Glossary

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• 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).

• American Society for Reproductive Medicine (ASRM)

  A professional society of more than 10,000 members who work in the field of reproductive healthcare. It provides educational information and sets standards of care for reproductive medicine.

• 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.

• ASRM

  A professional society of more than 10,000 members who work in the field of reproductive healthcare. It provides educational information and sets standards of care for reproductive medicine.

• 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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• 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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• 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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• 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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• 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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• 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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• 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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• 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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• 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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• 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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• 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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• 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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• Norethindrone Acetate

  See Aygestin.

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• 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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• 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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• 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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• 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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• 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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• 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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• 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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• Zona Pellucida

  The outer membrane of a human egg.