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KEY TERMS AND DEFINITIONS

Artificial Insemination

Method to place sperm in the female reproductive tractby means other than sexual intercourse. If the sperm arefrom the husband, the technique is called artificial

insemination husband (AIH). If the sperm are fromanother man, the method has been called artificialinsemination donor (AID). Other terms are donorinsemination and therapeutic donor insemination (TDI).

Assisted ReproductiveTechnology

Various techniques utilized to increase fecundability bynonphysiologic methods of enhancing probability offertilization. Categories include in vitro fertilization,gamete intrafallopian tube transfer, zygote intrafallopiantube 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 threebenzene rings given orally to induce ovulation inanovulatory women with circulating estradiol levels morethan 40 pg/mL.

Controlled OvarianHyperstimulation (COH)

Inducing development of more than one dominant folliclewith pharmacologic agents, usually clomiphene citrate orgonadotropins, also called superovulation or multiplefollicular recruitment (MFR). COH is usually combinedwith intrauterine insemination to treat unexplainedinfertility.

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 betweenfimbrial fronds of the partially occluded distal end of theoviduct.

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Gamete IntrafallopianTransfer (GIFT)

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

Hamster Egg Penetration

Assay (Sperm PenetrationAssay),

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

Human MenopausalGonadotropin (HMG)

Formulation made up of equal amounts of follicle-stimulating hormone (FSH) and luteinizing hormone (LH)derived from urine obtained from postmenopausalwomen. The injectable agent is used to stimulatefollicular development in both anovulatory and ovulatorywomen.

Several urinary extracts are available including one withproportionality greater FSH activity. Recombinant (pure)FSH is often used and recombinant (pure) LH is alsoavailable as a supplement.

Hysterosalpingogram (HSG)

Fluoroscopic and radiographic visualization of the interiorof the female upper genital tract after instillation ofradiopaque dye.

Intracytoplasmic Sperm

Injection (ICSI)

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

Infertility

Inability of couples of reproductive age to establish apregnancy by having sexual intercourse within a certainperiod of time, usually 1 year. Infertility is consideredprimary if the woman has never been pregnant andsecondary if it occurs after one or more pregnancies.

Intrauterine Insemination

Placement of spermatozoa that have been separatedfrom the seminal fluid into the endometrial cavity througha small catheter.

In Vitro Fertilization

Fertilization of human ova by sperm in a laboratoryenvironment.

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Luteal Phase Deficiency(Inadequate Luteal Phase)

,

Deficient progesterone secretion or action resulting in adelay 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 ofsemen.

Ovarian HyperstimulationSyndrome (OHSS)

Ovarian enlargement to a diameter of more than 6 cm asa result of stimulation of multiple follicles. In the mild formthere is abdominal pain, distention, and weight gain. Inthe moderate form ovarian enlargement is more than 10cm in diameter with ascites, nausea, and vomiting.Severe OHSS is associated with hemoconcentration,oliguria, and elevated serum creatine. Pleural effusionsand ascites can be present; OHSS becomes criticalwhen hypercoagulability and hypotension occur. Thiscondition may be fatal.

Postcoital Test

Examination of the cervical mucus to evaluate thepresence of sperm several hours after sexualintercourse.

Pronuclear Stage TubalTransfer (PROST) or ZygoteIntrafallopian Transfer (ZIFT)

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

Salpingitis Isthmica Nodosa

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

Salpingolysis

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

Salpingostomy

Surgical creation of a new opening of a completelyoccluded distal end of the oviduct.

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Semen Analysis

Quantitation of various parameters of a recentlyejaculated semen specimen analyzed after liquefactionhas occurred.

Spinnbarkeit,

Property of elasticity (distensibility) of cervical mucus.

Teratozoospermia

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

Treatment-IndependentPregnancy

Infertile women conceiving without use of infertilitytherapy.

Tubal Embryo Transfer (TET)or Tubal Embryo StageTransfer (TEST)

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

Unexplained Infertility

The diagnosis of an infertile couple when ovulation andtubal patency, as well as a normal semen analysis, areall present.

Testicular Sperm Extraction

Retrieval of sperm from the testis by biopsy or aspirationfrom men with azoospermia due to obstruction of the vasdeferens or epididymis (obstructive azoospermia) orwithout such obstruction (nonobstructive azoospermia).The sperm are injected into ova retrieved by follicleaspiration by the ICSI procedure.