ACTH- A pituitary hormone that stimulates the adrenal glands. High levels can lead to fertility problems.
ADHESION- Scar tissue that attaches to the surfaces of organs, the abdominal cavity, fallopian tubes, or inside the uterus. Adhesions may prevent egg pick up, transport of the egg, and implantation of the embryo in the uterus.
AMENORRHEA- The cessation of the menstrual period for six months or more at a time. Primary Amenorrhea: when a woman has never menstruated; Secondary Amenorrhea: When a woman has menstruated at one time, but she has not had a period for six months or more.
ANDROGENS- Male sex hormones produced by the adrenal gland. Excess androgens in the woman may lead to increased hair growth, acne and a deepened voice. Elevated levels of androgens may be found with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland or ovary.
ANDROLOGIST- An MD/Ph.D. who specializes in the study of male reproduction.
ANOVULATION- Total absence of ovulation. Menses may still occur although there is a failure to ovulate-a failure of an ovary to release an egg.
ANTAGON- A GnRH antagonist drug used to inhibit premature LH surges.
ANTIBODIES- Proteins made by the body to attack or fight foreign substances. Antibodies normally prevent infection; however they can be made against sperm, sometimes causing fertility problems. Either the male or female partner may produce sperm antibodies.
ANTISPERM ANTIBODIES- Antisperm antibodies attach themselves to the sperm and can inhibit movement. In men, these antibodies may be a response to injury or surgery to the testes when the blood-sperm barrier is broken. Antisperm antibodies may affect the ability to fertilize an egg.
ARTIFICIAL INSEMINATION- Placing sperm into the cervix of the uterus (intracervical insemination-ICI) or directly into the uterine cavity (intrauterine insemination- IUI). The sperm is usually washed then injected through a catheter. This procedure is used for both donor (Therapeutic Donor Insemination-TDI) and male partner's sperm. This technique is used for sexual dysfunction, sperm-mucus interaction, problems, for poor semen, and for donor sperm. Intrauterine insemination is more effective than intracervical insemination in helping couples become pregnant.
ASHERMAN'S SYNDROME- The uterine walls are scarred to one another-usually a result of uterine inflammation, pelvic inflammatory disease (PID), or past surgery of the uterus. Past surgery may include a D&C, cesarean section, removal of fibroid tumors.
ASSISTED HATCHING- A procedure in which a small hole is made in the outer shell around the embryo (zona pellucida) before embryo transfer to aid in implantation of the embryo and pregnancy. It may be considered for women who are age 38 and older, women who have a history of abnormally thick zona pellucida, and for couples who have not become pregnant with past IVF cycles.
ASSISTED REPRODUCTIVE TECHNOLOGY (ART)- A procedure that involves the surgical removal of eggs from the ovary to assist in fertilization of the egg and sperm. In Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), assisted hatching, microscopic epididymal sperm aspiration (MESA), testicular sperm aspiration (TESA) are the most common ART procedures.
ASTHENOZOOSPERMIA- Low sperm motility defined as less than 50% of sperm are moving in a semen sample. This condition is considered to be a major cause of infertility if motility is 40% or less.
AZOOSPERMIA- The absence of sperm in the seminal fluid. This may be due to a blockage or an impairment of sperm production.
BASAL BODY TEMPERATURE- The body temperature of a person recorded immediately upon awakening, before any activity is undertaken. The temperature can be taken orally or rectally. The temperature is recorded daily on a graph, which can show some evidence of ovulation.
BETA hCG TEST- (BhCG)- Blood test to detect pregnancy and to evaluate embryonic development.
BICORNUATE UTERUS- A congenital (present at birth) malformation of the uterus where the upper part of the uterus is divided into two parts. The outer appearance of the uterus is heart shaped. This is not a clear cause of infertility. In contrast, a septate uterus is a uterus divided into right and left halves by a wall of tissue (septum). Women with a septate uterus have an increased chance of early pregnancy loss. The outer surface shape of the uterus is round and normal in appearance.
BLASTOCYST- An embryo in its 5th to 6th days of development.
BLASTOMERE- A single cell in an embryo, which can divide at its own rate.
BLIGHTED OVUM (Egg)- A general term used to mean a fertilized egg that fails to survive after implantation in the uterus. Pelvic ultrasound may show an empty gestational sac in the uterus. This means the embryo died earlier and is no longer present. However, the placenta and sac are still present in the uterus. You may still feel pregnant during this time. You may have no symptoms of pregnancy loss either.
BROMOCRIPTINE (Parlodel)- An oral medication used to reduce prolactin hormone levels. It can reduce the size of prolactin secreting pituitary tumor. This medication may cause dizziness and upset stomach. It may also be effective when the tablet is placed in the vagina.
CANCELED CYCLE- An ART cycle in which ovarian stimulation was carried out but was stopped before eggs were retrieved. Cycles are canceled for many reasons: there may be too few or too many eggs developing; the uterine lining may not be optimal for embryo replacement; the patient may become ill; or the patient may stop treatment.
CANDIDIASIS (Yeast Infection)- A vaginal infection that may cause burning or itching.
CBC (Complete Blood Count)- A routine preoperative blood test that gives information regarding infection and anemia.
CERVICAL MUCUS- Secretions produced by the cervix which vary in viscosity according to the phase of the menstrual cycle; it becomes penetrable by sperm in the days preceding ovulation. The mucous fills the opening of the cervix; most of the time, it is a thick plug preventing sperm and bacteria from entering the uterus. At mid-cycle, estrogen causes the mucus to become thin, watery and stretchy-allowing sperm to enter uterus.
CERVIX- The lower section of the uterus which protrudes into the vagina and dilates during labor to allow the passage of the infant.
CERVICAL STENOSIS- A blockage of the cervical canal. This is usually from complications of cervical surgery and rarely from congenital defects.
CETROTIDE (CETRORELIX)- A GnRH antagonist drug used to inhibit premature LH surges.
CHEMICAL PREGNANCY- A positive hCG level in the blood that fails to continue to rise and does not lead to a clinical pregnancy.
CHLAMYDIA- This is a microorganism that may be transmitted by sexual contact. This microorganism could exist in the reproductive tract without symptoms and cause infertility. If present, both partners must be treated. The test for chlamydia involves obtaining a sample of vaginal fluid and culturing this in the laboratory under conditions suited to the chlamydia bacterium. Chlamydia causes infertility by damaging the fallopian tubes. This damage can be in the form of scar (adhesions) with partial or complete blockage of the fallopian tubes. It can also cause infertility create scarring inside the pelvis, around both of the tubes, ovaries and intestines. Chlamydia can lead to scarring in men reproductive tract leading to infertility.
CHOCOLATE CYST- An endometrioma. A cyst that is filled with old blood and contains endometriosis lining in its inner surface. Endometriosis invades an ovary and causes the cyst. Usually treatment can be carried out during laparoscopic surgery.
CHROMOSOME- A thread-like strand of DNA and protein in the nucleus of the cell that carries genetic information. The human has forty-six chromosomes-twenty-three coming from the egg and twenty-three coming from the sperm. Two X-chromosomes are present in a female and an X and a Y are present in a male.
CHROMOTUBATION- During surgery, the injection of a colored dye into the cervix and observation of the tubes in order to evaluate the status of the fallopian tubes. If dye is not observed to flow through a tube, then the tube may be considered blocked.A blocked tube may prevent an egg from being fertilized.
CILIA- Tiny hairlike projections on the cells lining the interior of the fallopian tubes. The cilia move the egg inward and the sperm outward to the isthmic-ampullary junction of the tube where fertilization occurs. Later, the cilia move the embryo to the uterus for implantation. The cilia can be damaged by infections. Damage to the cilia can lead to infertility.
CLINICAL PREGNANCY- Increased hCG secretion and pelvic ultrasound evidence showing an intrauterine gestational sac, fetus and fetal heart motion (cardiac activity). This does not exclude an ectopic pregnancy.
CLOMIPHENE CITRATE- A fertility drug taken orally that stimulates ovulation through the release of gonadotropins from the pituitary gland.
COMPACTION- A stage of early embryo development between the eight-cell and the blastocyst stage. Around Day 4 of in vitro culture, when the embryo consists of approximately eight cells, the cells merge together. At this stage the embryo is referred to as a morula.
CONE BIOPSY- Surgical removal of pre-cancerous cells from the cervix by cutting a cone-shaped piece out. This procedure may damage the cervix and disrupt mucus production or cause an incompetent cervix. An alternative procedure is the LEEP. Under microscopic control, an electrified loop is used to remove a more controlled amount of cervix, which decreases the risk of damage to the cervix. Women who have had these procedures performed may be at risk for cervical stenosis or incompetent cervix.
CONGENITAL- A characteristic or defect present at birth, acquired during pregnancy, but not necessarily hereditary.
CONGENITAL ADRENAL HYPERPLASIA- An inborn condition characterized by elevated androgens. The androgens suppress the pituitary gland and interfere with spermatogenesis or ovulation. Females may have ambiguous or male-like genitalia from the excess androgen. Women may also experience excessive hair growth in areas of their bodies typical of men such as the face, back, chest and abdomen. Some women may also have virilizing signs such as deepening of their voice, increased muscle mass and enlargement of the clitoris. Women may also have infertility due to this condition. This condition is genetic in origin and can be passed on to a child. It is treatable.
CONTROLLED OVARIAN HYPERSTIMULATION (COH)- A monitored stimulation of the ovaries to produce multiple follicles by using fertility drugs, blood tests and ultrasounds (sonograms).
CORPUS LUTEUM- After the follicle ruptures, the cells that originally surrounded the egg undergo changes and form a structure called the corpus luteum. The corpus luteum may exist as a cystic structure of varying sizes and primarily secretes the hormone, progesterone, which causes the endometrium to change and become secretory.
CRYOPRESERVATION- Excess embryos from one IVF cycle are frozen in liquid nitrogen and preserved for future transfer. A transfer using thawed cryopreserved eggs is called a frozen embryo transfer (FET). Cryopreservation allows for additional attempts at pregnancy without going through the entire IVF treatment process.
CRYPTORCHIDISM- Undescended testis; the man's scrotum does not contain a testicle. This can exist on one or both sides.
CUMULUS OOPHORUS- A protective layer of cells surrounding the egg.
CUSHING'S SYNDROME- Overproduction of adrenal gland hormones such as cortisol. The person usually has a very round face and may have a hump on the back at the base of the neck. One may suffer from hypertension and water retention. Elevation of adrenal gland androgens will suppress pituitary output of LH and FSH and decrease sperm production or cause a woman to be unable to ovulate. The excess androgen hormones in a woman may cause male secondary sex characteristics to develop, including abnormal hair growth. Cushing's Syndrome describes a disease where the primary problem is within the adrenal gland that is out of control. Cushing's Disease has the same symptoms, but those symptoms are the result of a primary problem in the brain such as a pituitary gland tumor or rarely gland tumors in the chest These tumors release hormones that turn on the otherwise normal adrenal gland to release an excessive amount of its hormones.
CYCLE- Refers to the period of time when infertility treatment is initiated and continues until treatment is discontinued or completed.
CYTOPLASM- The contents (protoplasm) of a cell outside of the nucleus.
CYTOPLASMIC TRANSFER- An experimental procedure whereby the cytoplasm of an older woman's egg is replaced with the cytoplasm of a younger woman's egg during the IVF process.
D & C (dilatation & curettage)- A minor surgical procedure in which the doctor dilates or opens the cervix and then inserts a thin, spoon-shaped instrument and uses it to remove material from the internal lining of the uterus. Dilatation refers to the opening of the cervix and curettage means the scraping of the uterine wall.
DIETHYLSTILBESTROL (DES)- This synthetic estrogen was prescribed in the 1950s and 1960s to women to prevent miscarriage. Some babies exposed to DES in utero after the eighth week of pregnancy have developed deformities, including blockage of the vas deferens, uterine abnormalities, cervical deformities, miscarriages, and unexplained infertility. DES is no longer prescribed; however, people who were exposed to it in while a fetus in their mother's womb are currently experiencing a variety of infertility issues.
DIHYDROEPIANDROSTERONE SULFATE (DHEAS)- An androgen-like hormone produced primarily by the adrenal gland in both sexes. If it is abnormally high, it can tell us the adrenal gland is overactive, producing too much androgen hormones that can cause hirsutism (excessive hair growth) and block ovulation (anovulation). Elevated levels are seen in patients with Stein-Leventhal or Polycystic Ovary syndrome (PCOS). Test results showing elevated levels can lead to diagnosis and effective treatments for these conditions.
DONOR EGG CYCLE OR EGG DONATION- An embryo is formed from the egg of one woman (the donor) and then transferred to another woman who cannot use her own eggs (the recipient). The donor relinquishes all parental rights to any resulting offspring.
DONOR INSEMINATION- This is a procedure that is performed when sperm is unavailable or if a genetic abnormality of the male is present. We work with sperm banks across the country to provide a variety of donors. Donor profiles are available for patients interested in this service. Once the donor is selected, the specimen is ordered in advanced and stored within our facility so that it will be available at the time of ovulation. Donor sperm is usually administered by intrauterine insemination but can also be used with Assisted Reproductive Technologies.
DOPAMINE AGONISTS- The presence of pituitary tumors, medications, or other medical conditions can lead to excess production of the hormone prolactin by the pituitary. This can lead to abnormal breast discharge and irregular or absent menses. The chemical dopamine normally maintains normal prolactin levels. When excess prolactin is being secreted, medications can be used to return prolactin levels to normal. Since these chemicals act like the chemical dopamine, they are called dopamine agonists. Different medications are available and have different treatment schedules. The medications are usually used orally, but can be used vaginally if the patient is unable to tolerate the side effects from oral administration.
DOSTINEX (CABERGOLINE)- An oral medication used to reduce prolactin hormone levels. It can reduce the size of prolactin secreting pituitary tumor. It is a pill taken twice a week, which is less frequent and with fewer side effects than bromocriptine.
DOWN REGULATION- A treatment cycle in which Lupron is used to suppress a woman's internal hormone secretion before injection of fertility medications containing Follicle Stimulating Hormone (FSH) to stimulate follicle and egg development.
DOXYCYCLINE- An antibiotic in the tetracycline family, which may be prescribed prophylactically (as a preventive measure against possible infection) in association with IVF egg retrieval surgery. A broad-spectrum antibiotic that inhibits many of the bacteria of the reproductive tract. It can also be used to treat ureaplasma or mycoplasma infections.
DYSMENNORHEA- Painful menstruation; may be a sign of endometriosis.
ECTOPIC PREGNANCY- An embryo implanted and developing outside the uterus, usually in a fallopian tube, on an ovary or in the abdominal area. Tubal pregnancies usually result from tubal damage, but in turn, they cause tubal damage sometimes leading to the loss of the tube. Early evaluation measuring hormone levels and ultrasound can lead to early diagnosis, which allows for early intervention. Early detection may allow for more conservative treatments with medication called methotrexate or by laparoscopy with less risk for loss of the affected fallopian tube.
EGG (oocyte, ovum)- A female reproductive cell.
EGG RETRIEVAL- Aspiration of eggs from ovarian follicles. This may be done by ultrasound guided aspiration in order to locate the follicles in the ovaries. The needle can be guided into each follicle and remove its contents. The eggs are then transferred to a sterile container to await insemination. Anesthesia is used in order to provide the greatest level of comfort for the woman.
EJACULATION- The expulsion of seminal fluid from the urethra of the penis during orgasm.
EMBRYO- A fertilized egg that has begun cell division.
EMBRYO CRYOPRESERVATION- The freezing of embryos created from one cycle, which may be stored and successfully thawed for use in another cycle.
EMBRYO DONATION- Embryos produced from a donating couples' oocytes and sperm.
EMBRYOLOGIST- A trained scientist specializing in maintaining a laboratory environment and caring for the sperm, egg and embryo through early development. They are highly trained to perform assisted reproductive technologies including ICSI, assisted hatching, embryo assessment, embryo and sperm cryopreservation and thawing.
EMBRYO TRANSFER- Placement of embryos into a woman's uterus through the cervix after in vitro fertilization.
ENDOCRINE GLAND- Any of the ductless glands, such as the thyroid, pancreas, ovary, testicle, pituitary and adrenal gland, the secretions of which pass directly into the blood stream from the cells of the gland.
ENDOCRINOLOGY- The study of the body's hormone-secreting glands.
ENDOMETRIAL BIOPSY- This is a procedure utilized to obtain a specimen of tissue from the lining of the uterus so that it can be evaluated by pathology to determine if any abnormalities are present. A speculum is placed, the cervix is cleansed with an antiseptic solution, and a small plastic catheter is passed through the cervix into the uterine cavity. Suction is applied to the catheter and tissue is removed. The procedure usually causes cramping so pretreatment with a medication such as Motrin approximately one hour prior to the procedure is recommended. There are no restrictions on activities for the remainder of the day.
ENDOMETRIOMA- A collection of endometriosis localized in one area-usually seen in the ovary.
ENDOMETRIOSIS- The presence of endometrial tissue (the normal uterine lining) in abnormal locations, such as the fallopian tubes, ovaries, intestines and peritoneal cavity. Each month, most women have some menstrual flow go out through the tubes and into the abdomen. Some women will then have that endometrium implant and grow. These endometrial implants continue to grow, sometimes causing adhesions in the abdominal cavity encasing the ovaries and/or the fallopian tubes like shrinkwrap. Endometriosis may interfere with ovulation, egg pick-up, fertilization and implantation of the embryo. It has also been related to poor egg quality. Endometriosis can also cause pain and bleeding, which may become so severe as to require medical or surgical treatment.
ENDOMETRIUM- The lining of the uterus which grows and sheds in response to estrogen and progesterone stimulation. This is the tissue in which implantation of an embryo occurs.
ENDORPHINS- Natural painkilling chemicals manufactured in the brain to reduce sensitivity to pain and stress. May be associated with PMS.
EPIDIDYMIS- A coiled, tubular organ attached to and lying on the testicle within the scrotum. Sperm complete their maturation and develop their powerful swimming capabilities within the epididymis. The matured sperm exit the epididymis through the vas deferens.
ESTRADIOL LEVEL (E2 Level)- The most potent form of estrogen. It is measured to determine follicular maturation prior to ovulation. The main estrogen produced by the ovary, which is responsible for formation and development of breasts. It is produced by the growing follicle and induces the development of the uterine lining. At mid-cycle, a rapid rise in estrogen levels triggers the release of the LH surge from the pituitary gland. The LH surge triggers the release of the ovum (egg) from the follicle. Women on fertility medications have routine E2 level monitoring.
ESTROGEN- A class of female hormones responsible for the development of secondary sexual characteristics. Estrogen is produced mainly by the ovaries from the onset of puberty until menopause.
FALLOPIAN TUBE- Either of a pair of tubes that conduct eggs from the ovary to the uterus. Normal fertilization takes place within this structure. The tube is attached to the uterus through which eggs travel after the tube's trumpet-shaped end (fimbriated end) catches the egg as it is released from the follicle. Sperm meet the egg in the fallopian tube where it narrows down (isthmic-ampullary junction), the site at which fertilization usually occurs. The fallopian tube then moves the fertilized egg-embryo through the tube into the uterine cavity over a 4-day period of time.
FEMALE KALLMAN'S SYNDROME- Infantile sexual development, very low FSH and LH levels and an inability to smell. Since the pituitary produces inadequate LH and FSH to turn on her otherwise normal reproductive organs, the woman is treated with hormone supplementation in order to develop and maintain normal breasts, have menstrual cycles and later, with gonadotropins (FSH) or GnRH, to achieve fertility.
FERNING- A fern-shaped pattern of dried cervical mucus viewed on a slide. When the fern pattern appears, the mucus is usually thin and stretchy for estrogen's effect. This creates tubular fluid filled passages in the mucus enhancing the passage of sperm. Mucus, which does not fern, suggests the woman is not at a fertile time of her menstrual cycle. It may also suggest she is not going to ovulate.
FERTILIZATION- Union of egg and sperm, which forms a zygote. Once the sperm and egg fuse and the first cell division has occurred the zygote has become an embryo. This occurs within the fallopian tube (in vivo) naturally, but may also occur in a petri dish (in vitro) during assisted reproductive technology (ART) procedures.
FERTINEX- Highly purified Follicle Stimulating Hormone (FSH) manufactured from the urine of postmenopausal women. It is a fertility drug administered as a subcutaneous injection.
FETAL REDUCTION- A medical procedure to decrease the number of fetuses in a multiple gestation.
FETUS- Unborn offspring from the eighth week after conception to birth.
FIBROID- A non-cancerous (benign) tumor of the uterine muscle and connective tissue usually located in the uterus. Also known as a myoma or leiomyoma. Fibroids can interfere with the implantation or growth of a fetus. Fibroids can increase in size during pregnancy and in certain instances result in miscarriage. This condition can usually be corrected with surgery. Not all women who have fibroids require surgery.
FIMBRIA- Finger-like projections that fan out at the end of the fallopian tube like a trumpet nearest the ovary. During ovulation, prostaglandins are released that cause contraction of portions of the fimbria, which connect to the ovary called the fimbria ovariaca, drawing the finger-like end of the tube toward the ovary and catching the egg when it is extruded and drawing it into the tube.
FIMBRIOPLASTY- Surgical repair of the fimbriated end of the fallopian tube. This is performed by means of a surgical procedure called laparoscopy.
FLARE PROTOCOL- This stimulation of the ovary takes advantage of the initial rise or flare of gonadotropins (LH & FSH) in response to Lupron administration starting on the second day of the menstrual cycle. Giving FSH 1 day after the start of Lupron for continued follicular development then augments this flare response. This fertility treatment protocol is usually prescribed for women with poor reserve of their ovaries. These women have not had a good ovary response to more conventional medication protocols in previous treatment cycles.
FOLLICLE- Fluid-filled cyst on the ovary which contains the ripening egg and from which the egg is released at ovulation or retrieved during the treatment cycle. The dominant follicle is approximately 1 inch in diameter when it is ready to ovulate.
FOLLICLE STIMULATING HORMONE (FSH)- A hormone produced in the pituitary gland that stimulates the ovary to develop a follicle for ovulation and also stimulates sperm production in the testicle. The FSH level is tested on one of the first 3 days of a woman's cycle in order to evaluate her fertility.
FOLLICULAR FLUID- The fluid inside the follicle.
FOLLICULAR PHASE- The portion of the woman's cycle prior to ovulation during which a follicle grows. Estrogen that is produced by the follicle causes the lining of the uterus to grow thicker.
FOLLISTIM- Follicle-stimulating hormone medication produced through recombinant DNA technology, which functions in the role of naturally-occurring FSH to stimulate the growth of follicles and the maturation of eggs.
FRAGMENTATION OF EMBRYOS- Sometimes when a cell divides in the pre-implantation embryo, the split is not clean and small pieces of cell are lost. Fragmented embryos are less likely to implant than those without fragmentation. The least fragmented embryos are selected for transfer.
FROZEN EMBRYO CYCLE- An ART cycle in which frozen (cryopreserved) embryos are thawed and transferred to the woman.
GAMETE- A reproductive cell (either a sperm or an egg).
GALACTORRHEA- A clear or milky discharge from the breasts, which may be associated with elevated prolactin.
GAMETE INTRAFALLOPIAN TUBE TRANSFER (GIFT)- A procedure similar to IVF except that the sperm and eggs are placed inside a catheter and then transferred inside a woman's fallopian tube, where fertilization takes place naturally (in vivo). This can be done only in women with at least one normal tube. Fertilization is not known to have occurred unless the woman becomes pregnant. General anesthesia and laparoscopy are required to perform this procedure and success rates are similar to IVF.
GENE- A unit of DNA found in a chromosome.
GENITOURINARY- Pertaining to the reproductive organs (genito-) and urinary tract.
GERM CELL (STEM CELL)- The cell in the testicle that divides to produce the immature sperm cells. In a woman, it is the egg (ovum). The male germ cell reproduces throughout the man's reproductive life. Women stop growing new eggs halfway through their development as a fetus in their mother's womb. These are the most eggs they will have in their lifetime. Eggs are present from birth. Eggs are used up at the rate of one thousand per menstrual cycle. In most women, only one egg matures per cycle.
GERM CELL APLASIA (Sertoli Cell Only)- A condition in which germ cells are absent from the testicles. With this condition, there are Leydig cells and hormones, so the man has secondary sex characteristics. May be inherited or caused by large and/or prolonged exposure to toxins or radiation.
GESTATION- The period of fetal development in the uterus from conception to birth, usually considered to be 40 weeks in humans.
GESTATIONAL CARRIER- A woman who carries a pregnancy for the genetic parents.
GESTATIONAL SAC- A fluid-filled structure that develops within the uterus early in pregnancy. In a normal pregnancy, a gestational sac contains a developing fetus.
GONAD- The gland that makes reproductive cells and sex hormones (testicles and ovaries).
GONADOTROPIN RELEASING HORMONE AGONISTS AND ANTAGONISTS- Minor alterations in the chemical structure of GnRH are used to create GnRH agonists or GnRH antagonists. A GnRH agonist acts like GnRH at the level of the pituitary, but because the analog stimulates the pituitary on a continuous basis rather than with pulses of GnRH as in the normal situation, the pituitary essentially becomes exhausted and will stop secreting FSH and LH after 7-10 days. GnRH agonists are commonly used to shut down the production of FSH and LH by the pituitary in the treatment of conditions such as endometriosis and fibroids as well as part of the superovulation protocols that are used with Assisted Reproductive Technologies. Because GnRH analogs initially cause an increase in FSH and LH, they have been used at midcycle instead of hCG to cause the LH surge. GnRH antagonists differ from analogs in that they block the effect of GnRH upon the pituitary. This leads to an immediate drop in levels of FSH and LH.
GONADOTROPINS- Gonadotropins are the hormones FSH and LH that are normally produced by the pituitary to stimulate the ovary. This group of medications can consist of both FSH and LH or FSH or LH alone. They can be administered by subcutaneous or intramuscular injection. Because their use causes a marked increase in ovarian stimulation, there is a higher risk of multiple gestation. Careful monitoring with ultrasound and hormone tests are required to prevent overstimulation of the ovary leading to the hyperstimulation syndrome.
GONAL-F- Follicle-stimulating hormone medication produced through recombinant DNA technology, which functions in the role of naturally-occurring FSH to stimulate the growth of follicles and the maturation of eggs.
GONORRHEA- This is a microorganism that may be transmitted by sexual contact. This microorganism could exist in the reproductive tract without symptoms and cause infertility. If present, both partners must be treated. The test for gonorrhea involves obtaining a sample of vaginal fluid and culturing this in the laboratory under conditions suited to the chlamydia bacterium. Gonorrhea causes infertility by damaging the fallopian tubes. This damage can be in the form of scar (adhesions) with partial or complete blockage of the fallopian tubes. It can also cause infertility create scarring inside the pelvis, around both of the tubes, ovaries and intestines. Gonorrhea can lead to scarring in men reproductive tract leading to infertility.
HIRSUTISM- Women experience excessive hair growth in areas of their bodies typical of men such as the face, back, chest and abdomen. This condition is seen in women with excess androgens or familial hypersensitivity to androgens.
HIV (HUMAN IMMUNODEFICIENCY VIRUS)- Test done on the blood of both the male and female partner to screen for previous exposure to the AIDS virus. A positive test does not necessarily mean that the individual has been exposed to the AIDS virus or that he/she will get AIDS. A positive test may mean that the antibody to the virus is present in the blood.
HMG (HUMAN MENOPAUSAL GONADOTROPIN)- A natural product containing both human FSH and LH. Distributed under the brand names Humegon, Repronex or Pergonal, the hormones are extracted from the urine of post-menopausal women. The drug is used to treat both male and female infertility and to stimulate the development of multiple oocytes.
HORMONAL ASSAY- Also known as hormone tests. These include: FSH (follicle stimulating hormone), LH (luteinizing hormone), DHEA-S (dehydroepiandresterone), prolactin and progesterone. A hormone is a chemical substance that is produced in the body by an organ or cells of an organ which has a specific regulatory effect on the activity of another organ.
HORMONE- A substance produced by an endocrine gland that travels through the bloodstream to a different organ, where it has a specific effect.
HOST UTERUS- A woman who carries a fetus that is not genetically hers in her uterus for another woman. The egg and sperm from a couple are fertilized in vitro and the resultant embryo is placed in the host uterus by embryo transfer. The baby is returned to the genetic parents immediately after birth. Also known as gestational carrier.
HOSTILE MUCUS- Thick cervical mucus that prevents the sperm from penetrating the cervical canal. This may be a sign that a woman is not ovulating. It can also be caused by certain fertility medications such as clomiphene citrate.
HUMAN CHORIONIC GONADOTROPIN (hCG)- Hormone secreted by the placenta that prolongs the life of the corpus luteum beyond its usual fourteen-day life span, resulting in the production of sufficient progesterone to support a pregnancy. hCG is chemically similar to LH and may be injected to start ovulation and ensure adequate luteal function. hCG is the hormone measured in pregnancy test. Medications containing hCG for use in fertility therapy are Novaril, Profasi, Pregnyl and Ovidrel.
HUMEGON- Human menopausal gonadotropins (hMG), a drug containing both FSH and LH. Humegon acts the same as Pergonal and acts directly on the ovaries to stimulate the development of follicles.
HYDROCELE- A swelling in the scrotum which contains fluid; this condition may be associated with infertility.
HYDROSALPINX- A fallopian tube that is enlarged, filled with fluid and blocked at the end farthest from the uterus and closest to the ovary. The inside lining of the tube (endosalpinx) is usually damaged. The wall of the tube is thinned and dilated. The normal cilia that line the inside of the tube are replaced by scar. The appearance would be similar to that of a person with severe burns of the skin. The skin is stiff, no longer soft and supple with loss of hair and movement of the underlying joints. So too is the function of the fallopian tube diminished. The fimbria are usually fused and may be gone. The tube is filled with fluid that may contain substances that impairs fertilization of an egg or development of an embryo. This means that even if a couple undergoes IVF therapy and the fallopian tube is bypassed completely, the tubal fluid may harm the embryos that are placed in the nearby uterine cavity. This may be the cause for lower pregnancy rates among women undergoing IVF therapy with at least one hydrosalpinx present. There have been many studies around the world since the mid 1990's demonstrating improved pregnancy rates if the hydrosalpinx fallopian tube(s) are removed in advance of IVF therapy.
Formation of a hydrosalpinx is the direct result of PID in most cases. Other causes can be infections due to intestinal disease such as a ruptured appendix from appendicitis. Hydrosalpinx may also be associated with severe endometriosis. In some patients, surgical repair of a hydrosalpinx may substantially improve the chance of pregnancy, but it may also increase the chance of ectopic tubal pregnancy. The tube may still not assist a fertilized egg in passing all the way into the uterus. In the final analysis, consultation with a reproductive endocrinologist will assist you in your choice of either surgical repair of the tube(s) or proceeding directly to IVF either with the hydrosalpinx removed before IVF or only to consider removal of the hydrosalpinx if IVF therapy was unsuccessful.
HYPERPROLACTINEMIA- Elevated blood levels of prolactin. This may be due to a benign tumor of the pituitary gland, but can be due to the use of certain medications, e.g., anti-hypertensive drugs or anti-depressants. Prolactin can suppress LH and FSH production, reducing male sex drive. Prolactin directly suppresses ovarian function in women and can block egg release, and stop a women from having periods (amenorrhea) Suppressing the ovary may decrease blood estrogen levels placing women at risk of osteoporosis (thinning of the bones). This condition is treatable with medications such as bromocriptine or Dostinex. It can be related to an underactive thyroid.
HYPERSTIMULATION SYNDROME- This is a potentially serious complication associated with the use of gonadotropins, but can also happen with Clomiphene citrate. The usual clinical situation involves the development of multiple follicles with high levels of estrogen. If hCG is given to trigger ovulation, the ovaries and surrounding tissue may start weeping large amounts of fluid into the peritoneal cavity. This can result in circulatory, vascular, or respiratory difficulties in addition to the discomfort associated with enlarged ovaries. Severe hyperstimulation requires intensive in-hospital care.
HYPERTHYROIDISM- Overproduction of thyroid hormone by the thyroid gland. This condition leads to an increase in metabolism and can cause estrogen to be depleted rapidly, thereby interfering with ovulation. May also cause menstrual disorders and miscarriages. The risk of miscarriage is 25% among women with hyperthyroidism.
HYPOESTROGENIC- Lower than normal levels of estrogen. It may reflect an inactivity of the ovary. Tests should be done to discover the cause.
HYPOGONADOTROPIC HYPOGONADISM- Low pituitary gland output of LH and FSH. Men will have low sperm counts and may lose their sex drive. Women do not ovulate.
HYPOSPERMATOGENESIS- Low sperm production.
HYPOTHALAMUS- A part of the brain that regulates hormones. It is located above the pituitary gland. This tissue secretes GnRH in pulses 60 to 120 minutes apart. The pulsatile GnRH stimulates the pituitary gland to secrete LH and FSH.
HYPOTHYROIDISM- Underproduction of thyroid hormone by the thyroid gland. The resulting lowered metabolism can interfere with the normal breakdown of hormones and may lead to lethargy. Women may have high levels of prolactin and estrogen, which can interfere with fertility.
HYSTERECTOMY- The removal of the uterus which can be total (including removal of the ovaries and tubes) or partial (just the uterus and sometimes including the cervix).
HYSTEROSALPINGOGRAM- This is a procedure performed in Radiology that evaluates the structure of the uterine cavity and fallopian tubes. A sterile speculum is placed in the vagina and the cervix is cleansed with an antiseptic solution. A small instrument is then attached to the cervix. Various types of cannulas or catheters can then be used to inject dye through the cervix into the uterine cavity. X-rays are taken during the course of this procedure. Cramping should be expected so pretreatment with a medication such as Motrin approximately one hour prior to the procedure is recommended. It is recommended that someone accompanies you to the hospital and that you not return to work for the rest of the day.
HYSTEROSCOPIC MYOMECTOMY- A procedure in which the doctor removes a uterine fibroid while using a hysteroscope.
HYSTEROSCOPY- Fiberoptic visualization of the inside of the uterus through the cervix with a telescope-like device. Many surgical repairs can be done during a hysteroscopy. This procedure is sometimes performed in conjunction with a laparoscopy. Diagnostic hysteroscopy can be done in the office with a 3-mm fiberoptic flexible telescope. Patients tolerate this procedure well without anesthesia. Should an abnormality be found by hysteroscopy in the office, then an operative hysteroscopy can be scheduled in the operating room. A larger telescope is used. This requires anesthesia. Conditions treated include fibroid tumors of the uterus, polyps, uterine septum, intrauterine scarring (Asherman's Syndrome), among others.
IDIOPATHIC INFERTILITY (UNEXPLAINED INFERTILITY)- The term used when no reason can be found to explain the cause of a couple's infertility.
IMPLANTATION- The embedding of the fertilized egg in the lining of the uterus.
IMPOTENCE- The inability of the man to establish and maintain an erection and to ejaculate.
INFERTILITY- The inability to conceive and/or carry a pregnancy to term after one year of unprotected intercourse for women less than 35 years of age or after 6 months for women 35 years of age or greater; also known as sub-fertility.
INHIBIN- A hormone made in the gonads to regulate FSH production by the pituitary gland for both men and women.
INSULIN SENSITIZING AGENTS- These are drugs that are used in patients with polycystic ovaries in an attempt to reduce their resistance to insulin. Use of such medications can result in return of normal ovulatory cycles or make the individual more responsive to fertility drugs.
INTRACYTOPLASMIC SPERM INJECTION (ICSI)- An advanced reproductive technology where a single sperm is injected into an egg. This micromanipulation technique helps enable fertilization with very low sperm counts or with non-motile sperm.
INTRAUTERINE INSEMINATION (IUI)- This office procedure involves washing and concentrating sperm in the lab and placing them into the uterine cavity. A speculum is placed into the vagina and a small flexible catheter attached to a syringe containing the prepared semen is then introduced into the endometrial cavity. The semen is slowly injected and the patient then remains lying down for 10 minutes following the procedure. There are no restrictions on activities for the remainder of the day.
IVF (in vitro fertilization)- An Assisted Reproductive Technology (ART) procedure that involves removing eggs from a woman's ovaries and fertilizing them outside her body. The resulting embryos are then transferred into the woman's uterus through the cervix.
KALLMAN'S SYNDROME- A congenital dysfunction of the hypothalamus which includes the failure to complete puberty and lack the sense of smell.
KARYOTYPING- A test to evaluate the number and make up of chromosomes for the presence of genetic defects.
KLINEFELTER'S SYNDROME- A genetic abnormality in a man with one Y (male) and two X (female) chromosomes. May cause a fertility problem with little to no sperm production.
LAPAROSCOPIC MYOMECTOMY- Removal of a uterine fibroid by using a laparoscope, a small telescope that can be inserted into a hole in the abdominal wall for viewing the internal organs. A laparoscope can be used to diagnose and treat a number of fertility problems including endometriosis, abdominal adhesions, and polycystic ovaries.
LAPAROSCOPY- A surgical procedure where a telescope-like device is inserted through a small incision near the navel in order to visualize the pelvic cavity, the ovaries, fallopian tubes and uterus. Used for diagnosis and treatment of infertility, pelvic pain, pelvic abnormalities including endometriosis, abdominal and pelvic adhesions, damaged fallopian tubes, fibroid tumors of the uterus, removal of cysts and polycystic ovaries.
LAPAROTOMY- Major abdominal surgery. For fertility needs, a laparotomy should only need to be done for removal of fibroid tumors or other masses that cannot be removed by laparoscopy.
Live birth - The delivery of one or more babies with any signs of life.
LUPRON (LEUPROLIDE ACETATE)- A GnRH analog which stimulates the female hormones initially, then suppresses a woman's secretion of FSH and LH, thus creating a pseudo menopause. Lupron has been extensively used in the United States and has been found to increase the number of follicles, oocytes (eggs), and embryos obtained, with a decreased chance of cancellation of the cycle. Also used to manage endometriosis.
LUPRON DOWN REGULATION A treatment cycle in which Lupron is used to suppress a woman's internal hormone secretion before injection of hMG to stimulate follicular development.
LUPRON FLARE This stimulation takes advantage of the initial rise or Flare of gonadotrophins (LH & FSH) which occurs 24 hours after the start of Lupron administration. This flare response is then augmented by giving other fertility agents.
LUTEAL PHASE- The days of a menstrual cycle following ovulation and ending with menses, during which progesterone is produced. Progesterone causes the uterine lining to thicken for implantation and growth of the embryo.
LUTEAL PHASE DEFICIENCY (LPD)- Inadequate progesterone or a failure of the corpus luteum to produce progesterone long enough to allow implantation, or the inability of the uterine lining to respond to progesterone stimulation. LPD may prevent implantation or cause an early miscarriage.
LUTEINIZED UNRUPTURED FOLLICLE (LUF) SYNDROME- The follicle develops and becomes a corpus luteum without releasing the egg.
LUTEINIZING HORMONE (LH)- A hormone secreted by the pituitary gland. When estrogen reaches a critical peak, the pituitary releases a surge of LH (the LH spike) that releases an egg from the follicle (ovulation). Ovulation detection kits detect the sudden increase in LH signaling that ovulation is about to occur, usually within 18 to 24 hours. LH is necessary for spermatogenesis (Sertoli cell function) and for production of testosterone (Leydig cell function). In the female, LH is necessary for normal function of FSH and for triggering ovulation.
LUTEINIZING HORMONE (LH) SURGE- A spontaneous release of large amounts of Luteinizing Hormone (LH). This normally results in the release of a mature egg (ovulation). Ovulation test kits detect the increase of LH, signaling that ovulation is to occur-usually within 18 to 24 hours.
MALE FACTOR- Any cause of infertility resulting from low sperm count or problems with sperm function that make it difficult for a sperm to fertilize an egg under normal conditions.
MATURATION ARREST- A testicular condition in which sperm development halts throughout all testicular tubules. May result in oligozoospermia or azoospermia.
MEIOSIS- The cell division peculiar to reproductive cells, which divides genetic material in half. New cells contain twenty-three chromosomes. The spermatids (immature sperm) and ova (eggs) each contain twenty-three chromosomes. Fertilization brings them together in the baby, which will have a normal complement of forty-six chromosomes.
MENOMETRORRHAGIA- Heavy bleeding at an unexpected time for menstruation to occur in a menstrual cycle.
MENOPAUSE- Permanent cessation of the menses; termination of the menstrual life due to hormonal changes.
MENORRHAGIA- Heavy or prolonged menstrual flow.
MENSTRUATION- The shedding of the lining of the uterus that occurs approximately every four weeks in non-pregnant women.
MESA- Microscopic epididymal sperm aspiration. A surgical procedure to collect sperm from the epididymis in order to use the sperm for in vitro fertilization. This is a treatment for male factor infertility, when no sperm is present in the ejaculate.
METFORMIN (GLUCOPHAGE)- This medication is in a family of drugs called oral hypoglycemics. It is used in the treatment of type 2 diabetes mellitus. This is the type of diabetes more commonly associated with obesity in men and women. Affected people make insulin and blood insulin levels are usually abnormally high. The problem lies in that the nature of their condition. Insulin is designed to move sugars from the blood stream into the tissues like the liver and muscle. With obesity, the tissues become more resistant to insulin moving sugars into them. This is called insulin resistance. Metformin acts to reduce the insulin resistance, thus allowing sugars to pass more easily into the tissues. Blood sugars decrease back into the normal range and the diabetes is effectively treated. Combining Metformin with a low carbohydrate (low sugar) diet is very effective in controlling diabetes. Weight loss also will follow if this treatment plan is religiously followed. Both the Metformin and weight loss leads to better control of the diabetes. If sufficient weight is lost and the diet change becomes a permanent lifestyle change, then Metformin may no longer be necessary to take. This treatment is also effective for some women with Polycystic Ovary Syndrome.
METRODIN- Purified Follicle Stimulating Hormone (FSH) manufactured from the urine of postmenopausal women. It is a fertility drug administered as a subcutaneous injection.
METRORRHAGIA- Spotting or light bleeding at an unexpected time for menstruation to occur in a menstrual cycle.
MICROINSEMINATION- A laboratory technique whereby sperm are injected next to the egg cell surface to increase the likelihood of fertilization.
MICROMANIPULATION- An IVF laboratory process in which the egg or embryo is held with special instruments and treated by procedures such as ICSI, assisted hatching, or embryo biopsy.
MICROSURGERY- Microscopic reconstruction surgery of the fallopian tubes.
MISCARRIAGE (SPONTANEOUS ABORTION)- A pregnancy ending in the spontaneous loss of the embryo or fetus before 20 weeks of gestation.
MITOSIS- The cell division leading to two identical cells with forty-six chromosomes.
MITTLESCHMERZ- Painful ovulation. During ovulation, the follicle ruptures. Small blood vessels on the surface of the follicle may tear and bleeding occurs. Any time there is blood in the abdomen, a chemical irritation occurs that leads to the sensing of pain.
MONOGAMOUS- An exclusive sexual relationship between 2 individuals.
MORULA- A stage of embryo development after four days of culture in vivo (inside the body). Between the eight-cell stage and the blastocyst stage of development, the cells of the embryo merge to form a solid ball known as a morula.
MOTILITY- The percentage of all moving sperm in a semen sample. Normally 50% or more are moving rapidly.
MULTI-FETAL PREGNANCY REDUCTION- A procedure to decrease the number of fetuses a woman carries and improve the chances that the remaining fetuses will develop into healthy infants. Multi-fetal reductions that occur naturally are referred to as spontaneous reductions.
MULTIPLE BIRTH- Birth of two or more children from a single term of pregnancy.
MYCOPLASMA- A bacteria that has been implicated in the cause of miscarriage. A clear cause effect relationship with miscarriage has not been scientifically proven. About 40% of all women have mycoplasma as part of the natural bacteria that resides in the vagina. Since these women who carry the bacteria are not necessarily the women that experience miscarriage or even have fertility problems, the role of this bacteria in infertility is not clear.
MYOMA- A common benign tumor of the muscle of the uterus. This is sometimes called a fibroid.
MYOMECTOMY- The surgical removal of fibroid tumors from the wall of the uterus. This surgery may be done either by laparoscopy or laparotomy. The surgical approach depends on the nature of the fibroid and the condition of the patient.
NECROSPERMIA- Condition in which sperm are produced and found in the semen, but they are dead. These sperm cannot fertilize eggs. Sperm that are not moving are not always dead; special stains are used to make this diagnosis.
OLIGO-OVULATION- Irregular or infrequent ovulation. Menstrual cycles 40 days or longer from the start of one period to the start of the next period.
OLIGOMENORRHEA- Scanty or infrequent menstrual periods.
OLIGOSPERMIA- A condition in which the number of sperm in a semen sample is abnormally low.
OOCYTE- The female reproductive cell. The egg cell produced in the ovaries. Also called the ovum or gamete.
OOCYTE CRYOPRESERVATION- Freezing of egg cells to keep them viable.
OOCYTE DONATION- Oocytes donated to women whose ovaries fail to produce usable
oocytes, or who have a genetic disorder that may be passed on to the child.
OOCYTE RETRIEVAL- A surgical procedure, usually under sedation, to collect the eggs contained with the ovarian follicles. A needle is inserted into the follicle, the fluid and egg are aspirated into the needle and then placed into a culture medium - filled dish.
OVARIAN CYST- A persistent fluid-filled sac in the ovary. A normal sac forms each cycle with follicular development. That is, a follicle is a specialized cyst that has an egg inside of it. Cysts may also be found with ovulation disorders, neoplasms of the ovary, and endometriosis. Cysts can produce hormones that interfere with ART cycles.
OVARIAN DRILLING- The use of lasers or electrosurgery to reduce the amount of hormonal producing tissue in the ovary in an attempt to restore ovulation in patients with the polycystic ovary syndrome. Surgical therapy for treatment of anovulation (wedge resection) originally involved removing a wedge shaped piece of the ovary and then sewing the ovary back together. Today's procedures are performed through the laparoscope.
OVARIAN FAILURE- Failure of the ovary to respond to FSH stimulation by not developing follicles. Diagnosed by elevated FSH in the blood, usually of a level greater than 20. May be due to exhaustion of the egg supply or an autoimmune problem. Exhaustion of eggs means menopause. Autoimmune problem means that a woman's immune (defense) system is interfering with the ovaries' ability to respond and develop follicles. Therefore the eggs that are present are neither developing nor being released (ovulating).
OVARIAN HYPERSTIMULATION- Administration of hormones to promote egg development in the ovaries.
OVARIAN HYPERSTIMULATION SYNDROME (OHSS)- When a woman is undergoing controlled ovulation hyperstimulation (COH), it is possible that this may result in a dramatic increase in the size of the ovaries, causing a cluster of symptoms referred to as ovarian hyperstimulation syndrome (OHSS). This is a serious condition characterized by swollen, painful ovaries and, in some cases, the accumulation of fluid in the abdomen and chest. This requires immediate treatment.
OVARIAN MONITORING- Use of ultrasound and/or blood or urine tests to monitor follicle development and hormone production.
OVARIAN RESERVE- This is a term that is used to describe the presence of responsive eggs within the ovary. Thus, decreased ovarian reserve implies a deficiency in responsive oocytes. The medical history, menstrual history, or prior response to ovarian stimulation may suggest the presence of decreased ovarian reserve. Pregnancy rates in spontaneous cycles or with Assisted Reproductive Technologies in such a situation are poor.
OVARIAN RESERVE TESTING- Hormones produced by the cells surrounding the egg inhibit the release of pituitary hormones. When the number of eggs is diminished, the levels of these hormones are diminished, so the levels of FSH begin to increase. Methods to assess ovarian reserve include baseline hormone testing (FSH and estrogen levels on day 3 of the cycle) and the levels of FSH on day 10 of the cycle after having used the fertility drug, clomiphene citrate, days 5-9 of the cycle (Clomiphene citrate challenge test).
OVARIAN STIMULATION- Use of drugs (oral or injected) to stimulate the ovaries to develop follicles and eggs.
OVARY- The two female gonads containing the eggs. The ovary releases hormones (estrogens, androgens and progesterone among many others) that cause development of secondary sex characteristics and reproductive organs in women.
OVIDREL- A fertility medication of human chorionic gonadotropin (hCG) used to prompt ovulation. It is the first preparation of hCG to be available of subcutaneous injection. It became available for use in the United States at the beginning of the year 2001. Other hCG preparations (Profasi, Pregnyl) require the deeper intra-muscular injection.
OVULATION- When the follicle reaches a critical size and is making critical levels of estrogen, it is as though the ovary was telling the pituitary that the egg is ready to be released. The pituitary responds with a sudden release of large amounts of LH and FSH. This surge of hormones completes the egg's development and causes the follicle to rupture (ovulation) so that the egg can be released and to be picked up by the fallopian tube (usually around the 14th day of the cycle). The hormonal surge also causes the cells that originally surrounded the egg to change into a structure called the corpus luteum. This structure primarily secretes the hormone Progesterone. The progesterone causes the uterine lining to change its appearance and begin secreting various substances that will allow the fertilized egg to invade under its surface and to survive (implantation).
OVULATION INDUCTION- The use of female hormone therapy (clomiphene citrate, FSH, hCG) to stimulate oocyte development and release.
OVULATION PREDICTOR KITS- This test is used to determine when ovulation will occur. The usual test is a urine test. The woman's urine is tested to determine the sudden release of hormones from the pituitary that occurs just prior to release of the egg. Other tests are also becoming available that look for other changes that occur prior to ovulation. Ovulation will usually occur within 24 hours of when the test becomes positive.
OVULATORY DYSFUNCTION- Infertility resulting from problems with egg production by the ovaries.
OVULATORY FAILURE- The failure to ovulate. Treatment may be ovulation induction therapy.
OVUM- Another name for the egg.
PANHYPOPITUITARISM- Complete failure of the pituitary gland.
PAPANICOLAOU SMEAR (Pap Smear)- Also known as Pap test. This is a screening test to evaluate the cells of the cervix and vagina to determine if the cells are normal.
PATENT- Open or unblocked (as in Fallopian tubes).
PELVIC INFLAMMATORY DISEASE (PID)- An infection of the pelvic organs. Chlamydia and gonorrhea infections can cause PID and can result in severe illness, high fever, and extreme pain. PID can also cause tubal blockage and pelvic adhesions. Constant pelvic pain and recurrent pelvic infections can develop after the initial infection. This condition is a common cause of infertility and may cause future ectopic pregnancy. Some women have no history of symptoms such as pain, but they have clear evidence of PID. Surgical treatment may improve fertility. Often, IVF therapy is needed.
PERGONAL- Human menopausal gonadotropin (hMG), a drug containing both FSH and LH. Pergonal acts directly on the ovaries to stimulate the development of follicles.
PITUITARY GLAND- The master gland. This gland is controlled by the hypothalamus and controls most hormonal functions. It is located at the base of the brain just below the hypothalamus. It controls the function of the thyroid, adrenal gland, ovary or testicle, and growth and development.
PLACENTA- The tissue part of the embryo that invades the uterine wall and provides an exchange of the baby's waste products for the mother's nutrients and oxygen. The baby is connected to the placenta by the umbilical cord.
POLAR BODY- Discarded genetic material resulting from female germ cell division. When an egg matures, it discards half of its genetic material so that the egg cell is ready to fuse with half of the male genes inside a sperm. This discarded genetic material can be seen in the egg as a small round piece of cytoplasm at the edge of the egg cell. The presence of a polar body tells us whether an egg is mature or immature.
POLYCYSTIC OVARIES (PCO)- A condition found in women who don't ovulate, characterized by excessive production of male sex hormones (androgens) and the presence of cysts on the ovary. PCO can be without symptoms although some women who do show symptoms are said to have PCOS.
POLYCYSTIC OVARY SYNDROME (PCOS)- The usual definition of this condition includes absent or infrequent ovulation and evidence of increased male hormones due to an abnormal release of LH and FSH hormones. The ovaries are usually enlarged and have multiple small, incompletely developed follicles immediately underneath the surface of the ovary with gives the appearance of multiple (poly) cysts. Insulin resistance appears to play a critical role in the development of this condition. The symptoms of having polycystic ovaries are evident, such as weight gain, acne, and excessive hair growth. Some women with excess insulin in the blood stream and obesity will benefit from medical treatment of Metformin (Glucophage) and a low carbohydrate diet.
POST COITAL TEST- A microscopic evaluation of cervical mucus performed twelve or more hours after intercourse to determine compatibility between the woman's mucus and the man's. The quality of the cervical mucus is also evaluated. There is strong evidence that this test offers little value in a couple's infertility evaluation; therefore it may not be recommended as part of your infertility testing.
POST EJACULATE URINE- A laboratory test where a man's urine is examined for the presence of sperm after he has ejaculated. This test is performed on men who have had a very low sperm count or no sperm seen in past semen analyses. These men may have retrograde ejaculation. That is, the sperm takes a wrong turn during orgasm and enters the bladder instead of exiting through the penis. This condition is more common among men with diabetes or nervous system disorders due to spinal cord injuries.
PREGNANCY (BIOCHEMICAL)- A positive pregnancy test that shows no evidence of a gestational sac or viable fetus on ultrasound. Can be classified as a very early miscarriage.
PREGNANCY (CLINICAL)- A pregnancy documented by ultrasound that shows a gestational sac containing a viable fetus in the uterus. For ART data collection purposes, pregnancy is defined as a clinical pregnancy rather than a biochemical pregnancy.
PREIMPLANTATION GENETIC DIAGNOSIS (PGD)- A process whereby a single blastomere (cell) from an 4 to 8 cell embryo (two to three days after egg collection during the IVF process) is removed, fixed, and subjected to a number of DNA probes. Currently, it can be used to diagnose a limited number of genetic disorders before implantation. Results can be obtained within 24 hours, which can allow for normal embryos to identified and selected for transfer. PGD is of benefit to couples known to be at risk of passing an inherited disorder to their children and possibly in improving the likelihood of a successful pregnancy and birth following IVF.
PREMATURE OVARIAN FAILURE- Ovarian failure before the age of 40.
PREGNYL- A fertility medication of chorionic gonadotropin (hCG) used to prompt ovulation; an intra-muscular injection.
PRIMARY INFERTILITY- Infertility in couples where the woman has never conceived.
PROFASI- A fertility medication of chorionic gonadotropin (hCG) used to prompt ovulation; an intra-muscular injection.
PROGESTERONE (P4)- A hormone produced and released by the corpus luteum of the ovary during the second half of an ovulatory cycle. It is necessary for the preparation of the lining of the uterus for the implantation of the fertilized egg. During pregnancy, the placenta produces progesterone. Injection or suppository will provide supplemental support when indicated such as in recurrent miscarriages and IVF therapy. Blood tests to monitor progesterone levels will help determine the progress of a cycle.
PROGESTERONE WITHDRAWAL- Some women have infrequent or no periods by their nature. This is called oligo-menorrhea and amenorrhea respectively. If it has been longer than 35-40 days since the last period, there has been no evidence of ovulation and a women is not pregnant, then progesterone medication may be taken to artificially cause menstrual bleeding to occur. Progesterone is commonly taken in the form of Provera (Medroxyprogesterone acetate) for 5 to 10 days. Then progesterone medication is stopped. When the progesterone is stopped or withdrawn, the lining of the uterus collapses and a period starts. Progesterone withdrawal has many advantages: 1) it can start a period permitting fertility medications to be started; 2) it can be used to clear the uterine lining from abnormal tissue overgrowth that would otherwise place a women at increased risk for developing cancer of the lining of her uterus; 3) it can regulate a woman's menstrual cycle giving her a sense of regularity and feeling normal and healthy; 4) it can be used as a test to make sure no other hormone imbalances are taking place that may cause a women not to have a period such as menopause, hyperprolactinemia, thyroid disease or intrauterine scarring (Asherman's Syndrome). In these cases, a period will not start with progesterone withdrawal. Progesterone withdrawal is most commonly used for women with Polycystic Ovary Syndrome or as hormone replacement along with estrogen for women in menopause.
PROLACTIN- A hormone produced by the pituitary. Measuring blood levels of prolactin is useful in providing an index of functional disorder within the hypothalamic-pituitary axis that may lead to failure to ovulate properly. Treatment with Parlodel may be recommended when the level is high.
PRONUCLEAR PHASE (2PN)- A fertilized egg (zygote). In IVF, the pronuclear stage is the morning after the egg collection.
PRONUCLEI (PN)- Evidence of fertilization. In a normally fertilized egg, two spherical structures (pronuclei) can be seen in the middle of the egg 16 to 22 hours after insemination. One sphere contains the female genetic material, and the other contains the male genetic material before they fuse to form the genes of the embryo.
PROSTAGLANDINS- Compounds that are present in semen, in the follicle of the ovary at the site of ovulation, produced by endometriosis, and are produced by the breakdown of the lining of the uterus and other tissue. Prostaglandins cause contraction of smooth muscle such as the uterus and intestines. Pain and diarrhea may be a result of the prostaglandins.
PROSTATE GLAND- The gland in the pelvis of a man that produces a portion of the semen, including the chemical that liquefies the coagulated semen after entering vagina.
PYOSPERMIA- Condition in which the presence of white cells in the sperm indicated possible infection and/or inflammation.
QUANTITATIVE hCG- Testing the exact value of the serum beta hCG level to assess the progress and reassurance of good progress during early pregnancy. The hCG levels may also assist in determining the timing of further testing and interventions during early pregnancy. It is also used during prenatal testing in the second trimester at about 16-18 weeks.
REPRODUCTIVE ENDOCRINOLOGIST- A subspecialist physician who has received residency training in Ob/Gyn and advanced training (fellowship) in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. Reproductive Endocrine fellows are trained in advanced procedures used through a minimally invasive technique of operative laparoscopy. Such procedures are more advanced infertility surgeries treating endometriosis, pelvic scarring that causes damage to the fallopian tubes and ovaries leading to infertility and pelvic pain, and to reverse tubal ligation. The Reproductive Endocrinologist also treats couples in need of injectable fertility drugs and assisted reproductive technologies- both of which require advanced monitoring with pelvic ultrasounds and hormone blood tests to control and optimize the chance of having a baby. Reproductive Endocrinologists also have special expertise managing these problems: abnormal or absent menstrual periods, laparoscopic or hysteroscopic laser surgery, menopause, birth defects of the female reproductive tract and contraceptive difficulties.
RESISTANT OVARY SYNDROME- An ovary unresponsive to follicle-stimulating hormone (FSH). Germ cells will be present in the ovary, but they will not respond to FSH.
RETROGRADE EJACULATION- A male infertility problem in which sperm travels to the bladder instead of out of the penis. This condition results from a failure in the sphincter muscle at the base of the bladder. Medical intervention is necessary to conceive.
RUBELLA TITER- A blood test which determines if the patient is immune to rubella (German measles). If immunity is not present the patient may be advised to have a rubella vaccination, wait three months before attempting pregnancy, and then re-test for immunity.
SALPINGECTOMY- Surgical removal of the fallopian tubes.
SALPINGOLYSIS- Surgical removal of adhesions that restrict the movement and function of the tubes.
SALPINGOSTOMY- Cutting open the fallopian tube that was completely blocked before surgery. It may also refer to cutting open the fallopian tube in the process of removing a tubal ectopic pregnancy.
SCROTUM- The bag of skin and thin muscle surrounding the man's testicles.
SECONDARY INFERTILITY- The inability to conceive or carry a pregnancy after having successfully conceived one or more times.
SECONDARY SEX CHARACTERISTICS- Beard, hair pattern, genital development, increased muscle mass and deep voice in men. Breast, genital development and female body hair pattern in women. Characteristics stimulated by sex hormones (testosterone and estrogen). These characteristics begin to appear at puberty (sexual maturity).
SEMEN- Fluid portion of the ejaculate consisting of the sperm and secretions from the seminal vesicles, prostate gland, and several other glands in the male reproductive tract.
SEMEN ANALYSIS (SA)- Freshly ejaculated semen is evaluated under microscope to count the number of sperm, the percentage of moving sperm (motility), assess the size and shape of the sperm (morphology). Also measured are semen (fluid) volume and presence of white blood cells, which might indicate an infection.
SEMEN CRYOPRESERVATION- Freezing of semen to keep it viable.
SEMEN DONATION- A process in which semen may be obtained from a donor bank.
SEMEN LEUCOCYTES- White blood cells in the semen. Increased numbers have been associated with deficiencies in sperm function and motility, genitourinary infection and/or inflammation.
SEMEN VISCOSITY- Liquid flow or consistency of semen.
SEMINAL VESICLES- Glands which produce much of the semen volume, including fructose (sugar) for nourishing the sperm.
SEMINIFEROUS TUBES- The testicular tubules where sperm mature and move toward the epididymis.
SEPTATE UTERUS- A uterus divided into right and left halves by a wall of tissue (septum). Women with a septate uterus have an increased chance of early pregnancy loss. The outer surface shape of the uterus is round and normal in appearance. This is in contrast to a bicornuate uterus where the outer wall is heart shaped following the shape if the inner cavity of the uterus.
SERTOLI (Nurse) CELL- A testicular cell that nurtures the spermatids (immature sperm). They secrete inhibin, a feedback hormone, which regulates FSH. When stimulated by FSH, the Sertoli cell initiates spermatogenesis (sperm production).
SHEEHAN'S SYNDROME- A condition caused by low blood pressure or shock at the time of delivery, which damages the pituitary gland. Tissue within the pituitary gland dies and becomes non-functional.
SONOGRAM (Ultrasound)- Use of ultra high-frequency sound waves (like sonar) to create an image of internal body parts. Used to evaluate the size and number of ovarian follicles. Also used to detect and monitor pregnancy, identify uterine fibroids, pelvic masses such as endometriomas, ovarian cysts and uterine malformations such as a septate or bicornuate uterus.
SONOHYSTEROGRAPHY- This is a procedure that utilizes ultrasound to evaluate the inside of the uterine cavity. A speculum is placed into the vagina, the cervix is cleansed, and a small catheter is inserted into the uterine cavity. A syringe filled with fluid is then attached to the catheter. The speculum is removed and is replaced with a vaginal ultrasound probe. Fluid is then injected into the uterine cavity while watching with ultrasound.
SPERM- The male reproductive cell; the microscopic cell that carries the male's genetic information. The male gamete.
SPERM AGGLUTINATION- Clumping of sperm caused by antibody reactions or by infection. This may occur when either the man or woman develops immunity to the sperm. Can only be seen with a microscope.
SPERM ANTIBODIES- Antibodies against sperm cells which may attack and destroy them. These antibodies can be produced either by men against their own sperm or by women through their own serum. Sperm antibodies attach themselves to parts of the sperm and inhibit movement and fertilization. IVF is often the only way to overcome infertility caused by sperm antibody problems. Not all sperm antibodies cause infertility. Testing can be done to see if sperm antibodies directed to critical parts of the sperm are present and are present in high levels to indicate IVF therapy.
SPERM ANTIBODY TESTING- Test that is done to determine if a man's sperm or a woman's blood harbors substances that cause his sperm to clump together, lose motility, or lose the ability to fertilize an egg. The direct immunobead test directly tests for the presence of antibodies in the man's sperm. The indirect immunobead test tests for sperm antibodies in the woman's blood serum. The direct immunobead test appears to be most predictive of a sperm antibody problem that may cause infertility. The indirect immunobead test for the women poorly predicts infertility. This may be the case because the presence of antibodies in her blood stream does not mean those antibodies will ever come in contact with a sperm during intercourse. In contrast, antibodies found in the man's semen (direct immunobead) are detecting antibodies that are already attached to the sperm. This is the reason only direct immunobead testing is usually done.
SPERMATOGENESIS- Sperm production in the testicles.
SPERM BANK- A place where sperm are kept frozen in liquid nitrogen for later use in artificial insemination. Couple's may bank sperm for many reasons: male partner has a serious disease and will be exposed to radiation or chemotherapy that will destroy his sperm producing cells; male partner may not be available at a critical time of ovulation for his female partner, therefore intrauterine insemination with banked sperm can be done; a man chooses to have vasectomy, but wishes to store sperm for future family planning should that be his choice. This will permit him to avoid having surgery to reconnect is vas deferens for future fertility. Couple's may also wish to use anonymous donor sperm for therapeutic donor insemination (TDI). On less common occasions, known donor sperm can be banked for future intrauterine insemination. If the male donor is not the female patient's partner in family planning, the sperm donor must undergo rigorous standards of screening and quarantined storage for 6 months as is the guideline standard of care for sperm donors in the United States.
SPERM COUNT- The number of sperm in the ejaculate, and is reported as millions per ml.
SPERM MATURATION- The sperm grow and gain their ability to swim. Sperm take about 72 days to reach maturity.
SPERM MORPHOLOGY- Number or percentage of sperm that look normal at the microscopic level. Assessment of the acrosome cap, the sperm head, the midpiece and the tail. The greater the percentage of abnormally shaped sperm, the less likely fertilization will occur. Abnormal appearing sperm does not lead to abnormal babies.
SPERM MOTILITY- The ability of sperm to move and swim normally. Normal sperm motility should be 50% or greater. Motility at 40% or less is a likely cause of infertility.
SPERM PENETRATION- The ability of the sperm to penetrate an egg.
SPERM SWIM-UP- This technique separates motile sperm from non-motile sperm and cellular debris in a semen sample. The most motile sperm will swim-up in a small volume of media so they can be more easily separated for insemination
SPERM WASH- Technique for separating sperm from seminal fluid. Sperm washing concentrates the more active, normally formed sperm. It is a method used in fertility therapy with intrauterine insemination and IVF.
SPINNBARKEIT- The stretchiness of cervical mucus; the stretchy quality that occurs at mid-cycle under the influence of estrogen. See Post Coital Test and Cervical Mucus. The greater the length of stretch, the more fertile the time of the female partner.
SPONTANEOUS ABORTION- A miscarriage or the unintended termination of a pregnancy before the twentieth week.
STEIN-LEVENTHAL SYNDROME- Polycystic ovaries with androgen-excess symptoms.
STERILITY- The total inability to reproduce. Not to be confused with infertility.
STILLBIRTH- Birth of an infant with no signs of life after 20 or more weeks of gestation.
STIMULATION- Administration of hormones which induce development of multiple ovarian follicles.
SUPEROVULATION- Stimulation of multiple follicles with fertility drugs.
SURGICAL SPERM RETRIEVAL- The extraction of sperm from the male reproductive tract can be accomplished using a variety of procedures including needle aspiration or biopsy.
SURROGACY- One woman carrying a pregnancy for another woman, either as a gestational carrier (the surrogate receives an embryo created by two other individuals), or a traditional surrogate (the surrogate is inseminated with sperm from the male partner of an infertile couple).
SURROGATE- A woman who becomes pregnant through insemination with the sperm of the husband of an infertile woman, and then following delivery , turns the child over for adoption by the couple.
TDI - Therapeutic or artificial insemination with donor sperm. During this procedure sperm from a donor is placed into a woman's vagina or cervix.
TESA- Testicular sperm aspiration. Biopsy sample of tissue containing sperm. The sperm are used for in vitro fertilization. This is a male factor infertility treatment for men who do not produce sperm in their ejaculate and if no sperm can be found in the epididymis (through a surgical procedure). The testicle tissue containing the sperm can be cryopreserved (frozen) and stored to be used at a time his female partner will undergo egg collection for in vitro fertilization (IVF). Intracytoplasmic sperm injection (ICSI) is required due to the low number of sperm. Intrauterine insemination is not possible with this type of sperm collection.
TESTICLE- The two male sexual glands contained in the scrotum. They produce the male hormone, testosterone, and produce the male reproductive cells, sperm.
TESTICULAR BIOPSY (TESE)- A procedure that takes a small sample of testicular tissue for microscopic examination. Sperm may be retrieved using a testicular biopsy when a tubal blockage prevents sperm from being ejaculated.
TESTICULAR FAILURE- Primary: A congenital, developmental or genetic error resulting in a testicular malformation that prevents sperm production. Secondary: Acquired testicular damage, for example, from drugs, prolonged exposure to toxic substances, or a varicocele.
TESTICULAR STRESS PATTERN- A semen analysis result showing decreased sperm count, poor sperm motility and morphology.
TESTOSTERONE- The male hormone responsible for the formation of secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for spermatogenesis.
THIRD PARTY REPRODUCTION- The use of oocytes, sperm, embryos or a uterus of someone other than one's partner.
THYROID GLAND- The endocrine gland in the front of the neck that produces thyroid hormones to regulate the body's metabolism.
TORSION- Torsion means twist. The twisting of the testis inside the scrotum will cause extreme pain and swelling. The rotation twists off the blood supply and causes severe damage to the testicle. Torsion of the ovary may occur in a woman experiencing hyperstimulation-a complication of ovulation induction treatment. A man and a woman with torsion of their gonad are at risk of losing the gonad. This is a surgical emergency.
TSH- Thyroid Stimulating Hormone is released by the pituitary gland to increase thyroid hormone production. TSH results can reveal whether thyroid function is normal, which is necessary for normal ovulation.
TUBAL FACTOR INFERTILITY- Structural or functional damage to one or both fallopian tubes that reduces fertility.
TUBAL REANASTOMOSIS- Reversal of a tubal ligation.
TUBOCORNUAL ANASTOMOSIS- Surgery performed to remove a blocked portion of the fallopian tube and to reconnect the tube to the uterus. Tubouterine implantation may also be performed to remove fallopian tube blockage near the uterus and reimplant the tube in the uterus. This procedure is performed far less often because of the ready availability of IVF treatment. IVF therapy offers excellent success without requiring the women to undergo general anesthesia and major abdominal surgery for this tubal surgery.
TUBOPLASTY- Plastic or reconstructive surgery on the fallopian tubes in order to correct abnormalities which may lead to blockage or otherwise cause infertility.
TUBOTUBAL ANASTOMOSIS- Surgery performed to remove a diseased portion of fallopian tube and reconnect the two ends. Can also be done for sterilization reversal for those who have had their tubes tied.This procedure is performed far less often because of the ready availability of IVF treatment. IVF therapy offers excellent success without requiring the women to undergo general anesthesia and major abdominal surgery for this tubal surgery.
TUBOVARIAN ABSCESS- A pocket of infection and puss that forms involving the ovaries and fallopian tubes. This can cause severe pain. Hospitalization with intravenous antibiotics may be required. Should a woman not improve with antibiotic therapy, surgical removal of one or both tubes and sometimes the one or both ovaries is done as a lifesaving measure.
TURNER'S SYNDROME- The most common genetic defect contributing to female fertility problems. The ovaries fail to form and appear as slender threads of atrophic ovarian tissue, referred to as streak ovaries.Karyotyping will reveal that this woman has only one female (X) chromosome instead of two. (46, XO Karyotype).
TWO PRONUCLEAR STAGE EMBRYO- Normally, when fertilization occurs, a sperm penetrates an egg resulting in a two pronuclear stage (2PN-one cell) embryo. Each pronucleus represents a nucleus from the egg and the other from the sperm. Shortly after this stage, the nuclei combine, the genes fuse and an embryo is formed.
ULTRASOUND- Technique for visualizing the follicles in the ovaries and the fetus in the uterus, allowing the estimation of size. Often used to monitor growth of ovarian follicles, retrieve oocytes, or follow the developing pregnancy.
UMBILICAL CORD- Two arteries and one vein encased in a gelatinous tube leading from the baby to the placenta. The umbilical cord is used to exchange nutrients and waste between the mother and the developing baby.
UNDESCENDED TESTICLES (Cryptorchidism)- The failure of the testicles to descend from the abdominal cavity into the scrotum by one year of age. If not repaired by age six, it may result in permanent infertility because the testicles are kept too warm within the abdominal cavity; sperm require 1 degree below core body temperature, which is why the testicles need to be within the scrotum. If an undescended testicle is left in place and not surgically removed before puberty, a man has a 25% risk of testicular cancer forming in that testicle. Therefore, such testicles are removed if they cannot be surgically brought into the scrotal sac during infancy.
UNEXPLAINED INFERTILITY- Infertility for which no cause has been determined despite a comprehensive evaluation of both partners.
UNICORNEATE UTERUS- An abnormality in the formation of the uterus from birth. Normally during fetal development, the uterus forms by the connection or fusion of two tubes resting side by side-left and right. The common wall of the two tubes is then resorbed leaving a hollow cavity between the outer walls of both tubes. In the case of a unicornuate uterus, one of the tubes never formed. Therefore the uterus is made up of only one tube. The cavity of the uterus tends to be slightly smaller than the normal uterine cavity and there is only one fallopian tube. The woman still has two ovaries. The condition of a unicornuate uterus has not been a clear cause of infertility. There is a risk of preterm labor. A woman's urinary tract from the kidney to the bladder forms in close connection to the reproductive tract: the fallopian tubes, uterus, cervix and vagina. This close relationship in development of the urinary tract and the genital tract is important. If a woman is missing one side of her reproductive tract as is the case with a unicornuate uterus, then there is a 15% risk of major urinary tract abnormalities such as a missing kidney on the same side as the missing uterine tube and a 40% risk of minor urinary tract abnormalities. Therefore if a women is diagnosed with a unicornuate uterus, she should undergo testing of her urinary tract. The same holds for the reverse situation. If a major abnormality of the urinary tract is first found, a woman's internal genital tract should be evaluated.
UNSTIMULATED CYCLE- An ART cycle in which the woman does not receive drugs to stimulate her ovaries to produce more follicles. Instead, follicles develop naturally. She may produce only one or two follicles.
UREAPLASMA- A bacteria that has been implicated in the cause of miscarriage. A clear cause effect relationship with miscarriage has not been scientifically proven. About 40% of all women have ureaplasma as part of the natural bacteria that resides in the vagina. Since these women who carry the bacteria are not necessarily the women that experience miscarriage or even have fertility problems, the role of this bacteria in infertility is not clear.
URETHRA- The tube that allows urine to pass from the bladder to the outside of the body. In the man, this tube also carries semen from the area of the prostate to the head of the penis.
UROLOGIST- A physician specializing in the genitourinary tract. This specialist is often needed for physical evaluation and treatment of male infertility issues.
UTERINE FACTOR- A disorder in the uterus, such as fibroid tumors, that reduces fertility.
UTERINE LINING- endometrium.
UTERUS- Female reproductive organ in which a fertilized egg is implanted and develops during the course of a pregnancy; also known as a womb.
VAGINA- Canal leading from the cervix to the outside of a woman's body.
VAGINAL ULTRASOUND- Visualization of soft tissue by projecting sound waves through a probe, which is inserted into the vagina. A baseline ultrasound shows the ovaries in their normal state. A follicular ultrasound shows ovary follicle maturation and is used for ovulation induction monitoring. A pregnancy ultrasound shows if a pregnancy is intrauterine or tubal and measures growth of the embryo or fetus.
VAGINISMUS- Spasmodic contraction of the entrance to the vagina during attempted intercourse, thus preventing the entrance of the penis. It is usually of psychological origin, although it may be due to inflammation of the vagina (vestibulitis), causing a reflex contraction. Treatment can be done with dilators in a physician's office. Vestibulitis may be treated surgically.
VAGINITIS- Yeast, bacterial vaginosis, or trichomonas infections of the vagina. Frequent vaginitis may indicate the presence of pelvic adhesions and tubal blockage from other infections, such as chlamydia. Vaginitis may interfere with sperm penetration of the cervical mucus, and the symptoms may even interfere with the ability and desire for the woman to have intercourse.
VARICOCELE- A collection of varicose veins in the scrotum. Blood flows in an abnormal direction in these veins towards the testicles. The resulting swollen vessels surrounding the testicles create a pool of stagnant blood, which elevates scrotal temperature. The elevated temperature may reduce sperm production and sperm quality. The back pressure of blood into the testicle tissue may also compress the stem cells reducing sperm production. This can progress to cause permanent damage of the testicles. This may be a cause of male infertility.
VARICOCELECTOMY- Repair of a varicocele is termed either a varicocelectomy or ligation of internal spermatic veins. The review of the medical research on varicoceles and their surgical repair has led to much discussion and uncertainty as to the effectiveness of such surgery. The problem is that about 50% of men do not have substantial improvement in their semen quality following surgery. Therefore, it is difficult advise a man as to the prognosis for improvement after surgery. It is also uncertain as to the time to wait to see an improvement. Most medical studies have followed men after surgery measuring success more as an improvement in sperm count and motility. Few studies have evaluated success in terms of the female partner becoming pregnant and having a baby. With the uncertainties in duration of time to see an improvement and what does improvement really mean-better sperm count or having a baby, many couples seek immediate treatment with IVF/ICSI therapy. IVF/ICSI is a very effective treatment for male factor infertility. The time to treatment is usually within a few months and the outcome results are immediate. The prognosis with IVF/ICSI per cycle of treatment is substantially greater than that of pregnancy chance per month following varicocelectomy.
VAS DEFERENS- One of the tubes through which the sperm move from the testicles (epididymis) toward the seminal vesicles and prostate gland. These tubes are severed during a vasectomy performed for birth control.
VASECTOMY- A surgical procedure to block sperm from being released in the ejaculate. Vasectomy is used as a form of birth control.
VENEREAL DISEASE- Any infection that can be sexually transmitted, such as chlamydia, gonorrhea, ureaplasma and syphilis. Many of these diseases will interfere with fertility and some will cause severe disease.
X CHROMOSOME- The genetic material that transmits the information necessary to make a female. All eggs contain one X chromosome, and half of all sperm carry an X chromosome. When two X-chromosomes combine, the baby will be a girl.
Y CHROMOSOME- The genetic material that transmits the information necessary to make a male. The Y chromosome can be found in one-half of the man's sperm cells. When an X and a Y chromosome combine, the baby will be a boy.
ZONA PELLUCIDA- Outer shell of the egg. The zona pellucida serves two purposes: it allows only one sperm to enter the egg for fertilization, and it holds together the cells of the developing embryo before compaction.
ZYGOTE- A fertilized egg that has not yet divided.
ZYGOTE INTRAFALLOPIAN TRANSFER (ZIFT)- The ovum is fertilized in vitro and transferred to the fallopian tube before it divides. This can be done only in women with at least one normal tube. Embryo formation and development is not known to have occurred unless the woman becomes pregnant. General anesthesia and laparoscopy are required to perform this procedure.