Adhesion: Scar tissue band attached
to organ surfaces, capable of connecting, covering or distorting organs, such
as fallopian tubes, ovaries, uterus,
and bowel.
Antibodies: Chemicals made by
the body to fight or attack foreign substances entering the body. Normally they
prevent infection; however, when they attack the sperm
or fetus, they cause infertility.
Sperm antibodies may be made by either the man or the woman.
Antisperm Antibodies (ASA): Antibodies
are produced by the immune system to fight off foreign substances, like bacteria.
Antisperm antibodies attach themselves to sperm and inhibit movement and their
ability to fertilize. Either the man or the woman may produce sperm antibodies
Artificial Insemination: Any of
the various techniques whereby sperm are introduced to
the female by means other than sexual intercourse.
Assisted hatching: Thinning of the
embryo's outer egg shell (zona pellucida) prior to embryo
transfer. Indicated for couples with advanced maternal reproductive age,
elevated FSH levels, and prior repetitive
IVF failures.
Asthenospermia: Decreased
number of motile sperm in the ejaculate.
Azoospermia: The complete absence
of sperm. It can result from obstruction of the vas deferens
(the duct that carries the sperm from the testicles
to the urethra) or from failure of the testes to produce sperm. MESA
and TESE are two procedures to obtain sperm
from azoospermic males.
Autoimmune: An immune reaction
against one's own tissue
Basal Body Temperature Test (BBT):
Indirect evidence of ovulation can be obtained with
the basal body temperature chart. The temperature can be taken orally with a
special thermometer immediately upon awakening and before any activity. This
is recorded on a special graph that enables you to visualize the different temperature
shifts. The temperature will drop to its lowest point, 1-2 days prior to ovulation,
and then rises and remains elevated until a couple of days before impending
menstruation. If the individual is pregnant the temperature
will remain elevated. This elevation is not considered a fever because it will
never exceed 38ºC (100ºF). This test is unfortunately not very reliable in every
woman, and is therefore not used universally.
Biphasic: A two-level BBT record,
which shows a rise in temperature and is suggestive of ovulation.
Blastocyst: An embryo
that has undergone multiple cellular divisions with the formation of a cavity
within it. A fertilized egg reaches the blastocyst stage
usually 4 to 5 days after fertilization.
Capacitation: The changes that
a sperm goes through to be capable of penetrating the layers
covering the egg. It involves the sequentially timed release of a series of
enzymes, which allows the sperm to digest a passage through those layers.
Cervical Cultures: The process
of obtaining samples (of secretions) from the cervix and culturing them on special
media for different types of infectious organisms such as Chlamydia,
Gonococcus and Ureaplasma. These sexually transmitted diseases, if present,
can cause infertility by damaging the fallopian
tubes or can interfere with implantation of
the embryo by infecting the lining of the uterus. They
are easily treated with antibiotics.
Cervical Mucus: Cervical mucus
is secreted by glandular cells that are present in the cervix.
This mucus protects the uterus from invasion by bacteria present in the vagina.
It also plays an important role in infertility. The cervical mucus, in response
to the estrogen hormone, becomes thin and elastic at
the time of ovulation. This allows the sperm
to travel through the cervix and the uterus to reach the egg in the fallopian
tube. It also helps the sperm to stay alive in the cervix for a longer period
of time. A thick and dense mucus could prevent the passage of sperm through
the cervix. The cervical mucus is checked by the Postcoital
test.
Cervical Stenosis: Narrowing of
the cervical canal in such a way that menstrual flow can partially or completely
be impeded. It is often the result of cervical injury due to surgery such as
cone biopsy done for an abnormal Pap smear. It can cause infertility by hampering
the normal passage of sperm through the cervix, and can often be treated by
intrauterine insemination that bypasses the cervix
altogether.
Cervix: The lower section of the uterus
that protrudes into the vagina and dilates during labor to allow the passage
of the infant.
Chlamydia: A bacteria responsible
for a sexually transmitted infection that can affect the tubes by causing permanent
damage and thus infertility. Often occurs without significant symptoms.
Chromosome: The nuclear structure
of every living cell. Every human cell has normally 46 chromosomes. These chromosomes
are made up of genes that govern all of the body's functions, and are also responsible
for all the physical characteristics of an individual. Human gametes
(i.e. eggs and sperm) contain only 23 chromosomes. When unified during fertilization,
the total number of 46 chromosomes is thus restored. Abnormalities of chromosomes
can result in miscarriages or congenital abnormalities. Age affects the quality
of chromosomes in an egg and that is why infertility and miscarriages are more
common in older women. For instance, the incidence of Down's Syndrome increases
when a woman gets older.
Conception: Also called fertilization
- when the sperm meets and penetrates the egg.
Controlled Ovarian Hyperstimulation:
Stimulation of the ovaries with various hormonal medications
in order to develop as many follicles as possible as
well as to control the timing of ovulation.
Corpus Luteum: A special gland that
forms on the surface of the ovary at the site of ovulation and produces progesterone
during the second half of the cycle. The follicle after it ruptures and releases
the egg. It is necessary to prepare the uterine lining for implantation
by the fertilized egg.
Cryopreservation (Embryo Freezing):
A procedure used to preserve (by freezing) and store embryos
or gametes (sperm).
Diethylstilbestrol (DES):
A synthetic estrogen prescribed in the 1950s, 1960s,
and early 1970s to women to prevent miscarriage. Many 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 was
banned in 1971 by the FDA in the U.S. for pregnant women. DES daughter/son:
the daughter/son of a woman who used DES. Research is also looking into effects
on DES grandchildren
Donor Insemination: The introduction
of sperm from a donor into a woman's vagina or cervix
using instruments, in order to achieve a pregnancy.
Donor Oocyte: Women with diminished
ovarian reserve or premature menopause have an extremely
low likelihood of establishing a pregnancy. For that reason, eggs from a young
donor can be utilized. Donor egg pregnancy rates, in our experience, have been
greater than 70% per cycle.
Donor sperm: Commercially available
donor sperm which is screened for all known sexually transmitted diseases, is
available from many suppliers. Patients select their own donor for insemination.
Ectopic Pregnancy (also called Tubal
Pregnancy): A normal pregnancy results when the embryo implants inside the
uterus. When implantation occurs outside the uterus,
an ectopic pregnancy ensues. Such an abnormal pregnancy can be located in the
tubes, the ovaries, the cervix or inside the abdomen.
Ejaculate: As a noun, it refers
to the mixture of sperm and seminal fluid that comes out of a man's penis during
sexual stimulation. As a verb, it refers to the passing of this material.
Egg: The mature female gamete. Also called
an oocyte.
Egg Retrieval: Minimally invasive procedure
to retrieve eggs for IVF using ultrasound
guided needle aspiration through the vagina. Typically takes 15 to 30 minutes.
Painless because of intravenous and local pain medicines.
Embryo: The developing individual
from approximately the second week until approximately the end of the second
month.
Embryologist: A scientist who
specializes is embryo development
Embryo Replacement: Introduction
of a thawed embryo into a woman's uterus after in vitro
fertilization.
Endometriosis: The presence
of endometrial tissue (the normal uterine lining) in abnormal locations such
as the tubes, ovaries and peritoneal cavity.
Endometrium: The lining of the
uterus.
Endometrial Biopsy: A procedure
that involves taking a small sample of tissue from the inside lining of the
uterus (called the endometrium). An endometrial biopsy is done for many reasons.
In a case of investigation for infertility, it is performed to evaluate the
endometrium for its readiness to accept the embryo.
An endometrial biopsy is also performed for abnormal uterine bleeding to diagnose
hormonal imbalances or an anatomic cause for the bleeding, such as polyps,
hyperplasia (abnormal benign growth of the endometrium) or cancer.
Epididymus: The organ in the man
where sperm are stored, nourished, and mature after manufacture.
Estrogen: The primary female hormone
produced mainly by the ovary from puberty to menopause.
Estrogen is responsible for the normal growth and differentiation of both the
follicle and the egg. It also plays
an important role in preparing the endometrial lining where implantation
would occur in case of pregnancy. Estrogen also changes the quality and texture
of the cervical mucus, making it thinner and more elastic.
This allows the normal passage of sperm through the cervix
towards the uterus and the tube where it meets the egg.
Fallopian Tube: A pair of tubes
that conduct the egg from the ovary to the uterus. Normal fertilization
takes place within this structure.
Fertilization: The unification
of sperm and egg to form a zygote (the earliest stage
of human life). The zygote would then become an embryo,
and then a fetus.
Fetus: A fertilized egg is called a
zygote. Further cellular division and differentiation
yields an embryo. Once organic differentiation occurs,
i.e., the embryo acquires human-like features, it is called a fetus.
Fibroid Tumors (or Myomas): Benign
tumors of the muscle of the uterus. Fibroids develop in
one of every four women sometime during their lifetime. If present inside the
uterine cavity, they can interfere with implantation.
Fibroids can also cause problems if they become large in size and impinge or
put pressure on the uterine lining. They are treated by surgical removal, either
via Laparoscopy, Hysteroscopy,
or a major abdominal surgery.
Fimbria: Finger-like outer ends
of the Fallopian tubes that sweep the egg into the fallopian
tube.
Folic acid: Vitamin started preconceptionally
by women of reproductive age, which reduce the fetuses' risk of neural tube
defects by 80%.
Follicle: The fluid-filled sac on
the ovary that has nurtured the egg and from which the egg is released during
ovulation, or aspiration.
Follicular Phase: The first half
of the menstrual cycle when ovarian follicle development takes place, pre-ovulatory.
Follicle Stimulating Hormone (FSH):
A hormone produced and released from the pituitary gland
that stimulates the ovary to ripen a follicle for ovulation. This hormone also
stimulates sperm production in the male.
Frozen Embryo Transfer (FET): A procedure
where frozen embryos are thawed and then placed into the uterus
Gamete: A generic term referring to
either the male sperm or the female oocyte
(egg).
Gamete Intrafallopian Transfer (GIFT):
A technique that may be used in lieu of in
vitro fertilization for women with patent (clear and open) tubes. After
egg retrieval the eggs are mixed with the husband's sperm and then immediately
injected through the fimbria into the woman's fallopian
tubes for In Vivo Fertilization. Procedure is done through Laparoscopy.
Gestation: The period of fetal
development in the womb from implantation to birth
GnRH: Gonadotropin releasing hormone
is the single most important hormone controlling ovarian function. It is secreted
by the hypothalamus and controls LH
and FSH secretion by the pituitary
gland, which in turn directly controls ovarian function. Absent or abnormal
secretion of GnRH results in irregular cycles and lack of ovulation. GnRH is
secreted in an episodic manner by the hypothalamus
to be able to carry its functions.
Gonads: The glands that makes reproductive
cells and "sex" hormones: the testicles, which make
sperm and testosterone, and
the ovaries, which make eggs (ova) and estrogen.
Gonorrhea: A sexually transmitted
disease than can cause tubal disease and infertility.
If caught early, it is totally curable without a bad sequel as far as fertility
potential is concerned. Common symptoms include pelvic pain, vaginal discharge
and fever.
Human Chorionic Gonadotropins (hCG):
The major hormone secreted by the placenta. In the early
stages of pregnancy continued survival of the Corpus Luteum
(the follicle that released the egg) is totally dependent on HCG, and in turn,
the survival of the pregnancy is dependent upon hormones secreted by the Corpus
Luteum.
Hypergonadism: Inadequate ovarian
or testicular function.
Hyperstimulation (Ovarian Hyperstimulation
Syndrome - OHSS): A potentially life-threatening side effect of ovulation
induction with injectable fertility medications such as hMG and urofollitropins.
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. Bloodclots sometimes develop.
Symptoms include sudden weight gain and abdominal pain. Cycles stimulated with
these drugs must be carefully monitored with ultrasound
scans. OHSS may be prevented by withholding the hCG injection
when ultrasound monitoring indicates that too many follicles
have matured
Hyperthyroidism: Overproduction
of thyroid hormone by the thyroid gland. The resulting
increased metabolism "burns up" estrogen too rapidly
and interferes with ovulation.
Hypothalamus: The gland at the
base of the brain that has a major role in regulating the hormones involved
in fertility and the menstrual cycle.
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, and women will suffer from elevated prolactin
and estrogen, both of which will interfere with fertility
Hysterosalpingography (hSG):
An x-ray dye test used to visualize the uterus and tubes.
It involves the injection of a radio-opaque dye through the cervix
and into the uterus and tubes. A series of x-rays is taken
and the contour and patency of the uterus and tubes are assessed.
Hysteroscopy: This is a procedure
that involves the introduction of a thin telescope-like instrument through the
cervix into the uterine cavity. It enables the direct
visualization of the uterine cavity and its lining, thereby providing an opportunity
to diagnose abnormalities such as polyps, fibroids or adhesions.
Idiopathic Infertility: The term
used to explain when the cause of infertility cannot
be explained.
Implantation: The embedding
of the fertilized egg in the endometrium.
Infertility: Unprotected intercourse
for more than one year without establishing a pregnancy (6 months for women
over age 35).
Intracytoplasmic sperm injection
(ICSI): In vitro fertilization method
to allow men with low sperm count, motility, or abnormal
forms to achieve fertilization. Direct injection of a single sperm
into an embryo.
Intramuscular Injection: Injection
into the muscle of the backside. Method to administer human menopausal gonadotropins
and hCG.
Intrauterine insemination (IUI):
Painless, quick, office procedure where concentrated sperm is placed into the
uterus with a small flexible catheter. Indicated for infertile couples with
abnormal semen analyses, or in conjunction with ovulation
induction.
In Vitro Fertilization
(IVF): Literally means "in glass." Fertilization takes place outside the
body in a small glass dish
In Vitro Fertilization/Embryo
Transfer (IVF-ET): A procedure in which an egg is removed transvaginally
from an ovarian follicle and fertilized artificially in the laboratory and placed
intrauterine through a specialized catheter for embryo transfer.
Kallman's Syndrome: A congenital
hypothalamus dysfunction which has multiple symptoms
including the failure to complete puberty
Karyotype: The chromosomal characteristics
of a cell
Karyotyping: A chromosome
analysis in which cells are studied to look for abnormalities. Testing a fetus
may show if there is a chromosomal reason for the pregnancy loss, which causes
about 50% of miscarriages. Testing the parents can
help determine if there is an underlying chromosomal problem that increases
the chances of repeated losses, which occurs in about 3% of couples with recurrent
pregnancy loss.
Klinefelter's Syndrome: A genetic
abnormality characterized by having one Y (male) and two X (female) chromosomes
or a mosaic (a combination of 46XY and 47XX). Klinefelters often causes a fertility
problem, though some men will produce sperm. ART and donor
inseminations are possible. This condition can be passed on
Laparoscopy: The process involves
the introduction of a thin telescope- like instrument through the belly button
into the pelvis for direct visualization of the pelvic organs. At the same time,
dye can be injected through the cervix, and its flow can be traced into and
through the fallopian tubes under direct vision.
Luteinizing hormone (LH): A hormone
secreted by the pituitary gland involved in the control
of ovulation. The role of LH is to trigger ovulation
and help prepare the endometrial lining for implantation.
Lupron: Known medically as a GnRH-ag
onist (see GnRH). Lupron is a commonly used medication in IVF
and also for the treatment of severe endometriosis
or large uterine fibroids. Lupron taken continuously either by daily subcutaneous
(under the skin) injections or monthly intramuscularly depot injections will
suppress the pituitary-ovarian axis. Simply stated, it will make the ovaries
"go to sleep" and stop functioning, therefore stopping the secretion of hormones
such as estrogen and progesterone.
Lupron is frequently used in IVF to prevent premature ovulation.
Luteal Phase: The last fourteen days
of the menstrual cycle after ovulation has occurred.
It is associated with progesterone production. Post-ovulatory.
Luteal phase defect: Inadequate
progesterone production or effect that does not allow normal implantation.
Cause of recurrent pregnancy loss. Diagnosed by two
consecutive out of phase endometrial biopsies, or repetitively low serum progesterone
levels in the mid-luteal phase.
Meiosis: The cell division, peculiar
to reproductive cells, which allows genetic material to divide in half. Each
new cell will contain twenty-three chromosomes. The spermatids (immature sperm)
and ova (eggs) each contain twenty-three chromosomes, so when they combine (fertilize),
the baby will have a normal complement of forty-six.
Menopause: Total depletion of eggs
resulting in the cessation of menstrual periods. The average age of menopause
in the United States is 52 years and 50 years for smokers.
Menstruation: Shedding of the
uterine lining by bleeding, which (in the absence of pregnancy) normally occurs
about once a month in the mature female.
Microsurgical Epididymal Sperm
Aspiration (MESA): A surgical Procedure to remove sperm from the epididymus
in men who have an obstruction of the vas deferens or epididymus (or congenital
absence of the vas deferens). Also in a procedure for obtaining
sperm from men who have had a prior vasectomy.
Miscarriage (MC, m/c): Spontaneous
loss of an embryo or fetus from the
womb.
Morphology: The physical structure
and configuration of sperm cells.
Morula: The stage of cell division
prior to blastocyst. It is a solid mass of blastomeres
formed by cleavage of a fertilized egg.
Motility: The measurement of motion
and forward progression of sperm in a semen analysis.
Myoma: Also called fibroid. Benign
tumors arising from the muscular wall of the uterus. Location can be on the
outside of the uterus (subserosal), in the uterine wall
(intramural), or pressing into the uterine cavity (submucosal). Fibroids cause
uterine enlargement, heavy and abnormal vaginal bleeding, bladder pressure,
need for frequent urination, and pelvic pain. May interfere with reproduction,
especially if submucosal in location.
Myomectomy: Surgical removal of
fibroids either hysteroscopically or by an
abdominal approach.
Ovarian Failure: The inability of
the ovary to respond to any hormone - this us usually due to menopause.
Ovarian reserve: The number and
quality of eggs remaining in a woman. Ovarian reserve diminishes over time,
especially in the transition from the late 30's to the early 40's. Ovarian reserve
can be assessed with measurement of follicle stimulating
hormone (FSH) on cycle day 3, or by Clomiphene citrate challenge test.
Ovaries: The female sex glands with
both a reproductive function (releasing eggs) and a hormone function (producing
estrogen and progesterone).
Ovulation: The release of a mature
egg from the surface of the ovary. Ovulation is triggered when a follicle
measures between 16 and 20 mm.
Ovulation Induction: Use of medication
to recruit and develop many eggs. Clomiphene citrate, Lupron,
and injectable FSH are used for ovulation induction
and IVF. Frequently coupled with intrauterine inseminations.
Ovulatory Dysfunction: A problem
with the ovary where the egg is not matured or released
properly.
Pelvic Inflammatory Disease (PID):
Infection of the pelvic organs that may result in scarring of the fallopian
tubes and /or pelvic adhesions.
Pituitary Gland: A gland located
at the base of the brain, below the hypothalamus,
which controls almost every endocrine gland in the body and therefore, controls
human growth, development and reproduction.
Placenta: The organ that is responsible
for the nourishment of the developing embryo.
Polycystic Ovarian Syndrome: The
formation of cysts in the ovaries that occurs when the follicle
stops developing. This is due to a hormonal imbalance in the ovary.
Polyp: Benign growth of the lining
of the uterus or the endometrium.
It looks like a small solid balloon and can interfere with normal implantation
and cause infertility, abnormal bleeding and theoretically
miscarriages.
Post-Coital Test (PCT): A test
to determine whether the sperm can move properly through the cervical
mucus.
Preimplantation Genetic Diagnosis
(PGD): An advanced technique that involves checking the cells (via biopsy)
of a developing embryo for genetic and chromosomal abnormalities and thus helping
to prevent serious transmissible genetic diseases.
Premature Ovarian Failure (POF):
Cessation of menstruation due to depletion of ovarian
follicles before the age of 40. It is a cause for infertility
requiring egg donation.
Primary Infertility (PI): Refers
to those struggling with infertility without ever having conceived. Popular
usage has been extended to include those who have conceived but not had a live
birth.
Progesterone: The hormone secreted
by the Corpus Luteum that makes the uterus prepare its
lining to receive the egg.
Prolactin: A hormone secreted by
the pituitary gland. Its major role is to control
milk production. Excess secretion can interfere with normal ovulation. This
is why Prolactin levels are checked in every woman during the evaluation process
for infertility.
Prostate: The gland in the male
that supplies some of the seminal fluid, and prepares the urethra for the passage
of sperm.
Provera: Synthetic progesterone
medication. Can be used to bring on a period for women who have Polycystic
Ovarian Disease and infrequent menstrual periods.
Recurrent pregnancy loss: Two or
three consecutive miscarriages.
Reproductive Endocrinologist (RE):
Obstetrician-Gynecologists with advanced education (usually a two year fellowship),
and research in Reproductive Endocrinology. These highly trained and qualified
physicians treat Reproductive Disorders that affect children, women, men, and
the mature woman.
Some physicians describing themselves as Reproductive Endocrinologists
have not completed certification with the American Board of Obstetrics and Gynecology
in the Sub-Specialty of Reproductive Endocrinology and Infertility
Retrograde ejaculation: Frequently
seen in men with diabetic complications or neurologic injury. Low semen volume
is noted because most of the ejaculate refluxes 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. Can be treated with medication,
isolation of sperm from urine and subsequent intrauterine
inseminations, or IVF.
Retroverted Uterus: Uterus
that is tilted back toward the rectum.
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 (Anti-D): 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.
Salpingitis: An inflammation
of one or both fallopian tubes.
Scrotum: The pouch at the base of
the penis that contains the testicles.
Secondary Infertility (SI): The
inability of a couple to achieve a second pregnancy. This strict medical definition
includes couples for whom the pregnancy did not go to term. The common vernacular,
however, refers to a couple which has one biological child (or more) but is
unable to conceive another.
Seminal Vesicle: The pair of pouch-like
glands around the prostate that produce the milky fluid that mixes with the
sperm prior to ejaculation.
Semen: The sperm
and seminal secretions ejaculated during orgasm by the male.
Semen Viscosity: The liquid flow or
consistency of the semen.
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.
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.
Sonohystogram: An ultrasound/sonogram
in which saline is injected into the uterus. It is used
to check for abnormalities. It has some similarity to a hysterosalpingogram
in purpose, but does not require iodine dye injection or radiation.
Sperm (Spermatozoa): Male reproductive
cells (gamete).
Spermatogenesis: The production
of sperm.
Sperm Count: The number of sperm in
ejaculate. Also called sperm concentration or sperm
density and given as the number of sperm per milliliter.
Sperm Morphology: A semen analysis
factor that indicates the number or percentage of sperm in the sample that appear
to have been formed normally. Abnormal morphology includes sperm with kinked,
doubled, or coiled tails. The higher the percentage of misshapen sperm, the
less likely fertilization can take place.
Sperm Motility: The ability
of sperm to swim. Poor motility means the sperm have a difficult time swimming
toward their goal---the egg.
Sperm Penetration Assay (SPA): A test
of the ability of sperm to penetrate a hamster egg that
has been stripped of the Zona Pellucida (outer membrane).
Also called a Hamster Test.
Sperm Washing: A laboratory technique
for separating sperm from semen, and
separating motile sperm from non-motile sperm, for use in assisted reproduction.
The washing technique for near normal specimens is mixing the ejaculate
after liquefaction with the appropriate washing medium followed by centrifugation.
The supernatant is discarded and the sediment (sperm rich fraction) is re-suspended
in more washing medium. This process is repeated 2-3 times maximum. In the final
wash, the sediment is re-suspended in 0.5 cc of medium, loaded into a syringe
and deposited in the uterus. "Sperm Rise" or "Swim-up" technique: Two to five
cc of medium are carefully layered on top of 0.2-0.5 cc of semen. Motile sperm
cells "swim-up" into the culture medium. After some time (30-90 minutes) the
medium (containing motile sperm cells) is carefully harvested and centrifuged.
If necessary, fresh medium is layered on top of the seminal fluid again to harvest
more sperm cells. Discontinuous gradient centrifugation: This technique utilizes
a dense liquid phase to separate sperm cells from seminal fluid and debris.
Different compounds commercially available can be utilized. Semen is deposited
on top of this fluid and subjected to centrifugation. Motile sperm cells migrate
to the bottom of the tube, which are used for IUI
after further washing.
Split Ejaculate: A method used to concentrate
the sperm for insemination; separating the semen
into two portions: the first portion of the ejaculate, which is rich in sperm,
and the second portion, which contains mostly seminal fluid.
Spontaneous Abortion: A miscarriage
that is caused by nature. It can have several causes, such as a genetically
abnormal fetus.
Superovulation: Using fertility
medications to stimulate the growth of multiple follicles
for ovulation. Also known as Controlled Ovarian Hyperstimulation
(COH).
Systemic Lupus Erythematosus (SLE):
An inflammatory connective tissue disease of unknown cause that occurs chiefly
in women, is characterized by fever, skin rash, and arthritis, often by acute
anemia, by small hemorrhages in the skin and mucous membrane, by inflammation
of the pericardium, and in serious cases by involvement of the kidneys and central
nervous system. If needed for arthritic symptoms or by women with the lupus
anticoagulant, daily doses of aspirin and the steroid prednisone seem to reduce
overall risk of pregnancy complications. Pregnancy complications in women with
lupus can include blood clotting problems and a high risk of preterm delivery.
Testicular Sperm Aspiration (TESA):
A needle biopsy of the testicle used to obtain small amounts of sperm. A small
incision is made in the scrotal skin and a spring loaded needle is fired through
the testicle. Usually does not result in enough sperm
to freeze for later use.
Testicular Sperm Extraction
(TESE): A minor surgical procedure usually performed under local anesthesia,
to obtain sperm from the ejaculate.
Testicles: Two oval glands present
in the scrotum responsible for making the male gamete,
the sperm. It also secretes many of the male hormones responsible
for masculinity.
Testicular Mapping: A diagnostic
procedure to identify "pockets" of isolated sperm production in the testicles
of men who have very low sperm production
Testosterone: The main hormone
secreted by the testicles and responsible for male
characteristics, such as beard growth, deep voice, and sperm maturation.
Thyroid Gland: The endocrine gland
in the front of the neck that produces thyroid hormones to regulate the body's
metabolism.
Trans-vaginal Aspiration: A
method of obtaining eggs by needle aspiration through the vagina.
TSH: A hormone secreted by the pituitary
gland that controls the thyroid gland. Elevated levels
imply abnormally low thyroid function. The level of this hormone in blood is
checked in most women with infertility because certain thyroid diseases may
be associated with infertility
Tubal Ligation: Surgical sterilization
of a woman by obstructing or tying the fallopian tubes.
Tubal Patency: Unobstructed Fallopian Tubes.
Tubal Pregnancy: The development and
attachment of a fertilized egg in a fallopian tube (see Ectopic Pregnancy).
Tubal Reversal: The process by which
the fallopian tubes are "untied" or reunited after a postpartum tubal
ligation, thereby allowing a woman to conceive.
Turner's Syndrome: The most common
genetic defect contributing to female fertility problems. The ovaries fail to
form and appear as slender threads of atrophic ovarian tissue, referred to as
streak ovaries. Karotyping will reveal that this woman has only one female (X)
chromosome instead of two or a mosaic (46XX and 45X).
Ultrasound: Radiographic method
for measurement of ovarian follicle growth and uterine lining thickness during
ovulation induction and in vitro fertilization. Follicles, which contain eggs,
are easily visualized. Transvaginal ultrasound is also used to guide embryo
transfer catheter for perfect placement of embryos during IVF.
Umbilical Cord: Two arteries and
one vein encased in a gelatinous tube leading from the baby to the placenta.
Used to exchange nutrients and oxygen from the mother for waste products from
the baby.
Urologist: A physician/surgeon
specializing in the urinary tract and male reproductive tract.
Uterine receptivity: The ability
of the uterus to allow for an embryo
to implant. Uterus is receptive only during the window of
implantation, from six to ten days after ovulation.
Uterine Septum: The presence of
a thick membrane that separates the uterine cavity either partially or completely
into two separate cavities. A septum can interfere with normal implantation
and cause recurrent pregnancy loss.
Uterus: The reproductive organ that
houses, protects and nourishes the developing embryo/fetus.
Vagina: A tubular passageway in the
female connecting the external sex organs with the cervix
and uterus.
Varicocele: An abnormal dilatation
of the veins surrounding the testes. They are present in 25% of infertile males.
Because of this blood pooling, testicular temperature is raised, which is detrimental
to sperm.
Vas Deferens: The segment of the tube
that connects the epididymus to the urethra in males.
Vasectomy: The surgical separation
of both vas deferens. A procedure used for birth control/sterilization.
Vasogram: An X-ray examination of
the vas deferens.
Window of implantation: The time during
the menstrual cycle when the uterus will allow implantation
of an embryo. The uterus is only receptive from six to
ten days after ovulation.
X Chromosome: The congenital, developmental,
or genetic information in the cell that transmits the information necessary
to make a female. All eggs contain one X chromosome,
and half of all sperm carry an X chromosome. When two X chromosomes combine,
the baby will be a girl.
Y Chromosome: The genetic material that
transmits the information necessary to make a male. The Y chromosome
can be found in one-half of the man's sperm cells. When
an X and a Y chromosome combine, the baby will be a boy.
Zona Pellucida: A translucent non-cellular
layer, which surrounds the egg and embryo. Just prior to
implantation the zona will be broken and the embryo
released to implant in the endometrium. In some women,
especially in women over the age of 37, the zona is thicker and therefore harder
for the embryo to hatch. Embryologists can thin
the zona pellucida just prior to embryo transfer in IVF
cycles (assisted hatching).
Zygote: The cell resulting after fertilization
of the oocyte by the sperm. e.g. A fertilized egg which
has not yet divided.
Zygote Intrafallopian Transfer (ZIFT):
An Assisted Reproductive Technology (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.
