Glossary of terms

Sometimes a semen analysis reveals that there are no sperm in the ejaculate; this is a condition called azoospermia. This absence is most often due to primary testicular failure, a lack of germ cells, blockage of the ducts or previous vasectomy.

A semen analysis can reveal asthenospermia, i.e. a condition where the sperm are not vital or motile enough to reach the egg and fertilise it. Asthenospermia is usually one of the reasons why a couple is unable to conceive a baby.

Assisted hatching consists of disrupting the hard shell of the embryo. This facilitates implantation (nesting) and thus increases the success of IVF. We recommend assisted hatching for women who have had repeated unsuccessful embryo implantation attempts, for older women, and for the transfer of frozen embryos (CET).

During a normal menstrual cycle, the egg matures and is released into the uterus, but this is not the case in anovulation - making it impossible for the woman to become pregnant. There are many causes of anovulation, but the most common ones include an unhealthy lifestyle, hormonal imbalance, malnutrition/excess weight, thyroid disorders, polycystic ovary syndrome, or advanced age. It is quite natural for women to not ovulate in about 25% of menstrual cycles.

One possible result of a genetic test is aneuploidy, which is a defect in the number of chromosomes occurring during conception. One possibility is trisomy, in which three copies of a chromosome are formed during conception. This means the individual has 47 chromosomes instead of 46. The risk of this occurring increases with the mother's age, whereas it most often affects chromosomes number 21 (Down syndrome), 13 (Patau syndrome) and 18 (Edwards syndrome).

Amniocentesis, or amniotic fluid sampling, is the most common invasive method used for prenatal diagnosis. Guided by ultrasound, about 20 ml of amniotic fluid is collected using a very fine needle at between the 16^th and 20^th week of pregnancy. Testing amniotic fluid can reveal certain serious congenital disorders (such as Down syndrome).

AMH (Anti-Müllerian Hormone) in the female body controls the process of egg maturation. The number of eggs a woman has left can be estimated based on the amount of AMH in the blood. The amount of AMH in the blood decreases with age. A simple blood test is used to determine the amount, and this can be done at the clinic.

We recommend the ALICE test for women who have had repeated unsuccessful embryo transfers. The ALICE test is used to detect chronic inflammation. To do this, a small sample of the endometrium (uterine lining) must be taken. This one sample can also be used to perform an EMMA and ERA test at the same time.

A blastocyst is the early embryonic stage of the human foetus, consisting of about 120 cells. In IVF, the embryo is transferred to the woman's uterus at this stage. The remaining blastocysts can be frozen for possible further attempts.

Biochemical pregnancy refers to a condition in which a woman has a positive urine or blood pregnancy test but miscarries before the pregnancy is confirmed by ultrasound. In this case, the miscarriage occurs within the first two weeks following embryo implantation. The usual cause of this miscarriage is a genetic defect in embryo development.

This is an error in the genetic code that is caused by the breaking off and reattaching of different chromosomes. A balanced translocation carrier is completely healthy, but his sex cells (eggs or sperm) contain defective chromosomes with missing or redundant genetic information. For this reason, there is a higher probability that this 'carrier' will have a child with some degree of disability or that the pregnancy will end in miscarriage. Genetic testing can determine whether a person has balanced translocation or not.

When a pregnancy is already clearly visible on the ultrasound, or the 'cardiac activity of the embryo' can be heard, then it is considered a clinical pregnancy. It can usually be detected from week 5-6 of pregnancy.

The drug Estrofem contains the female hormone oestrogen, which is used in assisted reproduction methods to support the growth of the endometrium.

Endometriosis is when tissue similar to the uterine lining (endometrium) in the uterine cavity appears in an abnormal location - most often in the genital organs outside the uterus, but also in the intestines, urinary system and lungs. This often very painful disease can cause women of childbearing age to have problems conceiving. It is treated hormonally or surgically, or with a combination of both methods. However, treatment is often unsuccessful.

The EmbryoScope allows continuous monitoring of embryo development 24 hours a day. This way, the best quality embryos can be selected for transfer and thus increase the success of IVF. The advantage is that the microscope is placed directly in the incubator, so it is not necessary to move the embryos for monitoring

EmbryoGlue facilitates the attachment of the embryo to the uterine wall and thus increases the success of IVF. EmbryoGlue is a tissue adhesive that mimics the environment in the womb during natural implantation of the embryo.

EmbryoGen is a culture medium that helps create an environment similar to the natural environment in a woman's body following in vitro fertilisation. As a result, the chances of attachment and successful growth of the embryo are increased following its transfer to the woman's uterus.

Embryo transfer is the transfer of an embryo into the uterine cavity. The transfer is painless and takes about 5 minutes; the procedure is performed without anaesthesia. A thin catheter is used to transfer the embryo and the whole process is guided by ultrasound.

Embryo implantation takes place on the 6^t to 7^th day after fertilisation. The goal is for the embryo to attach to the uterine lining. This process can be aided by additional methods such as assisted hatching or EmbryoGlue. After successful implantation, the hormone hCG starts being released into the blood, which allows confirmation of pregnancy.

Follicle-stimulating hormone (follitropin) is a hormone that stimulates the activity and development of the sexual organs and further regulates the proper function of the reproductive organs. Follitropin has the specific task of stimulating the growth and maturation of the follicles in which the eggs are stored. Its levels are therefore high until the fertile days, dropping after ovulation and remaining at very low levels until the next cycle.

This is an ultrasound examination in which a probe inserted into the vagina evaluates the condition of the follicles in the ovaries. It is not performed once, but repeatedly, in order to monitor the dynamics of follicle growth and predict the date of ovulation. It is recommended as one of the first basic examinations for women who are unable to conceive.

In follicular puncture, eggs are collected from the ovaries under general anaesthesia for subsequent fertilisation in the laboratory or freezing. This retrieval is performed with a thin needle under ultrasound guidance and takes no more than 15 minutes.

The Follicular phase is the first half of the menstrual cycle, respectively the phase before ovulation, during which a new egg or eggs are matured under the influence of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). In the first days of the follicular phase, the lining of the uterus is the thinnest, but it thickens as ovulation approaches. Towards the end of the phase, luteinizing hormone (LH) also becomes active, helping follicular maturation and subsequent ovulation.

A follicle is a pouch filled with fluid that contains an egg (oocyte). After the follicle ruptures, it releases a mature egg. Each ovary contains approximately 1.5 million follicles at birth, but only about 400 reach maturity.

Unlike men, women are only fertile a few days in a month - the probability of conception is highest during their fertile days, which are usually 3 days before and 1 day after ovulation.

Gonadotropins are hormones that are naturally produced by a part of the brain called the pituitary gland. This is an endocrine gland that stimulates the activity of the gonads by producing gonadotropins and influences the secretion of sex hormones. In reproductive medicine, these hormones are administered in the form of stimulating drugs that stimulate the ovaries to grow more follicles than one.

This is a potential complication of hormonal stimulation of the ovaries, in which the ovaries most often overreact to the administered drugs. Hyperstimulation syndrome is accompanied by pressure and pain in the lower abdomen, an enlarged abdomen, impaired urination or nausea and vomiting. These symptoms usually subside within two weeks but serious cases can also result in long-term hospitalisation of the patient. However, today's modern ovarian stimulation procedures allow doctors to minimise the occurrence of severe forms of hyperstimulation syndrome.

IUI (Intrauterine insemination) is the least invasive method of assisted reproduction. After preparing sperm in the laboratory, this is introduced into the uterus using a thin catheter.

ICSI (intracytoplasmic sperm injection) is a method of introducing sperm directly into an egg using a thin needle. It serves to increase the probability of egg fertilisation. We use this method to fertilise most eggs.

A karyotype test is a basic genetic laboratory test conducted to exclude chromosomal aberrations in the number or shape of chromosomes. Genetic testing of women or couples plays an important role in the management of diagnosis of fertility disorders. We most often recommend this test for women who have had repeated miscarriages, for women in later reproductive age, and for couples who have given birth to a genetically or otherwise affected foetus. It is also an important test before the preimplantation genetic testing (PGT) plan of embryos.

The luteal phase begins after ovulation, when the 'yellow body' (corpus luteum) is formed from the Graafian follicle. The cells of this body produce a large amount of progesterone, which acts on the lining of the uterus and supports the implantation and retention of the fertilised egg - embryo. If fertilisation does not occur, then the corpus luteum disintegrates and a rapid drop in progesterone and other hormones triggers menstrual bleeding.

MESA (Micro Epididymal Sperm Aspiration) is a surgical procedure that allows the retrieval of sperm in case of impaired transport of sperm between the epididymis and urethra. A microsurgical incision is made in the skin to insert a puncture needle and the fluid containing sperm is aspirated.

When a semen analysis shows normospermia, this means that all parameters of the ejaculate (sperm concentration, their overall motility or vitality, leukocytes) are within normal limits.

• Ejaculate volume greater than 1.5 ml
• The sperm count per ml of ejaculate is at least 15 million
• The ejaculate contains at least 40% motile sperm
• At least 4% of the sperm have a normal shape

An ovulation test is used to determine the days in a woman's cycle when she is most fertile and therefore has the highest chance of successful conception. These tests work similarly to pregnancy tests, and the most suitable time to perform them is around the 10th day of the cycle. You can buy them in any drugstore or pharmacy.

The drug Ovitrelle (in the form of a solution for injection) is used in women undergoing IVF and in women who are not ovulating (so-called anovulation), or who only ovulate in a small percentage of menstrual cycles (oligoovulation). In IVF, it helps mature the follicles; it is administered in patients who have problems with ovulation for the process of triggering the release of eggs (ovulation) - in both cases, however, it is used after women have taken other drugs for the development of follicles.

The oocyte is a female germ cell located inside the follicle. The moment the oocyte grows and is released from the follicle, a mature egg (ovum) is formed.

If the result of a semen analysis shows that the concentration of sperm in the ejaculate is lower than the lower limit of the established standard (15 million sperm per millilitre of semen), then this is oligospermia. The most common causes of low sperm production include hormonal problems, blocked ducts, infections, side effects of certain medications, and lifestyle factors - e.g. excessive alcohol consumption, smoking or frequent bathing in hot water or saunas.

A drug containing progesterone (a naturally occurring female sex hormone) that acts on the lining of the uterus during assisted reproduction - it enhances the probability of retention of a fertilised egg. This is why Progesterone is used before the introduction of the embryo in an IVF cycle and, if pregnancy occurs, throughout the first trimester.

In the luteal phase of the menstrual cycle, many women suffer from premenstrual syndrome, when the falling level of oestrogen and high levels of progesterone lead to certain physiological and psychological changes. About one week before menstruation, women may experience tender breasts, weight gain, headaches, muscle and joint pain and loss of appetite, or an increase in appetite. The most common mental symptoms of PMS are depression, anxiety, mood swings, poor sleep and nervousness.

PICSI (Intracytoplasmic Injection of Preselected Sperm) is a method that only allows mature sperm to be selected for egg fertilisation. Sperm are selected in a petri dish covered with a layer of hyaluronan, which can bind mature sperm. We have replaced the PICSI method with the more modern FERTILE PLUS method at our clinic.

PESA (Percutaneous Epididymal Sperm Aspiration) is a minor surgical procedure, that helps obtain sperm even if transport of sperm between the epididymis and urethra is impaired. Sperm are aspirated from the epididymal ducts using a thin puncture needle.

Semen analysis is a microscopic examination of sperm to determine the number, shape and motility of sperm. Sperm is retrieved directly at our clinic in a special discreet sampling room after several days of sexual abstinence. Semen analysis is a basic examination recommended for men who have been unsuccessful in conceiving naturally for more than one year.

When a couple is unable to conceive, teratospermia may be to blame - a condition in which the sperm cannot penetrate the egg due to its abnormal shape. A semen analysis can reveal this disorder.

A small oblong growth sometimes appears on the endometrium or cervix; in most cases it is painless and benign, but it can cause heavy menstruation, bleeding outside menstruation, and pain during intercourse or during a gynaecological examination. Undetected polyps can also complicate efforts to conceive, or cause repeated miscarriages. Histopathology is used to reliably rule out potential malignancy.

Vitrification is a modern, quick and safe method of freezing and storing eggs, sperm and embryos. During vitrification, ice crystals that could do damage do not form on cells.

After ovulation, the 'yellow body' (corpus luteum), which produces female sex hormones (mostly progesterone), remains temporarily on the ovary. If fertilisation does not occur, it slowly disintegrates, otherwise it persists and produces hormones that help maintain the pregnancy until the 12th week, when the placenta takes over this task.