Any fertility journey can be complex and emotional for individuals and couples. Understanding the key terms and concepts involved is crucial to navigating this terrain with confidence and clarity. In this blog, we will define and explore the essential terms you need to know before starting your fertility journey.
1. IVF (In Vitro Fertilization):
In Vitro Fertilization (IVF) is a fertility treatment in which eggs are retrieved from the ovaries and fertilized with sperm in a laboratory setting. The resulting embryos are then transferred into the uterus for implantation. IVF technology is advancing rapidly, and now involves various techniques such as ICSI (Intracytoplasmic Sperm Injection - defined below) and PGT (Preimplantation Genetic Testing - defined below). A recent NIH study reported an average success rate of 29.5% for the first IVF transfer. This took into account all age groups, demographics, and infertility causes/diagnoses.
2. ICSI (Intracytoplasmic Sperm Injection):
This technique involves the direct injection of a single sperm into the cytoplasm of an egg in order to achieve fertilization. ICSI has become a widely used technique in many IVF laboratories due to its high fertilization rate.
3. PGT (Preimplantation Genetic Testing):
This is a procedure used to analyze the genetic information of embryos produced through IVF before transferring them to the uterus. This testing aims to select embryos with the best chances of leading to a successful pregnancy and a healthy baby. PGT is performed after the eggs have been fertilized and the embryos have started to divide. A small number of cells are removed from each embryo for genetic analysis. There are two main types of PGT:
PGT-A (Preimplantation Genetic Testing for Aneuploidies) tests embryos for the correct number of chromosomes, aiming to improve implantation rates and reduce miscarriage rates by selecting embryos with the normal number of chromosomes.
PGT-M (Preimplantation Genetic Testing for Monogenic/Single Gene Disorders) tests for specific genetic disorders that are known to be present in one or both parents, allowing for the selection of embryos that do not carry the disorder (e.g. cystic fibrosis, BRCA, Huntington's disease, or sickle cell disease).
Benefits of PGT:
Reduces the risk of genetic conditions
Decreases miscarriage rates
Improves IVF success rates
Reduces the need for a decision regarding termination of a pregnancy
Saves time and emotional distress by increasing likelihood of pregnancy
It's important to note that while PGT offers many benefits, it also comes with limitations and ethical considerations, such as the potential for false positives/negatives, the costs involved, and the debate around "designer babies" and genetic modification. Couples considering PGT should consult with a fertility specialist and a genetic counselor to thoroughly understand the benefits, risks, and ethical implications.
4. ICI (Intracervical Insemination):
Intracervical Insemination (ICI) is a fertility procedure in which sperm is placed into the cervix using a syringe or catheter. This method is often used for artificial insemination and can be performed at home or in a clinical setting. This 2015 study estimated that 6 cycles of ICI resulted in a 37.9% success rate, which equates to about a 6% chance of live birth per ICI cycle. This number can vary based on demographics of the patient, medications used in the cycle, and underlying fertility diagnoses.
5. IUI (Intrauterine Insemination):
Intrauterine Insemination (IUI) involves placing washed and concentrated sperm directly into the uterus around the time of ovulation. This procedure is more successful than ICI (RATE OF SUCESS) as it helps increase the chances of sperm reaching and fertilizing the egg. This 2015 study estimated that 6 cycles of IUI resulted in a 40.5% success rate, which equates to about a 7% chance of live birth per IUI cycle. This number can vary based on demographics of the patient, medications used in the cycle, and underlying fertility diagnoses.
6. Fertility Doctor:
A fertility doctor, also known as a reproductive endocrinologist, is a specialized physician who diagnoses and treats reproductive issues. These experts provide a range of fertility treatments and assist individuals and couples in achieving their family-building goals.
7. OBGYN (Obstetrician-Gynecologist):
An Obstetrician-Gynecologist (OBGYN) is a medical professional specializing in reproductive health, pregnancy, and childbirth. OBGYNs play a crucial role in assessing and managing fertility concerns and may refer patients to fertility specialists for further evaluation and treatment.
8. Carrier Gene Panel:
A carrier gene panel is a genetic test that assesses an individual's carrier status for specific genetic conditions. This test helps identify carriers of genetic disorders who may pass on the condition to their offspring. Understanding your carrier status is crucial for family planning and making informed decisions about fertility treatments.
9. Quarantine Period:
A quarantine period is the time during which the donated gamete samples are stored and quarantined to ensure they are safe and free from infectious diseases. This serves as an additional measure of protection against transmission of certain sexually transmitted diseases such as Human immunodeficiency virus (HIV) or Hepatitis B virus. Based on the following CDC data, an HIV infection is first detectable on blood testing 10-33 days post-exposure. For this reason, some clinics will require a 35 day quarantine, after which HIV testing will be repeated.
10. Semen Analysis:
A semen analysis is a diagnostic test that evaluates the quality and quantity of sperm in semen. This test provides valuable information about male fertility potential, helps determine if someone qualifies to be a donor, and helps guide treatment decisions.
11. FDA Testing:
FDA testing refers to the regulatory requirements set by the U.S. Food and Drug Administration (FDA) for screening and testing donor sperm and eggs. These guidelines ensure the safety and quality of donor gametes used in assisted reproductive technologies.
12. Known Donor:
A known donor is a person who donates sperm, eggs, or embryos to help individuals or couples conceive a child. Known donors may be friends, family members, or acquaintances, and their involvement in the fertility process is transparent and agreed upon by all parties. The identity of a known donor is known by the intended parents at the time of donation.
13. Open ID Donor and Anonymous Donor:
An Open ID donor is a sperm or egg donor who agrees to have their identity disclosed to any resulting offspring once they reach a certain age. There is no guarantee that the donor's contact information will be the same nor that they will respond. In contrast, an Anonymous donor chooses to remain unidentified, maintaining confidentiality regarding their identity throughout the donor-conceived individual's life.
14. Reciprocal IVF:
In reciprocal IVF, one partner undergoes ovarian stimulation and egg retrieval. The eggs are then fertilized with donor sperm to create embryos, one of which can then be transferred to the second partner’s uterus. In this way, one partner contributes the genetic material and the second partner contributes the maternal environment, allowing both partners to have a profound impact on the development of the fetus and child.
Navigating the world of fertility treatments and assisted reproductive technologies can be overwhelming, but having a good grasp of these essential terms can empower you to make informed decisions and communicate effectively with your healthcare providers. Whether you are considering IVF, exploring donor options, or seeking guidance from fertility specialists, understanding these terms is a crucial first step in your fertility journey.
As you embark on this transformative path, remember that each individual's fertility experience is unique, and seeking support from healthcare professionals, counselors, and support groups can provide invaluable guidance and emotional assistance along the way. By arming yourself with knowledge, you can feel empowered to move forward in your fertility journey.