INFERTILITY,  KEY TERMS AND DEFINITIONS

Artificial Insemination.

Method to place sperm in the female reproductive tract by means other than sexual intercourse. If the sperm are from the husband, the technique is called artificial insemination husband (AIH). If the sperm are from another man, the method has been called artificial insemination donor (AID). Other terms are donor insemination and therapeutic donor insemination (TDI).

Assisted Reproductive Technology.

Various techniques utilized to increase fecundability by nonphysiologic methods of enhancing probability of fertilization. Categories include in vitro fertilization, gamete intrafallopian tube transfer, zygote intrafallopian tube transfer, and tubal embryo transfer.

Asthenospermia.

Loss or reduction of the motility of the spermatozoa.

Azoospermia.

Absence of sperm in the semen.

Clomiphene Citrate.

A weak synthetic estrogenic compound with three benzene rings given orally to induce ovulation in anovulatory women with circulating estradiol levels more than 40 pg/ml.

Controlled Ovarian Hyperstimulation (COH).

Inducing development of more than one dominant follicle with pharmacologic agents, usually clomiphene citrate or human menopausal gonadotrophin, also called superovulation or multiple follicular recruitment (MFR). COH is usually combined with intrauterine insemination to treat unexplained infertility.

Fecundability.

Probability of conception occurring in a population of couples in a given period of time, usually 1 month.

Fimbrioplasty.

Surgical technique of removing adhesions between fimbrial fronds of the partially occluded distal end of the oviduct.

Gamete Intrafallopian Transfer (GIFT).

Placement of human ova and sperm into the distal end of the oviduct.

Hamster Egg Penetration Assay (Sperm Penetration Assay).

Test of the fertilizing ability of human sperm based on their ability to penetrate zona-free hamster ova.

Human Menopausal Gonadotrophin (HMG).

Formulation made up of equal amounts of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) derived from urine obtained from postmenopausal women. The injectable agent is used to stimulate follicular development in both anovulatory and ovulatory women.

Hysterosalpingogram (HSG).

Fluoroscopic and radiographic visualization of the interior of the female upper genital tract after instillation of radiopaque dye.

Intracytoplasmic Sperm Injection (ICSI).

Technique by which a single spermatozoon is injected into the cytoplasm of an ovum.

Infertility.

Inability of couples of reproductive age to establish a pregnancy by having sexual intercourse within a certain period of time, usually 1 year. Infertility is considered primary if the woman has never been pregnant and secondary if it occurs after one or more pregnancies.

Intrauterine Insemination.

Placement of spermatozoa that have been separated from the seminal fluid into the endometrial cavity through a small catheter.

In Vitro Fertilization.

Fertilization of human ova by sperm in a laboratory environment.
 
Luteal Phase Deficiency (Inadequate Luteal Phase).

Deficient progesterone secretion or action resulting in a delay of normal endometrial development.

Microsurgery.
Operative technique using magnification and fine, nonreactive suture material.

Oligozoospermia (Oligospermia).

Presence of fewer than 20 million sperm per milliliter of semen.

Ovarian Hyperstimulation Syndrome (OHSS).

Ovarian enlargement to a diameter of more than 6 cm as a result of stimulation of multiple follicles. In the mild form there is abdominal pain, distention, and weight gain. In the moderate form ovarian enlargement is more than 10 cm in diameter with ascites, nausea, and vomiting. Severe OHSS is associated with hemoconcentration, oliguria, and elevated serum creatine. Pleural effusions and ascites can be present; OHSS becomes critical when hypercoagulability and hypotension occurs. This condition may be fatal.

Postcoital Test.

Examination of the cervical mucus to evaluate the presence of sperm several hours after sexual intercourse.

Pronuclear Stage Tubal Transfer (PROST) or Zygote Intrafallopian Transfer (ZIFT).

In vitro fertilization with transfer of the zygote to the oviducts by transabdominal cannulation.

Salpingitis Isthmica Nodosa.

Diverticula of the endosalpinx in the muscularis of the isthmic portion of the oviduct.

Salpingolysis.

Removal of adhesions attached to an oviduct that appears normal on gross inspection.

Salpingostomy.

Surgical creation of a new opening of a completely occluded distal end of the oviduct.

Semen Analysis.

Quantitation of various parameters of a recently ejaculated semen specimen analyzed after liquefaction has occurred.

Spinnbarkeit.

Property of elasticity (distensibility) of cervical mucus.

Teratozoospermia.

Greater-than-normal (50%) incidence of abnormal forms of sperm in semen analysis.

Treatment-Independent Pregnancy.

Infertile women conceiving without use of infertility therapy.

Tubal Embryo Transfer (TET) or Tubal Embryo Stage Transfer (TEST).

Same as ZIFT, except additional incubation to embryo stage occurs before transfer to the oviducts.

Unexplained Infertility.

The diagnosis of an infertile couple when ovulation and tubal patency, as well as a normal semen analysis, are all present.

Testicular Sperm Extraction.

Retrieval of sperm from the testis by biopsy or aspiration from men with azoospermia due to obstruction of the vas deferens or epididymis (obstructive azoospermia) or without such obstruction (nonobstructive azoospermia). The sperm are injected into ova retrieved by follicle aspiration by the ICSI procedure.

Comprehensive Gynecology 4th edition (September 6, 2002) by Morton A. MD Stenchever (Editor), William, MD Droegemueller (Editor), MD Herbst Arthur L. (Editor), Daniel R., Jr, MD Mishell (Editor), Arthur L. Herbst