ASRM Topics

Gestational Carrier

A Gestational Carrier is a woman who agrees to have a couple's fertilized egg (embryo) implanted in her uterus. The gestational carrier carries the pregnancy for the couple, who usually has to adopt the child. The carrier does not provide the egg and is therefore not biologically (genetically) related to the child.

Hysterectomy

A Hysterectomy is the surgical removal of the uterus. Hysterectomy may be performed through an abdominal incision (laparotomy), through the vagina (vaginal hysterectomy), or through laparoscopy assisted vaginal hysterectomy (LAVH). Sometimes the ovaries and fallopian tubes are also removed.

Hysterosalpingogram (HSG)

A Hysterosalpingogram is an x-ray procedure in which a special iodine-containing dye is injected through the cervix into the uterine cavity to illustrate the inner shape of the uterus and degree of openness (patency) of the fallopian tubes.

Hysteroscopy

A Hysteroscopy is a procedure in which a lighted scope (hysteroscope) is inserted through the cervix into the uterus to enable the physician to view the inside of the uterus to diagnose and treat problems within the uterine cavity.

Adenoma

A benign (non-cancerous) growth of cells that usually does not invade adjacent tissue. A pituitary adenoma can disrupt ovulation and menstruation and is often associated with excessive prolactin production.

Endometrioma

A blood-filled "chocolate" cyst that can occur when endometriosis tissue develops in the ovary.

Oligospermia

A cause of male infertility in which fewer than forty million sperm are present in the semen from one ejaculation.

Cryptorchidism

A cause of male infertility in which one or both testes have not descended into the scrotum after the first year of life.

Impotence

A condition in which a man cannot achieve or sustain an erection long enough to ejaculate inside a woman's vagina.

Incompetent Cervix

A condition in which a pregnant woman's cervix begins to dilate too soon, causing miscarriage.

Endometriosis

A condition in which endometrial tissue, which normally lines the uterus, develops outside of the uterine cavity in abnormal locations such as the ovaries, fallopian tubes, and abdominal cavity.

Anejaculation

A condition in which no semen is expelled from the penis during sexual arousal.

Pituitary

A gland located at the base of the brain that is stimulated by hormones released from the hypothalamus to secrete hormones that regulate various bodily functions, including ovulation in women and sperm production in men.

Hydrosalpinx

A hydrosalpinx is a blocked, dilated, fluid-filled fallopian tube.

Endometrial Ablation

A hysteroscopic procedure used to remove most of the endometrium (uterine lining); sometimes used to treat abnormal uterine bleeding.

Laparoscopy

A laparoscopy is a surgical procedure that allows viewing of the internal pelvic organs. During the procedure, a long narrow fiberoptic instrument, called a laparoscope, is usually inserted through an incision in or below the woman's navel. One or more additional incisions may be made for inserting additional instruments.

Laparotomy

A laparotomy is a procedure in which a surgeon makes an incision in the abdomen, usually several inches long, in order to treat conditions such as extensive endometriosis.

Myomectomy

A myomectomy is the surgical removal of myomas (fibroids) from the uterus.

Fallopian Tubes

A pair of hollow tubes attached one on each side of the uterus through which the egg travels from the ovary to the uterus. Fertilization usually occurs in the fallopian tube.

Ectopic Pregnancy

A pregnancy that implants outside of the uterus, usually in the fallopian tube. The tube may rupture or bleed as the pregnancy grows and create or result in a serious medical situation.

Ovulation Induction

A procedure in which medication is used to stimulate a woman's ovaries to produce multiple mature follicles and ova.

Dilatation and Curettage (D&C)

A procedure in which the cervix is gradually widened and the lining of the uterus is gently removed by scraping or suction.

Embryo Donation

A procedure that enables embryos either that were created by couples undergoing fertility treatment or that were created from donor sperm and donor eggs specifically for the purpose of donation to be transferred to infertile patients in order to achieve a pregnancy or to a researcher to further the study of reproductive medicine.

Gonorrhea

A sexually transmitted infection caused by the microorganism Neisseria gonorrhea, which if left untreated in a woman may cause pelvic inflammatory disease (PID), pelvic adhesions, and tubal blockage.

Chlamydia

A sexually transmitted infection caused by the microorganism chlamydia trachomatis, which if left untreated in a woman may cause pelvic inflammatory disease (PID), pelvic adhesions, and tubal blockage.

Hypothalamus

A structure located at the base of the brain that secretes hormones that regulate the pituitary gland which in turn regulates various bodily functions, including ovulation in women and sperm production in men.

Epididymis

A structure that covers part of each testis and is the storage place for mature sperm cells.

Follicle

A structure within the ovary containing the egg that is extruded at ovulation.

Postcoital Test

A test used to evaluate the interaction between a man's sperm and a woman's cervical mucus.

Gamete Intrafallopian Transfer (GIFT)

A variation of ART in which unfertilized eggs and sperm are placed together in the woman's fallopian tubes, with fertilization taking place in the tube instead of a laboratory dish.

Adenomyosis

Adenomyosis is a benign (non-cancerous) invasion of endometrial tissue into the muscular wall (myometrium) of the uterus; is associated with painful or heavy menstrual periods.

Adhesions

Adhesions are bands of fibrous scar tissue that may bind the pelvic organs and/or loops of bowel together. Adhesions can result from previous infections, endometriosis, or previous surgeries.

Amenorrhea

Amenorrhea is the complete absence or suppression of menstrual periods.

Anorexia Nervosa

An eating disorder associated with a distorted body image that is caused by a mental disorder. Inadequate calorie intake results in severe weight loss.

Endometritis

An inflammation of the endometrium caused by bacterial invasion.

Perinatologist

An obstetrician/gynecologist specializing in the care of pregnant women and their babies during pregnancy.

Oocyte

An ovum; the egg before it is released at ovulation.

Assisted Reproductive Technologies (ART)

Assisted Reproductive Technologies are all treatments which include the handling of eggs and sperm and/or embryos. Some examples of ART are in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), pronuclear stage tubal transfer (PROST), tubal embryo transfer (TET), and zygote intrafallopian transfer (ZIFT).

Assisted Hatching (AH)

Assisted hatching (AH) is a procedure in which the zona pellucida (outer covering) of the embryo is partially opened, usually by application of an acid or laser, to facilitate embryo implantation and pregnancy.

Azoospermia

Azoospermia is the absence of sperm present in seminal fluid.

Basal Body Temperature (BBT)

Basal body temperature (BBT) is the body temperature at rest. It is taken orally each morning immediately upon awakening and recorded on a BBT chart. The readings are studied to help identify ovulation, which usually occurs at approximately the same time as the rise in BBT.

Ovulation Detection

Because a variety of problems can prevent or disrupt ovulation and result in infertity, often it is necessary to determine whether or not a woman is ovulating. There are several ways to detect ovulation, including urine test kits to measure LH levels, transvaginal ultrasound, endometrial biopsy, blood tests to measure hormone levels, and the basal body temperature (BBT) chart.

Fibroids

Benign (non-cancerous) tumors of the uterine muscle wall that can cause abnormal uterine bleeding. Also known as leiomyomas or myomas.

Bulimia

Bulimia is an illness characterized by uncontrolled episodes of overeating usually followed by self-induced vomiting.

Cryopreservation and Storage

Cryopreservation is freezing at a very low temperature, such as in liquid nitrogen (-196oC) to keep embryos, eggs, or sperm viable.

Cytomegalovirus (CMV)

Cytomegalovirus (CMV) is a member of the herpes virus family and is found in body fluids, including urine, saliva (spit), breast milk, blood, tears, semen, and vaginal fluids. It can cause disease in unborn babies and people with weakened immune systems.

Dysfunctional Uterine Bleeding

Dysfunctional Uterine Bleeding (DUB) is abnormal uterine bleeding with no evidence of mechanical or structural cause. The most common cause of DUB is deficient or excessive production of estrogen and/or progesterone.

Electroejaculation (EEJ)

Electroejaculation (EEJ) is a procedure to cause ejaculation of sperm, performed by electrical stimulation of tissue in the region of the prostate.

Estrogen

Estrogen is the female sex hormones produced by the ovaries which are responsible for the development of female sex characteristics. Estrogens are largely responsible for stimulating the uterine lining to thicken during the first half of the menstrual cycle in preparation for ovulation and possible pregnancy. They are also important for healthy bones and overall health. A small amount of these hormones is also produced in the male when testosterone is converted to estrogen.

GnRH Analogs

GnRH analogs are synthetic hormones similar to the naturally occurring gonadotropin releasing hormones (GnRH) produced by the hypothalamus. GnRH analogs, when given in short pulses, stimulate the pituitary gland to produce FSH and LH. However, when given in more prolonged doses, they decrease FSH and LH production by the pituitary, which in turn decreases ovarian hormone production. Brand names are Lupron®, Synarel®, and Zolodex®.

Gonadotropins

Gonadotropins are hormones including FSH and LH used for ovulation induction. Gonadotropins include hMG (human menopausal gonadotropin - Pergonal®, Humegon™, Repronex™); hFSH (human follicle stimulating hormone - Metrodin®, Fertinex™, Bravelle™); rFSH (recombinant follicle stimulating hormone - Gonal F™, Follistim™); and hCG (human chorionic gonadotropin - Profasi®, APL®, Pregnyl®, Novarel™, Ovidrel®.

Hirsutism

Hirsutism is the growth of long, coarse hair on the face, chest, upper arms, and upper legs of women in a pattern similar to that of men. Hirsutism may be due to ethnic background or to excess levels of androgens.

Human Immunodeficiency Virus (HIV)

Human immunodeficiency virus or HIV is a retrovirus that causes acquired immune deficiency syndrome (AIDS), a disease that destroys the body's ability to protect itself from infection and disease. It is transmitted by the exchange of bodily fluids or blood transfusions.

Hyperprolactinemia

Hyperprolactinemia is high levels of prolactin in the bloodstream.

Fetus

In medical terms, an embryo becomes a fetus at about the end of the seventh week of pregnancy, after major structures (head, torso, limbs, etc.) have formed.

Androgen

In men, androgens are the "male" hormones produced by the testes which are responsible for encouraging masculine characteristics. In women, androgens are produced in small amounts by both the adrenal glands and ovaries. In women, excess amounts of androgens can lead to irregular menstrual periods, obesity, excessive growth of body hair (hirsutism), and infertility.

In Vitro Fertilization (IVF)

In vitro fertilization (IVF) is a method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo is transferred into the woman's uterus where it will hopefully implant in the uterine lining and further develop. IVF bypasses the fallopian tubes and is usually the treatment choice for women who have badly damaged or absent tubes.

Pelvic Inflammatory Disease (PID)

Inflammation of the female upper reproductive tract (uterus, tubes, and ovaries) usually resulting from infection with chlamydia and/or gonorrhea.

Insemination

Insemination: the placement of sperm via a syringe into a female's uterus or cervix for the purpose of producing a pregnancy.

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic Sperm Injection (ICSI) is a micromanipulation procedure in which a single sperm is injected directly into an egg to attempt fertilization, used with male infertility or couples with prior IVF fertilization failure.

Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is an office procedure in which prepared sperm cells are placed directly into a woman's cervix or uterus to produce pregnancy, with or without ovarian stimulation to produce multiple oocytes.

Implantation Bleeding

Light bleeding or spotting that sometimes occurs when a fertilized egg (embryo) implants in the uterus.

Luteal Phase Defect

Luteal phase defect is a condition present when the lining of the uterus does not mature properly in response to the progesterone secreted by the ovary after ovulation.

Microepididymal Sperm Aspiration (MESA)

MESA is an outpatient microsurgical procedure used to collect sperm in men with blockage of the male reproductive ducts such as prior vasectomy or absence of the vas deferens. It is used in IVF-ICSI procedures.

Insulin-Sensitizing Agents

Many women with PCOS have a decreased sensitivity to insulin for which their bodies compensate by overproducing insulin. The resulting high levels of insulin may contribute to excessive production of androgens (male hormones, such as testosterone) and contribute to ovulation disorders. In addition to reproductive problems, women with PCOS have a higher chance of developing medical problems such as Type 2 (non-insulin dependent) diabetes, high blood pressure, and heart disease. By the age of 40, up to 40% of PCOS patients develop impaired glucose tolerance or clinical diabetes. Recently, new drugs approved by the FDA for the treatment of Type 2 diabetes have shown promise for PCOS. These drugs, known as insulin sensitizing agents, have been shown to improve the body's response to insulin, thereby reducing the need for excess insulin and restoring the levels to normal.

Menopause

Menopause is the natural cessation of ovarian function and menstruation. It can occur between the ages of 42 and 56 but usually occurs around the age of 51, when the ovaries stop producing eggs and estrogen levels decline.

Menorrhagia

Menorrhagia is regular but heavy menstrual bleeding which is excessive in either amount (greater than 80 cc - approximately five tablespoons) or duration (greater than seven days).

Micromanipulation

Micromanipulation is an IVF laboratory process whereby the egg or embryo is held with special instruments and surgically altered by procedures such as intracytoplasmic sperm injection (ICSI), assisted hatching, or embryo biopsy.

Miscarriage or Recurrent Pregnancy Loss

Miscarriage is the naturally occurring expulsion of a nonviable fetus and placenta from the uterus; also known as spontaneous abortion or pregnancy loss.

Multifetal Pregnancy Reduction

Multifetal pregnancy reduction, also known as selective reduction, is a procedure to reduce the number of fetuses in the uterus. This procedure is sometimes performed on women who are pregnant with multiple fetuses who are at an increased risk of late miscarriage or premature labor. These risks increase with the number of fetuses.

Multiple Births or Multiple Gestation

Multiple births are much more common today than they were in the past. According to the U.S. Department of Health and Human Services, the twin birth rate has increased over 50% since 1980, and triplet, quadruplet, and higher order multiple births have increased at an even higher rate. There are more multiple births today in part because more women are receiving infertility treatment, which carries a risk of multiple pregnancy.

Myoma

Myomas are benign (non-cancerous) tumors of the uterine muscle wall that can cause abnormal uterine bleeding and miscarriage. Also called fibroids.

Abnormal Uterine Bleeding

Normal: every 21-35 days, not excessive. 2-7 days. Abnormal: either the frequency or quantity of uterine bleeding differs from that mentioned above or the woman has spotting in between her menstrual periods. Caused by a variety of factors, two main causes are 1) structural abnormalities of the reproductive system and 2) ovulation disorders.

Birth Defects

Occur in nearly one in 20 pregnancies, range in severity from minor anatomic abnormalities to extensive genetic disorders or mental retardation.

Osteoporosis

Osteoporosis is a condition in which bones become porous, fragile, and prone to breakage due to age and a decrease in estrogen levels.

Ovarian Cyst

Ovarian cysts are fluid-filled sacs that grow inside an ovary. They can affect women of all ages and most are small and benign and do not cause problems or pain. Most ovarian cysts disappear after a few weeks without treatment. In some cases the cysts can grow large, rupture and cause pain which will prompt your doctor to perform laparoscopic surgery to remove the cyst.

Ovarian Drilling

Ovarian drilling is a laparoscopic procedure, using laser or electrocautery, to destroy the androgen-producing tissue in the ovaries. This procedure is usually a last resort for ovulation induction in PCOS patients who have not responded to hormonal treatments.

Overian Hyperstimulation Syndrome (OHSS)

Ovarian hyperstimulation syndrome is a condition that may result from ovulation induction characterized by enlargement of the ovaries, fluid retention, and weight gain.

Ovarian Stimulation

Ovarian stimulation occurs with the administration of hormone medications (ovulation drugs) that stimulate the ovaries to produce multiple eggs. Sometimes called enhanced follicular recruitment or controlled ovarian stimulation.

Ovulation Drugs

Ovulation drugs stimulate the ovaries to produce and mature eggs so that they can be released at ovulation.

Ovulation

Ovulation is the release of a mature egg from its developing follicle in the outer layer of the ovary. This usually occurs approximately 14 days before the next menstrual period (the 14th day of a 28-day cycle).

Dyspareunia

Painful intercourse; sometimes a symptom of endometriosis.

Dysmenorrhea

Painful menstrual cramps.

Percutaneous Epididymal Sperm Apiration (PESA)

Percutaneous epididymal sperm aspiration (PESA) is a sperm aspiration procedure in which a needle is inserted into the epididymis (gland that carries sperm from testicle to vas deferens) in order to retrieve sperm for use in an IVF procedure.

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a condition in which the ovaries contain many cystic follicles that are associated with chronic anovulation and overproduction of androgens (male hormones). The cystic follicles exist presumably because the eggs are not expelled at the time of ovulation. Symptoms may include irregular menstrual periods, obesity, excessive growth of central body hair (hirsutism), and infertility. PCOS can also be associated with heart disease, hypertension, or diabetes. Also called Stein-Leventhal syndrome.

Posthumous Reproduction

Posthumous reproduction first became possible only after semen could be frozen and used for artificial insemination after the donor was deceased. The legal and social status of a child born from these origins has been ambiguous at best, even if the insemination and pregnancy occur with the wife of the dead man.

Contraception

Prevent a pregnancy. Can be either hormonal or nonhormonal. Most of the hormonal contraceptives work by changing a woman's hormone levels to mimic a pregnancy, therefore preventing eggs from being able to be released from the ovary. In contrast, nonhormonal contraceptive agents or devices work by preventing a man's sperm from joining a woman's egg.

Infertility

Result of a disease of male/female reproductive tract which prevents conception or ability to carry pregnancy to delivery. The duration of unprotected intercourse with failure to conceive should be about 12 months before an infertility evaluation is undertaken, unless medical history, age, or physical findings dictate earlier evaluation and treatment.

Cloning

Somatic Cell Nuclear Transfer (SCNT) and Therapeutic Cloning for Stem Cells involves taking the nucleus of an egg cell, replacing it with the material from the nucleus of a "somatic cell" (a skin, heart, nerve or any other non-germ cell), and stimulating this cell to begin dividing. This egg cell is never fertilized by sperm, and the genetic material within the cell is virtually identical to the genetic material extracted from the skin or other cell.

Artificial Insemination

Sperm from a female's partner or a donor is placed via a syringe into her uterus or cervix for the purpose of producing a pregnancy.

Adrenal Glands

The adrenal glands are located above each kidney that secrete a large variety of hormones (cortisol, adrenaline, and others) that help the body withstand stress and regulate metabolism. Altered function of these glands can disrupt menstruation, cause inappropriate hair growth, and affect blood pressure.

Embryo

The fertilized ovum after it has begun the process of cell division.

Cervix

The lower, narrow end, or neck, of the uterus, which opens into the vagina.

Ovarian Reserve

The ovarian reserve refers to a woman's fertility potential in the absence of any problems in the reproductive tract (fallopian tubes, uterus, vagina). It mainly depends on the number and quality of eggs in the ovaries and how well the ovarian follicles are responding to the hormonal signals from the brain.

Egg Donation

The process of fertilizing eggs from a donor and transferring the resulting embryos to the recipient's uterus. The recipient will not be biologically related to the child, although she will be the birth mother on record.

Endometrial Biopsy

The removal of a small piece of tissue from the endometrium (lining of the uterus) for microscopic examination. The results may indicate whether or not the endometrium is at the appropriate stage for successful implantation of a fertilized egg (embryo) and/or if it is inflamed or diseased.

Gametes

The sex cells—oocytes (eggs) and spermatozoa (sperm).

Placenta

The thick pad of tissue inside a pregnant woman's uterus that provides nourishment to and disposes of waste from the growing fetus.

Endometrium

The tissue lining the inside of a woman's uterus, in which a fertilized egg implants at conception.

Ovaries

Two small organs on either side of a woman's lower pelvis which produce ova, or eggs, and hormones.