EGG RETRIEVAL A procedure used to obtain eggs from ovarian follicles for use in In vitro fertilization. The procedure may be performed during laparoscopy or by using a long needle and ultrasound to locate the follicle m the ovary.

EJACULATE The semen and sperm expelled during ejaculation.

EMBRYO The early products of conception; the undifferentiated beginnings of a baby; the conceptus.

EMBRYO TRANSFER Placing an egg fertilised outside the womb into a woman’s uterus or fallopian tube.

EMPTY SELLA SYNDROME A condition that occurs when spinal fluid leaks into the bony chamber (fossa) housing the pituitary gland. The fluid pressure compresses the pituitary gland and may adversely affect its ability to secrete LH and FSH and may elevate prolactin levels.

ENDOMETRIAL BIOPSY A test to check for Luteal Phase Defect. A procedure during which a sample of the uterine lining is collected for microscopic analysis. The biopsy results will confirm ovulation and the proper preparation of the endometrium by estrogen and progesterone stimulation

ENDOMETRIOSIS A condition where endometrial tissue is located outside the womb. The tissue may attach itself to the reproductive organs or to other organs in the abdominal cavity. Each month the endometrial tissue inbreeds with the onset of menses. The resultant irritation causes adhesions in the abdominal cavity and in the fallopian tubes. Endometriosis may also interfere with ovulation and with the implantation of the embryo.

ENDOMETRIUM The lining of the uterus which grows and sheds in response to estrogen and progesterone stimulation; the bed of tissue designed to nourish the implanted embryo.

ENDORPHINS Natural narcotics manufactured in the brain to reduce sensitivity to pain and stress. May contribute to stress related fertility problems.

EPIDIDYMIS A coiled, tubular organ attached to and lying on the testicle. Within this organ the developing sperm complete their maturation and develop their powerful swimming capabilities. The matured sperm leave the epididymis through the vas deferens.

ESTRADIOL The principal estrogen produced by the ovary. Responsible for formation of the female secondary sex characteristics such as large breasts; supports the growth of the follicle and the development of the uterine lining. At midcycle the peak estrogen level triggers the release of the LH spike from the pituitary gland. The LH spike is necessary for the release of the ovum from the follicle. Fat cells in both obese men and women can also manufacture estrogen from androgens and interfere with fertility. The blood test to monitor estradiol is E2 Rapid Assay. Women on Menogon and other fertility drugs have routine E2 monitoring.

ESTROGEN Female sex hormone.

FEMALE KALLMAN’S SYNDROME A condition characterized by infantile sexual development and an inability to smell. Since the pituitary cannot produce LH and FSH, the woman must take hormone supplements to achieve puberty, to maintain secondary sex characteristics, and to achieve fertility.

FERNING A pattern characteristic of dried cervical mucus viewed on a slide. When the fern pattern appears, the mucus has been thinned and prepared by estrogen for the passage of sperm. If it does not fern, the mucus will be hostile to the passage of the sperm.

FERTILITY TREATMENT Any method or procedure used to enhance fertility or increase the likelihood of pregnancy, such as ovulation induction treatment, varicocele repair, and microsurgery to repair damaged fallopian tubes. The goal of fertility treatment is to help couples have a child.

FERTILISATION The combining of the genetic material carried by sperm and egg to create an embryo. Normally occurs inside the fallopian tube (in vivo) but may also occur in a petri dish (in vitro). See also In Vitro Fertilization.

FETUS A term used to refer to a baby during the period of gestation between eight weeks and term.

FIBROID (MYOMA OR LEIOMYOMA) A benign tumor of the uterine muscle and connective tissue.

FIMBRIA Finger like projections at the end of the fallopian tube nearest the ovary. When stimulated by the follicular fluid released during ovulation, the fingerlike ends grasp the ovary and coax the egg into the tube.

FOLLICLE STIMULATING HORMONE (FSH) A pituitary hormone that stimulates spermatogenesis and follicular development. In the man FSH stimulates the Sertoli cells in the testicles and supports sperm production. In the woman FSH stimulates the growth of the ovarian follicle. Elevated FSH levels are indicative of gonadal failure in both men and woman.

FOLLICLES Fluid filled sacs in the ovary which contain the eggs released at ovulation. Each month an egg develops inside the ovary in a fluid filled pocket called a follicle. This follicle is one inch in size and is about ready to ovulate.

FOLLICULAR FLUID The fluid inside the follicle that cushions and nourishes the ovum. When released during ovulation, the fluid stimulates the fimbria to grasp the ovary and coax the egg into the fallopian tube.

FOLLICULAR PHASE The preovulatory portion of a womans cycle during which a follicle grows and high levels of estrogen cause the lining of the uterus to proliferate. Normally takes between 12 and 14 days.

GAMETE A reproductive cell: Sperm in men, the egg in women.

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 husbands sperm and then injected through the fimbria into the womans fallopian tubes for in vivo fertilization.

GERM CELL In the male the testicular cell that divides to produce the immature sperm cells; in the woman the ovarian cell that divides to form the egg (ovum). The male germ cell remains intact throughout the mans reproductive life; the woman uses up her germ cells at the rate of about one thousand per menstrual cycle, although usually only one egg matures each cycle.

GERM CELL APLASIA (SERTOLI CELL ONLY) An inherited condition in which the testicles have no germ cells. Since men with this condition have normal Leydig cells, they will develop secondary sex characteristics. May also be caused by large and/or prolonged exposure to toxins or radiation.

GONAD The gland that makes reproductive cells and “sex” hormones: the testicles, which make sperm and testosterone, and the ovaries, which make eggs (ova) and estrogen.

GONADOTROPINS Hormones which control reproductive function: Follicle Stimulating Hormone and Lutenizing Hormone.

GONADOTROPIN RELEASING HORMONE (GNRH) The hormone which controls the production and release of gonadotropins. Secreted by the hypothalamus every ninety minutes or so, this hormone enables the pituitary to secrete LH and FSH, which stimulate the gonads. See FSH,LH.

HOSTILE MUCUS Cervical mucus that impedes the natural progress of sperm through the cervical canal. HUMAN

CHORIONIC GONADOTROPIN (HCG) The hormone produced in early pregnancy which keeps the corpus luteum producing progesterone. Also used via injection (Profasi) to trigger ovulation after some fertility treatments, and used in men to stimulate testosterone production.

HUMAN MENOPAUSAL GONADOTRIPIN (HMG MENOGON) A combination of hormones FSH and LH, which is extracted from the urine of postmenopausal women. Used to induce ovulation in several fertility treatments.

HUMEGON (HMG) Similar to Menogon: the lutenizing and follicle stimulating hormones recovered from the urine of postmenopausal women. Used to stimulate multiple ovulation in some fertility treatments.

HYPERPROLACTINAEMIA A condition in which the pituitary gland secretes too much prolactin. Prolactin can suppress LH and FSH production, reduce male sex drive, and directly suppress ovarian function.

HYPERSTIMULATION (OVARIAN HYPERSTIMULATION SYNDROME OHSS) A potentially life threatening side effect of Menogon, Humegon or Puregon ovulation induction. A woman’s ovaries become enlarged and produce an over abundance of eggs. Blood hormone levels rise, fluid may collect in the lungs or abdominal cavity, and ovarian cyst may rupture, causing internal bleeding. Blood clots 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 Over production of thyroid hormone by the thyroid gland. The resulting increased metabolism “burns up” estrogen too rapidly and interferes with ovulation.

HYPOESTROGENIC Having lower than normal levels of estrogen.

HYPOGONADOTROPIC HYPOPITUITARISM A spectrum of diseases resulting in low pituitary gland output of LH and FSH. Men with this disorder have low sperm counts and may lose their virility; women do not ovulate and may lose their secondary sex characteristics.

HYPOSPERMATOGENESIS Low sperm production.

HYPOTHALAMUS A part of the brain, the hormonal regulation center, located adjacent to and above the pituitary gland. In both the man and the woman this tissue secretes GnRH every ninety minutes or so. The pulsatile GnRH enables the pituitary gland to secrete LH and FSH, which stimulate the gonads. See also FSH; LH; Ovary; Pituitary Gland; Testicle.

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 (see Hyperprolactinemia), and women will suffer from elevated prolactin and estrogen, both of which will interfere with fertility.

HYSTEROSALPINGOGRAM (HSG) An x-ray of the pelvic organs in which a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. This test checks for malformations of the uterus and blockage of the fallopian tubes.

HYSTEROSCOPY A procedure in which the doctor checks for uterine abnormalities by inserting a fibreoptic device. Minor surgical repairs can be executed during the procedure.

IMMATURE SPERM (GERMINAL CELL) A sperm that has not matured and gained the ability to swim. In the presence of illness or infection such sperm may appear in the semen in large numbers.

IMPLANTATION (EMBRYO) The embedding of the embryo into tissue so it can establish contact with the mothers blood supply for nourishment. Implantation usually occurs in the lining of the uterus; however, in an ectopic pregnancy it may occur elsewhere in the body.

IMPOTENCE The inability of the man to have an erection and to ejaculate.

INFERTILITY The inability to conceive after a year of unprotected intercourse or the inability to carry a pregnancy to term.

INHIBIN A male feedback hormone made in the testicles to regulate FSH production by the pituitary gland.

INHIBIN F (FOLLICULOSTATIN) A female feedback hormone made in the ovary to regulate FSH production by the pituitary gland.

INTRACYTOPLASMIC SPERM INJECTION (ICSI) A micromanipulation procedure where a single sperm is injected into the egg to enable fertilization with very low sperm counts or with nonmotile sperm.

INTRAUTERINE INSEMINATION (IUI) A relatively “lowtech” ART which deposits “washed” sperm directly into the uterus, bypassing cervical mucus and depositing the sperm more closely to the fallopian tubes, where fertilization occurs. Used to bypass hostile cervical mucus and to overcome sperm count and motility problems. See Artificial Insemination .

IN VITRO FERTILISATION (IVF) Literally means “in glass.” Fertilization takes place outside the body in a small glass dish.

KARYOTYPING A test performed to analyze chromosomes for the presence of genetic defects.

KLINEFELTERS SYNDROME A genetic abnormality characterized by having one Y (male) and two X (female) chromosomes. May cause a fertility problem.

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.

MENORRHAGIA Heavy or prolonged menstrual flow.

METRODIN (PURE FSH) An injectable form of Follicle Stimulating Hormone used to stimulate ovulation.

METRORRHAGIA Menstrual spotting during the middle of the cycle.

MISCARRIAGE Spontaneous loss of an embryo or fetus from the womb.

MITOSIS The division of a cell into two identical cells in which all forty-six human chromosomes are duplicated; the first division of the germ cell.

MITTLESCHMERZ The discomfort felt on one side of the lower abdomen at the time of ovulation.

MYCOPLASMA See Ureaplasma.