Sims International Fertility Clinic Building, mother with child and doctor at work in laboratory

Terminology

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

ADHESION Scar tissue occurring in the abdominal cavity, fallopian tubes, or inside the uterus. Adhesions can interfere with transport of the egg and implantation of the embryo in the uterus.

ADRENAL ANDROGENS Male hormones produced by the adrenal gland which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in the woman may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland, or ovary. May also be associated with excess prolactin levels. AID (Artificial Insemination Donor) or AIH (Artificial Insemination Homologous/Husband) See Artificial Insemination ~ Donor Insemination, Intrauterine Insemination.

AMENORRHEA The cessation of the menstrual periods for six months or more at a time. Primary Amenorrhea afflicts a woman who has never menstruated. Secondary Amenorrhea afflicts a woman who has menstruated at one time, but who has not had a period for six months or more.

ANDROLOGIST A physician scientist who performs laboratory evaluations of male fertility. May hold a Ph.D. degree instead of an M.D. Usually affiliated with a fertility treatment center working on in vitro fertilisation.

ANOVULATION The failure to ovulate, ovulatory failure.

ANTIBODIES Chemicals made by the body to fight or attack foreign substances entering the body. Normally they prevent infection, however, when they attack the sperm or fetus, they cause infertility. Sperm antibodies may be made by either the man or the woman.

ANTISPERM ANTIBODIES Antibodies are produced by the immune system to fight off foreign substances, like bacteria. Antisperm antibodies attach themselves to sperm and inhibit movement and their ability to fertilize.

ARTIFICIAL INSEMINATION (Al) Placing sperm into the vagina, uterus or fallopian tubes through artificial means instead of by coitus usually injected through a catheter or cannula after being washed. This procedure is used for both donor (AID) and husband's (AIH) sperm. This technique is used to overcome sexual performance problems, to circumvent sperm-mucus interaction problems, to maximize the potential for poor semen, and for using donor sperm. See Intrauterine Insemination.

ARTIFICIAL SPERMATOCOELE An artificial, surgically created pouch used to collect sperm from men with irreversible tubal blockage.

ASHERMAN'S SYNDROME A condition where the uterine walls adhere to one another. Usually caused by uterine inflammation.

ASSISTED REPRODUCTIVE TECHNOLOGY (ART) Several procedures employed to bring about conception without sexual intercourse, including IUI, IVF, GIFT and ZIFT.

ASTHENOZOOSPERMIA Low sperm motility.

AZOOSPERMIA Semen containing no sperm, either because the testicles cannot make sperm or because of blockage in the reproductive tract.

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B

BASAL BODY TEMPERATURE (BBT) Your body temperature when taken at its lowest point, usually in the morning before getting out of bed. Charting BBT is used to predict ovulation. Biphasic: A BBT pattern consistent with ovulation and the formation of the corpus luteum, which secretes progesterone. This hormone will elevate the basal body temperature about one half degree during the latter half of the menstrual cycle. Monophasic: An anovulatory BBT pattern where the temperature remains relatively constant throughout the cycle.

BETA HCG TEST A blood test used to detect very early pregnancies and to evaluate embryonic development.

BICORNUATE UTERUS A congenital malformation of the uterus where the upper portion (horn) is duplicated.

BROMOCRIPTINE (PARLODEL) An oral medication used to reduce prolactin levels and reduce the size of a pituitary tumor when present. This medication often causes dizziness and upset stomach and must be started with a small dose which is gradually increased as needed. This medication is equally effective when the tablet is placed into the vagina.

BUSERELIN A long acting GnRH available in Europe as a nasal spray and used to create the pseudomenopause desirable for reducing the size and number of endometriotic lesions. It can also be used to treat fibroid tumors, PMS, hirsuitism, ovulation induction and for in vitro fertilisation.

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C

CANDIDIASIS (YEAST) An infection that may be uncomfortable and itchy and may impair fertility.

CAPACITATION A process that sperm undergo as they travel through the womans reproductive tract. Capacitation enables the sperm to penetrate the egg.

CERVICAL STENOSIS A blockage of the cervical canal from a congenital defect or from complications of surgical procedures. See also "Cervix."

CERVICAL SMEAR A sample of the cervical mucus examined microscopically to assess the presence of oestrogen (ferning) and white blood cells, indicating possible infection.

CERVICAL MUCUS A viscous fluid plugging the opening of the cervix. Most of the time this thick mucus plug prevents sperm and bacteria from entering the womb. However, at midcycle, under the influence of estrogen, the mucus becomes thin, watery, and stringy to allow sperm to pass into the womb. See also "Cervix."

CERVIX The opening between the uterus and the vagina. The cervical mucus plugs the cervical canal and normally prevents foreign materials from entering the reproductive tract. The cervix remains closed during pregnancy and dilates during labor and delivery to allow the baby to be born.

CERVIX, INCOMPETENT A weakened cervix which opens prematurely during pregnancy and can cause the loss of the fetus. A

CERVICAL CERCLAGE is a procedure in which a stitch or two is put around the cervix to prevent its opening until removed when the pregnancy is to term.

CHOCOLATE CYST A cyst in the ovary that is filled with old blood; endometrioma. Occurring when endometriosis invades an ovary, it causes the ovary to swell. Frequently, patients with large endometriomas do not have any symptoms. If the cyst ruptures or the ovary containing the cyst twists, emergency surgery may be necessary. Usually treatment can be carried out through the laparoscope.

CHROMOSOME The structures in the cell that carry the genetic material (genes); the genetic messengers of inheritance. The human has forty-six chromosomes, twenty three coming from the egg and twenty three coming from the sperm.

CILIA Tiny hair like projections lining the inside surface of the fallopian tubes. The waving action of these 'hairs' sweeps the egg toward the uterus.

CLOMIPHENE CITRATE (CLOMID) , A fertility drug that stimulates ovulation through the release of gonadotropins from the pituitary gland.

CONDOM THERAPY Therapy prescribed to reduce the number of sperm antibodies in the woman by using a condom during intercourse for six months or more and by the woman refraining from all skin contact with the husband's sperm. The woman's antibody level may fall to levels that will not adversely affect the sperm.

CONE BIOPSY A surgical procedure used to remove precancerous cells from the cervix. The procedure may damage the cervix and thus disrupt normal mucus production or cause an incompetent cervix, which may open prematurely during pregnancy.

CONGENITAL ADRENAL HYPERPLASIA A congenital condition characterized by elevated androgens which suppress the pituitary gland and interfere with spermatogenesis or ovulation. Women may have ambiguous genitalia from the excess production of male hormone.

CORPUS LUTEUM The yellow pigmented glandular structure that forms from the ovarian follicle following ovulation. The gland produces progesterone, which is responsible for preparing and supporting the uterine lining for implantation. Progesterone also causes the half degree basal temperature elevation noted at midcycle during an ovulatory cycle. If the corpus luteum functions poorly, the uterine lining may not support a pregnancy. If the egg is fertilised, a corpus luteum of pregnancy forms to maintain the endometrial bed and support the implanted embryo. A deficiency in the amount of progesterone produced (or the length of time it is produced) by the corpus luteum can mean the endometrium is unable to sustain a pregnancy. This is called Luteal Phase Defect (LPD).

CUMULUS OOPHORUS The protective layer of cells surrounding the egg.

CUSHING'S SYNDROME A condition characterized by an over production of adrenal gland secretions. The person will suffer from high blood pressure and water retention as well as a number of other symptoms. A concurrent elevation of adrenal androgens will suppress pituitary output of LH and FSH and result in low sperm production or ovulatory failure. A woman may also develop male secondary sex characteristics, including abnormal hair growth. Cushings Disease is another condition in which these same symptoms occur, but as the result of a pituitary tumor.

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D

D&C (DILATATION AND CURETTAGE) A procedure used to dilate the cervical canal and scrape out the lining and contents of the uterus. The procedure can be used to diagnose or treat the cause of abnormal bleeding and to terminate an unwanted pregnancy.

DANAZOL A medication used to treat endometriosis. Suppresses LH and FSH production by the pituitary and causes a state of amenorrhea during which the endometrial implants waste away. Many women experience oily skin, acne, weight gain, abnormal hair growth, deepening of the voice and muscle cramps with this medication.

DES (DIETHYLSTILBESTROL) A medication prescribed in the 1950's and 1960's to women to prevent miscarriage. Male and female fetuses exposed in utero to this drug developed numerous deformities including blockage of the vas deferens, uterine abnormalities, cervical deformities, miscarriages, and unexplained infertility. DES is no longer prescribed for this indication.

DHEAS (DIHYDROEPIANDROSTERONE SULFATE) An androgen produced primarily by the adrenal gland. A high level suggests too much adrenal androgen output. See "Adrenal Androgens."

DONOR INSEMINATION Artificial insemination with donor sperm. See Artificial Insemination.

DOXYCYCLINE A tetracycline derivative, an antibiotic that inhibits many of the microorganisms infecting the reproductive tract. Often used for treating ureaplasma infections. Many physicians find routine treatment with this antibiotic more cost effective than performing multiple cultures on both the husband and wife looking for infection.

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E

ECTOPIC PREGNANCY A pregnancy outside of the uterus, usually in the fallopian tube. Such a pregnancy can rarely be sustained, and often leads to decreased or complete loss of function in the affected tube. Methotrexate is now used to dissolve the pregnancy without causing major damage to the tube.

EGG RETRIEVAL A procedure used to obtain eggs from ovarian follicles for use in In vitro fertilisation. The procedure may be performed during laparoscopy or by using a long needle and ultrasound to locate the follicle m the ovary.

EJACULATE The semen and sperm expelled during ejaculation.

EMBRYO The early products of conception; the undifferentiated beginnings of a baby; the conceptus.

EMBRYO TRANSFER Placing an egg fertilised outside the womb into a woman's uterus or fallopian tube.

EMPTY SELLA SYNDROME A condition that occurs when spinal fluid leaks into the bony chamber (fossa) housing the pituitary gland. The fluid pressure compresses the pituitary gland and may adversely affect its ability to secrete LH and FSH and may elevate prolactin levels.

ENDOMETRIAL BIOPSY A test to check for Luteal Phase Defect. A procedure during which a sample of the uterine lining is collected for microscopic analysis. The biopsy results will confirm ovulation and the proper preparation of the endometrium by estrogen and progesterone stimulation

ENDOMETRIOSIS A condition where endometrial tissue is located outside the womb. The tissue may attach itself to the reproductive organs or to other organs in the abdominal cavity. Each month the endometrial tissue inbreeds with the onset of menses. The resultant irritation causes adhesions in the abdominal cavity and in the fallopian tubes. Endometriosis may also interfere with ovulation and with the implantation of the embryo.

ENDOMETRIUM The lining of the uterus which grows and sheds in response to estrogen and progesterone stimulation; the bed of tissue designed to nourish the implanted embryo.

ENDORPHINS Natural narcotics manufactured in the brain to reduce sensitivity to pain and stress. May contribute to stress related fertility problems.

EPIDIDYMIS A coiled, tubular organ attached to and lying on the testicle. Within this organ the developing sperm complete their maturation and develop their powerful swimming capabilities. The matured sperm leave the epididymis through the vas deferens.

ESTRADIOL The principal estrogen produced by the ovary. Responsible for formation of the female secondary sex characteristics such as large breasts; supports the growth of the follicle and the development of the uterine lining. At midcycle the peak estrogen level triggers the release of the LH spike from the pituitary gland. The LH spike is necessary for the release of the ovum from the follicle. Fat cells in both obese men and women can also manufacture estrogen from androgens and interfere with fertility. The blood test to monitor estradiol is E2 Rapid Assay. Women on Menogon and other fertility drugs have routine E2 monitoring.

ESTROGEN Female sex hormone.

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F

FALLOPIAN TUBES Ducts through which eggs travel to the uterus once released from the follicle. Sperm normally meet the egg in the fallopian tube, the site at which fertilisation usually occurs.

FEMALE KALLMAN'S SYNDROME A condition characterized by infantile sexual development and an inability to smell. Since the pituitary cannot produce LH and FSH, the woman must take hormone supplements to achieve puberty, to maintain secondary sex characteristics, and to achieve fertility.

FERNING A pattern characteristic of dried cervical mucus viewed on a slide. When the fern pattern appears, the mucus has been thinned and prepared by estrogen for the passage of sperm. If it does not fern, the mucus will be hostile to the passage of the sperm.

FERTILITY TREATMENT Any method or procedure used to enhance fertility or increase the likelihood of pregnancy, such as ovulation induction treatment, varicocele repair, and microsurgery to repair damaged fallopian tubes. The goal of fertility treatment is to help couples have a child.

FERTILISATION The combining of the genetic material carried by sperm and egg to create an embryo. Normally occurs inside the fallopian tube (in vivo) but may also occur in a petri dish (in vitro). See also In Vitro Fertilisation.

FETUS A term used to refer to a baby during the period of gestation between eight weeks and term.

FIBROID (MYOMA OR LEIOMYOMA) A benign tumor of the uterine muscle and connective tissue.

FIMBRIA Finger like projections at the end of the fallopian tube nearest the ovary. When stimulated by the follicular fluid released during ovulation, the fingerlike ends grasp the ovary and coax the egg into the tube.

FOLLICLE STIMULATING HORMONE (FSH) A pituitary hormone that stimulates spermatogenesis and follicular development. In the man FSH stimulates the Sertoli cells in the testicles and supports sperm production. In the woman FSH stimulates the growth of the ovarian follicle. Elevated FSH levels are indicative of gonadal failure in both men and woman.

FOLLICLES Fluid filled sacs in the ovary which contain the eggs released at ovulation. Each month an egg develops inside the ovary in a fluid filled pocket called a follicle. This follicle is one inch in size and is about ready to ovulate.

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 preovulatory portion of a womans cycle during which a follicle grows and high levels of estrogen cause the lining of the uterus to proliferate. Normally takes between 12 and 14 days.

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G

GALACTORRHOEA A clear or milky discharge from the breasts associated with elevated prolactin.

GAMETE A reproductive cell: Sperm in men, the egg in women.

GAMETE INTRAFALLOPIAN TRANSFER (GIFT) A technique that may be used in lieu of in vitro fertilisation for women with patent (clear and open) tubes. After egg retrieval the eggs are mixed with the husbands sperm and then injected through the fimbria into the womans fallopian tubes for in vivo fertilisation.

GERM CELL In the male the testicular cell that divides to produce the immature sperm cells; in the woman the ovarian cell that divides to form the egg (ovum). The male germ cell remains intact throughout the mans reproductive life; the woman uses up her germ cells at the rate of about one thousand per menstrual cycle, although usually only one egg matures each cycle.

GERM CELL APLASIA (SERTOLI CELL ONLY) An inherited condition in which the testicles have no germ cells. Since men with this condition have normal Leydig cells, they will develop secondary sex characteristics. May also be caused by large and/or prolonged exposure to toxins or radiation.

GONAD The gland that makes reproductive cells and "sex" hormones: the testicles, which make sperm and testosterone, and the ovaries, which make eggs (ova) and estrogen.

GONADOTROPINS Hormones which control reproductive function: Follicle Stimulating Hormone and Lutenizing Hormone.

GONADOTROPIN RELEASING HORMONE (GNRH) The hormone which controls the production and release of gonadotropins. Secreted by the hypothalamus every ninety minutes or so, this hormone enables the pituitary to secrete LH and FSH, which stimulate the gonads. See FSH,LH.

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H

HIRSUITISM The overabundance of body hair, such as a mustache or pubic hair growing upward toward the navel, found in women with excess androgens.

 

HOSTILE MUCUS Cervical mucus that impedes the natural progress of sperm through the cervical canal. HUMAN

CHORIONIC GONADOTROPIN (HCG) The hormone produced in early pregnancy which keeps the corpus luteum producing progesterone. Also used via injection (Profasi) to trigger ovulation after some fertility treatments, and used in men to stimulate testosterone production.

HUMAN MENOPAUSAL GONADOTRIPIN (HMG MENOGON) A combination of hormones FSH and LH, which is extracted from the urine of postmenopausal women. Used to induce ovulation in several fertility treatments.

HUMEGON (HMG) Similar to Menogon: the lutenizing and follicle stimulating hormones recovered from the urine of postmenopausal women. Used to stimulate multiple ovulation in some fertility treatments.

HYPERPROLACTINAEMIA A condition in which the pituitary gland secretes too much prolactin. Prolactin can suppress LH and FSH production, reduce male sex drive, and directly suppress ovarian function.

HYPERSTIMULATION (OVARIAN HYPERSTIMULATION SYNDROME OHSS) A potentially life threatening side effect of Menogon, Humegon or Puregon ovulation induction. A woman's ovaries become enlarged and produce an over abundance of eggs. Blood hormone levels rise, fluid may collect in the lungs or abdominal cavity, and ovarian cyst may rupture, causing internal bleeding. Blood clots sometimes develop. Symptoms include sudden weight gain and abdominal pain. Cycles stimulated with these drugs must be carefully monitored with ultrasound scans. OHSS may be prevented by withholding the hCG injection when ultrasound monitoring indicates that too many follicles have matured.

HYPERTHYROIDISM Over production of thyroid hormone by the thyroid gland. The resulting increased metabolism "burns up" estrogen too rapidly and interferes with ovulation.

HYPOESTROGENIC Having lower than normal levels of estrogen.

HYPOGONADOTROPIC HYPOPITUITARISM A spectrum of diseases resulting in low pituitary gland output of LH and FSH. Men with this disorder have low sperm counts and may lose their virility; women do not ovulate and may lose their secondary sex characteristics.

HYPOSPERMATOGENESIS Low sperm production.

HYPOTHALAMUS A part of the brain, the hormonal regulation center, located adjacent to and above the pituitary gland. In both the man and the woman this tissue secretes GnRH every ninety minutes or so. The pulsatile GnRH enables the pituitary gland to secrete LH and FSH, which stimulate the gonads. See also FSH; LH; Ovary; Pituitary Gland; Testicle.

HYPOTHYROIDISM A condition in which the thyroid gland produces an insufficient amount of thyroid hormone. The resulting lowered metabolism interferes with the normal breakdown of 'old' hormones and causes lethargy. Men will suffer from a lower sex drive and elevated prolactin (see Hyperprolactinemia), and women will suffer from elevated prolactin and estrogen, both of which will interfere with fertility.

HYSTEROSALPINGOGRAM (HSG) An x-ray of the pelvic organs in which a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. This test checks for malformations of the uterus and blockage of the fallopian tubes.

HYSTEROSCOPY A procedure in which the doctor checks for uterine abnormalities by inserting a fibreoptic device. Minor surgical repairs can be executed during the procedure.

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I

ICSI INTRACYTOPLASMIC SPERM INJECTION A procedure in which a single sperm is injected into an egg. See intracytoplasmic Sperm Injection article.

IMMATURE SPERM (GERMINAL CELL) A sperm that has not matured and gained the ability to swim. In the presence of illness or infection such sperm may appear in the semen in large numbers.

IMPLANTATION (EMBRYO) The embedding of the embryo into tissue so it can establish contact with the mothers blood supply for nourishment. Implantation usually occurs in the lining of the uterus; however, in an ectopic pregnancy it may occur elsewhere in the body.

IMPOTENCE The inability of the man to have an erection and to ejaculate.

INFERTILITY The inability to conceive after a year of unprotected intercourse or the inability to carry a pregnancy to term.

INHIBIN A male feedback hormone made in the testicles to regulate FSH production by the pituitary gland.

INHIBIN F (FOLLICULOSTATIN) A female feedback hormone made in the ovary to regulate FSH production by the pituitary gland.

INTRACYTOPLASMIC SPERM INJECTION (ICSI) A micromanipulation procedure where a single sperm is injected into the egg to enable fertilisation with very low sperm counts or with nonmotile sperm.

INTRAUTERINE INSEMINATION (IUI) A relatively "lowtech" ART which deposits "washed" sperm directly into the uterus, bypassing cervical mucus and depositing the sperm more closely to the fallopian tubes, where fertilisation occurs. Used to bypass hostile cervical mucus and to overcome sperm count and motility problems. See Artificial Insemination.

IN VITRO FERTILISATION (IVF) Literally means "in glass." Fertilisation takes place outside the body in a small glass dish.

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J

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K

KALLMAN'S SYNDROME A congenital hypothalamus dysfunction which has multiple symptoms including the failure to complete puberty.

KARYOTYPING A test performed to analyze chromosomes for the presence of genetic defects.

KLINEFELTERS SYNDROME A genetic abnormality characterized by having one Y (male) and two X (female) chromosomes. May cause a fertility problem.

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L

LAPAROSCOPE A small telescope that can be inserted into a hole in the abdominal wall for viewing the internal organs; the instrument used to perform a laparoscopy. Used to diagnose and treat a number of fertility problems including endometriosis, abdominal adhesions, and polycystic ovaries. Also used in egg retrieval for in vitro fertilisation. Examination of the pelvic region by using a laparoscope is called a laparoscopy.

 

LAPAROTOMY Major abdominal surgery where reproductive organ abnormalities can be corrected and fertility restored, such as tubal repairs and the removal of adhesions.

LEYDIG CELL The testicular cell that produces the male hormone testosterone. The Leydig cell is stimulated by LH from the pituitary gland.

LUTEAL PHASE Postovulatory phase of a womans cycle. The corpus luteum produces progesterone, which cause the uterine lining to thicken to support the implantation and growth of the embryo.

LUTEAL PHASE DEFECT (OR DEFICIENCY) (LPD) A condition that occurs when the uterine lining does not develop adequately because of inadequate progesterone stimulation; or because of the inability of the uterine lining to respond to progesterone stimulation. LPD may prevent embryonic implantation or cause an early abortion.

LUTEINIZED UNRUPTURED FOLLICLE (LUF) SYNDROMEA condition in which the follicle develops and changes into the corpus luteum without releasing the egg.

LUTEINIZING HORMONE (LH) A pituitary hormone that stimulates the gonads. In the man LH is necessary for spermatogenesis (Sertoli cell function) and for the production of testosterone (Leydig cell function). In the woman LH is necessary for the production of estrogen. When oestrogen reaches a critical peak, the pituitary releases a surge of LH (the LH spike), which releases the egg from the follicle.

LUTEINIZING HORMONE SURGE (LH SURGE) The release of luteinizing hormone (LH) that causes release of a mature egg from the follicle. Ovulation test kits detect the sudden increase of LH, signaling that ovulation is about to occur (usually within 24-36 hours).

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M

MATURATION ARREST A testicular condition in which at one stage of sperm production all sperm development halts throughout all testicular tubules. May result in oligospermia or azoospermia.

 

MEIOSIS The cell division, peculiar to reproductive cells, which allows genetic material to divide in half. Each new cell will contain twenty-three chromosomes. The spermatids (immature sperm) and ova (eggs) each contain twenty three chromosomes, so when they combine (fertilize), the baby will have a normal complement of forty-six.

MENORRHAGIA Heavy or prolonged menstrual flow.

METRODIN (PURE FSH) An injectable form of Follicle Stimulating Hormone used to stimulate ovulation.

METRORRHAGIA Menstrual spotting during the middle of the cycle.

MISCARRIAGE Spontaneous loss of an embryo or fetus from the womb.

MITOSIS The division of a cell into two identical cells in which all forty-six human chromosomes are duplicated; the first division of the germ cell.

MITTLESCHMERZ The discomfort felt on one side of the lower abdomen at the time of ovulation.

MYCOPLASMASee Ureaplasma.

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O

OLIGMENORRHEA Infrequent menstrual periods.

OLIGOSPERMIA Having few sperm.

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 CYST A fluid filled sac inside the ovary. An ovarian cyst may be found in conjunction with ovulation disorders, tumors of the ovary, and endometriosis. See also Chocolate Cyst.

OVULATION INDUCTION Medical treatment performed to initiate ovulation.

OVULATION The release of the egg (ovum) from the ovarian follicle.

OVULATORY FAILURE (ANOVULATION) The failure to ovulate.

OVUM The egg; the reproductive cell from the ovary; the female gamete; the sex cell that contains the womans genetic information.

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P

PANHYPOPITUITARISM Complete pituitary gland failure.

PARLODEL See Bromocriptine.

PATENT The condition of being open, as with tubes that form part of the reproductive organs.

PELVIC INFLAMMATORY DISEASE (PID) An infection of the pelvic organs that causes severe illness, high fever, and extreme pain. PID may lead to tubal blockage and pelvic adhesions.

MENOGON (HMG) A medication used to replace the pituitary hormones LH and FSH. May be used to induce ovulation in women who do not respond to clomiphene citrate. Most frequently used with women who do not normally produce estrogen because of a pituitary gland or hypothalamic malfunction. May also be used with men to stimulate sperm production.

PITUITARY GLAND The master gland; the gland that is stimulated by the hypothalamus and controls all hormonal functions. Located at the base of the brain just below the hypothalamus, this gland controls many major hormonal factories throughout the body including the gonads, the adrenal glands, and the thyroid gland.

PLACENTAThe embryonic tissue that invades the uterine wall and provides a mechanism for exchanging the babys waste products for the mothers nutrients and oxygen. The baby is connected to the placenta by the umbilical cord.

POLAR BODY The discarded genetic material resulting from female germ cell division. See Meiosis.

POLYCYSTIC OVARIES (PCO OR "STEINLEVENTHAL SYNDROME") A condition found in women who dont ovulate, characterized by excessive production of androgens (male sex hormones) and the presence of cysts in the ovaries. Though PCO can be without symptoms, some include excessive weight gain, acne and excessive hair growth.

POST COITAL TEST (PCT) A microscopic examination of the cervical mucus best performed twelve or more hours after intercourse to determine compatibility between the womans mucus and the mans semen; a test used to detect sperm-mucus interaction problems, the presence of sperm antibodies, and the quality of the cervical mucus.

POSTTESTICULAR SYSTEM The ducts that store and deliver the sperm to the opening of the penis; also includes the glands that produce seminal fluids.

PREMATURE OVARIAN FAILURE A condition where the ovary runs out of follicles before the normal age associated with menopause.

PRETESTICULAR SYSTEM The male hormonal system responsible for stimulating sperm production and the development of male secondary sex characteristics.

PROGESTERONE The hormone produced by the corpus luteum during the second half of a womans cycle. It thickens the lining of the uterus to prepare it to accept implantation of a fertilised egg.

PROGESTERONE WITHDRAWAL A diagnostic procedure used to analyze menstrual irregularity and amenorrhea; uterine bleeding that occurs within two weeks after taking progesterone; a procedure used to demonstrate the presence or absence of estrogen and to demonstrate the ability of the uterus and reproductive tract to bleed. Prior to ovulation induction therapy, progesterone withdrawal may be used to induce a menstrual period.

PROLACTIN The hormone that stimulates the production of milk in breast feeding women. Excessive prolactin levels when not breast feeding may result in infertility.

PROSTAGLANDINS Hormone like substances found in men and women. It is hypothesised that prostaglandins secreted by active, young endometrial implants may interfere with the reproductive organs by causing muscular contractions or spasms. Also, prostaglandins not washed from sperm can cause severe cramping during IUI procedures.

PROSTATE GLAND A gland in the male reproductive system that produces a portion of the semen, including a chemical that liquifies the coagulated semen twenty minutes to one hour after entering the vagina.

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R


RESISTANT OVARY An ovary that cannot respond to the follicle stimulating message sent by FSH. Primitive germ cells will be present in the ovary; however, they will not respond to FSH stimulation.

RETROGRADE EJACULATION A male fertility problem that allows the sperm to travel into the bladder instead of out the opening of the penis due to a failure in the sphincter muscle at the base of the bladder.

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S

SALPINGECTOMY Surgical removal of the fallopian tube.

SALPINGOLYSISSurgery performed to remove adhesions that restrict the movement and function of reproductive organs.

SALPINGOSTOMY/FIMBRIOPLASTY Surgical repair made to the fallopian tubes, a procedure used to open the fimbria.

SCROTUM The bag of skin and thin muscle surrounding the mans testicles.

SECONDARY INFERTILITY The inability of a couple to achieve a second pregnancy. This strict medical definition includes couples for whom the pregnancy did not go to term. The common vernacular, however, refers to a couple which has one biological child but is unable to conceive another.

SECONDARY SEX CHARACTERISTICS The physical qualities that distinguish man and woman, such as beard, large breasts, and deep voice. Formed under the stimulation of the sex hormones (testosterone or oestrogen), these characteristics also identify those people who have gone through puberty (sexual maturity).

SEMEN VISCOSITY The liquid flow or consistency of the semen.

SEMEN ANALYSIS A laboratory test used to assess semen quality: sperm quantity, concentration, morphology (form), and motility. In addition, it measures semen (fluid) volume and whether or not white blood cells are present, indicating an infection.

SEMEN The fluid portion of the ejaculate consisting of secretions from the seminal vesicles, prostate gland, and several other glands in the male reproductive tract. The semen provides nourishment and protection for the sperm and a medium in which the sperm can travel to the womans vagina. Semen may also refer to the entire ejaculate, including the sperm.

SEMINAL VESICLES Glands in the male reproductive system which produce much of the semen volume, including fructose (sugar) for nourishing the sperm and a chemical that causes the semen to coagulate on entering the vagina.

SEMINIFEROUSTUBES The testicular tubules in which the 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.

SERTOLI (NURSE) CELL A testicular cell responsible for nurturing the spermatids (immature sperm). Secretes inhibin, a feedback hormone, which regulates FSH production by the pituitary gland. When stimulated by FSH, the Sertoli cell initiates spermatogenesis .

SHEEHANS SYNDROME A condition caused by profuse hemorrhage at the time of delivery. The severe blood loss shocks the pituitary gland, which dies and becomes nonfunctional.

SONOGRAM (ULTRASOUND) Use of high frequency sound waves for creating an image of internal body parts. Used to detect and count follicle growth (and disappearance) in many fertility treatments. Also used to detect and monitor pregnancy.

SPERM The microscopic cell that carries the males genetic information to the females egg; the male reproductive cell; the male gamete.

SPERM AGGLUTINATION Sperm clumping caused by antibody reactions or by infection.

SPERMATOGENESIS Sperm production in the testicles.

SPERM COUNT The number of sperm in ejaculate. Also called sperm concentration and given as the number of sperm per millilitre.

SPERM MATURATION A process during which the sperm grow and gain their ability to swim. Sperm take about ninety days to reach maturity.

SPERM MORPHOLOGY A semen analysis factor that indicates the number or percentage of sperm in the sample that appear to have been formed normally. Abnormal morphology includes sperm with kinked, doubled, or coiled tails. The higher the percentage of misshapen sperm, the less likely fertilisation can take place.

SPERM MOTILITY The ability of sperm to swim. Poor motility means the sperm have a difficult time swimming toward their goal the egg.

SPERM PENETRATION The ability of the sperm to penetrate the egg so it can deposit the genetic material during fertilisation.

SPINNBARKEIT The stretchability of cervical mucus; the stringy quality that occurs at midcycle under the influence of oestrogen. See also Postcoital Test.

SPLIT EJACULATE A method used to concentrate the sperm for insemination; separating the semen into two portions: the first portion of the ejaculate, which is rich in sperm, and the second portion, which contains mostly seminal fluid.

STEIN LEVENTHAL DISEASE Another name for Polycystic Ovaries.

STERILITY An irreversible condition that prevents conception.

STILLBIRTH The death of a fetus between the twentieth week of gestation and birth.

SUPEROVULATION Stimulation of multiple ovulation with fertility drugs; also known as controlled ovarian hyperstimulation.

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T

TESTICULAR BIOPSY A minor surgical procedure used to take a small sample of testicular tissue for microscopic examination; a test used to diagnose male fertility problems when no other means is available (this is because the biopsy procedure itself may cause testicular damage).

TESTICULAR STRESS PATTERN A semen analysis result showing depressed sperm production, poor sperm motility, and poor sperm morphology. The pattern is consistent with secondary testicular failure or illness.

TESTICULAR ENZYME DEFECT A congenital enzyme defect that prevents the testes from responding to hormonal stimulation. Will result in oligospermia or azoospermia.

TESTICULAR FEMINIZATION An enzymatic defect that prevents a man from responding to the male hormone testosterone. The man will look like a woman, but karyotyping will reveal a normal XY male chromosome pattern, and testosterone levels will be in the normal male range.

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.

TESTOSTERONE The male hormone responsible for the formation of secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for spermatogenesis.

THYROID GLAND The endocrine gland in the front of the neck that produces thyroid hormones to regulate the bodys metabolism.

TORSION The twisting of the testis inside the scrotum. Besides causing extreme pain and swelling, the rotation twists off the blood supply and causes severe damage to the testicle. Torsion of the ovary may also occur in a woman suffering from hyperstimulation, a complication of ovulation induction treatment.

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.

TUBOTUBAL ANASTOMOSIS Surgery performed to remove a diseased portion of the fallopian tube and reconnect the two ends; sterilization reversal.

TURNERS 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.

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U

ULTRASOUND See Sonogram.

 

UMBILICAL CORD Two arteries and one vein encased in a gelatinous tube leading from the baby to the placenta. Used to exchange nutrients and oxygen from the mother for waste products from the 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, may result in permanent fertility loss.

UNICORNATE UTERUS An abnormality in which the uterus is "one sided" and smaller than usual.

UREAPLASMA (MYCOPLASMA) An infection that may cause the formation of sperm antibodies and an inflammation of the uterine lining, either of which may interfere with implantation of the embryo.

URETHRA The tube that allows urine to pass between the bladder and the outside of the body. In the man this tube also carries semen from the area of the prostate to the outside.

UROLOGIST A physician specializing in the genitourinary tract.

UTERUS The hollow, muscular organ that houses and nourishes the fetus during pregnancy.

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V

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 to have intercourse.

VARICOCELE A dilation of the veins that carry blood out of the scrotum. The resulting swollen vessels surrounding the testicles create a pool of stagnant blood, which elevates the scrotal temperature. A major cause of male infertility.

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 The accidental or elective surgical separation of the vasa deferential a procedure used for birth control.

VENEREAL DISEASE Any infection that can be sexually transmitted, such as chlamydia, gonorrhoea, ureaplasma, and syphilis. Many of these diseases will interfere with fertility and some will cause severe illness. See also PID.

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W

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X

X CHROMOSOME The congenital, developmental, or genetic information in the cell 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.

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Y

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.

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Z

ZYGOTE A fertilised egg which has not yet divided.

ZYGOTE INTRAFALLOPIAN TRANSFER (ZIFT) An ART in which eggs are removed from a woman's ovaries, fertilised with the man's sperm in a lab dish, and the resulting Zygotes are transferred into the womans fallopian tubes during a minor surgical procedure.

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