Infertility Concerns
FACT: The break down of infertility is as follows:

	% Of Cases
Female factor:	35
Male factor:	35
Combined couple factor:	20
Unexplained:	10

FACT: Infertility is a disease or condition of the reproductive system. Stress and deep emotions that you feel are the result of the infertility, not the cause of it.

FACT: Infertility is a medical issue that may be treated. At least 50 % of those who complete and infertility evaluation will respond to treatment either a successful pregnancy. Some infertility problems respond with higher or lower success rates. Those who do not seek help have a "spontaneous pregnancy rate" of about 5% after a year of infertility

What is infertility?
Infertility is a disease or condition of the reproductive system diagnosed after a couple has had one year of unprotected, well-timed intercourse, which has not resulted in a live birth. How long should we try before we see a doctor? You need not be concerned unless you have been trying to conceive for at least one year. However, if you are a female that is over 30 years old, have a history of PID (Pelvic Inflammatory Disease), painful periods, miscarriages, irregular cycles, or if you partner has a known low sperm count, you may want to seek help sooner. How often should we have intercourse? It is a good idea to have intercourse every other day around the time you ovulate (Day 10, 12, 14, and 16). Every woman is different, and may not ovulate exactly on "Day 14." Just because you ovulated on "Day 14" this month, doesn't mean you will next month. It is preferable to have intercourse every other day so that sufficient sperm will be available. How is a semen analysis done? The lab will provide instructions to abstain from sex for a certain period of time before the test, and it will give you a small jar to use for the specimen. After masturbating and ejaculating into the jar, you must take the whole specimen immediately to the lab. You may be asked to produce a specimen at the lab, where they will provide a private room.

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Glossary of Terms

Adhesion: Scar tissue attaching abnormally connecting, covering or distorting organs, such as the tubes, ovaries or other internal organs, limiting their movement and possibly causing infertility and pain.

Amniocentesis: Sampling a small quantity of the fluid that surrounds the fetus that permits detection of certain abnormalities.

Artificial Insemination (AI): Placement of "washed", concentrated swimming sperm into the female reproductive tract

Aspiration: Removal of fluid and cells by suction through a needle.

Assisted Reproductive Technologies(ART): A group of therapies that employ manipulation of the egg and/or sperm and/or early conceptus in order to establish a pregnancy.

Basal Body Temperature (BBT): The body temperature at rest. It is taken orally each morning immediately upon awakening and recorded on a calendar chart. The readings are studied to help identify the time of ovulation.

Biopsy: Surgical removal of tissue for analysis

Capacitation: A process the sperm must undergo that enables fertilization.

Cervical Factor: Infertility due to previous surgery or structural abnormality of the cervix. Also applied when there are factors associated with the cervix which inhibit sperm function.

Cervical Mucus: The secretion of the cervix which changes in volume and consistency throughout the menstrual cycle. Its quality is a reflection of hormonal stimulation. This mucus increases in volume and clarity at the time of ovulation

Cervix: The lower section of the uterus which protrudes into the vagina and serves as a reservoir for sperm.

Chemical Pregnancy: A positive pregnancy test, but with levels of pregnancy hormone too low for ultrasound documentation of a pregnancy.

Cleavage: Division of one cell into 2, 2 into 4, 4 into 8, etc.

Clinical Pregnancy: A pregnancy in which the beating fetal heart has been identified by ultrasound.

Clomiphene Citrate (Clomid TM or Serophene TM): An oral medication used to stimulate the ovary and/or synchronize an ovarian follicle development.

Congenital Anomaly: A non-hereditary characteristic, or defect, developing before birth.

Corpus Luteum: A special gland that forms on the surface of the ovary at the site of ovulation. It produces progesterone during the second half of the cycle which is necessary to prepare the uterine lining for implantation.

Cumulus: The cloud-like collection of supportive follicle cells that surround the oocyte.

Cryopreservation: Controlled freezing and storage.

Cyst: A fluid filled structure. May be normal or abnormal depending on circumstances.

Donor Embryo Transfer: The transfer of a fertilized egg from a volunteer (may be paid or unpaid) donor to an otherwise infertile recipient.

Donor Insemination: The introduction of sperm from a volunteer donor into a women's vagina, cervix, or uterine cavity, in order to achieve a pregnancy.

Ductus Deferens (vas): A thick walled tubular structure running from each testis into the ejaculatory duct. These structures carry sperm from the epididymis to the penis.

Ectopic Pregnancy: A pregnancy implanted outside the uterus; most often in the Fallopian tube (tubal pregnancy).

Ejaculate: Sperm combined with fluid from the seminal vesicles ane prostate gland. This is the fluid discharged through the penis.

Embryo: The term used to describe the early stages of fetal growth. Strictly defined from the second to the ninth week of pregnancy but often used to designate any time after conception.

Endocrinology: The study of hormones, their function, the organs that produce them and how they are produced.

Endometrial biopsy: The extraction of a small piece of tissue from the endometrium (lining of the uterus) for microscopic examination.

Endometriosis: The presence of endometrial tissue (tissue that normally lines the uterus) in abnormal locations such as the ovaries, fallopian tubes and abdominal cavity.

Endometrium: The inner lining of the uterus. The area of initial attachment of the conceptus. A portion of this lining is shed each month with menstruation.

Epididymis: Portion of the male genital tract next to the testis where sperm maturation is partially accomplished. Receives sperm from the testis and continues as the vas deferens.

Estradiol: The principal hormone produced by the growing ovarian follicle.

Fallopian Tubes: The long. Narrow tube between the ovaries and uterus. After release and fertilization of the egg, the tube transports the embryo to the uterus.

Fertilization: Union of a sperm with an oocyte.

Fimbria: The finger like extensions from the end of the uterine tube that aid in gathering the oocyte at ovulation.

Follicle: A functioning ovarian "cyst" containing a wall of granulosa cells which produce estrogen and nourish the oocyte (egg). Each Follicle contains a single oocyte.

Follicle Stimulating Hormone (FSH): A hormone produced by the pituitary gland which cause the ovarian follicles to grow and sperm to be produced within the testes.

Gamete Intra-Fallopian Tube Transfer (GIFT): A method of assisted fertilization that involves surgically removing an egg from the ovary, combining it with sperm, and immediately placing the egg and sperm into the fallopian tube. Fertilization takes place inside the fallopian tube.

Gestation: pregnancy

Gonadotropin: hormonal medication given by injection to stimulate the development of eggs.

Gonadotropin Releasing Hormone (GnRH): Hormone produced by the brain that stimulates the pituitary to secrete gonadotropins.

Gonadotropin Releasing Hormone Agonist (GnRHa): a medication given by injection or nasal spray to suppress the release of hormones that stimulate the development of eggs.

Hamster Test: see Sperm Penetration Assay

Human Chorionic Gonadotropin (hCG): A hormone of early pregnancy that can be monitored to determine the age and viability of the gestation. This hormone is also used as an injection in ovarian stimulation regimens to cause the final maturation of the oocyte (egg) and its follicle and eventually cause ovulation.

Human Menopausal Gonadotropin (HMG): A purified extract of LH and FSH, hormones secreted from the pituitary gland which stimulate the ovary. It is a commercial preparation used by injection to facilitate development of multiple follicles.

Humegon(TM): see human menopausal gonadotropin

Hypothalamus: A portion of the brain that acts as a "pacemaker" controlling the production and periodic release of hormones from the pituitary gland.

Hysterosalpingogram (HSG): An x-ray procedure in which a special dye is injected into the uterus to illustrate the inner contour of the uterus and degree of openness (patency) of the uterine tubes.

Hysteroscope: A telescopic device, much like the laparoscope, that enables examination of the uterine cavity.

Implantation: The embedding of the conceptus (embryo) into the lining of the uterus.

Infertility: the inability of a couple to achieve a pregnancy after approximately one year of regular unprotected intercourse or the inability to maintain a pregnancy that results in a live birth

Insemination: Transfer of semen or sperm for the purpose of establishing a pregnancy.

Intracytoplasmic Sperm Injection (ICSI): Placement of a single sperm into an oocyte (egg) using a small glass needle to penetrate the outer coatings of the egg.

Intrauterine Insemination (IUI): The placement of sper( from partner or donor) into the uterus via a fine tube

In Vitro Fertilization (IVF): A method of assisted reproduction that involves surgically removing an egg from the ovary, combining it with prepared sperm in the laboratory to permit fertilization.

Laparoscope: A thin, lighted viewing instrument with a telescopic lens through which a surgeon views the exterior surfaces of a female's reproductive organs and abdominal cavity.

LupronTM: A synthetic form of gonadotropin (luteinizing hormone) releasing hormone used to suppress ovarian function.

Luteal Phase: The last fourteen days of an ovulatory cycle, associated with progesterone production from the corpus luteum.

Luteinizing Hormone (LH): A hormone produced and released by the pituitary gland. In the female it is responsible for ovulation and the maintenance of the corpus luteum. In the male it stimulates testosterone production and is important in the production of sperm cells.

MetrodinTM: Human FSH prepared in an injectable form for ovarian stimulation.

Media: Fluid containing nutritive growth substances enabling cells to survive in an artificial environment.

Menses: A period. Cyclic (monthly) flow of blood (menstruation) signifying ovulation, but failure to achieve pregnancy. Onset of bleeding is considered cycle day 1.

Micromanipulation: A method of assisted reproduction when the process is manually performed under the guidance of the microscope.

Oocyte: The female germ cell often called an egg.

Ovary: The female sex gland with both a reproductive function (releasing oocytes) and a hormonal function (production of estrogen and progesterone).

Ovulation: The release of a mature egg from the surface of the ovary.

Ovum (ova or egg): Mature oocytes.

Pap test: A screening test to determine the presence of cervical cancer. It is done by gently touching a cotton swab on the cervix and then wiping the swab on a slide which is treated and examined under a microscope. Another type of pap test, ThinPrep, replaces the conventional method by rinsing the cells into a vial filled with a solution that preserves them - a process that improves the quality and is believed to lead to more effective cervical cancer diagnosis and reduction in repeat testing.

PergonalTM:A purified extract of LH and FSH, hormones secreted from the pituitary gland which stimulate the ovary. It is a commercial preparation used by injection to facilitate development of multiple follicles.

Pituitary Gland: A small organ at the base of the brain that both controls and is controlled by production of hormones from the various endocrine glands including the ovary.

Polyspermy: Abnormal condition where the oocyte is fertilized by more than 1 sperm.

Post-Coital Test (PCT): The microscopic analysis of a sample of vaginal and cervical secretions that has been collected after sexual intercourse.

Progesterone: A hormone produced by the ovary which prepares the uterus for implantation and supports the early pregnancy.

Pronucleus: A specialized stage of the oocyte or sperm nucleus before their union. After this union the conceptus is referred to as a zygote.

Pronuclear Stage Tubal Transfer (PROST or ZIFT): Oocytes are aspirated, allowed to fertilize in vitro and the conceptus transferred before cell division (cleavage).

Semen Analysis: The microscopic examination of the ejaculate to determine the number of sperm, their shapes (morphology), and their ability to move (motility).

Sperm Antibody Test: In some couples blood, semen and/or cervical mucus contain substances which hinder sperm action through an allergic or immune reaction.

Sperm Penetration Assay (SPA): A test where sperm are incubated with non-viable hamster eggs to determine the capacity of the sperm to fertilize.

Testicular/Epididymal Sperm Aspiration (TESA): The removal of sperm directly from the testis or the epididymis using a needle for aspiration. Usually associated with sperm injection into the oocyte (ICSI).

Trans-tubal Embryo Transfer (TET): Replacement of a cleaving conceptus into the uterine tube rather than into the uterus.

Transvaginal: Through the vagina.

Tubal Patency: Lack of obstruction of the Fallopian tubes.

Ultrasound: High frequency sound waves that can be used painlessly, safely, and without radiation, to view the internal portions of the body.

Unexplained Infertility: Inability to conceive where no cause has been found despite routine testing of semen, ovulation, and pelvic anatomy by laparoscopy.

Uterus: Womb. The reproductive organ that houses, protects and nourishes the developing embryo and fetus.

Uterine Tube (Fallopian): The anatomic and physiologic connection between the uterus and the ovary which serves to transport the egg and sperm, as the site of fertilization and support and transport the conceptus in route to the uterus.

Varicocele: A varicose vein around the ductus deferens and the testes. This may be a cause of male infertility.

Zygote: A conceptus in which the egg and sperm genetic material (pronuclei) have united.

Zygote Intra-fallopian tube Transfer (ZIFT): Oocytes are aspirated, allowed to fertilize in vitro and the conceptus transferred before cell division (cleavage).