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Abortion, Spontaneous: the medical term for miscarriage. The various types include.

Abortion, Habitual: A term referring to a condition where a woman has had three or more miscarriages.

Abortion, Incomplete: A miscarriage after which some tissue remains inside the uterus. A D&C must be performed to remove the tissue and prevent complications.

Abortion, Missed: A miscarriage where the fetus dies in the uterus but there is no bleeding or cramping. A D&C will be needed to remove the fetal remains and prevent complications.

Abortion: Spontaneous: A pregnancy loss during the first twenty weeks of gestation. Habitual: When a woman has had three or more miscarriages. Incomplete: An abortion after which some tissue remains inside the uterus. A D&C must be performed to remove the tissue and prevent complications. Missed: The fetus dies in the uterus but there is no bleeding or cramping. A D&C will be needed to remove the fetal remains and prevent complications.

Abortion, Threatened: Spotting or bleeding that occurs early in the pregnancy. May progress to spontaneous abortion.

Acid tyrodes digestion: A form of assisted hatching in which the embryo is introduced into a chemical solution that partially erodes the zona (egg covering) in order to promote hatching.

Acrosome: The protective structure around the head of the sperm. The acrosome contains enzymes that enable the sperm to penetrate the egg. Acrosome reaction The second stage of capacitation, when a sperm sheds its outer membrane to expose receptors that interact with the egg's zona pellucida to initiate fertilization.

Acrosome reaction: a chemical change that enables a sperm to penetrate an egg.

Acrosome: the packet of enzymes in a sperm's head that allows the sperm to dissolve a hole in the coating around the egg, which allows the sperm to penetrate and fertilize the egg.

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

Adenomyosis: A condition in which the endometrial glands grow into the uterine wall, creating a sponge like effect; can be associated with poor uterine linings. This condition is sometimes associated with heavy, painful periods and uterine enlargement.

Adrenal glands: Small structures located at the top of each kidney that produce a number of hormones indispensable to proper growth, development, and a wide variety of physiologic functions.

Adhesion: a union of adjacent organs by scar tissue. It has also been defined as abnormal attachment of adjacent tissues by bands, scars, masses of fibrous tissue 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.

Adnexum: A normal tube and ovary as seen at laparoscopy.

Adrenal Glands: the endocrine gland on top of each kidney. Two glands near the kidneys that produce hormones, including some male sex hormones (the adrenal androgens).

Adrenal Androgens: Male hormones produced by the adrenal gland which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in the woman may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland, or ovary. May also be associated with excess prolactin levels.

Aerobic bacteria: the bacterial organisms that require relatively high concentrations of oxygen to survive and reproduce.

AF: See assisted fertilization.

Agglutination of Sperm: Sticking together of sperm.

Agglutination: clumping together, as of sperm, often due to infection, inflammation, or antibodies.

AID (Artificial Insemination Donor): See Artificial Insemination Donor. It involves the use of donor semen or sperm in cases where the woman's partner is infertile or the woman chooses to conceive without having intercourse with the sperm provider.

AID (Artificial Insemination Donor) or AIH (Artificial Insemination Homologous/Husband): See Artificial Insemination, Donor Insemination, and Intrauterine Insemination (IUI).

AIDS: A sexually transmitted disease caused by one or a variety of viruses that are harbored in the nuclei of cells and attack the immune system. Infected individuals become highly susceptible to opportunistic infections; AIDS ultimately leads to death.

AIH (Artificial Insemination Homologous): See Artificial Insemination Homologous.

Alloimmune factors: natural killer cells, leukocyte antigen cross match. Alloimmune factors can lead to pregnancy loss in two different ways. First, the body fails to recognize a pregnancy, and second, there is an abnormal immunological response to the pregnancy. A patient may be tested for leukocyte antibodies, natural killer cells, and embryo toxic factor. Possible treatments are intravenous immunoglobulin (IVIg) or paternal white blood cell immunization. This area of reproductive medicine is considered controversial.

Alloimmunity: Immunity that develops against the proteins of another individual of the same species.

Alpha-fetoprotein Test (AFP): A blood test performed to evaluate the development of the fetus and to look for fetal abnormalities. AFP is a chemical in the blood and amniotic fluid that if found might point toward a neurologic fetal malformation.

Amenorrhea: The absence of menstruation for six months or more at a time. Primary Amenorrhea afflicts a woman who has never menstruated. Secondary Amenorrhea afflicts a woman who has menstruated at one time, but who has not had a period for six months or more.

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

American Fertility Society Former name of the American Society for Reproductive Medicine (ASRM): A professional society that primarily includes physicians but also includes laboratory personnel, psychologists, nurses, and other paramedical personnel interested in infertility. Formerly known as the American Fertility Society. It is a professional society whose affiliate organization, the Society for Assisted Reproductive Technology (SART), reports annual fertility clinic data to the Centers for Disease Control and Prevention (CDC).

Amniocentesis: the aspiration of amniotic fluid from the uterus usually performed at three to three and one half months of pregnancy, to test the fetus for genetic abnormalities.

Ampulla: The outer half of the fallopian tube, where fertilization occurs. It opens into the abdominal cavity through the tubal ostium, which is lined by the fimbria.

Anaerobic bacteria: bacterial organisms that survive in relatively low oxygen concentrations.

Androgens: Male sex hormones. Testosterone is one example.

Andrologist: a specialist who treats sperm problems and who performs laboratory evaluations of male fertility. Andrologists are usually affiliated with a fertility treatment center working on in vitro fertilization.

Andrology: It is the science of diseases peculiar to the male sex, particularly infertility, and sexual dysfunction.

Anomaly: A malformation or abnormality in any part of the body.

Anorexia Nervosa: A life threatening eating disorder; self-imposed starvation. Severe weight loss and malnutrition from this disorder cause anovulation.

Anovulation: the absence of ovulation. Note: This is not necessarily the same as "amenorrhea. " Menses may still rarely occur with anovulation.

Anovulatory Bleeding: The type of menstruation often associated with failure to ovulate. May be scanty and of short duration; or abnormally heavy and irregular.

Antibodies: a protective agent produced by the body's immune system in response to a foreign substance. 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. Either the man or the woman may make sperm antibodies.

Antibodies to sperm: Substances in the man's or woman's blood and in reproductive secretions (semen, uterine and tubal secretions, and cervical mucus) that reduce fertility by causing sperm to stick together, coating their surface or killing them. Antisperm antibodies attach themselves to sperm and inhibit movement and their ability to fertilize.

Anticardiolipin antibody (ACA): an antibody directed against cardiolipin. These are one of the antiphospholipid groups of antibodies. They are the most widely accepted and tested for immune factor. Approximately 80% of patients who have an antiphospholipid antibody problem will test positive for anticardiolipin antibodies, but the remaining 20% will test positive for one of the other six antiphospholipid antibodies. These antibodies can cause a miscarriage or stillbirth and can be tested for by a blood sample.

Antigen: any substance that induces the formation of an antibody.

Antilymphocyte antibodies (ALA): Antibodies formed to combat the male partner's lymphocytes and hence against the fetus's lymphocytes.

Antinuclear antibody (ANA): an antibody showing an affinity for cell nuclei; this antibody is found in a high proportion of people with lupus (systemic lupus erythematosus), rheumatoid arthritis, and certain collagen diseases, and in about 1% of normal individuals. If you have systemic lupus erythematosus, it can be transmitted through the placenta to the baby, resulting in heart problems.

Antiphospholipid antibodies (APA): Antibodies to some of the chemical substances that coat the root system of the placenta as it grows into the uterine wall. Women with high concentrations of these substances may have a higher incidence of miscarriages or may fail to conceive after repeated attempts.

Apoptosis: a genetically determined destruction of cells from within due to activation of a stimulus or removal of a suppressing agent or stimulus that is postulated to exist to explain the orderly elimination of superfluous cells -- called also programmed cell death

ART (assisted reproductive technology): All treatments or procedures that involve the handling of human eggs and sperm for the purpose of helping a woman become pregnant. Types of ART include in vitro fertilization, gamete intrafallopian transfer, zygote intrafallopian transfer, embryo cryopreservation, egg or embryo donation, and surrogate birth. ART cycle. A process in which 1) an ART procedure is carried out, 2) a woman has undergone ovarian stimulation or monitoring with the intent of having an ART procedure, or 3) in the case of frozen embryos, embryos have been thawed with the intent of transferring them to a woman. A cycle begins when a woman begins taking fertility drugs or having her ovaries monitored.

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

Artificial insemination by donor (AID): The most common form of insemination into the vagina or uterus with donor sperm. A thawed frozen specimen is injected next to the woman's cervix.

Artificial Insemination by Husband (AIH): The injection of husband's semen into the wife's reproductive tract for the purpose of conception. 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.

Aspermia: The absence of semen. This is not the same as azoospermia.

Aspiration: follicular: suctioning of fluid, as from a follicle.

ASRM: See American Society for Reproductive Medicine.

Assisted fertilization (AF): Methods for promoting successful IVF in cases of severe male infertility; these approaches require highly sophisticated technical expertise and equipment. Also known as micromanipulation.

Assisted hatching: A technique in which the zona pellucida (outer shell of the egg) is chemically or mechanically thinned prior to embryo transfer in order to improve the likelihood of subsequent hatching.

Assisted Reproductive Technology (ART): Several procedures employed to bring about conception without sexual intercourse, including IUI, IVF, GIFT and ZIFT. ARTs are procedures involving retrieval of eggs, and the enhancement of eggs and sperm outside the body. It includes procedures such as gamete intrafallopian transfer (GIFT), in vitro fertilization (IVF), and zygote intrafallopian transfer/tubal embryo transfer (ZIFT/TET).

Asthenospermia: A condition in which the sperm do not move (swim) at all or move more slowly than normal.

Asthenozoospermia: Low sperm motility.

Asymptomatic: without any symptoms.

Augmented laparoscopy: A procedure in which eggs are retrieved from the woman's ovaries while diagnostic laparoscopy is being performed to evaluate the integrity of her pelvic organs. These eggs are subsequently fertilized in vitro, and the embryos are transferred into the woman's uterus two or three days later. This procedure affords a woman undergoing routine diagnostic laparoscopy a chance to determine the cause of her infertility and an opportunity to conceive by IVF at the same time.

Autoantibodies: Antibodies that are formed against the proteins of the individual's own body. Antibodies formed against one's own tissues.

Autoimmune disease: the process in which the body's defense system acts against its own tissues, causing damage.

Autoimmunity: an immune reaction against one's own tissues.

Azoospermia: The absence of sperm in the ejaculate. Azoospermia occurs either because the testicles cannot make sperm or because of blockage in the reproductive tract.

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Bacteria: microscopic, single celled organisms that can cause infections of the genital tract.

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

Balanced translocation: A condition where some there is excess genetic material in one chromosome. This excess material belongs to another chromosome which is as a result shorter. Thus there is translocation of genetic material but this does not manifest clinically as the total is normal. However, in the offspring of such an individual, only one of these chromosomes may be inherited resulting in excess or deficiency of that particular genetic material (unbalanced translocation).

Basal body temperature (BBT): body temperature when taken at its lowest point, usually in the morning before getting out of bed. Charting BBT is used to predict ovulation. Daily body temperature chart provides a rough idea of when ovulation occurred. This is possible because body temperature rises when the corpus luteum produces progesterone (after ovulation) and drops at or just before the beginning of menstruation, when estrogen and progesterone levels fall (see also biphasic pattern of temperature on BBT chart).

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.

BBT chart: See basal body temperature chart.

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 in which it appears to have two "horns " (cornu).

Billings Method of contraception: It is a method of predicting ovulation in which the woman examines the quality and quantity of her cervical mucus secretions. This method can be used to help the woman determine her most fertile period for the purpose of conceiving or for contraception. Biphasic pattern of temperature on BBT chart Charting pattern that occurs because the woman's temperature is likely to be lower during the first phase of her menstrual cycle than during the second half, when the progesterone produced by the corpus luteum raises her temperature slightly (see also basal body temperature chart).

Biopsy: a fragment of tissue removed for study under the microscope.

Bladder: It is the anatomical reservoir that receives urine produced by the kidneys.

Blastocyst: An advanced stage of embryo development during which a cavity develops within the young embryo.

Blastomere: Cell within the developing embryo. Each blastomere is capable of developing into an identical embryo until the embryo reaches about the 30-cell stage, after which the cells begin to differentiate into specific tissues.

Blood hormone test LH:  When this test is performed several times daily around the presumed time of ovulation, the detection of a rapidly rising blood LH (luteinizing hormone) concentration can accurately determine the time of probable ovulation. This test, which requires blood to be drawn several times and is therefore painful, time consuming, and expensive, has been virtually supplanted by serial urine LH testing (see also urine ovulation test).

Blood hormone test progesterone: Measuring of the concentration of progesterone in the woman's blood during the second half of the menstrual cycle about one week prior to anticipated menstruation; indicates whether or not she is likely to have ovulated because progesterone is usually produced only by the corpus luteum, which develops after ovulation.

Blood testis barrier:  the barrier that separates sperm from the bloodstream.

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

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.

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Canceled cycle: It is an ART cycle in which ovarian stimulation was carried out but which was stopped before eggs were retrieved, or in the case of frozen embryo cycles, before embryos were transferred.

Candidiasis (yeast): An infection that may be uncomfortable and itchy and may impair fertility.

Cannula: a hollow tube used, for example, to inseminate sperm artificially.

Capacitation: enables the sperm to penetrate the egg. During this process sperm are altered, acquiring the capacity to bind to the zona pellucida, undergo the acrosome reaction, and penetrate and fertilize the ovum. The processes by which sperm are prepared for fertilization as they pass through the woman's reproductive tract (in vivo capacitation); sperm may also be capacitated in the laboratory (in vitro capacitation).

Cervical canal: It is the connection between the outer cervical opening and the uterine cavity.

Catheter: a flexible tube used for aspirating or injecting fluids.

Cauterize: to destroy tissue with heat, cold, or caustic substances usually to seal off blood vessels or ducts. It is 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.

Centers for Disease Control and Prevention (CDC): A government agency within the Department of Health and Human Services responsible for publishing annual U.S fertility clinic success rates.

Cervical mucus: Mucus produced by glands in the cervical canal; it plays an important role in transporting sperm into the uterus and in initiating capacitation.

Cervical mucus insufficiency: A condition in which the ability of the cervical mucus to initiate the capacitation process is compromised through a deficiency in the amount of mucus produced, an abnormality in the physical chemical components of the mucus, the presence of infection, an abnormal hormonal environment, or the secretion of antibodies to sperm in the mucus. Cervical mucus insufficiency is responsible for about 10 percent of all cases of infertility. Most of the time the cervical mucus is thick plugging the cervical os and preventing sperm and bacteria from entering the womb. However, at midcycle, under the influence of estrogen, the mucus becomes thin, watery, and stringy to allow sperm to pass into the womb. See also Cervix.

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.

Cervicitis: inflammation of the cervix.

Cervix: Lowermost part of the uterus, which protrudes like a bottleneck into the upper vagina; the cervix opens into the uterus through the narrow cervical canal.

Cervix, Incompetent: A weakened cervix which opens prematurely during pregnancy and can cause the loss of the fetus. A cervical cerclage is a procedure in which a stitch or two is put around the cervix to prevent its opening until removed when the pregnancy is to term.

Chemical Pregnancy Biochemical: evidence of a possible developing pregnancy based on a positive blood or urine pregnancy test; at this point, pregnancy is presumptive until confirmed by ultrasound (see also clinical pregnancy).

Child Free Living: A resolution to infertility in which the couple opts for a life style without parenting, either temporarily or permanently.

Chlamydia: Pathogen responsible for a sexually transmitted infection that may damage the fallopian tubes and/or the male reproductive ducts, thereby causing infertility. Pathogen transmitted between partners or from an infected mother to her newborn child; the most common sexually transmitted disease.

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.

Chorionic villus sampling (CVS): taking a biopsy of the placenta, usually at the end of the second month of pregnancy, to test the fetus for genetic abnormalities.

Chromosome: threads of DNA in a cell's nucleus that transmit hereditary information. They are 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: Microscopic hair likes projections from the surface of a cell capable of beating in a coordinated fashion. They pertain to cells in the lining, the inside surface of the fallopian tubes. The waving action of these "hairs" sweeps the egg toward the uterus.

Classic surrogacy: It is the use of a third party to conceive and carry a baby to term. In this form of surrogacy, the baby would bear the genetic imprint of the surrogate and of the sperm provider.

Cleavage: The process of cell division.

Clexane: It is an anti-clotting or anticoagulant medicine, and works by interfering with the body's natural blood clotting mechanism. Enoxaparin inactivates a compound in this pathway called thrombin, which plays an important role in blood clot formation. Blood clots within the body can be dangerous as they can travel in the blood vessels and potentially block off blood supply to the heart, lungs or brain. This can occur in various conditions where the normal blood circulation is disturbed. Surgery, particularly abdominal surgery, produces a risk of thrombosis, as does a heart attack and poorly controlled angina (unstable angina). In addition, enoxaparin is used to prevent blood clotting when it is filtered through a kidney dialysis machine.

Climacteric: The hormonal change that precedes the menopause by a number of years and is associated with a progressive loss of fertility, an increased incidence of abnormal or absent ovulation, hot flashes, irregular menstruation, a progressive rise in blood FSH levels, and mood changes. The climacteric usually represents an important stage in a woman's life.

Clinical pregnancy: A pregnancy that has been confirmed by ultrasonic examination or through pathologic assessment of a surgical specimen obtained either from a miscarriage or from an ectopic pregnancy. A clinical pregnancy should be distinguished from a chemical pregnancy, which through a positive blood pregnancy test merely suggests the possibility that a pregnancy has occurred.

Clitoris: The small structure at the junction of the labia minora in front of the vulva. The clitoris, which is analogous to the penis in the male, undergoes erection during erotic stimulation and plays an important role in orgasm. It is also defined as a small erectile sex organ of the female, which contains large numbers of sensory nerves, the female counterpart of the penis.

Clomiphene Citrate: A synthetic drug used to stimulate the hypothalamus and pituitary gland to increase FSH and LH production. It is usually used to treat ovulatory failure due to hypothalamic pituitary dysfunction. A synthetic drug used to stimulate the hypothalamus and pituitary gland to increase FSH and LH production. It is usually used to treat ovulatory failure due to hypothalamic pituitary dysfunction.

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

COH: See controlled ovarian hyperstimulation.

Coitus: Intercourse; the sexual union between a man and a woman, or sexual intercourse.

Colposcopy: examination of the cervix through a magnifying telescope to detect abnormal cells.

Complete abortion: A miscarriage in which all of the products of conception have been expelled and the cervix is closed.

Conception: It is the creation of a zygote by the fertilization of an egg by a sperm (see fertilization).

Conceptus: A term used to describe the developing implanted embryo and/or early fetus.

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

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

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

Congenital defect: a birth defect.

Congenital: A characteristic or defect present at birth. It is acquired during pregnancy but is not necessarily hereditary.

Conization: surgical removal of a cone shaped portion of the cervix, usually as a treatment for a precancerous condition.

Contraception: The use of a method, medication, or device that will prevent pregnancy, such as condom, oral contraceptives, diaphragms, natural family planning, IUDs, spermicides, and sponges.

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.

Contraindication: a reason not to use a particular drug or treatment.

Controlled ovarian hyperstimulation (COH): In response to the administration of fertility drugs, the maturation of several follicles simultaneously, which results in the production of an exaggerated hormonal response.

Cordocentesis: Transabdominal blood sampling of the fetal umbilical cord, performed under ultrasound guidance. Used to test for certain abnormalities.

Corona radiata: See cumulus granulosa.

Corpus Luteum: The special gland that forms in the ovary at the site of the released egg. This gland produces the hormone progesterone during the second half of the normal menstrual cycle responsible for preparing and supporting the uterine lining for implantation. Progesterone also causes one 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).

Count (or Density): Refers to the number of cells present (i.e., sperm).

Cryobank: A place where either cells or tissues (i. e., sperm, oocytes, embryos) are stored in the frozen state.

Cryocautery: cautery by freezing.

Cryopreservation (Freezing): A procedure used to preserve (by freezing) and store embryos or gametes (sperm, oocytes). The process of freezing (in liquid nitrogen) and storing eggs, sperm, and embryos for future use cul De sac area of the woman's abdominal cavity behind the lower part of the uterus.

Cryopreservation and embryo cryopreservation: In this report, cryopreserved embryos are referred to as frozen embryos.

Cryptorchidism: failure of one or both testicles to descend into the scrotum.

Cul de sac: pouch located at the bottom of the abdominal cavity between the uterus and rectum.

Culdoscopy: examination of the internal female pelvic organs through an incision in the vagina.

Cumulative birthrate: The overall chance of a woman having one or more babies per egg retrieval or per embryo transfer following several attempts.

Cumulus granulose: The group of ovarian cells resembling a sunburst that surround the zona pellucida of the human egg; also called the corona radiata. These cells nurture the egg while in the fallopian tube.

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.

Cyst: a sac filled with fluid.

Cytomegalovirus (CMV): a group of viruses that cause enlargement of cells of various organs. Infection in a baby in utero can cause jaundice, high-tone deafness, eye problems, malformation, or fetal death.

Cytokines: any of various proteins, secreted by cells, that carry signals to neighboring cells and is important in controlling implantation. Interleukins and interferons are cytokines.

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

Danazol (danocrine): A synthetic androgen frequently prescribed for endometriosis. Suppresses LH and FSH production by the pituitary and causes a state of amenorrhea during which the endometrial implants waste away. Many women experience oily skin, acne, weight gain, abnormal hair growth, deepening of the voice and muscle cramps with this medication.

De Miranda Institute: A consumer protection agency for infertile couples.

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

Delayed Puberty: A condition in which the youngster 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.

Deoxyribonucleic acid (DNA): the combination of amino acids in the cell's nucleus that make up the chromosomes, which transmit hereditary characteristics.

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 (Dehydroepiandrosterone Sulfate): An androgen produced primarily by the adrenal gland. A high level suggests too much adrenal androgen output. See "Adrenal Androgens."

Diagnostic hysteroscopy: A procedure usually performed under local or general anesthesia in the office setting or in the operating room. A thin telescope like instrument is inserted via the vagina and cervix into the uterine cavity. Carbon dioxide gas or a liquid is injected to distend the cavity and allow direct visualization of its structure.

Diagnostic IVF: The performance of in vitro fertilization for the purpose of assessing the ability for fertilization to take place. It is an objective test of sperm/egg fertilization potential, although impractical.

Diethylstilbestrol (DES): a synthetic, nonsteroidal estrogenic compound. Currently, it is sometimes used after sex to prevent implantation of the fertilized egg. Women whose mothers took DES during pregnancy (at a time when it was wrongly thought to prevent threatened miscarriage) can pass it along to their unborn children, causing stillbirth or birth defects. The US FDA banned this in 1971 for use in pregnant women.

Dilatation and Curettage (D & C): Dilatation of the cervix to allow scraping of the uterine lining with an instrument (curette). This is also a means to induce abortion in the first trimester of pregnancy.

Donor Insemination: Artificial insemination with donor sperm. See Artificial Insemination.

Donor embryo: An embryo formed from the egg of a woman who has donated it for transfer to a woman who is unable to conceive with her own eggs (the recipient). The donor relinquishes all parental rights to any resulting offspring.

Donor Oocytes: Eggs donated for patients who have lost their ovaries, have premature ovarian failure or advanced maternal age to help achieve pregnancy.

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

Dysgenesis: Faulty formation of any organ.

Dysmenorrhea: Painful menstruation. This may be a sign of endometriosis.

Dyspareunia: Painful intercourse for either the woman or the man.

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E₂: See estradiol.

Ectopic Pregnancy: A pregnancy that occurs when the embryo implants in a location other than the uterus; the most likely site for such implantation is the fallopian tube (in which case the term ectopic pregnancy is used synonymously with tubal pregnancy). If undetected, an ectopic pregnancy may rupture and cause life threatening internal bleeding. Ectopic pregnancies require surgical intervention, unless a folic acid antagonist (i.e., Methotrexate) is used in non-complicates cases. Methotrexate is now used to dissolve the pregnancy without causing major damage to the tube.

Egg: The female gamete, which develops in the ovary; also known as an ovum or oocyte. An egg is the largest cell in the human body.

Egg retrieval: The retrieval of eggs from the ovarian follicles prior to ovulation; the eggs are sucked out of the follicles through a needle either during ultrasound guidance or laparoscopy.

Egg (Oocyte) Donation: donation of an egg by one woman to another who attempts to become pregnant by in vitro fertilization. More technically Egg Donation can be defined as the surgical removal of eggs from one woman for transfer into the fallopian tube or uterus of another woman.

Egg retrieval (also called oocyte retrieval): A procedure to collect the eggs contained in the ovarian follicles.

Egg transfer (also called oocyte transfer): The transfer of retrieved eggs into a woman's fallopian tubes through laparoscopy (see definition). This procedure is used only in gamete intrafallopian transfer (GIFT) (see definition).

Egg: A female reproductive cell, also called an oocyte or ovum.

Egg (ovum): The female reproductive cell.

Ejaculate: The semen and sperm expelled during ejaculation, or the sperm containing fluid released at orgasm.

Ejaculation: The physiological process by which the semen is propelled from the testicles, through the reproductive tract, and out the opening of the penis. It is the emission of approximately two to five ml of semen (seminal fluid and sperm) through the urethra and penis that follows erotic stimulation and accompanies male orgasm.

Ejaculatory ducts: the male ducts that contract with orgasm to cause ejaculation.

Electrocautery: cauterization using electrical current.

Electroejaculation: controlled electrical stimulation to induce ejaculation in a man with damage to the nerves that control ejaculation.

Embryo adoption: This occurs when a woman receives into her uterus an embryo to which neither she nor her partner has contributed a gamete.

Embryo co-culturing: The addition of cells derived from the growth of other tissue (from the lining of human or bovine fallopian tubes, or human follicular lining) to the culture medium in which the zygote is being nurtured in the laboratory. This is thought to enhance growth and promote the development of healthier embryos.

Embryo Cryopreservation: Cryopreservation involves slowly freezing embryos to store them for future use. This process involves a liquid nitrogen freezer and the use of cellular antifreezes. The embryos are stored and submersed in liquid nitrogen until they are thawed and placed into the uterus. There is approximately a 67 percent survival rate for embryos in cryopreservation. After the thaw, embryos retaining 50 percent or more of the cells they had before freezing are cultured and placed back into the uterus exactly like step four in IVF.

Embryo: The term for a fertilized egg from the time of initial cell division through the first six to eight weeks of gestation. Thereafter, the embryo begins to differentiate and take on a human organic form; at this point it is traditionally referred to as a fetus.

Embryo Transfer: Placing an egg fertilized outside the womb into a woman's uterus or fallopian tube. Placement of embryos into a woman's uterus through the cervix after in vitro fertilization (IVF) or in the case of zygote intrafallopian transfer (ZIFT) (see definition), into her fallopian tube. It is the introduction of an embryo into a woman's uterus after in vitro (or in vivo) fertilization.

Embryo: The term used to describe the early stages of fetal growth, from conception to the eighth week of pregnancy. It can also be defined as the egg that has been fertilized by a sperm and undergone one or more divisions. It can also be defined as the developing baby from implantation to the second month of pregnancy. It can also be defined as the early products of conception; the undifferentiated beginnings of a baby; the conceptus.

Embryologist: a specialist in embryo development.

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.

Endocrine System: The system of glands including the pituitary, thyroid, adrenals, testicles or ovaries.

Endocrine gland: an organ that produces hormones.

Endocrinologist: A doctor who specializes in diseases of the endocrine glands.

Endometrial Biopsy: The extraction of a small sample of tissue from the uterus for examination. Usually done to show evidence of ovulation. It can also be defined as a test to check for Luteal Phase Defect. It can also be defined as 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.

Endometrioma: a special type of ovarian cyst that is chocolate in color and contains endometrial cells that grows and bleeds during menstruation.

Endometriosis: A condition in which the endometrium grows outside the uterus, causing scarring, pain, and heavy bleeding, and often damaging the fallopian tubes and ovaries in the process. Endometriosis is a common organic cause of infertility. It can also be defined as 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.

Endometritis: inflammation of the endometrium.

Endometrium: The mucous membrane lining the uterus. It can also be defined as the lining of the uterus, which grows during the menstrual cycle under the influence of estrogen and progesterone. The endometrium grows in anticipation of nurturing an implanting embryo in the event of a pregnancy; it sloughs off in the form of menstruation if implantation does not occur. The lining of the uterus, which grows and sheds in response to estrogen and progesterone stimulation; the bed of tissue designed to nourish the implanted embryo.

Endorphins: They are natural narcotics manufactured in the brain to reduce sensitivity to pain and stress. May contribute to stress-related fertility problems.

Endosalpinx: The tissue lining in the fallopian tube.

Epididymis: Tubular reservoir that contains and transfers sperm to the vas deferens and subsequently through the urethra and penis at the time of ejaculation. 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. It can also be defined as an elongated organ in the male lying above and behind the testicles. It contains a highly convoluted canal, four to six meters in length, where, after production, sperm are stored, nourished and ripened for a period of several months.

Epididymitis: inflammation of the epididymis.

Erection: The enlarged, rigid state of the penis when sexually aroused. It can also be defined as the process during which the erectile tissue of the penis becomes engorged with blood, causing the penis to swell and become rigid.

Erythema: more or less diffuse redness of the skin due to concentration of an abnormally large amount of blood within the small vessels of the skin (hyperemia), as in burns.

Erythema nodosum: is often associated with systemic diseases such as tuberculosis and rheumatic fever. Tender, bright red, slightly elevated nodules develop along the shins.

Erythema multiforme: can have a number of causes, including viral and bacterial infection, chronic disease of the visceral organs, or allergic reactions to drugs

Estradiol (E₂): A female hormone produced by ovarian follicles. The concentration of estrogen in the woman's blood is often measured to determine the degree of her response to controlled ovarian hyperstimulation with fertility drugs. In general, the higher the estradiol response, the more follicles are likely to be developing and, accordingly, the more eggs are likely to be retrieved. A hormone released by developing follicles in the ovary. Plasma estradiol levels are used to help determine progressive growth of the follicle during ovulation induction. E2 is 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 4he 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.

Estradiol Valerate: A preparation of natural estradiol taken orally or by injection. 

Estrogen: Female sex hormone. It is a class of female hormones, produced mainly by the ovaries from the onset of puberty until menopause, which are also responsible for the development of secondary sexual characteristics in women. It can also be defined as a primary female sex hormone, produced by the ovaries, placenta, and adrenal glands.

Expectant Therapy (Endometriosis): A wait and see approach used after laparoscopic surgery for mild endometriosis.

Extracorporeal fertilization: Synonym for in vitro fertilization.

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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. A pair of narrow tubes that carry the ovum (egg) from the ovary to the body of the uterus. They are ducts that pick up the egg from the ovary; where a sperm normally meets the egg to fertilize it.

Falloposcope: A telescope like instrument that is introduced into the fallopian tubes for diagnostic purposes during falloposcopy.

Falloposcopy: A procedure performed at the time of laparoscopy or hysteroscopy, in which a thin telescope like instrument is introduced into the fallopian tube to evaluate its condition.

Fecundability: the ability to become pregnant.

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 Specialist: A physician specializing in the practice of fertility. The American Board of Obstetrics and Gynecology certifies a subspecialty for OB GYNs who receive extra training in endocrinology (the study of hormones) and infertility.

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 fusion of the sperm and egg to form a zygote (see also zygote, conception). It is the penetration of the egg by the sperm and the resulting combining of genetic material that develops into an embryo. It is 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. It is the union of the male gamete (sperm) with the female gamete (egg).

Fetal Death: The term often used to include both miscarriage and stillbirth.

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. It is a benign tumor of fibrous tissue that may occur in the uterine wall. May be totally without symptoms or may cause abnormal menstrual patterns or infertility.

Fibroid tumors (myomas): Nonmalignant growths within the wall of the uterus that may expand during pregnancy. They are most common in women over 35 years of age. Occasionally, these cause problems, increasing slightly the risk of ectopic pregnancy, miscarriage, placenta previa, abruptio placenta, premature labor, premature rupture of the membranes, stalled labor, fetal malformation, and breech and other more difficult to deliver fetal positions.

Fimbria: The opening of the fallopian tube near the ovary. When stimulated by the follicular fluid released during ovulation, the fingerlike ends grasp the ovary and coax the egg into the tube. They are finger like projections at the end of the fallopian tube nearest the ovary. When stimulated by the follicular fluid released during ovulation, the fingerlike ends grasp the ovary and coax the egg into the tube.

FISH test: fluorescence in situ hybridization test. It is a method of chromosome evaluation done with amniotic fluid. The results are usually available in about 3 days and can show evidence of disorders such as trisomy.

Fluoroscope: an imaging device that uses X rays to view internal body structures on a screen.

Follicle Stimulating Hormone (FSH): Follicle Stimulating Hormone (FSH): A pituitary hormone that stimulates spermatogenesis and follicular development. In the man FSH stimulates the Sertoli cells in the testicles and supports sperm production. In the woman FSH stimulates the growth of the ovarian follicle. Elevated FSH levels are indicative of gonadal failure in both men and woman. It is the pituitary hormone that stimulates follicle growth in women and sperm formation in men.

Follicle: A structure in the ovaries that contains a developing egg. It is a fluid filled sac in the ovary that releases an egg 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 Phase: The first half of the menstrual cycle when follicle development takes place in the ovary.

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 of the menstrual cycle: See proliferative phase of the menstrual cycle. It is the first half of the menstrual cycle when follicle development takes place in the ovary. It is the pre-ovulatory phase of a woman's cycle during which the follicle grows and high estrogen levels cause the uterine lining to proliferate.

Fornix (Pl. fornices): Deep recesses in the upper vagina created by the protrusion of the cervix into the roof of the vagina.

Fresh, eggs, sperm, or embryos: They are eggs, sperm, or embryos that have not been frozen. However, fresh embryos may have been conceived using fresh or frozen sperm.

Frigidity: The inability to become sexually aroused. Not a known cause of infertility.

Fructose: produced by the seminal vesicles, the sugar that sperm use for energy.

FSH: See follicle-stimulating hormone.

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

Gamete Intra-Fallopian Transfer (GIFT): Procedure in which the sperm and eggs are transferred by laparoscopy into the fallopian tubes where fertilization may then take place. It is 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 husband's sperm and then injected through the fimbria into the woman's fallopian tubes for in vivo fertilization.

Gamete micromanipulation: A special procedure performed on eggs to promote in vitro fertilization in cases where there is severe sperm dysfunction.

Gardnerella: a bacterium that may cause a vaginal infection.

Gastrulation: The stage of embryonic development in which blastomeres are dedicated to the development of specific organs and structures. 

Gender Selection: Gender selection is a method by which X and Y sperm can be separated through filtering processes. This sperm sample is used for insemination when ovulation is anticipated. In most cases couples participating in gender preselection have a baby of their chosen gender.

Gene: the unit of heredity, composed of DNA; the building block of chromosomes. It is pair base that conveys hereditary characteristics, consisting primarily of DNA and proteins and occurring at specific points on the chromosomes.

Genetic Abnormality: A disorder arising from an anomaly in the chromosomal structure which may or may not be hereditary.

Genetic Counseling: Advice and information provided, usually by a team of experts, on the detection and risk of recurrence of genetic disorders.

Genetic: Pertaining to hereditary characteristics.

Genitals: The external sex organs, as the labia and clitoris in the woman and the penis and testicles in the man. Also called genitalia.

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.

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.

Gestational sac: the fluid filled sac in which the fetus develops, visible by an ultrasound exam.

Gestation: The period of fetal development in the uterus from conception to birth, usually considered to be 40 weeks in humans.

Gestational Carrier: A woman who carries an embryo that was formed from the egg of another woman; the gestational carrier is expected to return the infant to its genetic parents.

Gestational Surrogacy: Gestational Surrogacy involves transferring the couple's embryo into another woman who carries the pregnancy to term. Utilizing traditional In Vitro Fertilization techniques, the female partner undergoes ovarian stimulation and monitoring followed by egg retrieval. Eggs are taken to the laboratory and fertilized with the husband or donor's sperm. The resulting fertilized embryo is transferred to the surrogate. The surrogate is not genetically related to the resulting child.

GIFT (See gamete intrafallopian transfer): An ART procedure that involves removing eggs from a woman's ovary, combining them with sperm, and using a laparoscope to assist in placing the unfertilized eggs and sperm into the woman's fallopian tube through small incisions in her abdomen. GIFT is a relatively new technique, which has shown promise as a means of therapy for infertile couples where patency of the fallopian tubes can be demonstrated (i.e. in unexplained infertility). The oocytes are retrieved from the follicles as for IVF, but instead of fertilizing the oocytes in vitro, they are replaced into the fallopian tubes with a small aliquot of washed spermatozoa using a fine catheter during the same surgical procedure. As with IVF the risks of multiple pregnancies suggest that the number of oocytes transferred to the fallopian tubes should be limited to between two and three oocytes.

Gland: an organ that produces and secretes essential body fluids or substances, such as hormones.

GnRHa (see Gonadotropin Hormone Releasing Hormone Agonist; GnRHa): GNRH like hormones that block the body's release of both FSH and LH. Through blocking LH production, GNRH agonists are capable of improving a woman's response to fertility drugs and may be used in combination with fertility hormones to promote an enhanced response in women who demonstrate resistance to controlled ovarian hyperstimulation. In the United States, GNRH agonists are also known as Lupron, Synarel, and Nafarelin.

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.

Gonadotropin Releasing Hormone (GNRH): A substance secreted by the hypothalamus every ninety minutes or so. This hormone enables the pituitary to secrete LH and FSH, which stimulate the gonads. See also FSH, LH.

Gonadotropin: A hormone capable of stimulating the gonads to produce hormones and / or gametes. Hormones, which control reproductive function: Follicle Stimulating Hormone and Luteinizing Hormone.

Gonads: organs that produce the sex cells and sex hormones; testicles in men and ovaries in women. They are the glands that make the gametes (the testicles in the male and the ovaries in the female).

Gonorrhea: A common venereal disease that may cause sterility in both men and women. A sexually transmitted infection caused by bacteria Neisseria gonococcus that can lead to infertility. It is 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 the man gonorrhea seldom leads to damage, but it may cause a painful infection.

Granuloma: a ball of inflamed tissue, commonly formed after vasectomy due to sperm leaking from the vas deferens.

Gynecologist: A doctor who specializes in the diseases of the female reproductive system.

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Habitual Aborter: When a woman has had three or more miscarriages. Incomplete: An abortion after which some tissue remains inside the uterus. A D&C must be performed to remove the tissue and prevent complications.

Habitual abortion: A miscarriage occurring on two or more separate occasions.

Hamster Test (Sperm Penetration Assay): used to determine the ability of a man's sperm to penetrate a hamster egg. Thought to provide evidence of the sperm's fertilizing ability. A test of the ability of sperm to penetrate a hamster egg which has been stripped of the Zona Pellucida (outer membrane). Also called either Hamster Zona Free Ovum (HZFO) or SPERM PENETRATION ASSAY (SPA).

Hatching: Opening of the zona (outer shell of the egg) due to expansion of the volume of the embryo through repeated cleavage. It occurs a few days after the embryo arrives or is deposited in the uterus and immediately precedes implantation (see also ASSISTED HATCHING).

HCG: See human chorionic gonadotropin.

Hemizona assay: a laboratory test of the ability of sperm to penetrate into a human egg; first the egg is split in half, then one half is tested against the husband's sperm and the other half against sperm from a fertile man.

Hemorrhage: Excessive bleeding.

Heparin: A drug that may be added to the solution used to flush eggs out of ovarian follicles during egg retrieval; its purpose is to prevent blood clotting within the fluid that harbors the egg.

Hereditary: Transmitted from one's ancestors by way of the genes within the chromosomes of the fertilizing sperm and egg.

Herpes: any of several inflammatory viral diseases of the skin characterized by clusters of vesicles (blisters). Herpes is an infection that can be harmful to pregnancy. It is passed on through skin-to-skin contact. Simplex 1 is usually seen in the form of mouth sores, while simplex 2 includes sores on the genitalia. Simplex 2 can cause serious health problems or the death of a baby if the baby is vaginally delivered while the mother has active herpes on the genitals; therefore, active herpes on the genitals during labor often requires a Cesarean section. Simplex 1 can cause early health problems; people with mouth sores should therefore not be allowed to kiss your child. Active herpes can also delay infertility treatments such as in vitro fertilization.

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

HLA antigens: The imprints of the man's immunologic make up.

HMG (See human menopausal gonadotropin).

Hormonal insufficiency: A condition resulting in infertility and/or miscarriage; in the IVF setting, hormonal insufficiency may be produced by an abnormal response to fertility drugs and may lead to the failure of an embryo to implant because the amount of hormones produced and the timing of their production and release were not perfectly synchronized.

Hormone (sex hormone): Chemicals produced by the testicles, ovaries, and adrenal glands that play a major role in reproduction and sexual identity. It is a chemical, produced by an endocrine gland, which circulates in the blood and has widespread action throughout the body.

Host Uterus: Also called a "surrogate gestational mother or 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.

HSG (See hysterosalpingogram).

Hühner Test: See postcoital test.

Human Chorionic Gonadotropin (HCG): A hormone secreted by the placenta during pregnancy that prolongs the life of the corpus luteum. The hormone produced in early pregnancy, which keeps the corpus luteum producing progesterone. Also used via injection (Profasi) to trigger ovulation after some fertility treatments, and used in men to stimulate testosterone production. A hormone, produced by the implanting embryo (and subsequently also by the placenta), whose presence in the woman's blood indicates a possible pregnancy; hCG may also be administered to women undergoing stimulation with hMG alone or in combination with other fertility drugs in order to trigger ovulation. Injections of HCG may also be administered to encourage the production of progesterone by the corpus luteum in the hope of promoting implantation following embryo transfer and thereby reducing the incidence of spontaneous miscarriage in a pregnancy resulting from IVF. The hormone HCG is derived from the urine of pregnant women.

Human Chorionic Gonadotropin (HCG) for Male Infertility: Also used via injection to stimulate testosterone production in men.

Human Menopausal Gonadotropin (HMG): A combination of hormones FSH and LH, which is extracted from the urine of postmenopausal women. Used to induce ovulation in several fertility treatments. A natural hormone that is administered either alone or in combination with other fertility drugs to induce ovulation of more than one egg. The hormone hMG is derived from the urine of menopausal women. When marketed in the United States, hMG is also known as Pergonal, Humegon.

Humegon (HMG): The luteinizing and follicle stimulating hormones recovered from the urine of postmenopausal women. Used to stimulate multiple ovulations in some fertility treatments.

Hydrocele: A swelling in the scrotum containing fluid.

Hydrosalpinx: A large fluid filled clubbed shaped fallopian tube closed at the fimbriated end. It is a cause of infertility.

Hydrotubation: injection of fluid, often into the fallopian tubes to determine if they are open. Lavage or "flushing" of the fallopian tubes with a sterile solution which sometimes contains medication such as antibiotics, enzymes, or steroids.

Hymen: A membrane that partially covers the virgin vagina.

Hyperandrogenism: excessive production of androgens in women, frequently a cause of hirsutism and also associated with polycystic ovarian disease (PCOD).

Hyperplasia: An abnormal enlargement of an organ or tissue of the body.

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 either directly suppresses ovarian function in the woman or spermatogenesis in the man.

Hyperstimulation Syndrome (Ovarian Hyperstimulation Syndrome: OHSS): A potentially life threatening side effect of Pergonal, Humegon or Metrodin ovulation induction. A woman's ovaries become enlarged and produce an overabundance of eggs. Blood hormone levels rise, fluid may collect in the lungs or abdominal cavity, and ovarian cyst may rupture, causing internal bleeding. Blood clots sometimes develop. Symptoms include sudden weight gain and abdominal pain. Cycles stimulated with these drugs must be carefully monitored with ultrasound scans. Withholding the HCG injection when ultrasound monitoring indicates that too many follicles have matured may prevent OHSS.

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.

Hypogonadism: Inadequate gonadal function as manifested by deficiencies in sperm production in males or egg production in females and/or the secretion of gonadal hormones (estrogens and androgens, respectively).

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.

Hypoplastic uterus: an underdeveloped uterus.

Hypospadia: A malformation of the penis in which the urethral opening is found on the underside rather than at the tip of the penis.

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 releases GNRH every ninety minutes or so. The pulsatile GNRH release enables the pituitary gland to secrete LH and FSH, which stimulate the gonads. See also FSH, LH, Ovary, Pituitary Gland, and Testicle. Hypothalamus is a small area in the mid-portion of the brain that, together with the pituitary gland, regulates the formation and release of many hormones in the body, including estrogen and progesterone by the ovaries and testosterone by the testes. It is a part of the base of the brain that controls the release of hormones from the pituitary.

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): A procedure used to assess the interior of the fallopian tubes and uterus; it involves injecting a dye into the uterus via the vagina and cervix, and tracking the dye's pathway by a series of X rays.

Hysteroscope: A lighted, telescope like instrument that is passed through the cervix into the uterus, enabling the surgeon to examine the cervical canal and the inside of the uterus for defects or disease.

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. Examination of the cervical canal and inside of the uterus for defects, by means of the hysteroscope. Surgery designed to correct such defects can be performed through the hysteroscope during this procedure, thereby often making more invasive abdominal surgery unnecessary.

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IAIH (Intrauterine Artificial Insemination Homologous): Artificial insemination where the husband'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.

ICSI (see intracytoplasmic sperm injection): A procedure in which a single sperm is injected directly into an egg; this procedure is most commonly used to overcome male infertility problems.

Idiopathic (Unknown or Unexplained): The term used when no reason can be found to explain the cause of a medical condition.

Immature oocyte (or egg) retrieval: The retrieval of numerous healthy but immature eggs from women who had not received any fertility drugs in advance of the egg retrieval; these eggs are subjected to a complex process of maturation in the laboratory and are then fertilized using ICSI.

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.

Immune system: the body's defense against any injury or invasion by a foreign substance or organism.

Immunoglobulins: a class of proteins endowed with antibody activity; antibodies.

Immunological: anything that pertains to the body's natural defenses or immunity against disease. Immunological factors for pregnancy loss include antiphospholipid antibodies, lupus anticoagulant, antinuclear antibodies, and antithyroid antibodies.

Immunological Response: The production of antibodies in the woman or man.

Immunosuppressive drug: a drug that interferes with the normal immune response.

Immunotherapy: a medical treatment for an immune system disorder that involves transfusing donor white blood cells into a woman who has had recurrent miscarriages.

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. The process that occurs when the embryo burrows into the endometrium and eventually connects to the mother's circulatory system.

Impotence: The inability of the male to achieve or maintain an erection or ejaculation during intercourse due to physical or emotional problems.

In Vivo Fertilization: The fertilization of an egg by a sperm within the woman's body.

In utero: while in the uterus during early development.

In Vitro (literally, in glass) Fertilization (IVF): A procedure in which an egg is removed from a ripe follicle and fertilized by a sperm cell outside the human body. Also called "test tube baby" and "test tube fertilization. ". In Vitro Fertilization is more commonly known as "test tube baby" and has helped couples who are infertile, conceive and bear children. Today this process actually occurs in a dish and not a test tube. The In Vitro Fertilization procedure is a four-step process. First, the patient will take medications to stimulate the ovary to produce multiple eggs. Step two involves retrieving the eggs from the ovary. Once the eggs have been retrieved, the third step is the fertilization of the eggs and culture of the embryos in the IVF Laboratory. Once the eggs are appropriately fertilized, the fourth and final step occurs. This step involves placing the embryos into the uterus for implantation (embryo transfer or ET).

Inclusive pregnancy: rates Pregnancy success reports that combine rates for both clinical and chemical pregnancies and do not distinguish between the two.

Incompetent Cervix (See Cervix, Incompetent): A weakened cervix that is incapable of holding the fetus within the uterus for the full nine months. Can be a cause of late miscarriage. It is when the cervix has the inability to remain closed throughout an entire pregnancy. It is a frequent cause of premature birth.

Incomplete abortion: A miscarriage in which only portions of the products of conception have been expelled. This usually requires dilatation and curettage.

Inevitable abortion: A miscarriage that cannot be halted.

Infertility: The inability to conceive after one full year of normal, regular heterosexual intercourse without the use of contraception, or according to others the inability of the woman to carry a pregnancy to live birth.

Inflammation: a response to some type of injury such as infection, characterized by increased blood flow, heat, redness, swelling, and pain.

Inhibin. F (Folliculostatin): A female feedback hormone made in the ovary to regulate FSH production by the pituitary gland. A male feedback hormone made in the testicles (e.g., Sertoli cells) to regulate FSH production by the pituitary gland.

Insemination: In the laboratory, the addition of a drop or two of the medium containing capacitated sperm to a petri dish containing the egg in order to achieve fertilization. Also refers to placement of sperm into the woman's reproductive tract.

Insemination media: A liquid that bathes and nourishes the eggs and embryos in the petri dish just as the mother's body fluids sustain them in nature.

Integrins: a large family of proteins involved in the attachment, migration, invasion, and control of cellular function. Over the past decade, investigators have learned that integrins participate in multiple reproductive events including fertilization, implantation, and placentation in many species.

Interstitial Cells: The cells between the seminiferous tubules of the testicles that produce the male hormone testosterone. Also called Leydig cells.

Intracervical insemination (ICI): artificial insemination of sperm into the cervical canal.

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. Intracytoplasmic sperm injection is a newer advancement in reproductive technology in which procedures are performed on eggs under a specially constructed microscope in a process known as micromanipulation. ICSI is typically used in the event of severe sperm abnormalities to fertilize eggs. This technique involves injecting a single sperm directly into the egg. After injection of the sperm, the eggs are incubated for 16-18 hours, and then examined for possible damage and for evidence that fertilization has occurred. The resulting undamaged embryos can then either be transferred back to the woman's uterus, using standard IVF techniques (or tubes using ZIFT), or can be frozen for transfer at a later time.

Intratubal insemination (ITI): artificial insemination of sperm, which have been washed free of seminal fluid, into the fallopian tubes.

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

Intravaginal insemination (IVI): The injection of semen (usually donor semen) into the vagina in direct proximity to the cervix in the hope that pregnancy will occur.

Invasive procedure: Any operative procedure, major or minor, that traverses body tissues. In the case of fertility related treatments, a surgical procedure that requires that one or more punctures or incisions be made in the woman's abdomen. 

Isohormones: Similarly structured components that have different levels of biological activity; the influence of isohormones may be responsible for the variations in potency among different batches of gonadotropins such as hMG and purified FSH.

IUD (Intrauterine Device): 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.

IUI: See intrauterine insemination.

IVF (in vitro fertilization): An ART procedure that involves removing eggs from a woman's ovaries and fertilizing them outside her body. The resulting embryos are then transferred into the woman's uterus through the cervix.

IVF surrogacy: It is a synonym for gestational surrogacy.

IVF third party parenting: A situation in which an individual other than one of the aspiring parents provides gametes (as with sperm or ovum donation) or a uterus, and the woman who will carry the baby to term undergoes embryo transfer.

IVI:. See intravaginal insemination.

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Kallman's Syndrome: A congenital hypothalamus dysfunction, which has multiple symptoms including the failure to complete puberty. It is hypogonadism with anosmia (loss of the sense of smell). It is an uncommon cause of male infertility.

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

Klinefelter's Syndrome: A congenital abnormality of the male wherein he receives an XXY chromosomal complement instead of XY. These men are infertile. It is a chromosome abnormality that prevents normal male sexual development and causes irreversible infertility due to the presence of an extra female (X) chromosome.

Knee chest position: Position the woman may be asked to assume during embryo transfer if the uterus is tipped forward, to contribute to optimal placement of the embryos.

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Labia majora: The hair covered outer lips of the external portion of the female reproductive tract.

Labia minora: The small inner lips of the outer female reproductive tract, partially hidden by the labia majora.

Labia: Folds of skin on either side of the entrance of the vagina.

Laparoscope: A long, thin telescope like instrument containing a high intensity light source and a system of lenses that enables the surgeon to examine the abdominal/pelvic cavity and to perform other diagnostic or surgical procedures under direct vision without necessitating major surgery. 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: A surgical procedure using the laparoscope. Laparoscopy may be used for egg retrieval, diagnostic evaluation, reparative surgery, and various other fertility procedures. Because of its dual abilities to enable the physician to assess tubal patency and visualize the abdominal cavity, laparoscopy has largely replaced hysterosalpingography as the most popular method of assessing the anatomical integrity of the reproductive tract (see also augmented laparoscopy). Once the favored procedure for egg retrieval, too, laparoscopic egg retrieval has been supplanted by ultrasound guided egg retrieval.

Live birth: The delivery of one or more babies with any sign of life.

Laparotomy: A procedure in which an incision is made in the abdomen to expose the abdominal contents for diagnosis or surgery. Major abdominal surgery where reproductive organ abnormalities can be corrected and fertility restored, such as tubal repairs and the removal of adhesions.

Leiomyoma (See Fibroid): a benign tumor of the uterus.

Leydig Cell (See interstitial cells): The testicular cell that produces the male hormone testosterone. LH stimulates the Leydig cell from the pituitary gland.

LH: See luteinizing hormone.

LH surge: the sudden release of luteinizing hormone (LH) that causes the follicle to release a mature egg.

LHRH: Luteinizing hormone releasing hormone (see GnRH).

Libido: Sexual desire.

Lithotomy Position: It is the position a woman is asked to assume in order to undergo a gynecological examination or other procedure such as embryo transfer, vaginal ultrasound examination, etc.

Lupus anticoagulant: an antiphospholipid antibody causing elevation in partial thromboplastin time (the time needed for plasma to form a clot after the addition of calcium and a phospholipid reagent; used to evaluate the clotting system), associated with venous and arterial thrombosis (clotting within an artery or vein). 

Luteal Phase Defect (or deficiency; LPD): A shortened luteal phase or one with inadequate progesterone production. It is the inadequate function of the corpus luteum that may prevent a fertilized egg from implanting in the uterus or may lead to early pregnancy loss. It is a condition that occurs when the uterine lining does not develop adequately because of inadequate progesterone stimulation, or because of the inability of the uterine lining to respond to progesterone stimulation. LPD may prevent embryonic implantation or cause an early abortion.

Luteal phase of the menstrual cycle: See secretory phase of the menstrual cycle.

Luteal Phase: Postovulatory phase of a woman's cycle. The corpus luteum produces progesterone, which cause the uterine lining to thicken to support the implantation and growth of the embryo. The days of the menstrual cycle following ovulation and ending with menses during which progesterone is produced by the corpus luteum.

Luteal phase insufficiency or defect: The inadequate production of hormones during the second phase of the menstrual cycle, which may result in infertility or miscarriage.

Luteinized Unruptured Follicle Syndrome (LUF): A condition in which the egg is not released during ovulation; the follicle does not rupture and the egg is trapped. It is a condition in which the follicle develops and changes into the corpus luteum without releasing the egg.

Luteinizing Hormone (LH): A hormone secreted by the pituitary gland. Secretion of LH increases in the middle of the cycle to induce release of the egg. A gonadotropin released by the pituitary gland to stimulate the ovaries and testicles. It is 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. 36 hours).

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Macrophages: Cells of the immune system that destroys invading organisms or foreign proteins.

Male factor: Any cause of infertility due to deficiencies in sperm quantity, function, or motility (ability to move) that make it difficult for a sperm to fertilize an egg under normal conditions.

Male subfertility: Less than optimal sperm quality, including configuration, motility, and count (number produced in a semen specimen), which reduce the chance of conception without completely preventing its spontaneous occurrence.

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.

Meiosis: The process of reducing and dividing the chromosomes in both the sperm and egg, which occurs immediately prior to and during fertilization. It is the cell division, peculiar to reproductive cells, which allows genetic material to divide in half. Each new cell will contain twenty-three chromosomes. The spermatids (immature sperm) and ova (eggs) each contain twenty-three chromosomes, so when they combine (fertilize), the baby will have a normal complement of forty-six.

Menarche: The onset of menstruation in girls.

Menopause: The period of a woman's life that begins with the total cessation of menstruation, usually between the ages of 40 and 55.

Menorrhagia: Heavy or prolonged menstrual flow.

Menotropins (Human Menopausal Gonadotropin or HMG): Injections which containing FSH and LH. They are produced by extraction from the urine of menopausal women.

Menstrual cycle: The time that elapses between menstrual periods. The average cycle is 28 days, with ovulation usually occurring at the midpoint (around the 14th day).

Menstruation: The monthly flow of blood when pregnancy does not occur; the flow comprises about two thirds of the endometrium and blood, often including the unfertilized egg or unimplanted embryo. The shedding of the uterine lining by cyclic bleeding that normally occurs about once a month in the mature female. It is 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.

Methotrexate: a toxic anticancer drug that is an analogue of folic acid and an antimetabolite. Used as an antineoplastic agent (to attack abnormal tissue growth). Sometimes used to treat ectopic and molar pregnancies.

Metrorrhagia: Menstrual spotting during the middle of the cycle.

Micromanipulation: A term used to describe a variety of mechanical procedures used to promote the entry of sperm into the egg. Also called assisted fertilization. Micromanipulation is a method of assisted reproduction when the process is manually performed under the guidance of the microscope.

Micro organelles: Tiny intracellular factories that provide energy and perform metabolic functions in the egg, where the micro organelles are located largely in the ooplasm.

Microsurgery: It is a fine and delicate surgery requiring magnification often using a microscope. It is used to reconnect tied tubes after sterilization or repair blocked fallopian tubes. Reconstructive surgery performed under magnification using delicate instruments and precise techniques.

Miscarriage (see spontaneous abortion): Spontaneous expulsion of the products of conception from the uterus in the first half of pregnancy. It is a spontaneous abortion of a fetus up to the age of viability.

Missed abortion: A miscarriage in which a dead fetus and other products of conception remain in the uterus for four or more weeks. The fetus dies in the uterus but there is no bleeding or cramping. A D&C will be needed to remove the fetal remains and prevent complications. Therapeutic: A procedure used to terminate a pregnancy before the fetus can survive on its own.

Mitosis: The identical replication of cells by cleavage; mitosis is the process responsible for the growth and development of all tissues. The divisions of a cell into two identical cells in which all forty-six human chromosomes are duplicated; the first division of the germ cell.

Mittleschmerz: German for "middle pain," referring to the pain during ovulation that some women experience. The discomfort felt on one side of the lower abdomen at the time of ovulation.

Mock embryo transfer: A trial procedure wherein a thin catheter is introduced via the cervix into the uterine cavity. It is intended to simulate embryo transfer and evaluate the potential for embryo transfer.

Molar pregnancy (trophoblastic disease): the fertilization of an egg without a nucleus. A baby (usually anomalous) may or may not be present, and the placenta develops into a nonmalignant tumor called a hydatidiform mole. The layer of cells that line the gestational sac and normally give rise to the chorionic villi convert into a mass of clear, tapioca-like vesicles instead of into a healthy placenta. The fertilized egg then deteriorates. Probably caused by a chromosomal abnormality in the fertilized egg. A continuous or intermittent brownish discharge is the prime symptom. A molar pregnancy is treated by a D&C and sometimes methotrexate.

Monosomy: the absence of one chromosome of a pair

Mycoplasma (T-strain mycoplasma): a microscopic organism thought to be responsible for pregnancy loss.

Morphology of sperm: The study of the shape of sperm cells. This evaluation is part of a semen analysis. Refers to form or shape of the sperm. It is the percentage of sperm that have a normal vs. abnormal shape, structure, or configuration.

Morulla: It is an early phase of embryo development.

Motility of Sperm: The ability of the sperm to move about. Refers to percent of sperm demonstrating any type of movement.

Mucus: secretion from a gland that can be watery, gel like, stretchy, sticky or dry; fertile mucus is watery and stretchy.

Multifetal pregnancy reduction: A procedure used to decrease the number of fetuses a woman carries and improve the chances that the remaining fetuses will survive and develop into healthy infants. Multifetal reductions that occur naturally are referred to as spontaneous multifetal reductions.

Multiple births: It is a pregnancy that results in the birth of more than one infant.

Mumps Orchitis: Inflammation of the testicle caused by mumps virus. Can lead to sterility if infection with the virus occurs after puberty.

Mycoplasma: an infectious agent that falls structurally between a virus and a bacterium.

Mycoplasma: See Ureaplasma.

Myomectomy: Surgical removal of a fibroid tumor (myoma) in the uterine muscular wall.

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Necrospermia (Necrozoospermia): A condition in which sperm are produced and found in the semen but they are dead. These sperm cannot fertilize eggs.

Nidation: The implantation of the fertilized egg in the endometrium of the uterus.

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Obstetrician and Gynecologist (Ob. Gyn): a physician who specializes in the treatment of female disorders and pregnancy.

Obstetrician: A doctor who specializes in pregnancy and childbirth.

Oligomenorrhea: Infrequent menstrual periods.

Oligo-Ovulation: Infrequent ovulation, usually less than six ovulatory cycles per year.

Oligomenorrhea: infrequent and irregular menstrual cycles.

Oligospermia (Oligozoospermia): Having few sperm. A sperm count below 20 million; a low sperm count; a sperm count low enough to cause a fertility problem.

Oocyte Retrieval: A surgical procedure to collect the eggs contained within the ovarian follicles.

Oocyte: The female reproductive cell, also called an egg. It is the egg or ovum that is produced in the ovary.

Orchitis: An inflammation of the testes.

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

Ovarian Failure: The inability of the ovary to respond to any gonadotropic hormone stimulation, usually due to the absence of oocytes.

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 factor: A cause of infertility due to problems with egg production by the ovaries.

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 monitoring: The use of ultrasound and/or blood or urine tests to monitor ovarian follicle development and hormone production.

Ovarian stimulation: The use of drugs to stimulate the ovaries to develop follicles/eggs.

Ovarian wedge resection: surgical removal of a portion of a polycystic ovary to produce ovulation.

Ovaries: The sexual gland of the female which produces the hormones estrogen and progesterone, and in which the ova are developed.

Oviduct: Fallopian tube.

Ovulation Induction: Medical treatment performed to initiate ovulation. See also Clomiphene Citrate, Humegon, and Pergonal.

Ovulation: release of an egg from the ovary. It is the discharge of a mature egg, usually at about the midpoint of the menstrual cycle.

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.

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Panhypopituitarism: Complete pituitary gland failure.

Pap smear: removal of cells from the surface of the cervix to study microscopically.

Parlodel: See Bromocriptine.

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

Pelvic cavity: the area surrounded by the pelvic bone that contains the uterus, fallopian tubes, and ovaries in women, and the prostate gland and seminal vesicles in men.

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.

Penetrak: a test of how fast sperm can travel up through cow mucus.

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

Penis: the male organ of sexual intercourse. The male organ that becomes enlarged and erect for the purpose of depositing semen in the woman's vagina.

Pergonal (HMG): A medication used to replace the pituitary hormones, LH and FSH. May be used to induce ovulation in women who do not respond to clomiphene citrate. Most frequently used with women who do not normally produce estrogen because of a pituitary gland or hypothalamic malfunction. May also be used with men to stimulate sperm production. The luteinizing and follicle stimulating hormones recovered from the urine of postmenopausal women that is used to induce multiple ovulations in various fertility treatments.

PID: See also 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. A gland located at the base of the human brain that secretes a number of important hormones related to normal growth and development and fertility.

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 ovarian disease (PCOD, or "Stein. Leventhal Syndrome"): a condition found among women who do not ovulate, characterized by multiple ovarian cysts and increased androgen production. 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.

Polyp: A nodule or small growth found frequently on mucous membranes, such as in the cervix or the uterus. It is a growth or tumor on an internal surface, usually benign.

Post Coital Test (PCT, Hühner Test): 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. 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 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.

Pre-embryo: a fertilized egg in the early stage of development prior to cell division.

Pregnancy, Clinical: Pregnancy verified by the presence of a gestational sac on ultrasound.

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. Also produced by the placenta during pregnancy.

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. It is the pituitary hormone that in high amounts stimulates milk production.

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.

Prostaglandins: A group of hormone like chemicals that have various effects on reproductive organs; so named because they were first discovered in the prostate gland. It is hypothesized that prostaglandins secreted by active, young endometrial implants may interfere with the reproductive organs by causing muscular contractions or spasms. Also, prostaglandins not "washed" from sperm can cause severe cramping during IUI procedures.

Prostate Gland: A gland in the male reproductive system that produces a portion of the semen including a chemical that liquefies the coagulated semen twenty minutes to go one hour after entering the vagina. It also secretes an alkaline liquid that neutralizes acid in the urethra and stimulates motility of the sperm. The Prostate can also be defined as a male gland encircling the urethra that produces one third of the fluid in the ejaculate.

Puberty: The time of life when the body begins making adult levels of sex hormones, (i.e., estradiol, testosterone) and the youngster takes on adult body characteristics: developing breasts, growing a beard, pubic hair, and auxiliary hair; attaining sexual maturity.

Pyospermia: A condition in which the presence of white cells in the semen indicates possible infection.

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Recurrent pregnancy loss/recurrent miscarriage/recurrent spontaneous abortion: repeated pregnancy losses. Testing can be done to try to determine the cause of such losses. If an underlying condition is found, the woman may need to be treated for the problem before a pregnancy can be carried to term.

Refractory Period: A period of time after orgasm during which a man or woman cannot have another orgasm, a recovery period.

Reproductive endocrinologist: an ob gyn who specializes in the treatment of hormonal disorders that affect reproductive function.

Reproductive Surgery of Endometriosis: The word Endometriosis comes from "endometrium" which is the tissue that lines the inside of the uterus and builds up and sheds each month in the menstrual cycle. In endometriosis, tissue like the endometrium is found outside the uterus and in other areas of the body. In these locations outside the uterus, the endometrial tissue develops into what are called "nodules", or "growths". These growths can cause pain, infertility and other problems. One method utilizes a laparoscope to remove or destruct the growths. In operative laparoscopy, surgery is carried out though the Laparoscope using laser, cautery, or other small surgical instruments.

Repronex®: is a human menopausal gonadotropin (hMG). Repronex® contains equal amounts of follicle stimulating hormone (FSH) and luteinizing hormone (LH) activity. It is used for induction of ovulation in the anovulatory patient (not due to primary ovarian failure) and to stimulate the development of multiple follicles in patients participating in an IVF program. Repronex® induces follicular growth and maturation in most instances.

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.

RESOLVE: It is a national, nonprofit consumer organization offering education, advocacy, and support to those experiencing infertility. These services include a national Help Line, quarterly newsletter, extensive literature list, and membership to contact systems, and local support groups through a network of over 50 chapters nationwide.

Retrograde Ejaculation: Discharge of semen backward into the bladder rather than forward through the penis. 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.

Retroverted Uterus: uterus that is bent backward.

Rh factor: any of one or more genetically determined antigens present in the red blood cells of most persons and capable of inducing intense immunologic reactions. Some women develop a sensitization to Rh during pregnancy. If a woman is Rh negative and her husband is Rh positive, she is a candidate for Rh incompatibility problems. After the first pregnancy, the Rh factor enters the Rh-negative mother's circulatory system during the delivery (or miscarriage) of a child who has inherited the Rh factor from his father. The mother's body then produces antibodies against it. If she becomes pregnant with another Rh-positive baby, the antibodies cross the placenta and attack the baby's red blood cells, causing mild to serious anemia in the baby. The medication Rhogam (called "Anti-D" in Britain and New Zealand) is given to prevent these problems.

Rhogam: an immunization given to Rh-negative women after a miscarriage, stillbirth, or live birth to prevent production of antibodies in any Rh-positive babies they may have in future pregnancies

Rubella (German measles): a viral disease characterized by headache, fever, rash, and inflammation of the throat. Infection in a pregnant mother can damage the baby. The risks are greater the earlier in the pregnancy that the mother contracts the illness.

Rubin Test: Obsolete test in which a gas such as carbon dioxide is blown into the uterus under pressure to test if the fallopian tubes are open.

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Salpingectomy: Surgical removal of the fallopian tube.

Salpingitis isthmica nodosa: an abnormal condition of the fallopian tube where it attaches to the uterus, characterized by nodules.

Salpingitis: inflammation of one or both fallopian tubes.

Salpingolysis: Surgery performed to remove adhesions that restrict the movement and function of the fallopian tubes.

Salpingoplasty: Surgery to correct blocked fallopian tubes.

Salpingostomy & Fimbrioplasty: Surgical repair made to the fallopian tubes; a procedure used to open the fimbria.

Salpingostomy: an incision in a fallopian tube, such as to remove an ectopic pregnancy.

Salpingotomy: an operation to open a blocked fallopian.

Scrotum: The bag of skin and thin muscle surrounding the man's testicles.

Secondary Infertility: The inability to conceive or carry a pregnancy after having successfully conceived and carried one or more pregnancies. It may also be defined as the inability of a couple to achieve a second pregnancy. This strict medical definition includes couples for which the pregnancy did not go to term. The common vernacular, however, refers to a couple which has one biological child but is unable to conceive another.

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

Selective abortion: A term often used to refer to intentional termination of one or more gestational sacs within the uterus, usually in the case of a multiple pregnancy (triplets or more).

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.

Semen: the fluid containing sperm and secretions from the testicles, prostate, and seminal vesicles that are expelled during ejaculation. 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. The sperm and seminal secretions ejaculated during orgasm.

Seminal Vesicle: A pair of pouch like glands above the prostate in the male that produce a thick, alkaline secretion that is passed in the semen during ejaculation. Glands in the male reproductive system, which produce much of the semen volume, include fructose (sugar) for nourishing the sperm and a chemical that causes the semen to coagulate on entering the vagina. It can also be defined as the paired glands at the base of the bladder that produce seminal fluid and fructose.

Seminiferous Tubules: The long tubes in the testicles in which sperm are formed. It can also be defined as 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.

Septum: a wall that divides a cavity in half, such as a uterine septum.

Serophene: Brand name for clomiphene citrate (See Clomid).

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. It can also be defined as the cells in the testicles that provide nourishment to the early sperm cells.

Sexually transmitted disease (STD): a disease caused by an infectious agent transmitted during sex.

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

Sims-Hühner Test: See postcoital test.

Society for Assisted Reproductive Technology (SART): An affiliate of the American Society for Reproductive Medicine composed of clinics and programs that provide ART. SART reports annual fertility clinic data to the Centers for Disease Control and Prevention (CDC).

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 (Spermatozoa): The male reproductive cell that has measurable characteristics such as.

Sperm Motility: Refers to percent of sperm demonstrating any type of movement.

Sperm Washing: A technique that separates the sperm from the seminal fluid.

Sperm (Spermatozoa): The male reproductive cell that has measurable characteristics such as.

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 husband'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. It is the number of sperm in the ejaculate (when given as the number of sperm per ml it is more accurately known as the sperm concentration or sperm density).

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

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

Sperm Motility: The ability of sperm to swim. Poor motility means the sperm have difficult time swimming toward their goal: the egg.

Sperm penetration assay (SPA): see Hamster test. It is the ability of the human sperm to penetrate the hamster egg so it can deposit the genetic material during fertilization. It is an obsolete test that presently has no clinical utility in our practice.

Sperm Washing: A technique that separates the sperm from the seminal fluid. It is the dilution of sperm sample prior to insemination to remove prostaglandin chemicals in the semen that cause contractions of the uterus. It may also be used to remove other debris from semen.

Sperm: male gamete or reproductive cell. It is the microscopic cell that carries the male's genetic information to the female's egg; the male reproductive cell; the male gamete.

Spermatogenesis: Sperm production in the testicles. It is the production of sperm within the seminiferous tubules.

Spermicide: an agent that kills sperm.

Spinnbarkeit: The stretch ability of cervical mucus; the stringy quality that occurs at midcycle under the influence of estrogen. See also Postcoital Test.

Split Ejaculate: A method of collecting a semen specimen so that the first half of the ejaculate is caught in one container and the rest in a second container. The first half usually contains the majority of the sperm. 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.

Spontaneous abortion (See Abortion, Spontaneous): A miscarriage or the unintended termination of a pregnancy before the twentieth week.

Stein Leventhal Disease: Another name for Polycystic Ovaries.

Sterility: An irreversible condition that prevents conception.

Sterilization reversal: a surgical procedure used to undo a previous sterilization operation and restore fertility.

Stillbirth:  A fetus or infant delivered without signs of life after 20 weeks or more of gestation.

Stimulated cycle: An ART cycle in which a woman receives drugs to stimulate her ovaries to produce more follicles.

Super ovulation: Stimulation of multiple ovulations with fertility drugs; also known as controlled ovarian hyperstimulation (COH).

Surrogate mother: It is a woman who gestates an embryo and then turns over the child to the infertile couple, who may be its genetic parents. It is the woman who becomes artificially inseminated with a man's sperm and carries the pregnancy for an infertile couple, which adopts the baby after its birth (the man being the biological father of the child).

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Tamoxifen: an estrogen antagonist used to treat infertility caused by a failure to ovulate properly (it is also used to treat postmenopausal breast cancer). The dose for infertility depends on the menstrual cycle. In women who are having regular periods, the treatment usually begins by taking 20 mg on the 2nd, 3rd, 4th, and 5th days of the menstrual cycle. If this is not successful, the dosage might be increased to 40 mg daily and then to 80 mg if required. In women who do not have regular periods, the treatment can be started on any day.

Tetraploidy: cells containing 4 sets of chromosomes instead of the normal two.

Test Tube Baby: A child born through in vitro fertilization.

Testicle: the male gonad; produces sperm and male sex hormones. The male sexual glands of which there are two. Contained in the scrotum, they produce the male hormone testosterone and produce the male reproductive cells, the sperm.

Testicular Biopsy: Surgical excision of testicular tissue to determine the ability of the testes to produce normal sperm. 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 Failure: Occurs when the testes fail to produce sperm.

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. Occurs when the testes fail to produce sperm.

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

Testicular/Epididymal Sperm Aspiration (TESA): Testicular Sperm Aspiration involves retrieving sperm using an open testicular biopsy technique. Several small samples of the testes are taken, either for analysis or for the recovery of sperm in the most severe case of azoospermia. These operations are done as day cases under general or local anesthesia or with intravenous sedation.

Testosterone: The male hormone responsible for the formation of secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for spermatogenesis. The most potent male sex hormone, produced in the testicles.

Thawed cycle: A cycle in which previously frozen embryos are thawed for embryo transfer.

Therapeutic abortion: An intentional termination of pregnancy for the purpose of preserving the life of the mother.

Threatened abortion: symptoms such as vaginal bleedings, with or without pain, which may end with a miscarriage or with continuation of a normal pregnancy. Spotting or bleeding that occurs early in the pregnancy. May progress to spontaneous abortion.

Thyroid Gland: A gland located at the front base of the neck, which secretes hormones (i.e., thyroxine), which is necessary for normal fertility. It is the endocrine gland in the front of the neck that produces thyroid hormones to regulate the body's metabolism.

Tocolytic: a drug that relaxes smooth muscles and therefore interferes with uterine contractions; frequently used to stop premature labor.

Torsion of the ovary: it may also occur in a woman suffering from hyperstimulation, a complication of ovulation induction treatment.

Torsion, Testicle: 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.

Total effective sperm count: an estimate of the number of sperm in an ejaculate capable of fertilization; total sperm count X percent motility X percent forward progressive motility X percent normal morphology.

Toxin: a poison produced by a living organism, such as by some bacteria.

Toxoplasmosis: It is an infection or disease caused by a bacterium that invades the tissues and may seriously damage the central nervous system, especially of infants. It also may be transmitted by a mother to her unborn child, resulting in abnormalities such as water on the brain (hydrocephalus), the development of jaundice shortly after birth, etc. Often found in cat feces, which is why doctors ask their pregnant patients to refrain from changing kitty litter during pregnancy.

Transvaginal ultrasound: an ultrasound examination performed by means of inserting a probe into the vagina. This can produce better images in early pregnancy that could be obtained with conventional abdominal sonograms.

Trendelenburg position: the position in which the patient lies on her back with the bed tilted so that her knees and hips are higher than her head. Used to help prevent preterm delivery.

Trimester: one of the 3-month periods into which a pregnancy is divided

Triploidy: the presence of 3 chromosomes instead of 2

Trisomy: a cell with an extra chromosome. There are various types of trisomies depending on which chromosome is affected. Trisomy 8 is characterized by abnormal face/head, short wide neck but narrow cylindrical trunk, and multiple joint and digit defects. Trisomy 13 (also called trisomy D syndrome and Patau's syndrome) is characterized by mental retardation and malformed ears, cleft lip or palate, defects of the eyes, small jaw, extra fingers or toes, cardiac defects, convulsions, renal anomalies, umbilical hernia, malrotation of the intestines, and other anomalies (not all patients have all signs of this syndrome), and is usually fatal within 2 years. Trisomy 18 (also called Edward's syndrome) is usually fatal within 2 months and is characterized by mental retardation, abnormal skull shape, low-set and malformed ears, small jaw, cardiac defects, short sternum, abnormal flexion of the fingers (for instance, the fetus is shown with clenched fists), and diaphragmatic or inguinal hernia. Trisomy 20 is characterized by profound mental retardation, abnormally large mouth and tongue, minor abnormalities of the ears, and other skeletal defects. Trisomy 21 (Down's syndrome) includes abnormalities such as mental retardation, retarded growth, flat face with short nose, prominent skin folds, small low-set ears, thickened tongue, broad hands and feet, stubby fingers, and others. Heart disease in Down's syndrome patients is common, and Alzheimer's disease by age 40 is almost inevitable. The majority of babies with trisomies are miscarried

Trophoblastic disease: trophoblastic cells normally contribute to the formation of the placenta and are the pathway through which the baby receives nutrients from the placenta. See "molar pregnancy.

Tubal pregnancy: see "ectopic pregnancy.

Turner's Syndrome: a genetically determined condition that is associated with the presence of only one complete X chromosome and no Y chromosome and that is characterized by a female phenotype with underdeveloped and infertile ovaries. When these women grow up, they are often infertile but have very normal mental acuity.

Traditional Surrogacy: Traditional Surrogacy involves artificially inseminating a woman who carries a baby to term, which will be raised by its genetic father and his partner.

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

Tubal factor: Structural or functional damage of one or both fallopian tubes that reduces fertility.

Tubal ligation: surgical sterilization of a woman by obstructing or "tying" the fallopian tubes.

Tubal Recannulization and Selective Salpingography: Selective hysterosalpingography, or proximal tubal cannulation may open the tubes avoiding surgery. Recannulization is usually painless. It should performed fluoroscopic supervision (i.e., X-ray) with pre-medication and a local block or during a hysteroscopy procedure in the operating room if the patient also needs laparoscopy. A 5. 5 french 2 mm catheter is steered into the corner (cornua) of the uterus. An attempt is made to pass dye by selective chromotubation (i.e., selective dye test). If tube is ok, probably there was spasm. In that case the tubes were never really blocked. That is one of the weaknesses of regular HSG. In case of anxiety or pain, the tubes go into spasm and appear blocked even if they are not.

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.

Tuboplasty: plastic or reconstructive surgery on the fallopian tubes to correct abnormalities that cause infertility.

Tubotubal Anastomosis: Surgery performed to remove a diseased portion of the fallopian tube and reconnect the two ends; sterilization reversal.

Tumor: an abnormal growth of tissue that can be benign or malignant (cancerous).

Turner's Syndrome (Ovarian Dysgenesis): A congenital abnormality of the female wherein she receives an XO instead of an XX genetic sex complement. Women with this condition are sterile. Turner's is the most common genetic defect contributing to female fertility problems. The ovaries fail to form and appear as slender threads of atrophic ovarian tissue, referred to as streak ovaries. Karyotyping will reveal that this woman has only one female (X) chromosome instead of two.

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Ultrasound (Sonography): An imaging technique for visualizing the growth of ovarian follicles during infertility therapy. It is the use of high frequency sound waves for creating an image of internal body parts. It is a noninvasive technique for visualizing the follicles in the ovaries and the gestational sac or fetus in the uterus.

Ultrasound: See Sonogram.

Umbilical Cord: Two arteries and one vein encased in a gelatinous tube leading from the baby to the placenta. It is used to exchange nutrients and oxygen from the mother for waste products from the baby.

Undescended Testicles (Cryptorchidism): The failure of the testicles to descend from the abdominal cavity into the scrotum by one year of age. If not repaired by age six may result in permanent fertility loss.

Unexplained cause of infertility (See idiopathic infertility): Infertility for which no cause has been determined despite a comprehensive evaluation.

Unicornate Uterus: An abnormality in which the uterus is "one sided" and smaller than usual.

Unstimulated cycle: An ART cycle in which the woman does not receive drugs to stimulate her ovaries to produce more follicles. Instead, follicles develop naturally.

Ureaplasma (Mycoplasma): Are the smallest of free-living organisms. They are unlike all other bacteria because they have no cell walls and therefore must live inside cells. They are unlike viruses because they can live in cultures outside of cells and can be killed by certain antibiotics. However, most antibiotics cannot kill them, as most antibiotics work by damaging a bacteria's cell wall. Antibiotics such as the tetracyclines or erythromycins that do not act on a cell wall can kill them.

Urethra: The tube that carries urine from the bladder to the outside. In men it also carries semen from the prostate to the point of ejaculation during intercourse. It is 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 doctor who specializes in diseases of the urinary tract in men and women, and the genital organs in men. It is a physician specializing in the genitourinary tract.

Uterine factor:  It is a disorder in the uterus that reduces fertility.

Uterotubogram: See hysterosalpingogram.

Uterus: The hollow, muscular organ in the woman that holds and nourishes the fetus until the time of birth. It is the womb, female reproductive organ that nourishes the fetus until birth.

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Vagina: The birth canal opening in the woman extending from the vulva to the cervix of the uterus. It is the female organ of sexual intercourse, the birth canal.

Vaginismus: A spasm of the muscles around the opening of the vagina, making penetration during sexual intercourse either impossible or very painful.

Vaginitis: Inflammation of the vagina, 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 varicose vein of the testicles, sometimes a cause of male infertility. It is 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. It is a major cause of male infertility.

Vas Deferens: A pair of thick walled tubes about 45cm long in the male that lead from the epididymis to the ejaculatory duct in the prostate. It is the tube(s) 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 reversal: surgical repair of a previous vasectomy for a man who wants to regain his fertility.

Vasectomy: Surgery to excise part of the vas deferens to sterilize a man. It is the surgical sterilization of a man by interrupting both vas deferentia.

Vasogram: an X-ray study of the vas deferens.

Venereal Disease (VD, See also Pelvic Inflammatory Disease [PID], or Sexually transmitted diseases [STD]): 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. Also known as STD or sexually transmitted disease most commonly gonorrhea, syphilis and chlamydia. VD is any infection pertaining to or transmitted by sexual intercourse.

Viability: Refers to whether or not the sperm are alive.

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

Virus: a microscopic infectious organism that reproduces inside living cells.

Viscosity: Thickness of the semen.

Vulva: The external genitalia of the female.

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X Chromosome (see also Y Chromosome): The congenital, developmental, or genetic information in the cell that transmits the information necessary to make a female. All eggs contain one X chromosome, and half of all sperm carry an X chromosome. When two X chromosomes combine, the baby will be a girl.

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Y Chromosome (see also X Chromosome): The genetic material that transmits the information necessary to make a male. The Y chromosome can be found in one half of the man's sperm cells. When an X and a Y chromosome combine the baby will be a boy.

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ZIFT (zygote intrafallopian transfer): An ART procedure in which eggs are collected from a woman's ovaries and fertilized outside her body. A laparoscope is then used to assist in placing the resulting zygote (fertilized egg) into the woman's fallopian tube through small incisions in her abdomen.

Zona Pellucida: The outer covering or eggshell of the egg that the sperm must penetrate before fertilization can occur. It is the protective coating surrounding the egg.

Zygote: A fertilized egg, which has not yet divided.

Zygote Intra Fallopian Transfer (ZIFT): in vitro fertilization with a transfer of the zygote into the fallopian tube, a combination of in vitro fertilization and gamete intrafallopian transfer (usually done by laparoscopy). An ART in which eggs are removed from a woman's ovaries, fertilized with the man's sperm in a lab dish, and the resulting Zygotes are transferred into the woman's fallopian tubes during a minor surgical procedure. The ZIFT procedure is somewhat similar to the procedure used in GIFT. However, in ZIFT, fertilized embryos (zygotes) rather than unfertilized eggs, are placed in a woman's fallopian tubes. ZIFT as opposed to GIFT allows for direct information as to whether or not fertilization has occurred. As in IVF, once fertilization has occurred, the embryos are placed into the fallopian tubes using a laparoscope under general anesthesia.

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