Glossary

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Abortion, Clinical

An abortion of a clinical pregnancy that takes place between the diagnosis of pregnancy and 20 completed weeks.

Abortion, Habitual

A term referring to a condition where a woman has had three or more miscarriages.

Abortion, Incomplete

An abortion after which some tissue remains inside the uterus. A dilation and curettage (D&C) must be performed to remove the tissue and prevent complications.

Abortion, Missed

An abortion in which the fetus dies in the uterus, but there is no bleeding or cramping. A dilation and curettage (D&C) will be needed to remove the fetal remains and prevent complications.

Abortion, Spontaneous

A pregnancy loss during the first 20 weeks of gestation.

Abortion, Therapeutic

A procedure used to terminate a pregnancy before the fetus can survive on its own.

Abortion, Threatened

Spotting or bleeding that occurs early in the pregnancy. May progress to spontaneous abortion.

ACTH

A hormone produced by the pituitary gland to stimulate the adrenal glands. Excessive levels may lead to fertility problems.

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 that, 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 a tumor in the pituitary gland, adrenal gland, or ovary. May also be associated with excess prolactin levels.

Alpha-fetoprotein Test (AFP)

A blood test performed to evaluate the development of the fetus and to look for fetal abnormalities.

Amenorrhea

A woman who has never had a period.

Amenorrhea, Secondary

A woman who has menstruated at one time, but who has not had a period for six months or more.

Androgens

Male sex hormones.

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 fertilization.

Anorexia Nervosa

A life-threatening eating disorder involving self-imposed starvation. Severe weight loss and malnutrition from this disorder cause anovulation.

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, such as bacteria. Antisperm antibodies attach themselves to sperm and inhibit movement and their ability to fertilize.

Artificial Insemination (AI)

The depositing of sperm in the vagina near the cervix or directly into the uterus, with the use of a syringe instead of by coitus. 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 also Artificial Insemination Donor; Artificial Insemination Homologous.

Artificial Insemination Donor (AID)

Artificial insemination with donor sperm. A fresh donor semen specimen or a thawed frozen specimen is injected next to the woman’s cervix.

Artificial Insemination Homologous (AIH)

Artificial insemination with the husband’s sperm. The sperm may be washed and injected directly into the wife’s uterus (IAIH). Often used with poor semen or to overcome sperm-mucus problems.

Artificial Spermatocele

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.

Aspiration Cycle

An initiated assisted reproductive technology (ART) cycle in which one or more follicles are punctured and aspirated irrespective of whether or not oocytes are retrieved.

Assisted Hatching

\An in vitro procedure in which the zona pellucida of an embryo (usually at eight-cell stage or a blastocyst) is perforated by chemical, mechanical, or laser-assisted methods to assist separation of the blastocyst from the zona pellucida.

Assisted Reproductive Technology (ART)

Several procedures employed to bring about conception without sexual intercourse, including IUI, 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.

Bacterial Vaginosis Infection

A vaginal infection that causes a burning sensation and a gray, malodorous discharge. May interfere with fertility.

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.

Basal Body Temperature, Biphasic

A basal body temperature 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.

Basal Body Temperature, Monophasic

An anovulatory basal body temperature 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.

Birth Defect

Structural, functional, or developmental abnormalities present at birth or later in life, due to genetic or nongenetic factors acting before birth.

Blastocyst

An embryo with a fluid-filled blastocele cavity (usually developing by five or six days after fertilization).

Bulimia

An eating disorder characterized by voracious eating followed by forced vomiting. The resulting weight loss and malnutrition may cause anovulation.

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, hirsutism, ovulation induction, and for in vitro fertilization.

Canceled Cycle

An assisted reproductive technology (ART) cycle in which ovarian stimulation or monitoring has been carried out with the intent of undergoing ART, but did not proceed to follicular aspiration or, in the case of a thawed embryo, to transfer.

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 woman’s reproductive tract. Capacitation enables the sperm to penetrate the egg.

Cauterize

To burn tissue with electrical current (electrocautery) or with a laser. Used in surgical procedures to remove unwanted tissue such as adhesions and endometrial implants. Also used to control bleeding.

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.

Cervical Smear

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

Cervical Stenosis

A blockage of the cervical canal from a congenital defect or from complications of surgical procedures. 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 up 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.

Chromosomes

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.

Clinical Pregnancy

Evidence of pregnancy by clinical or ultrasound parameters (ultrasound visualization of a gestational sac); includes ectopic pregnancy. Multiple gestational sacs in one patient are counted as one clinical pregnancy.

Clinical Pregnancy Rate

The number of clinical pregnancies expressed per 100 initiated cycles, aspiration cycles, or embryo transfer cycles. When clinical pregnancy rates are given, the denominator (initiated, aspirated, or embryo transfer cycles) must be specified.

Clitoris

The small erectile sex organ of the female which contains large numbers of sensory nerves; the female counterpart of the penis.

Coitus

Intercourse; the sexual union between a man and a woman.

Conception

See Fertilzation

Conceptus

The early products of conception; the embryo and placenta.

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 that suppress the pituitary gland and interfere with spermatogenesis or ovulation. Women may have ambiguous genitalia from the excess production of male hormone.

Contraception

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

Contraceptive, Oral

A medication that prevents ovulation and pregnancy. Up to 3 percent of women taking the pill will become anovulatory when they stop taking it. The regulatory effects of the pill can also disguise symptoms of fertility problems — for example, an irregular cycle or endometriosis. May be used to control the symptoms and development of endometriosis.

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 fertilized, 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).

Cryopreservation

The freezing and storage of gametes, zygotes, or embryos.

Cumulus Oophorus

The protective layer of cells surrounding the egg.

Cushing’s Syndrome

A condition characterized by an overproduction 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. Cushing’s Disease is another condition in which these same symptoms occur, but as the result of a pituitary tumor.

Dilation and Curettage (D&C)

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.

Delayed Ejaculation

A condition in which the man fakes orgasm and does not actually ejaculate when having sex.

Delayed Puberty

A condition in which a child fails to complete puberty and develop secondary sex characteristics by sixteen years of age. Puberty may be stimulated with hormonal replacement therapy. Some will outgrow the condition without treatment.

Delivery Rate

The number of deliveries expressed per 100 initiated cycles, aspiration cycles, or embryo transfer cycles. When delivery rates are given, the denominator (initiated, aspirated, or embryo transfer cycles) must be specified. It includes deliveries that resulted in a live birth and/or stillbirth. Note  The delivery of a singleton, twin, or other multiple pregnancies is registered as one delivery.

DES (Diethylstilbestrol)

A medication prescribed in the 1950s and 1960s 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

See Adrenal Androgens.

Dysmenorrhea

Painful menstruation; may be a sign of endometriosis.

Dyspareunia

Painful coitus for either the man or the woman.

Early Neonatal Death

A death occurring within the first seven days after delivery.

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 fertilization. The procedure may be performed during laparoscopy or by using a long needle and ultrasound to locate the follicle in the ovary.

Ejaculate

The semen and sperm expelled during ejaculation.

Ejaculation

The physiological process by which the semen is propelled from the testicles, through the reproductive tract, and out the opening of the penis.

Embryo

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

Embryo Donation

The transfer of an embryo resulting from gametes that did not originate from the recipient or her partner.

Embryo Transfer

Placing an egg fertilized outside the womb into a woman’s uterus or fallopian tube.

Embryo Transfer Cycle

An assisted reproductive technology (ART) cycle in which one or more embryos are transferred into the 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 that 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.

Erection

The process during which the erectile tissue of the penis becomes engorged with blood, causing the penis to swell and become rigid.

Estradiol

The female hormone produced in 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.

Estrogen

Female sex hormone.

Expectant Therapy (Endometriosis)

A wait-and-see approach used after laparoscopic surgery for mild endometriosis.

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 fertilization 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.

Fertile Eunuch

A rare disorder characterized by an LH deficiency leading to low testosterone levels and poor sperm production. Male secondary sex characteristics will be incomplete and sex drive will be low.

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.

Fertility Workup

The initial medical examinations and tests performed to diagnose or narrow down the cause of fertility problems.

Fertilization

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 Fertilization.

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

The opening of the fallopian tube near the ovary. When stimulated by the follicular fluid released during ovulation, the finger-like ends grasp the ovary and coax the egg into the tube.

Follicles

Fluid-filled sacs in the ovary which that 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.

Follicle Stimulating Hormone (FSH)

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

Follicular Phase

The pre-ovulatory portion of a woman’s 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.

Full-term Birth

A birth that takes place at 37 or more completed weeks of gestational age. This includes both live births and stillbirths.

Galactorrhea

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

Gamete

A reproductive cell; sperm in men and eggs in women.

Gamete Intrafallopian Transfer (GIFT)

A technique that may be used in lieu of in vitro fertilization for women with patent tubes. After egg retrieval, the eggs are mixed with the man’s sperm and then injected through the fimbria into the woman’s fallopian tubes for in vivo fertilization.

Genitals

External sex organs; the labia and clitoris in the woman and the penis and testicles in the man. Also called genitalia.

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 man’s 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.

Gestational Age

The age of an embryo or fetus calculated by adding 14 days to the number of completed weeks since fertilization.

Gestational Carrier

A woman in whom a pregnancy resulted from fertilization with third-party sperm and oocytes. She carries the pregnancy with the intention or agreement that the offspring will be parented by one or both of the persons that produced the gametes.

Gestational Sac

A fluid-filled structure containing an embryo that develops early in pregnancy usually within the uterus.

Gonadotropins

Hormones which control reproductive function  Follicle Stimulating Hormone and Luteinizing Hormone.

Gonadotropin Releasing Hormone (GnRH)

A substance secreted by the hypothalamus every 90 minutes or so. This hormone enables the pituitary to secrete LH and FSH, which stimulate the gonads. See also FSH; LH.

Gonad

The gland that makes reproductive cells and “sex” hormones, as the testicles, which make sperm and testosterone, and the ovaries, which make eggs (ova) and estrogen.

Gonorrhea

An infection that is usually asymptomatic, but that may cause a bad-smelling yellowish vaginal discharge and red and swollen vaginal walls. If it reaches the fallopian tubes, the woman will suffer pain, develop a high fever, and possibly develop tubal blockage. The responsible organism may also impair sperm and prevent pregnancy. In a man, gonorrhea seldom leads to damage, but it may cause a painful infection.

Hamster Test

A test of the ability of sperm to penetrate a hamster egg which has been stripped of the Zona Pellucida (outer membrane). Also called Sperm Penetration Assay (SPA).

Hatching

The process that precedes implantation by which an embryo at the blastocyst stage separates from the zona pellucida.

Hirsutism

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

Host Uterus

Also called a “gestational carrier.” A couple’s embryo is transferred to another woman who carries the pregnancy to term and returns the baby to the genetic parents immediately after birth.

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 to trigger ovulation after some fertility treatments and used in men to stimulate testosterone production.

Hyperprolactinemia

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

Hyperstimulation (Ovarian Hyperstimulation Syndrome, OHSS)

A potentially life-threatening side effect of Pergonal ovulation induction treatment. Arises when too many follicles develop and hCG is given to release the eggs. May be prevented by withholding the hCG injection when ultrasound monitoring indicates too many follicles have matured.

Hyperthyroidism

Overproduction 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.

Hysterectomy

The surgical removal of the uterus. May also include the removal of other reproductive structures, such as the fallopian tubes and ovaries.

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 fiber-optic device. Minor surgical repairs can be executed during the procedure.

IAIH (Intrauterine Artificial Insemination Homologous)

Artificial insemination where the man’s sperm is injected directly into the uterus to avoid cervical mucus problems or to maximize the potential for poor semen. See also Artificial Insemination.

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.

Imperforate Hymen

A condition where the membrane (hymen) covering the vagina fails to open and allow menstrual flow.

Implantation (Embryo)

The embedding of the embryo into tissue so it can establish contact with the mother’s 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.

Initiated Cycles

Assisted reproductive technology (ART) treatment cycles in which the woman receives ovarian stimulation or monitoring, in the case of spontaneous cycles, irrespective of whether follicular aspiration was attempted.

Intracytoplasmic Sperm Injection (ICSI)

A micromanipulation procedure where a single sperm is injected into the egg to enable fertilization with very low sperm counts or with non-motile sperm.

In Vitro Fertilization (IVF)

Literally means “in glass.” Fertilization takes place outside the body in a small glass dish.

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-3 (Folliculostatin)

A female feedback hormone made in the ovary to regulate FSH production by the pituitary gland.

Intrauterine Device (IUD)

A device placed into the uterus to prevent pregnancy. IUD insertion has been associated with an increased incidence of infection, which may damage the fallopian tubes, and is therefore not recommended for women with multiple sexual partners.

Kallman’s Syndrome

A congenital hypothalamic dysfunction that has multiple symptoms, including the failure to complete puberty.

Karyotyping

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

Klinefelter’s Syndrome

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

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 fertilization.

Laparoscopy

Examination of the pelvic region by using a small telescope called a laparoscope.

Laparotomy

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

Leiomyomata

See Fibroid.

Leydig Cell

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

Live Birth

A birth in which a fetus is delivered with signs of life after complete expulsion or extraction from its mother, beyond 20 completed weeks of gestational age. Live births are counted as birth events (e.g., a twin or triplet live birth is counted as one birth event).

Live Birth Delivery Rate

The number of live birth deliveries expressed per 100 initiated cycles, aspiration cycles, or embryo transfer cycles. When delivery rates are given, the denominator (initiated, aspirated, or embryo transfer cycles) must be specified. It includes deliveries that resulted in at least one live birth. Note  The delivery of a singleton, twin, or other multiple birth is registered as one delivery.

Luteal Phase

Post-ovulatory phase of a woman’s cycle. The corpus luteum produces progesterone, which causes 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 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) Syndrome

A 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 estrogen 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 to 36 hours).

Malformation Rate

Includes all structural, functional, genetic, and chromosomal abnormalities identified in aborted tissue or diagnosed before or after birth.

Masturbation

A technique used to collect semen for analysis and for artificial insemination; manual stimulation of the penis leading to ejaculation.

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.

Medically Assisted Conception

Conception brought about by noncoital conjunction of the gametes. This includes assisted reproduction technology (ART) procedures and intrauterine, intracervical, and intravaginal insemination with semen of a partner or donor.

Meiosis

The cell division, peculiar to reproductive cells, which allows genetic material to divide in half. Each new cell will contain 23 chromosomes. The spermatids (immature sperm) and ova (eggs) each contain 23 chromosomes, so when they combine (fertilize), the baby will have a normal complement of 46.

Menorrhagia

Heavy or prolonged menstrual flow.

Menstruation

The cyclical shedding of the uterine lining in response to stimulation from estrogen and progesterone.

Metrodin (Pure FSH)

An injectable form of Follicle Stimulating Hormone used to stimulate ovulation.

Metrorrhagia

Menstrual spotting during the middle of the cycle.

Micromanipulation (also referred to as assisted fertilization)

The use of special micro manipulative technology that allows operative procedures to be performed on the oocyte, sperm, or embryo.

Microsurgical Epididymal Sperm Aspiration (MESA)

A procedure in which spermatozoa are obtained from the epididymis by either aspiration or surgical excision.

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.

Mycoplasma

See Ureaplasma.

Myomectomy

Surgery performed to remove fibroid tumors.

Neonatal Death

A death within 28 days of birth.

Newborns or Infants Born

The number of live births plus stillbirths.

Oligomenorrhea

Infrequent menstrual periods.

Oligospermia, Oligozoospermia

A sperm count below 20 million; a low sperm count; a sperm count low enough to cause a fertility problem.

Oocyte Donation

An assisted reproduction technology (ART) procedure performed with third-party oocytes.

Orgasm

The psychological and physical thrill that accompanies sexual climax. For the man, orgasm causes ejaculation.

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.

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.

Ovulation

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

Ovulation Induction

Medical treatment performed to initiate ovulation. See also Clomiphene Citrate; Pergonal.

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 woman’s genetic information.

Panhypopituitarism

Complete pituitary gland failure.

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.

Penile Implant

A device surgically inserted into the penis to provide rigidity for intercourse. Used to treat impotence.

Penis

The male organ that becomes enlarged and erect for the purpose of depositing semen in the woman’s vagina.

PID

See Pelvic Inflammatory Disease.

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.

Placenta

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

Polar Body

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

Polycystic Ovaries (PCO or “Stein-Leventhal Syndrome”)

A condition found in women who don’t 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.

Preclinical Abortion

An abortion that takes place before clinical or ultrasound evidence of pregnancy.

Preclinical Pregnancy (Biochemical Pregnancy)

Evidence of conception based only on biochemical data in serum or urine before ultrasound evidence of a gestational sac.

Preimplantation Genetic Diagnosis (PGD)

Screening of cells from preimplantation embryos for the detection of genetic and/or chromosomal disorders before embryo transfer.

Preterm Birth

A birth that takes place after at least 20, but less than 37, completed weeks of gestation. This includes both live births and stillbirths. Births are counted as birth events (e.g., a twin or triplet live birth is counted as one birth event).

Post Coital Test (PCT)

A microscopic examination of the cervical mucus best performed twelve or more hours after intercourse to determine compatibility between the woman’s mucus and the man’s semen; a test used to detect sperm-mucus interaction problems, the presence of sperm antibodies, and the quality of the cervical mucus.

Post-testicular System

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

Premature Ejaculation

A condition in which the man becomes so sexually excited that most of the time he ejaculates prior to penetrating the woman’s vagina.

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 woman’s cycle. It thickens the lining of the uterus to prepare it to accept implantation of a fertilized 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 breastfeeding women. Excessive prolactin levels when not breastfeeding may result in infertility.

Prostaglandin

A hormone secreted by the uterine lining. It is hypothesized that prostaglandins secreted by active, young endometrial implants may interfere with the reproductive organs by causing muscular contractions or spasms.

Prostate Gland

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

Puberty

The time of life when the body begins making adult levels of sex hormones – (estrogen or testosterone) and the youngster takes on adult body characteristics  developing breasts, growing a beard, pubic hair, and axillary hair; attaining sexual maturity.

Recipient

In an assisted reproduction technology (ART) cycle, refers to the woman who receives an oocyte or an embryo from another woman.

Refractory Period

A period of time after orgasm during which a man or woman cannot have another; a recovery period.

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.

Salpingectomy

Surgical removal of the fallopian tube.

Salpingolysis

Surgery 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 man’s testicles.

Secondary Infertility

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

Secondary Sex Characteristics

The physical qualities that distinguish men and women, such as a beard, large breasts, and a deep voice. Formed under the stimulation of the sex hormones (testosterone or estrogen), these characteristics also identify those people who have gone through puberty (sexual maturity).

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 woman’s vagina. Semen may also refer to the entire ejaculate, including the sperm.

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 Viscosity

The liquid flow or consistency of the semen.

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.

Seminiferous Tubes

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.

Sheehan’s 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.

Short Luted Phase

A condition in which the corpus luteum deteriorates prematurely, causing the menstrual period to begin approximately ten days (instead of 14) after ovulation. Frequently found with women undergoing ovulation induction treatment.

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 male’s genetic information to the female’s egg; the male reproductive cell; the male gamete.

Sperm Agglutination

Sperm clumping caused by antibody reactions or by infection.

Sperm Antibodies

Antibodies that attack and maim sperm. May be formed by either the man against his own sperm or by the woman against her partner’s sperm.

Sperm Bank

A place where sperm are kept frozen in liquid nitrogen for later use in artificial insemination.

Sperm Count

The number of sperm in ejaculate. Also called sperm concentration and given as the number of sperm per milliliter.

Sperm Maturation

A process during which the sperm grow and gain their ability to swim. Sperm take about 90 days to reach maturity.

Sperm Morphology

A semen analysis factor that indicates the number or percentage of sperm in the sample that appears to have been formed normally. Abnormal morphology includes sperm with kinked, doubled, or coiled tails.

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 fertilization.

Spermatogenesis

Sperm production in the testicles.

Spinnbarkeit

The stretchability of cervical mucus; the stringy quality that occurs at midcycle under the influence of estrogen. 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 (COH).

Surrogate Mother

A woman who is artificially inseminated and carries to term a baby that will be raised by its genetic father and his partner.

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 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 Enzyme Defect

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

Testicular Failure, Primary

A congenital, developmental, or genetic error resulting in a testicular malformation that prevents sperm production.

Testicular Failure, Secondary

Acquired testicular damage; for example, from drugs, prolonged exposure to toxic substances, or a varicocele.

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 Function

The ability of the testicles to produce sperm and testosterone.

Testicular Sperm Aspiration (TESA)

A procedure in which spermatozoa are obtained directly from the testicle by either aspiration or surgical excision of testicular tissue.

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.

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 body’s 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.

Trichomonas

An infection that may produce a greenish, bad-smelling vaginal discharge.

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.

Turner’s Syndrome

The most common genetic defect contributing to female fertility problems. The ovaries fail to form and appear as slender threads of atrophic ovarian tissue, referred to as streak ovaries. Karyotyping will reveal that this woman has only one female (X) chromosome instead of two.

Ultrasound

A test used instead of X-rays to visualize the reproductive organs; for example, to monitor follicular development and to examine the tubes and uterus. The instrument works by bouncing sound waves off the organs. A picture displayed on a digital screen shows the internal organs.

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 6, may result in permanent fertility loss.

Unicornuate 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.

Vagina

The canal leading from the cervix to the outside of the woman’s body; the birth passage.

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, gonorrhea, ureaplasma, and syphilis. Many of these diseases will interfere with fertility and some will cause severe illness. See also PID.

Virility

Masculinization; having male secondary sex characteristics; being able to perform sexually.

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. See also Y Chromosome.

Y Chromosome

The genetic material that transmits the information necessary to make a male. The Y chromosome can be found in half of the man’s sperm cells.

Zygote

A fertilized egg which has not yet divided.

Zygote Intrafallopian Transfer (ZIFT):

An ART in which eggs are removed from the woman’s ovaries, fertilized with the man’s sperm in a lab dish, and the resulting embryos are transferred into the woman’s fallopian tubes during a minor surgical procedure.

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