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Fertility Testing

Glossary of Terms

Acanthosis Nigricans: a type of skin change characterized by darkened patches of skin that may have a thicker, velvety texture. The development of acanthosis nigricans in women with PCOS is likely related to insulin resistance and/or excess weight. 

Amenorrhea: absence of menses

Androgenic Alopecia: thinning of hair caused by excess androgen levels. also known as “male-pattern baldness.” Hair loss begins above both temples, thins at the crown and often progresses to partial baldness but rarely leads to complete baldness in women

Androgens: hormones that are produced by men and women (but usually in higher levels in men) and are responsible for masculine traits. In women, these are produced by the ovaries but can also involve the adrenal glands. High androgen levels can present as adult acne, thinning hair, excess hair growth on places like the chin, chest, back, abdomen requiring frequent shaving or plucking (this is called “hirsutism”), or high levels of testosterone on lab tests

Anovulatory Cycles: In an anovulatory menstrual cycle, a woman does not release an egg (ovum), resulting in an infertile cycle. The shedding of the uterine lining is called an anovulatory bleeding rather than menstruation

Body Mass Index (BMI): is a measure based on a person’s weight and height. A BMI of 18-24.9 is considered healthy weight, 25-29.9 is considered overweight, 30 or higher is considered obese, and over 40 is considered morbidly obese

Clomid: a medication used to cause ovulation; it is a “SERM” (selective estrogen receptor modulator); generic name is Clomiphene Citrate

Clomiphene Citrate: the generic name for Clomid (see Clomid)

Femara: a medication used to cause ovulation; it is an alpha reductase inhibitor meaning that it blocks conversion of androgens to estrogen; generic name is Letrozole 

Glucose: the body’s blood sugar, used by cells to produce energy

Glycemic Index: a system that assigns a value of 0-100 to represent how much a food causes your blood sugar to rise two hours after its consumption.  Foods that are high on the glycemic index break down more rapidly and foods with a glycemic index that are lower break down more gradually. This can affect insulin level spikes (a more abrupt spike in blood sugar requires more insulin), energy levels, and satiety

HDL-C: stands for high density lipoprotein cholesterol; this is known as the “good cholesterol;” numbers are ideally more than 55 mg/dL in women

Hirsutism: terminal hair growth women in places where men might typically have hair such as face, chin, sideburns, chest, back, middle abdomen, inner thighs

Hormone: a chemical messenger in the body that regulates vital functions

Hyperandrogenism: excess androgens

Hyperinsulinemia: elevated levels of insulin that result when pancreatic beta cells must produce higher levels of insulin to compensate for insulin resistance

Hypertension: medical term for high blood pressure; defined as a systolic blood pressure (top number) of greater than 140 mm Hg or diastolic blood pressure (bottom number) greater than 90 mm Hg on two separate occasions

Insulin: hormone that allows cells to process glucose for energy

Insulin Resistance: a condition where insulin in present, but the cells of the body are not absorbing glucose effectively to produce energy; this typically causes the body to produce extra insulin to compensate

LDL-C: stands for low density lipoprotein cholesterol; this is known as the “bad cholesterol;” numbers are ideally low or less than 130 mg/dL

Letrozole: the generic name for Femara (see Femara)

Metabolic syndrome: also known as “Syndrome X;” multiple clinical manifestations that usually indicate insulin resistance and abnormal fat deposition; presence of this syndrome increases coronary artery disease risk; may also increase risk for diabetes, fatty liver, several cancers. To be diagnosed, at least 3 of 5 conditions must be present: fasting glucose greater than or equal to 100 mg/dL (or receiving drug therapy for high blood sugars), blood pressure greater than or equal to 130/85 mm Hg (or receiving drug therapy for high blood pressure), Triglycerides greater than or equal to 150 mg/dL (or receiving drug therapy for high triglycerides), HDL-C (good cholesterol) less than 50 mg/dL in women (or receiving drug therapy for low HDL-C), waist circumference of greater than or equal to 35 inches in women (greater than or equal to 32 inches in Asian Americans)

Metformin: brand name Glucophage; prescribed oral medication that increases a patient’s sensitivity to insulin, decreases sugar production in the liver, decreases intestinal sugar absorption

Oligomenorrhea: Irregular menstrual cycle longer than 35 days or a history of ≤ nine menses per year

Oligo-ovulation: Infrequent release of egg from the ovary (infrequent ovulation). It is indicated by serum luteal phase progesterone <4 mg in patients with regular menses 

Ovarian Hyperstimulation Syndrome (OHSS): swelling of the ovaries and abnormal fluid shifts in the body; In severe forms can lead to kidney failure, blood clots, electrolyte abnormalities, etc. This risk is higher (approximately 10%) in women with PCOS using injectable medications to stimulate the ovaries to produce follicles

Ovulation: a release of an egg from the ovary where it is available for fertilization by sperm

Pre-Diabetes: a condition with evidence of insulin resistance that is worsening but is not yet at levels severe enough to be considered diabetes; 1/3 of patients with this condition will progress to diabetes.  It is diagnosed if Hemoglobin A1c (Hgb A1c) value is 5.7-6.4 or fasting glucose is 100-125. 

Triglycerides: fatty compounds found in the blood; levels greater than 150 mg/dL are considered elevated; can be elevated with high carbohydrate diets or excess alcohol consumption; can be indicative of insulin resistance if seen with two other manifestations of metabolic syndrome and cause increased risk of coronary artery disease.

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