes to help increase your chances of a successful pregnancy.
• Semen Analysis/Male Fertility MOT: Our detailed semen analysis looks at the density, morphology and mobility of your sperm.
• Sperm Freezing: we perform Sperm Freezing through vitrification. The sample will be frozen by our embryologists using vitrification technology, an advanced fast-freezing. Once frozen, the sperm can be thawed at your disposal, with very high survival rates from thawing.
• Subcutaneous injections: Subcutaneous injections are medications that are injected just under the skin, compared to intramuscular injections that are injected directly into the muscle. Our fertility nursing team will give you practical injection teaching as part of your IVF cycle, so you confidently and safely administer the medications you need to at home.
• Surrogacy: There are different types of surrogacy (partial, genetic, or straight surrogacy) which involve natural or artificial insemination of a surrogate. If the intended father's sperm is used in the insemination, then the resulting child is genetically related to the intended father and genetically related to the surrogate.

Common Fertility Problems

• Azoospermia: this is when there is no sperm present in a man’s ejaculate. This can be due to blockage in the tubes that the sperm is transported through, a vasectomy, low or no sperm production in the testicle.
• Endometriosis: is a common condition in women where tissue that behaves like the lining of the womb (endometrium) is found in other places such as: the fallopian tubes, the ovaries, and in or around the bladder or bowel.
• Low Ovarian Reserve/Low AMH: This means that there are low numbers of developing cells in the ovaries. This indicates that your fertility status is lower, something that declines with age.
• Polycystic Ovarian Syndrome (PCOS): This is where the levels of the hormones estrogen and progesterone are out of balance. This leads to the growth of ovarian cysts. Manchester Fertility are highly experienced in treating patients with PCOS.
• Tubal Disease: a disease where women have blocked or damaged fallopian tubes.
• Thyroid Disease: Infertility can be caused by diseases of the thyroid, when it is under- or over-active. Women with a thyroid disease will be given tailor-made treatment under the care of our experienced doctors.

Our equipment

• Electronic Witnessing: Electronic Witnessing is our ‘track-and-trace’ system that ensures you use only the eggs, embryos and sperm belonging to you in your treatment cycle.
• EmbryoGlue: EmbryoGlue is a product we use at no extra cost to you, which can help your embryo to adhere to the uterus after transfer.
• EmbryoScope: Our EmbryoScopes are special incubators that produce a time-lapse video of the development of your embryos, helping us to identify which embryos have the highest potential for pregnancy.
• Ultrasound: An ultrasound is a method of scanning that uses high frequency sound waves to produce images of internal organs such as the womb and ovaries.
• Ultrasound 3D Advanced Doppler Scan: this is the advanced transvaginal scan that we use to assess your ovarian-reserve. This will check how healthy your uterus, ovaries and follicles are by examining the blood flow to each of them.
• Vitrification: Vitrification is the freezing method we use in our laboratory for eggs and embryos. It helps to prevent damage to the cells, resulting in high survival rates for frozen eggs and embryos.

What may be required for some tests

• Abstinence: This is the practice of refraining from sexual activity. This is required for some of our tests such as our Semen Analysis, to ensure that we receive the best sample.

Fertility treatment: Clearly and simply explained

At Manchester Fertility it’s our aim to make your path to parenthood as stress free as we can – and this includes avoiding confusion by making sure you clearly understand what your treatment involves and what’s going to happen. If you are ever unsure about any aspect of your journey, you can talk to our friendly New Patient Coordinators on 0161 300 2737.

To begin treatment with us, you don’t need a GP referral. Self-refer for fertility treatment here and we’ll be in touch to make you your first appointment.