A
B C D
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H I K
L M N
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A
Adhesions
Bands of scar tissue caused by surgical procedures,
endometriosis, or infections. Adhesions connect
two organs together, affecting normal reproductive
function.
Agglutination of sperm
When sperm cells clump or stick together.
Amenorrhea
Absence of menstrual cycles (periods).
Androgen
A hormone, such as testosterone, that stimulates
the male sex drive.
Andrology
A specialty focusing on male infertility in assisted
reproductive technology (ART).
Antagon
A GnRH (gonadotropin releasing hormone) antagonist
(drug used to block the action of GnRH) that can
prevent a premature LH surge, and is sometimes
prescribed in ovulation induction therapies. GnRH
antagonists need to be injected during the time
period when a LH surge is likely to occur.
Aspiration
The application of light suction to the ovarian
follicle to remove the eggs in IVF, or to tubules
in the testis to remove sperm in TESA.
Assisted Hatching
A sophisticated micromanipulation technique for
perforating the shell surrounding the egg (the
zona pellucida) so that the embryo can "break
out" and implant in the uterus. As women
get older, the zona pellucida may become harder
or tougher, making it difficult for the embryos
to hatch. As a result, implantation and pregnancy
may not occur. Using micromanipulation, a portion
of the zona pellucida (outer shell) is thinned
by applying a weak acid solution to a very small
area.
Assisted Reproductive Technology (ART)
Treatments and procedures involving the handling
of human eggs and sperm for the purpose of establishing
a pregnancy. Types of ART include in vitro fertilization
(IVF), oocyte donation, preimplantation genetic
diagnosis (PGD) intracytoplasmic sperm injection
(ICSI), assisted hatching, fragment removal, embryo
cryopreservation, frozen embryo transfer, and
oocyte donation.
Aygestin (Norethindrone Acetate)
Aygestin is a form of progestin, a synthetic substance
that chemically resembles progesterone, that may
be prescribed in ovulation induction therapies
to inhibit ovulation and quiet the ovaries in
advance of egg stimulation using injectable hormones.
This "down time" helps the ovaries respond
better to treatment. In much the same way that
oral contraceptives prevent pregnancy by inhibiting
normal ovulation, Aygestin is used in IVF and
related procedures to turn off the body's natural
ovulatory cycle. Side effects of Aygestin may
include: abdominal pain or cramps; diarrhea; fatigue;
unusual tiredness; weakness; hot flashes; decreased
sex drive; nausea; trouble sleeping; depression,
irritability, or other mood changes; swelling
in the face, ankles, or feet; weight gain.
Azoospermia
The absence of sperm in the ejaculate.
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B
Baby Aspirin
Low-dose aspirin (80 to 100 milligrams) used in
infertility treatment to thin the blood.
Basal Body Temperature (BBT)
The body temperature at rest. A slight rise in
the BBT indicates that ovulation has occurred.
Some female infertility patients are asked to
fill out a BBT chart showing their temperature,
taken orally, on consecutive days over a period
of one or more months.
Blastocyst
An embryo that is approximately five days old
and consists of some 100 cells that form an outer
shell of cells protecting an attached inner group
of cells surrounding a fluid core. The outer cells
develop into the placenta, which protects the
fetus created from the inner cells.
Blastocyst transfer
Allowing in vitro embryos to reach blastocyst
stage (typically five days after fertilization)
before transferring them into the uterus. By waiting
for the embryos to reach a more developed stage,
more viable embryos may be selected, and thus
fewer embryos may be transferred than is customary
when embryos are transferred on the third day
of development.
Blastomere
A single cell from a developing embryo.
Blighted ovum
A pregnancy that stops developing very early on.
The amniotic sac may contain fluid and no fetal
tissue when the miscarriage occurs.
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C
Catheter
A thin, flexible tube used for aspirating or injecting
fluids.
Cervical mucus
A secretion produced by the lining of the cervical
canal.
Cervix
The lower section of the uterus, which protrudes
into the vagina and dilates during labor to allow
the passage of the infant.
Chemical pregnancy
A pregnancy where hCG levels are detected but
the pregnancy is lost before a heartbeat is seen
on ultrasound. This is a very early miscarriage,
often before the woman misses a period.
Cleavage
The division of a fertilized egg. The embryo size
remains unchanged; the cleavage cells become smaller
with each division.
Clomiphene Citrate (Seraphene/Clomid)
Clomiphene citrate is an oral medication that
induces ovulation by blocking estrogen receptors.
This artificial estrogen effect causes your body
to believe estrogen is low, triggering the production
of more follicle-stimulating hormone (FSH) and
luteinizing hormone (LH). Clomiphene citrate is
available in 50 mg tablets. It is used to stimulate
the ovaries to produce one or more eggs in women
who do not otherwise ovulate or have irregular
cycles or infrequent periods. The dosage range
is 25 mg (½ tablet) to 150 mg (3 tablets)
once a day for five days early in a woman's menstrual
cycle, frequently cycle days two through six.
If your body responds properly to the drug, you
should ovulate about a week after you have taken
the last tablet. The dosage and the days the drug
is taken are determined by your physician based
on your diagnosis. Some form of monitoring is
recommended while you are taking clomiphene citrate.
This monitoring may include ultrasounds, blood
estrogen levels, and/or urinary LH testing. Side
effects may include: hot flashes, ovarian enlargement,
breast tenderness, nausea, vomiting, visual disturbances,
headache, and multiple pregnancy.
Clomid
See Clomiphene Citrate.
Corpus Luteum
After a woman ovulates, the fluid filled sac in
which the egg matures (the follicle) becomes the
corpus luteum. It continues to produce androgen,
estrogen, and progesterone, hormones that prepare
the uterine lining to accept and nurture the fertilized
egg.
Cryopreservation
A technique that involves freezing and preserving
embryos, oocytes, or sperm.
Cycle Synchronization
A procedure for making sure that an egg donor
and an egg recipient reach the middle of their
menstrual cycle at the same time.
Cyst
A fluid-filled sac.
Cytoplasmic Transfer
A laboratory-based micromanipulation technique
that involves the injection of the cytoplasm from
a healthy egg from a donor into the core of another
woman's egg. The intent is to overcome deficiencies
that preclude normal development of embryos created
after the deficient egg is fertilized.
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D
Donor Insemination
Artificial insemination with donor sperm.
Donor Embryo
An embryo formed from the egg of a woman who donated
it (the donor) for transfer to a woman who is
unable to conceive with her own eggs (the recipient).
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E
Ectopic Pregnancy
A pregnancy in the fallopian tube or elsewhere
outside the lining of the uterus. Also called
a tubal pregnancy.
Egg
A female reproductive cell, also called an oocyte
or ovum.
Egg Donation
Surgical removal of an egg from one woman for
in vitro fertilization (IVF) and transfer into
another woman.
Egg Harvest
See Egg Retrieval.
Egg Retrieval
Using a needle to puncture the wall of the vagina
while a patient is under sedation, the physician
enters the ovaries to retrieve the ripened eggs
as part of in vitro fertilization. Also known
as egg harvest, follicle aspiration, or oocyte
aspiration.
Ejaculate
The seminal fluid and sperm released from the
penis during orgasm.
Embryo
An egg in the early stages of growth from fertilization
by a sperm until the eighth week of pregnancy.
Embryo Transfer
A quick and usually painless procedure involving
the placement of embryos into a woman's uterus
through the cervix after in vitro fertilization
(IVF).
Embryology
A scientific specialty focusing on embryo development.
Embryologist
A scientist who is specially trained in the various
aspects of embryo formation and their development,
as well as assisted reproductive technologies.
Endometrial Biopsy
A procedure that involves removal of a small piece
of endometrial tissue, the lining of the uterus,
to determine whether it has the qualities required
to sustain pregnancy.
Endometriosis
A disease in which tissue from the uterine lining
grows outside of the uterus. When this tissue
"sheds" during a menstrual cycle, blood
and tissue collects in the abdomen.
Epididymis
A highly convoluted, 10-20 foot-long central passageway
attached to the male testes, through which sperm
moves.
Estradiol (E2)
The most important hormone in the estrogen family.
Produced by the corpus luteum, it promotes growth
and maintenance of the reproductive system. Your
doctor may take a blood test to determine your
E2 level; if it is more than 50, your FSH level
may be suppressed, which could indicate a compromised
ovarian reserve despite a normal FSH level.
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F
Fallopian Tubes
A pair of tubes, one on each side of the pelvis,
leading from the ovaries to the uterus. The sperm
and egg meet in the fallopian tubes during normal
conception.
Fertilization
The process during which a sperm penetrates an
egg, fusion of genetic material occurs, and an
embryo develops.
Fetus
The stage of development of a pregnancy from the
third month until delivery.
Fibroid
Also known as a myoma or leiomyoma, a benign (noncancerous)
tumor found in the wall of the uterus. Fibroids
are extremely common; more than 40% of all women
develop fibroids, and most do not cause symptoms
or require treatment. Some fibroids, however,
may cause problems with fertility and should be
removed. They may also be removed if they are
growing large enough to cause pressure on other
organs, such as the bladder, or are causing abnormal
bleeding.
Fimbria
The delicate ends of the fallopian tubes that
help pick up the egg from the ovary.
Fluorescence In-situ Hybridization (FISH)
A laboratory technique, used in preimplantation
genetic diagnosis, to distinguish abnormal cells
taken from a human embryo. FISH uses probes -
small pieces of DNA that are "labeled"
with a fluorescent dye. When applied to the cell
being studied, the probes attach to matching chromosomes,
showing the geneticist whether the cell has an
unbalanced make-up, indicating a genetic abnormality.
Embryos with certain identifiable chromosomal
abnormalities that may prevent implantation, contribute
to pregnancy loss or result in a child born with
a genetic disease are not transferred into the
female during in vitro fertilization.
Follicle
A sac-like structure in the ovary that protects
and nurtures a ripening egg until ovulation, the
point at which the egg is released.
Follicle Aspiration
See Egg Retrieval.
Follicle-Stimulating Hormone (FSH)
A hormone, secreted by the anterior pituitary
gland, which promotes the development of ova in
the female and testicular function in the male.
In women, FSH stimulates the ovary to ripen a
follicle during the menstrual cycle. High FSH
values in a woman before menopause may mean that
her ovaries are not working or that she may have
polycystic ovary syndrome (PCOS). In men, FSH
helps control the production of sperm. The amount
of FSH in men normally remains constant.
Injectable Follicle-Stimulating Hormone
(FSH) (brand names: Follistim, Gonal-F)
is a genetically engineered (recombinant) form
of FSH which is used to stimulate the recruitment
and development of multiple eggs in women during
an ovulation induction cycle. FSH products may
be used alone or in combination with human menopausal
gonadotropins (hMG). Due to the variability in
response from patient to patient, each patient's
cycle must be individualized. This requires ultrasound
exams and blood estrogen levels to assess ovarian
response. FSH is available only in an injectable
form. You will need to learn injection techniques.
FSH is administered by subcutaneous or intramuscular
injection. This injection should be given at the
same time each evening. Side effects may include:
ovarian enlargement and discomfort, ovarian hyperstimulation
syndrome, multiple gestation, abdominal pain,
and headache. Discomfort and bruising may occur
at the injection site. Monitoring with ultrasounds
and estradiol minimizes the risk of complications.
Follicular Fluid
The fluid inside the follicle that cushions and
nourishes the ovum. When released during ovulation,
the fluid stimulates the fimbria to grasp the
ovary and coax the egg into the fallopian tube.
Follicular Phase
The first half of the menstrual cycle, during
which the dominant follicle secretes large amounts
of estrogen.
Follistim
See Follicle-Stimulating Hormone.
Fragment Removal
Performed in conjunction with assisted hatching,
this laboratory-based technique involves removing
tiny pieces of cytoplasm from between the individual
cells of an embryo to help it develop normally.
Frozen Embryo Transfer (FET)
The transfer to the uterus of an embryo that has
been frozen (cryopreserved) and then thawed.
FSH
See Follicle-Stimulating Hormone.
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G
Gamete
A male or female reproductive cell, i.e., a sperm
or an ovum (egg).
Gene
A structure within the nucleus of a cell that
contains hereditary characteristics. Genes consist
of DNA and are found at specific locations on
chromosomes.
Genetic Abnormality
A disorder resulting from a chromosomal error
or a mistake in the structure of a gene.
Genetic Counseling
Advice offered by experts in genetics on the detection,
consequences, and risk of recurrence of chromosomal
and genetic disorders.
Geneticist
A specialist in the areas of biology that deal
with genetic make-up and heredity. Geneticists
in the field of human reproductive medicine focus
on eggs and sperm as well as the embryos and offspring
resulting from fertilization.
Gestational Sac
A fluid-filled structure surrounding a fetus that
develops within the uterus early in pregnancy.
GnRH
See Gonadotropin-Releasing Hormone.
Gonadotropin-Releasing Hormone (GnRH)
Hormone secreted by the hypothalamus, a control
center in the brain, that prompts the pituitary
gland to release follicle-stimulating hormone
(FSH) and luteinizing hormone (LH) into the bloodstream.
Gonal-F
See Follicle-Stimulating Hormone.
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H
hCG
See Human Chorionic Gonadotropin.
hMG
See Human Menopausal Gonadotropin.
HSG
See Hysterosalpingogram.
Human Chorionic Gonadotropin (hCG)
A hormone produced following ovulation which aids
the corpus luteum in the production of progesterone,
required to prepare the uterine lining for implantation
of the fertilized egg. One single dose of injectable
HCG (brand names: Ovidrel, Profasi, Pregnyl) is
given to IVF patients approximately 35 hours prior
to egg retrieval. HCG completes the maturation
of the eggs and readies them for retrieval. Side
effects may include: headaches, irritability,
restlessness, depression, fatigue, edema, and
ovarian hyperstimulation.
Humegon
See Human Menopausal Gonadotropin.
Human Menopausal Gonadotropin (hMG)
A hormone used to stimulate the development of
multiple follicles. Injectable human menopausal
gonadotropin, also known as menotropin (brand
names: Humegon, Pergonal, Repronex), is a purified
preparation of the naturally occurring hormones
follicle-stimulating hormone (FSH) and luteinizing
hormone (LH). These medications stimulate the
ovaries to develop many follicles and mature eggs.
If your pituitary does not release FSH and LH
properly, hMG can be given to stimulate the production
of eggs. Studies show that about 90% of women
on hMG will ovulate and 40% will conceive when
the tubes are patent, the sperm count is adequate,
and the ovary has normal reserve. Formulations
of hMG intended for intramuscular injection (an
injection into muscle) must not be administered
subcutaneously (into fat), and vice versa. If
you are administering this medication at home,
your doctor will give you detailed instructions
on how to mix the solution and give yourself the
injection. Do not inject menotropins if you are
not sure how. Side effects may include: allergic
reactions, ovarian enlargement and discomfort,
hyperstimulation syndrome, multiple gestation,
abdominal pain, and headaches. Discomfort and
bruising may occur at the injection site. Monitoring
with ultrasounds and blood tests minimizes the
risk of complications.
Hydrosalpinx
Is a blocked, fluid-filled fallopian tube caused
by a previous tubal infection. Mild cases may
be opened surgically. If both fallopian tubes
are completely blocked (hydrosalpinges), conception
can not occur without medical intervention. In
vitro fertilization (IVF) is the method of choice.
The fluid from the hydrosalpinx appears to reduce
the success of embryo implantation and increase
the chance of miscarriage. Because of this, your
physician may recommend removing your tube(s)
to increase your chances of success with IVF.
Hyperprolactinemia
An overproduction of prolactin by the pituitary
gland, this condition affects ovulation and breast
milk production.
Hyperstimulation Syndrome
See Ovarian Hyperstimulation Syndrome.
Hypothalmic Amenorrhea
This results when the hypothalamus, a gland in
the brain, stops producing gonadotropin-releasing
hormone (GnRH), which stimulates the pituitary
gland to release the appropriate levels of follicle-stimulating
hormone (FSH) and luteinizing hormone (LH) needed
for egg development and ovulation.
Hypothyroidism
Caused by an underactive thyroid, this affects
hormone production and can cause irregular periods
and breast milk production in women who aren't
pregnant.
Hysterosalpingogram (HSG)
A radiological examination of the female reproductive
system in which radiographic contrast (dye) is
injected into the uterine cavity through the vagina
and cervix and X-ray pictures are taken as the
dye is expelled from your reproductive system.
The uterine cavity fills with dye, and if the
fallopian tubes are open, the dye will then fill
the tubes and spill out into the abdominal cavity,
allowing the doctor to determine whether the fallopian
tubes are open or blocked and whether the blockage
is located at the junction of the tube and the
uterus (proximal) or at the end of the fallopian
tube (distal). These two areas where the tube
is most commonly blocked have different causes.
If blockage is detected, your doctor will discuss
with you effective treatments for tubal factor
infertility. Your HSG can also give us a better
picture of the uterine cavity and detect the presence
of polyps, fibroids, or scar tissue. The fallopian
tubes can also be examined for defects or blockage.
Hysterosonogram
Also called Saline Infusion Sonography (SIS) or
sonohystogram (SonoHSG), hysterosonogram is a
test to study the inner surface of the uterus.
An ultrasound is performed using a vaginal probe,
and at the same time saline solution is injected
into the uterus through a thin catheter. This
helps delineate the inner contents of the uterus.
Lumps called submucosal fibroids or polyps cannot
be seen well without the injection of saline solution.
This test is used to find the cause of heavy periods
and to investigate infertility and repeated miscarriages.
Hysteroscopy
An outpatient diagnostic procedure in which the
physician uses a fiber optic scope, inserted through
the vagina and cervical canal, to examine the
inside of the uterus. If adhesions or blockages
exist, they often can be removed at the same time
in what's known as an "operative hysteroscopy."
In an operative hysteroscopy specialized surgical
instruments are inserted through the scope. Guided
by the hysteroscope, surgery on the lining of
the uterus can remove polyps and fibroids, correct
congenital uterine abnormalities and surgically
excise the lining of the uterus to manage heavy
menstrual flow.
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I
ICSI
See Intracytoplasmic Sperm Injection.
Implantation
The embedding of a fertilized egg in the endometrium
of the uterus.
Impotence
The inability of a man to achieve or maintain
an erection and to ejaculate due to physical or
emotional problems or a combination thereof. Impotence
is not to be confused with sterility.
Incomplete Abortion
A miscarriage where some tissue is passed but
some remains in the uterus.
Infertility
The inability of a couple to achieve a pregnancy
after one year of unprotected sex, or the inability
of a woman to carry a pregnancy to live birth.
Inhibin
One of two hormones (inhibin A and inhibin B)
that inhibit the production of follicle-stimulating
hormone from the pituitary gland. Women with low
levels of Inhibin-B have been found to have more
impaired ovulation during IVF, lower pregnancy
rates, and higher miscarriage rates. Inhibin B
may be tested on day three of the menstrual cycle
to measure ovarian reserve.
Injectable Fertility Medications
Medications given by injection in fertility treatments
such as ovulation induction and IVF, which may
include the following drugs: Lupron (leuprolide
acetate, a GnRH analog) to prevent premature ovulation;
FSH (Follistim /Gonal-F), a genetically engineered
(recombinant) form of follicle-stimulating hormone,
used to stimulate the recruitment and development
of multiple eggs; hMG (Humegon/Repronex), a purified
preparation of the naturally occurring hormones
follicle-stimulating hormone (FSH) and luteinizing
hormone (LH), also used to stimulate the ovaries
to develop many follicles and mature eggs; and
hCG or Human Chorionic Gonadotropin (Ovidrel/Profasi/Pregnyl),
a natural hormone that helps with the final maturation
of the eggs and triggers the ovaries to release
the mature eggs (ovulation).
Insemination
The placement of semen into a woman's vagina for
the purpose of conception.
Intracytoplasmic Sperm Injection (ICSI)
A micromanipulation procedure, ICSI is used most
commonly in cases of severe male infertility.
It involves injection of a single sperm directly
into the core of an egg. In order to undergo ICSI,
a couple must follow the same steps as for in
vitro fertilization (IVF). All treatments and
procedures are the same as those for standard
IVF, with the addition of the ICSI procedure itself.
Fertilization rates following ICSI are similar
to those of standard IVF.
Intrauterine Insemination (IUI)
Intrauterine insemination uses injectable fertility
medications or oral medications (clomiphene citrate)
to stimulate the release of mature eggs on a known
schedule. At maturation, a semen specimen is obtained,
which may be washed (separated from the seminal
fluid) and prepared in an andrology laboratory,
to increase its potency. The semen is then placed
into a catheter, which is positioned into the
woman's uterus, where the semen is released.
In Vitro Fertilization (IVF)
An assisted reproductive technology that involves
ovulation induction and the surgical removal of
eggs from the woman's ovaries, which are then
combined with sperm in a laboratory dish to facilitate
fertilization. If fertilization occurs, a limited
number of resulting embryos are transferred to
the uterus.
IUI
See Intrauterine Insemination.
IVF
See In Vitro Fertilization.
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K
Karyotype
The general appearance, including size, number,
and shape, of the set of somatic chromosomes.
Karyotyping involves creating a photomicrograph
of an individual's chromosomes arranged in a standard
format showing the number, size, and shape of
each chromosome type.
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L
Laparoscopy
A procedure that allows a physician to view the
ovaries, as well as the outside of the fallopian
tubes and uterus, with a scope inserted through
a small incision through the umbilicus. If necessary,
growths and blockages may be removed during the
same procedure.
Laparotomy
Inpatient surgery performed through an abdominal
incision. It may be performed for procedures such
as a myomectomy, excision of endometriosis and
ovarian tumors. In certain situations a laparotomy,
as opposed to a laparoscopy, is necessary to gain
better access of the pelvis and is the safer surgical
choice.
Leiomyoma
See Fibroid.
Leuprolide acetate
See Lupron.
LH
See Luteinizing Hormone.
LH Surge
The spiking release of luteinizing hormone (LH)
that causes release of a mature egg from its follicle.
Ovulation test kits detect the sudden release
of LH, signaling that ovulation is about to occur
(usually within 24-36 hours).
Lupron
The brand name for Leuprolide acetate, a GnRH
analog. Lupron suppresses the brain's secretion
of LH and FSH. It is used in preparation for cycles
of treatment with ovulation induction drugs (hMG
and/or FSH) for IVF. Lupron causes the ovaries
to shut down and rest (suppression). Given a chance
to rest, the ovaries respond better and a more
controlled cycle can be achieved. Lupron enables
the ovaries to respond with the recruitment of
multiple follicles since in most cases it can
override the selection of a single dominant follicle.
It also prevents premature ovulation (release
of eggs) by preventing LH release.
To confirm the effectiveness of the Lupron treatment,
an ultrasound will be performed before the ovarian
stimulation is begun and a blood estrogen level
will be required. Lupron is available in an injectable
form. Therefore, you and your partner will be
taught subcutaneous injection. The multi-dose
vial should be kept cool (< 75°F), so refrigeration
is recommended. This drug should be given at the
same time every day (one-hour leeway). If you
are starting Lupron after a spontaneous menstrual
cycle (no oral contraceptive pills) you should
use barrier contraception for the preparatory
cycle.
Side effects may include: hot flushes, vaginal
dryness, and skin rash. Side effects of long-term
treatment (greater than six weeks) include hot
flushes, vaginal dryness, and bone loss. These
side effects are extremely rare after short-term
use associated with standard IVF. No long-term
side effects after IVF treatment have been known
to occur.
Luteinizing Hormone (LH)
A hormone, secreted by the anterior lobe of the
pituitary gland. In females it stimulates ovulation
and the development of the corpus luteum, which
produces progesterone. In men LH stimulates the
development of interstitial tissue as well as
the secretion of testosterone. The increase in
LH (produced by the pituitary gland) during the
middle of a woman's cycle triggers ovulation,
the release of a ripened egg from a follicle.
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M
Male Factor Infertility
Infertility that can be attributed to a reproductive
problem in the male partner. In roughly 35% of
all infertility cases, the cause is attributed
to a factor in the male and in some 25% of cases
the cause is attributed to both male and female
factors. Male factor infertility can include any
of the following problems: lack of sperm, low
sperm counts, poor motility or movement of the
sperm, poor sperm quality, sperm that lack the
ability to penetrate an egg, or problems with
sperm delivery such as retrograde ejaculation.
Meiosis
The process of two consecutive nuclear divisions
in the formation of gamete cells, by which the
number of chromosomes is reduced from the diploid,
or double, number found in somatic cells to the
haploid, or halved, number found in gametes (sperm
and ova).
Menotropin
See Human Menopausal Gonadotropin.
Menses
A woman's menstrual flow or period.
Micromanipulation
The mechanical manipulation of oocytes, sperm,
or embryos under a microscope. Intracytoplasmic
sperm injection (ICSI), assisted hatching, and
embryo biopsy are all forms of micromanipulation.
MicroSort®
A method used to select a baby's sex or gender
by separating X-bearing (female) sperm from Y-bearing
(male) sperm. The MicroSort technology is based
on the difference in size between an X chromosome
and the much smaller Y chromosome. Since chromosomes
are made of DNA, human sperm cells having an X
chromosome will contain approximately 2.8% more
total DNA than sperm cells having a Y chromosome
. This DNA difference can be measured and the
X- and Y-bearing sperm cells individually separated
using a modified flow cytometer instrument. The
resulting purity (enrichment) of the separated
sperm cells can be determined by a DNA analysis
method called FISH (fluorescence in situ hybridization)
in a small unused portion of the sorted sample.
FISH uses DNA probes that specifically attach
to either the X or Y chromosome in sperm and emit
a red/pink color for X-bearing sperm and green
for Y-bearing sperm. The X- and Y-bearing sperm
can be identified and counted under a microscope
to determine the purity. At the present time the
MicroSort technology yields a better than 80%
success rate in selecting for female babies and
a better than 70% success rate in selecting for
male babies.
Microsurgical Sperm Aspiration
A procedure using an operating microscope to obtain
sperm that can be used in conjunction with Intracytoplasmic
Sperm Injection (ICSI) to treat certain cases
of male infertility.
Microsurgical Epididymal Sperm Aspiration
(MESA)
A microsurgical procedure to extract fluid and
sperm directly from an epididymal tubule, where
sperm is stored. The sperm is prepared in the
laboratory for use with ICSI.
Miscarriage
A spontaneous abortion.
Myoma
See Fibroid.
Myomectomy
A surgical procedure to remove fibroids from the
uterus and repair the uterine wall. (See also
Advanced Laparoscopic Surgery)
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N
Norethindrone Acetate
See Aygestin.
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O
OHSS
See Ovarian Hyperstimulation Syndrome.
Oocyte
The ovum or egg; the female gamete.
Oocyte Aspiration
See Egg Retrieval.
Oocyte Donation
See Egg Donation.
Oral Contraceptives
Although typically prescribed to prevent pregnancy,
oral contraceptives may be prescribed to IVF cycling
patients to inhibit ovulation and quiet the ovaries
in advance of egg stimulation using injectable
hormones. This "down time" helps the
ovaries respond better to treatment. In much the
same way that oral contraceptives prevent pregnancy
by inhibiting normal ovulation, these drugs are
used in IVF and related procedures to turn off
the body's natural ovulatory cycle. Side effects
may include: abdominal pain or cramps; diarrhea;
fatigue; unusual tiredness; weakness; hot flashes;
decreased sex drive; nausea; trouble sleeping;
depression, irritability, or other mood changes;
swelling in the face, ankles, or feet; weight
gain.
Ovarian Cyst
A fluid-filled sac inside the ovary. An ovarian
cyst may be found in conjunction with ovarian
disorders, tumors of the ovary, and endometriosis.
Ovarian Failure
The failure of the ovary to respond to FSH stimulation
from the pituitary because of damage to or malformation
of the ovary. Diagnosed by elevated FSH in the
blood.
Ovarian Hyperstimulation Syndrome (OHSS)
A possible side effect of treatment with follicle-stimulating
hormone (FSH) or human menopausal gonadotropin
(hMG) in which ovaries become painful and swollen
and fluid may accumulate in the abdomen and chest.
Close monitoring of IVF patients helps to minimize
the occurrence of OHSS.
Ovarian Reserve
The number and quality of eggs remaining in a
woman. Some never mature, while others mature
and are released during menstrual cycles.
Ovary
The sexual gland of the female that produces the
hormones estrogen and progesterone, and in which
the ova are developed. A woman has two ovaries,
one on each side of the pelvis, which are connected
to the uterus by the fallopian tubes.
Ovulation
The release of a ripened egg from its follicle.
Ovidrel
See Human Chorionic Gonadotropin.
Ovulation Induction
A type of infertility treatment that uses hormone
therapy to stimulate oocyte (egg) development
and release. Initial therapy may include oral
tablets taken for a few days (clomiphene citrate).
Second-line ovulation induction therapy may require
the use of injectable fertility medications, which
are the same as hormones found in the body, but
administered in higher doses than are produced
naturally. In either case, the desired effect
is to promote the release of mature eggs on a
known schedule, increasing the chances of pregnancy
through intercourse.
Ovulatory Dysfunction
Any one of a number of conditions that affect
menstruation and ovulation. Ovulatory dysfunction
results from congenital defects, hormonal deficiencies,
and/or the aging process. Types include amenorrhea,
lack of a period; anovulation, when no eggs are
released during ovulation; oligoovulation, characterized
by longer cycles and infrequent ovulation and
luteal phase defects; and other types of ovulatory
dysfunction.
Ovum
The egg or oocyte; the female gamete.
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P
Pap Smear
A procedure in which cells are removed from the
surface of the cervix and studied under a microscope.
Pelvic Inflammatory Disease (PID)
PID is the general term for inflammation of the
female genital tract. It is caused by a serious
infection and can lead to irreparable damage to
the fallopian tubes. PID is often caused by a
sexually transmitted disease such as gonorrhea
or Chlamydia.
Pergonal
See Human Menopausal Gonadotropin.
Pituitary Gland
An organ at the base of the brain that secretes
the hormones prolactin, luteinizing hormone (LH),
and follicle-stimulating hormone (FSH). Known
as the "master gland," the pituitary
gland controls most of the other endocrine glands
of the body.
Polar Body
Two microscopic structures that are produced by
the ripening egg and degenerate after fertilization.
Examination of the polar bodies can provide an
indication of the egg's chromosomal content.
Polycystic Ovarian Syndrome (PCOS)
A genetically-linked hormonal imbalance that prevents
ovulation. PCOS may also cause overproduction
of estrogen, abnormal thickening of the uterine
lining, very heavy and/or irregular periods, as
well as acne and facial hair. The latter are caused
by an overproduction of male hormones, including
testosterone.
Polyp
A small growth or fold of the lining in the uterus
or cervix.
Preimplantation Genetic Diagnosis (PGD)
A technique that involves examination of the chromosomes
contained in the polar body, taken from an egg,
or a blastomere from a developing embryo. Using
a special technique, scientists and geneticists
can look for genetic abnormalities that can affect
embryo implantation, contribute to miscarriage,
or cause genetic disease in offspring.
Pregnyl
See Human Chorionic Gonadotropin.
Premature Ovarian Failure
Also called early menopause, this can result from
exposure to certain chemicals, chemotherapy and
radiation for cancer treatment. Other causes are
certain genetic disorders and certain immunological
abnormalities.
Primary Infertility (PI)
Refers to those struggling with infertility without
ever having conceived. Popular usage extends to
those who have conceived but have not had a live
birth.
Profasi
See Human Chorionic Gonadotropin.
Progestin
A synthetic substance that chemically resembles
progesterone. See Aygestin.
Progesterone
A major female hormone produced by the corpus
luteum and later, when an embryo develops, by
the placenta. Progesterone is needed to prepare
and sustain the uterus for pregnancy. It controls
the development of the lining of the uterus and
prepares it for embryo implantation. If progesterone
production is inadequate, the endometrium will
not be able to sustain the implantation of the
embryo.
Prolactin
A female hormone, produced by the pituitary gland,
that controls lactation (breast milk production).
Elevated prolactin levels (>25 ng/ml) may interfere
with ovulation.
Prostate Gland
A structure in the male reproductive system through
which semen enters the urethra (a long tube leading
from the prostate gland to the end of the penis)
prior to ejaculation.
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R
Recombinant (Human) Follicle-Stimulating Hormone
(R-FSH or R-hFSH)
Genetically engineered follicle-stimulating hormone,
as opposed to the FSH extracted from the urine
of post-menopausal women. See Follicle-Stimulating
Hormone.
Reproductive Endocrinologist (RE)
An obstetrician/ gynecologist who specializes
in female reproduction. A reproductive endocrinologist
must attain additional academic and clinical training,
a fellowship, in reproduction and the diagnosis
and treatment of infertility.
Repronex
See Human Menopausal Gonadotropin.
RESOLVE
A national organization devoted to education and
advocacy about infertility.
Retrograde Ejaculation
A male infertility problem that causes sperm to
travel to the bladder rather than out of the opening
of the penis due to a malfunction of the sphincter
muscle at the base of the bladder.
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S
Secondary Infertility
The inability to conceive or carry to term a pregnancy
after having successfully conceived and carried
one or more pregnancies.
Semen
The sperm and seminal secretions ejaculated during
orgasm.
Semen Analysis
Part of the male infertility work-up. Semen analysis
is used to determine the quantity and quality
of sperm available for fertilization.
Seminal Vesicle
A small pouch located behind the male's bladder
and connected to the vas deferens, through which
semen and sperm pass on the way to the prostate
gland and urethra.
Seminiferous Tubules
Tiny tubes, located in the male testes, in which
sperm is produced.
Serephene
See Clomiphene Citrate.
Sexually Transmitted Diseases (STDs)
Any one of a number of infectious diseases that
are transmitted through sexual intercourse such
as: gonorrhea, Chlamydia and HIV. Sexually transmitted
diseases can lead to pelvic inflammatory disease
and other fertility-related problems in women.
Sperm
A male reproductive cell.
Sperm Morphology
The size and shape (form) of an individual sperm.
Sperm Motility
The ability of sperm to move and swim in a forward
direction.
STD
See Sexually Transmitted Disease.
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T
TESA
See Testicular Sperm Extraction/Aspiration.
TESE
See Testicular Sperm Extraction/Aspiration.
Testicular Biopsy
A procedure that allows for microscopic examination
of a tissue sample of the seminiferous tubules
that contain sperm. The sample, removed through
a small incision in the scrotum, can help identify
the causes of infertility and suggest a course
of treatment.
Testicular Sperm Extraction/Aspiration
(TESE/TESA)
When sperm are only present in the testis and
not in the collecting tubules, they may be obtained
directly from the testicle in one of two techniques
known collectively as TESE/TESA. Either a small
incision is made in the scrotum and testicle to
remove a tiny biopsy sample of the testis (TESE),
or a fine needle is inserted into the testis to
suck sperm from the tubules (TESA). In the laboratory,
the tissue is then processed to extract sperm
for use in intracytoplasmic sperm injection (ICSI)
and in vitro fertilization.
Thyroid-Stimulating Hormone (TSH)
A hormone secreted by the thyroid gland . TSH
levels may be tested to check for thyroid disease,
which is common among women. A suppressed level
of TSH (<0.35 microIU/ml) is found in hyperthyroid
patients, patients on suppressive thyroid medications,
or possibly patients with hypothalamic pituitary
disease. Conversely, a high TSH level (>5.0
microIU/ml) is consistent with primary hypothyroidism.
Either condition may cause fertility problems
by promoting hormonal imbalances, leading to anovulation
or other problems in a woman's menstrual cycle.
Tubal Factor
A cause of infertility related to structural or
functional damage to one or both fallopian tubes.
Tubal Ligation
The process of "tying" the tubes to
prevent pregnancy, this surgical procedure can
involve tying, clamping off or burning the ends
of the fallopian tubes.
Tubal Pregnancy
See Ectopic Pregnancy.
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U
Ultrasound
A diagnostic procedure using sound waves that
produces a two or three dimensional picture used
for the examination, evaluation and measurement
of the abdominal cavity, reproductive organs,
developing follicles and developing fetus.
Unexplained (Idiopathic) Infertility
Infertility for which no cause has been determined
despite a comprehensive evaluation.
Uterine Septum
An abnormality of the uterus in which the inside
of the uterus is divided by a wall (septum). The
septum may extend only part way into the uterus
or it may reach as far as the cervix. A uterine
septum does not usually cause infertility but
it may make it more difficult for a woman to carry
a baby for the full nine months of pregnancy.
A uterine septum can usually be corrected without
damage to the uterus through a procedure called
a hysteroscopy.
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V
Varicocelectomy
(Varicocele Repair)
Microsurgery performed to tie off swollen veins
around the male testes. This prevents the pooling
of blood which can raise testicular temperatures
and potentially affect sperm production.
Vas Deferens (Vas)
Attached to the epididymis, the vas deferens is
one of two tubes through which semen and sperm
move before reaching the seminal vesicle and prostate
gland.
Vasectomy
An elective male sterilization procedure, it involves
cutting and tying off the ends of the vas deferens
to keep sperm from traveling to the ejaculatory
duct.
Vasovasostomy (Vasectomy Reversal)
Microsurgical removal of scarred sections, and
recon-nection of the inner and outer layers of
the vas deferens after a vasectomy, allowing sperm
to travel out of the epididymis and into the ejaculate.
Vasoepididymostomy (Epididymal Repair)
A microsurgical technique used in cases where
the epididymal tubule is blocked, it involves
stitching both layers of the vas deferens directly
to the epididymis and its inner tubule at a point
above the obstruction, allowing fluids to bypass
the blockage.
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Z
Zona Pellucida
The outer membrane of a human egg.
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