TPAL terminology= A system used to describe obstetrical history.
    T=term births
    P=preterm births (prior to 37 weeks gestation)
    L=living children
    Example: a woman who has 2 living children born as preterm twins in her first pregnancy would be designated as: TPAL 0-1-0-2 - 0 term births, 1 delivery prior to 37 weeks gestation (preterm), 0 pregnancies ending in spontaneous or induced abortions, and 2 living children
Separate TPAL numbers by hyphens. Obstetric history: 4-2-2-4

Alternatively, spell out the terms as follows:

Obstetric history: 4 term infants, 2 premature infants, 2 abortions, 4 living children

Sometimes, GPA terminology is combined with TPAL terminology.

The patient is gravida 3, 3-0-0-3.
GPA terminology with GPA as the abbreviation for gravida, para, abortus. Accompanied by arabic numbers, G, P, and A (or Ab) describe the patient's obstetric history. Roman numerals are not used.
    G gravida (number of pregnancies)
    P para (number of births of viable offspring)
    A or Ab abortus (abortions)

    nulligravida gravida 0 no pregnancies
    primigravida gravida 1, G1 1 pregnancy
    secundigravida gravida 2, G2 2 pregnancies
    nullipara para 0 offspring
Separate GPA sections by commas. Alternatively, spell out the terms, using lower case.

Obstetric history: G4, P3, A1
or Obstetric history: gravida 4, para 3, abortus 1.

When one or more of the numbers is 0, the preferred form is to write out the terms.

gravida 2, para 0, abortus 2


Interruption of pregnancy; characteristic symptoms are vaginal bleeding and expulsive uterine contractions.

Abortion, Habitual:
A term referring to a condition where a woman has had three or more miscarriages.

Abortion, Incomplete:
An abortion after which some tissue remains inside the uterus. A D&C must be performed to remove the tissue and prevent complications.

Abortion, Missed:
An abortion where the fetus dies in the uterus but there is no bleeding or cramping. A D&C will be needed to remove the fetal remains and prevent complications.

Abortion, Spontaneous:
A pregnancy loss during the first twenty weeks of gestation.

Abortion, Therapeutic:
A procedure used to terminate a pregnancy before the fetus can survive on its own.

Abortion, Threatened:
Spotting or bleeding that occurs early in the pregnancy. May progress to spontaneous abortion.

A hormone produced by the pituitary gland to stimulate the adrenal glands. Excessive levels may lead to fertility problems.

Scar tissue occurring in the abdominal cavity, fallopian tubes, or inside the uterus. Adhesions can interfere with transport of the egg and implantation of the embryo in the uterus.

Adrenal Androgens:
Male hormones produced by the adrenal gland which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in the woman may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland, or ovary. May also be associated with excess prolactin levels.

Adnexal mass:
A mass in the area of the Fallopian tube or ovary.

Adnexal torsion:
A twisting of the Fallopian tube.

Alpha-fetoprotein Test (AFP):
A blood test performed to evaluate the development of the fetus and to look for fetal abnormalities. .

Relative underdevelopment of the human newborn infant compared to other primates. Resultant from shortened gestation.

AID (Artificial Insemination Donor):
See Artificial Insemination Donor.

AIH (Artificial Insemination Homologous):
See Artificial Insemination Homologous.

Refers to a woman who has never had a period.

Amenorrhea, Secondary:
A term describing a woman who has menstruated at one time, but who has not had a period for six months or more.

Male sex hormones.

A physician-scientist who performs laboratory evaluations of male fertility. May hold a Ph.D. degree instead of an M.D. Usually affiliated with a fertility treatment center working on in vitro fertilization.

One of the androgens (male hormones) that are naturally present in women. (Other androgens include testosterone and DHEAS.) These hormones play an important role in ovulation. High levels of androgens in women may indicate an abnormality in the ovulation process.

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

Anorexia Nervosa:
A life-threatening eating disorder; self-imposed starvation. Severe weight loss and malnutrition from this disorder cause anovulation.

The failure to ovulate; ovulatory failure.

The pre-delivery pregnant period.

Top or upper.

Chemicals made by the body to fight or attack foreign substances entering the body. Normally they prevent infection; however, when they attack the sperm or fetus, they cause infertility. Sperm antibodies may be made by either the man or the woman.

Antisperm Antibodies:
Antibodies are produced by the immune system to fight off foreign substances,like bacteria. Antisperm antibodies attach themselves to sperm and inhibit movement and their ability to fertilize.

Artificial Insemination (AI):
The depositing of sperm in the vagina near the cervix or directly into the uterus, with the use of a syringe instead of by coitus. This technique is used to overcome sexual performance problems, to circumvent sperm-mucus interaction problems, to maximize the potential for poor semen, and for using donor sperm. See also Artificial Insemination Donor; Artificial Insemination Homologous.

Artificial Insemination Donor (AID):
Artificial insemination with donor sperm. A fresh donor semen specimen or a thawed frozen specimen is injected next to the woman's cervix.

Artificial Insemination Homologous (AIH):
Artificial insemination with the husband's sperm. The sperm may be washed and injected directly into the wife's uterus (IAIH). Often used with poor semen or to overcome sperm-mucus problems.

Artificial Spermatocoele:
An artificial, surgically created pouch used to collect sperm from men with irreversible tubal blockage.

Asherman's Syndrome:
A condition where the uterine walls adhere to one another. Usually caused by uterine inflammation.

Assisted Reproductive Technology (ART):
Several procedures employed to bring about conception without sexual intercourse, including IUI, GIFT and ZIFT.

Low sperm motility.

Thinning and decreased blood flow to tissue resultant from a lack of hormones, most commonly estrogen.

Autoimmune Disorders
When a person has an autoimmune disorder, immune cells mistakenly attack the body’s own cells. Examples of autoimmune disorders are lupus, rheumatoid arthritis, and Grave’s Disease. Some autoimmune factors, such as antiphospholipid antibodies, may affect fertility or pregnancy. Many IVF clinics test for autoimmune disorders. Treatment may consist of low-dose heparin (an anticoagulant), baby aspirin, or prednisone (a steroid).

Semen containing no sperm, either because the testicles cannot make sperm or because of blockage in the reproductive tract.


ß-human chorionic gonadotropin (ß-hCG):
A polypeptide hormone produced by the placenta; its secretion begins soon after implantation of the fertilized ovum.

Bacterial Vaginosis Infection:
A vaginal infection that causes a burning sensation and a gray, malodorous discharge. May interfere with fertility.

Basal Body Temperature (BBT)
The body reaches a basal metabolic temperature early in the morning when we are at rest. Charting this temperature variation helps determine when ovulation occurs. The basal body temperature is measured with a special basal thermometer.

Basal Body Temperature, Biphasic:
A basal body temperature pattern consistent with ovulation and the formation of the corpus luteum, which secretes progesterone. This hormone will elevate the basal body temperature about one-half degree during the latter half of the menstrual cycle.

Basal Body Temperature, Monophasic:
An anovulatory basal body temperature pattern where the temperature remains relatively constant throughout the cycle.

Beta hCG Test:
A blood test used to detect very early pregnancies and to evaluate embryonic development.

Bicornuate Uterus:
A congenital malformation of the uterus where the upper portion (horn) is duplicated.

Biological Father: 
The man whose sperm fertilized the ovum from which a child developed and who is therefore genetically related to that child. 

Biological Mother: 
The woman from whose ovum a child developed and who is therefore genetically related to that child. 

Walking erect on two legs.

Bladder neck:
Junction between urethra and bladder

Bromocriptine (Parlodel):
An oral medication used to reduce prolactin levels and reduce the size of a pituitary tumor when present. This medication often causes dizziness and upset stomach and must be started with a small dose which is gradually increased as needed. This medication is equally effective when the tablet is placed into the vagina.

An eating disorder characterized by voracious eating followed by forced vomiting. The resulting weight loss and malnutrition may cause anovulation.

A long-acting GnRH available in Europe as a nasal spray and used to create the pseudomenopause desirable for reducing the size and number of endometriotic lesions. It can also be used to treat fibroid tumors, PMS, hirsutism, ovulation induction and for in vitro fertilization.


Candidiasis (Yeast):
An infection that may be uncomfortable and itchy and may impair fertility.

A process that sperm undergo as they travel through the woman's reproductive tract. Capacitation enables the sperm to penetrate the egg.

A hollow flexible tube that is passed into the body. In IVF, a special catheter is used to transfer fertilised embryos into the uterus.

To burn tissue with electrical current (electrocautery) or with a laser. Used in surgical procedures to remove unwanted tissue such as adhesions and endometrial implants. Also used to control bleeding.

CBC (Complete Blood Count) A routine blood test is that analyses the three major types of cells in blood: red blood cells, white blood cells, and platelets. A CBC is a general indicator of overall health.

Cervical Mucus:
A viscous fluid plugging the opening of the cervix. Most of the time this thick mucus plug prevents sperm and bacteria from entering the womb. However, at midcycle, under the influence of estrogen, the mucus becomes thin, watery, and stringy to allow sperm to pass into the womb. See also Cervix

Cervical Smear:
A sample of the cervical mucus examined microscopically to assess the presence of estrogen (ferning) and white blood cells, indicating possible infection.

Cervical Stenosis:
A blockage of the cervical canal from a congenital defect or from complications of surgical procedures. See also Cervix.

The opening between the uterus and the vagina. The cervical mucus plugs the cervical canal and normally prevents foreign materials from entering the reproductive tract. The cervix remains closed during pregnancy and dilates during labor and delivery to allow the baby to be born.

Cervix, Incompetent:
A weakened cervix, which opens up prematurely during pregnancy and can cause the loss of the fetus. A CERVICAL CERCLAGE is a procedure in which a stitch or two is put around the cervix to prevent its opening until removed when the pregnancy is to term.

Chemical Pregnancy
Very early pregnancy that is indicated through a positive pregnancy test only. When applied to IVF, a chemical pregnancy may not be a pregnancy at all, but rather the result of the hCG injection creating a false-positive pregnancy test. This term may also refer to a true chemical pregnancy that may or may not progress to a clinical pregnancy. When comparing IVF Success Rates, “Chemical Pregnancy Rates” are not very helpful.

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. 

Chocolate Cyst:
A cyst in the ovary that is filled with old blood; endometrioma. Occurring when endometriosis invades an ovary, it causes the ovary to swell. Frequently, patients with large endometriomas do not have any symptoms. If the cyst ruptures or the ovary containing the cyst twists, emergency surgery may be necessary. Usually treatment can be carried out through the laparoscope.

The structures in the cell that carry the genetic material (genes); the genetic messengers of inheritance. The human has forty-six chromosomes, twenty-three coming from the egg and twenty-three coming from the sperm.

Tiny hairlike projections lining the inside surface of the fallopian tubes. The waving action of these "hairs" sweeps the egg toward the uterus.

Classical caesarian section:
Caesarian section where the incision in the uterine muscle is made through the thickest part of the uterus. This leads to future significantly increased risk for rupture of the scar.

Clinical Pregnancy
Pregnancy in which the foetus shows on ultrasound at about seven weeks.


The small erectile sex organ of the female which contains large numbers of sensory nerves; the female counterpart of the penis.

Clomiphene Citrate (Clomid, Serophene):
A fertility drug that stimulates ovulation through the release of gonadotropins from the pituitary gland."

To cause the conversion of a fluid into a jelly-like solid.

Intercourse; the sexual union between a man and a woman.

The fertilization of an ovum or the act of becoming pregnant. See Fertilization.

The early products of conception; the embryo and placenta.

Condom Therapy:
Therapy prescribed to reduce the number of sperm antibodies in the woman by using a condom during intercourse for six months or more and by the woman refraining from all skin contact with the husband's sperm. The woman's antibody level may fall to levels that will not adversely affect the sperm.

Cone Biopsy:
A surgical procedure used to remove precancerous cells from the cervix. The procedure may damage the cervix and thus disrupt normal mucus production or cause an incompetent cervix, which may open prematurely during pregnancy.

Congenital Adrenal Hyperplasia:
A congenital condition characterized by elevated androgens which suppress the pituitary gland and interfere with spermatogenesis or ovulation. Women may have ambiguous genitalia from the excess production of male hormone.

Any agent or device used for the prevention of conception (getting pregnant).  For further information on this topic, a search of the internet will prove fruitful.

Contraceptive, Oral:
A medication that prevents ovulation and pregnancy. Up to 3 percent of women taking the Pill will become anovulatory when they stop taking it. The regulatory effects of the Pill can also disguise symptoms of fertility problems-- for example, an irregular cycle or endometriosis. May be used to control the symptoms and development of endometriosis.

Corpus Luteum:
The yellow-pigmented glandular structure that forms from the ovarian follicle following ovulation. The gland produces progesterone, which is responsible for preparing and supporting the uterine lining for implantation. Progesterone also causes the half-degree basal temperature elevation noted at midcycle during an ovulatory cycle. If the corpus luteum functions poorly, the uterine lining may not support a pregnancy. If the egg is fertilized, a corpus luteum of pregnancy forms to maintain the endometrial bed and support the implanted embryo. A deficiency in the amount of progesterone produced (or the length of time it is produced) by the corpus luteum can mean the endometrium is unable to sustain a pregnancy. This is called Luteal Phase Defect (LPD).

A professional counselor employed by (or referred by) the IVF clinic to help those going through treatment deal with the emotional stresses associated with infertility treatment.

A special freezing technique used to preserve embryos and sperm for future use in an ART procedure. 

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

Cumulus Oophorus:
The protective layer of cells surrounding the egg.

Cushing's Syndrome:
A condition characterized by an overproduction of adrenal gland secretions. The person will suffer from high blood pressure and water retention as well as a number of other symptoms. A concurrent elevation of adrenal androgens will suppress pituitary output of LH and FSH and result in low sperm production or ovulatory failure. A woman may also develop male secondary sex characteristics, including abnormal hair growth. Cushing's Disease is another condition in which these same symptoms occur, but as the result of a pituitary tumor.

Prolapse of the bladder into the vagina. This can be seen as a bulge from the anterior wall of the vagina.


D&C (Dilation and Curettage):
A procedure used to dilate the cervical canal and scrape out the lining and contents of the uterus. The procedure can be used to diagnose or treat the cause of abnormal bleeding and to terminate an unwanted pregnancy.

Danazol (danocrine):
A medication used to treat endometriosis. Suppresses LH and FSH production by the pituitary and causes a state of amenorrhea during which the endometrial implants waste away. Many women experience oily skin, acne, weight gain, abnormal hair growth, deepening of the voice and muscle cramps with this medication.

Delayed Ejaculation:
A condition in which the man fakes orgasm and does not actually ejaculate when having sex.

Delayed Puberty:
A condition in which the youngster fails to complete puberty and develop secondary sex characteristics by sixteen years of age. Puberty may be stimulated with hormonal replacement therapy. Some will outgrow the condition without treatment.

The act of giving birth.

Loss of neuronal connections.

DES (Diethylstilbestrol):
A medication prescribed in the 1950s and 1960s to women to prevent miscarriage. Male and female fetuses exposed in utero to this drug developed numerous deformities including blockage of the vas deferens, uterine abnormalities, cervical deformities, miscarriages, and unexplained infertility. DES is no longer prescribed for this indication.

Detrusor instability:
Instability of the bladder muscle leading to uninhibited, abnormal, bladder contractions. This leads to urgency or urgency incontinence.

Loss of vascular connections.

DHEAS (dihydroeprandrostone):
One of the androgens (male hormones) that are naturally present in women. (Other androgens include testosterone and androstenedione.) These hormones play an important role in ovulation. High levels of androgens in women may indicate an abnormality in the ovulation process.  See Adrenal Androgens.

A condition in which the glucose (sugar) in the blood is too high because the body is unable to use it properly. Diabetes may be responsible for decreased fertility and increased incidence of miscarriage.

Dilation and Currettage:
Surgical dilation of the cervix followed by surgical scraping of the interior of the uterine cavity with a currette (spoon-shaped surgical instrument) to remove growths (e.g. pregnancy, tumour) or diseased tissue, or to obtain tissue for examination (biopsy).

A disease is defined as any deviation from or interruption of the normal structure or function of any part, organ, or system, or combination thereof, of the body that is manifested by a characteristic set of symptoms or signs. Dorland's Medical Dictionary 1988: 481. 

Doppler flow ultrasonography:
Measures and visually record changes in the frequency of a ultrasonic wave, indicative of the change in velocity of the blood flow in underlying vessels.

A tetracycline derivative; an antibiotic that inhibits many of the microorganisms infecting the reproductive tract. Often used for treating ureaplasma infections. Many physicians find routine treatment with this antibiotic more cost-effective than performing multiple cultures on both the husband and wife looking for infection.


Painful menstruation. This may be a sign of endometriosis.

A condition in women in which intercourse is uncomfortable or painful due to a medical problem or emotional issues.


Ectopic Pregnancy:
A pregnancy outside of the uterus, usually in the fallopian tube. Such a pregnancy can rarely be sustained, and often leads to decreased or complete loss of function in the affected tube. Methotrexate is now used to dissolve the pregnancy without causing major damage to the tube.

Female cells containing 23 chromosomes that are stored in the ovaries. When fertilized by sperm, an egg forms an embryo. A woman is born with all the eggs she will ever have. Each month, an egg is released during ovulation. If it isn’t fertilised, menstruation will occur about two weeks later. During IVF, fertility drugs are given which cause the ovaries to produce numerous eggs instead of just one.

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 in the ovary.

The semen and sperm expelled during ejaculation.

The physiological process by which the semen is propelled from the testicles, through the reproductive tract, and out the opening of the penis.

Elective caesarian birth: Delivery of baby by planned caesarian section

An instrument for cauterizing (burning with heat or chemical in order to close a wound) tissue in which a platinum wire is heated by a current of electricity.

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

A scientist who is highly trained in embryo growth and development.

Embryo Transfer:
Placing an egg fertilized 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.

A condition in which tissue similar to the uterine lining (the endometrium) implants and grows outside the uterus. Endometrial growths are often found on the ovaries, fallopian tubes, peritoneum, bowel, bladder, and/or vagina, but may also grow in other areas of the body. Each month the endometrial growths respond to the hormonal cycle, resulting in inflammation, lesions, adhesions, and cysts. Endometriosis can cause a variety of symptoms, including menstrual pain, painful intercourse, pelvic pain, bowel changes, heavy menstrual bleeding, bloating, fatigue, and infertility.

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.

Endopelvic fascia:
The fascia of the inner pelvis.

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

A true herniation into the top of the vagina. This results from loops of small bowel herniating through a fascia tear into the space between the pelvic fascia and the vaginal wall.

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.

Epidural anesthetic:
Injection of anesthetic solution in the epidural space. This is done by placing a needle and catheter into the lower back outside the spinal column. Patients lose motor and sensory function in the lower body but remain awake. Epidurals can be "topped up" as a result of the catheter that remains as long as necessary.

An incision made in the lower vulva, to increase the vaginal outlet aperture.

The process during which the erectile tissue of the penis becomes engorged with blood, causing the penis to swell and become rigid.

The female hormone produced in 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.

General term for the female sex hormone; responsible for stimulating the development and maintenance of female secondary sex characteristics; formed in the ovary, placenta, testis, adrenal cortex and some plants; therapeutic uses (with natural or synthetic preparations) include the relief of menopausal symptoms and of prostate cancer.

Expectant management:
This modality of treatment involves no active intervention; the patient is followed closely to determine if any future action is needed.

Expectant Therapy (Endometriosis):
A wait-and-see approach used after laparoscopic surgery for mild endometriosis.

External sphincter:
The outer layer of the sphincter. Usually under voluntary control.


Fallopian Tubes:
Ducts through which eggs travel to the uterus once released from the follicle. Sperm normally meet the egg in the fallopian tube, the site at which fertilization usually occurs.

Connective tissue supporting organ structures. Consisting of mostly collagen fibers, this tissue makes up ligaments and keeps muscular bundles together as well as lending structural integrity and strength to the body.

Number of children.

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.

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.

Fertile Eunuch:
A rare disorder characterized by an LH deficiency leading to low testosterone levels and poor sperm production. Male secondary sex characteristics will be incomplete and sex drive will be low.

The capacity to initiate or support conception.

Fertility Specialist:
A physician specializing in the practice of fertility. The American Board of Obstetrics and Gynecology certifies a subspecialty for OB-GYNs who receive extra training in endocrinology (the study of hormones) and infertility.

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

Fertility Workup:
The initial medical examinations and tests performed to diagnose or narrow down the cause of fertility problems.

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.

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.

The opening of the fallopian tube near the ovary. When stimulated by the follicular fluid released during ovulation, the fingerlike ends grasp the ovary and coax the egg into the tube.

Bowel gas.

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.

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.

Follicular Phase:
The pre-ovulatory portion of a woman's 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.

An instrument resembling a pair of tongs, used for grasping, compressing, manipulating, or extracting tissue or specific structures.

Free Thyroxine (T4)
A blood test that checks proper thyroid and pituitary function. Thyroid disorders may affect ovulation.

Free Triiodothyronine (T3)
A blood test that checks proper thyroid function. Thyroid disorders may affect ovulation.


A clear or milky discharge from the breasts associated with elevated prolactin.

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 tubes. After egg retrieval the eggs are mixed with the husband's sperm and then injected through the fimbria into the woman's fallopian tubes for in vivo fertilization.

The external sex organs, as the labia and clitoris in the woman and the penis and testicles in the man. Also called genitalia.

The science that deals with the analysis of DNA (gene activity and expression)  in body tissues and fluids with respect to specific diseases.

Genuine stress urinary incontinence:
Incontinence related to episodes of increased intra-abdominal pressure.

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 man's 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.

Length of pregnancy.

Gestational Mother: 
In a surrogacy arrangement, the woman who carries a pregnancy to term and delivers a baby, which may or may not be genetically related to her.

GnRH Analogue (gonadotrophin releasing hormone agonists):
A class of drugs that are used to prevent the ovaries from releasing eggs too early during an IVF cycle. There are two types of GnRH analogues: 1) GnRH agonists (GnRH-a), which cause a sharp increase of LH and FSH, and 2) GnRH antagonists, which cause immediate suppression of LH (i.e., no "flare"). Your doctor will choose the protocol that is right for you.

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

Gonadotropin Releasing Hormone (GnRH):
A substance secreted by the hypothalamus every ninety minutes or so. This hormone enables the pituitary to secrete LH and FSH, which stimulate the gonads. See also FSH; LH.

The gland that makes reproductive cells and "sex" hormones, as the testicles, which make sperm and testosterone, and the ovaries, which make eggs (ova) and estrogen.

An infection that is usually asymptomatic, but that may cause a bad-smelling yellowish vaginal discharge and red and swollen vaginal walls. If it reaches the fallopian tubes, the woman will suffer pain, develop a high fever, and possibly develop tubal blockage. The responsible organism may also impair sperm and prevent pregnancy. In the man gonorrhea seldom leads to damage, but it may cause a painful infection.

Specialist physician specialized in female disorders, particularly those of the reproductive and urological organs.


Hamster Test:
A test of the ability of sperm to penetrate a hamster egg which has been stripped of the Zona Pellucida (outer membrane). Also called SPERM PENETRATION ASSAY (SPA).

hCG (human chorionic gonadotropin)
A drug that triggers ovulation during an IVF cycle.

Blood clot.

Escape of blood in the peritoneal cavity.

The arrest of bleeding.

Heterotopic pregnancy:
The simultaneous presence of a uterine and an ectopic pregnancy.

The overabundance of body hair, such as a mustache or pubic hair growing upward toward the navel, found in women with excess androgens.

A chemical secreted from a part of the body (usually an endocrine gland) and carried in the bloodstream to another part to stimulate or retard its function.

Host Uterus:
Also called a "surrogate gestational mother." A couple's embryo is transferred to another woman who carries the pregnancy to term and returns the baby to the genetic parents immediately after birth.

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 to trigger ovulation after some fertility treatments, and used in men to stimulate testosterone production.

Human Menopausal Gonadotropin (HMG - PERGONAL, HUMEGON):
A combination of hormones FSH and LH, which is extracted from the urine of post-menopausal women. Used to induce ovulation in several fertility treatments.

Humegon (HMG):
The lutenizing and follicle-stimulating hormones recovered from the urine of post-menopausal women. Used to stimulate multiple ovulation in some fertility treatments.

Hydatiform mole ("molar pregnancy"):
A mass of cysts (air or fluid filled sac) occupying the uterine cavity resulting from the abnormal development of a fertilized ovum.

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

Hyperstimulation (Ovarian Hyperstimulation Syndrome, OHSS):
A potentially life-threatening side effect of Pergonal ovulation induction treatment. Arises when too many follicles develop and hCG is given to release the eggs. May be prevented by withholding the hCG injection when ultrasound monitoring indicates that too many follicles have matured.

Overproduction of thyroid hormone by the thyroid gland. The resulting increased metabolism "burns up" estrogen too rapidly and interferes with ovulation.

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.

Low sperm production.

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.

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.

The surgical removal of the uterus. May also include the removal of other reproductive structures, such as the fallopian tubes and ovaries.

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.

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


IAIH (Intrauterine Artificial Insemination Homologous):
Artificial insemination where the husband's sperm is injected directly into the uterus to avoid cervical mucus problems or to maximize the potential for poor semen. See also Artificial Insemination.

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.

Imperforate Hymen:
A condition where the membrane (hymen) covering the vagina fails to open and allow menstrual flow.

Implantation (Embryo):
The embedding of the embryo into tissue so it can establish contact with the mother's 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.

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

Immune system:
The system within the body that secures against harmful substances; it enables the body to recognize materials as foreign to itself and to neutralize, eliminate or metabolize them with or without injure to its own tissues.

New occurrences of a disorder per year.

Loss of normal bodily control over the storage role of a particular organ.

Incontinence: Anal/fecal incontinence:
Loss of storage mechanism of rectum. This means loss of control over flatus or stool.

Incontinence: Urinary Incontinence:
Loss of control over urinary storage function, thus leakage of urine.

Incompetent Cervix:
See Cervix, Incompetent

Induction of labor:
The process of initiating and expediting labor and delivery.

Informed consent:
A contractual agreement between a patient and a physician, whereby the patient gives permission to undergo a certain procedure based on as clear an understanding of the issue as is possible. This understanding should be based on education and explanation.

Connection with intact nerves. This is used in conjunction with muscles.

Internal sphincter:
The internal layer of the sphincter. Usually under involuntary control.

Interstitial pregnancy:
An ectopic pregnancy implanted in the portion of the Fallopian tube which pierces the wall of the uterus.

Inside the abdominal cavity.

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 non-motile sperm.

Inside the uterus.

As in “invasive procedures”: Procedures involving interference to change an outcome. It could also mean penetrating, or entering, the temporal order of the proceedings, or the physical body.

In Vitro Fertilization (IVF):
Literally means "in glass." Fertilization takes place outside the body in a small glass dish.

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

Infertility Specialist:
A physician who specialises in infertility. Most are board-certified reproductive endocrinologists, but some gynaecologists have considerable experience in infertility and may be considered experts in the field.

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.

Intramuscular Injection :
A shot that is inserted into the muscle. Some IVF drugs are administered in the muscle, usually in the upper hip.

IUD (Intrauterine Device):
A device placed into the uterus to prevent pregnancy. IUD insertion has been associated with an increased incidence of infection, which may damage the fallopian tubes, and is therefore not recommended for women with multiple sexual partners.

Intrauterine insemination (IUI): 
A technique in which sperm are introduced directly into a woman’s cervix or uterus to produce pregnancy, with or without ovarian stimulation to produce multiple ova.


Kallman's Syndrome:
A congenital hypothalamus dysfunction which has multiple symptoms including the failure to complete puberty.

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

Klinefelter's Syndrome:
A genetic abnormality characterized by having one Y (male) and two X (female) chromosomes. May cause a fertility problem.


Lab Technician:
Assistants who may help draw and interpret laboratory blood tests, interpret semen analysis, and/or assist with IVF procedures.

A small telescope that can be inserted into a hole in the abdominal wall for viewing the internal organs; the instrument used to perform a laparoscopy. Used to diagnose and treat a number of fertility problems including endometriosis, abdominal adhesions, and polycystic ovaries. Also used in egg retrieval for in vitro fertilization.

Examination of the pelvic region by using a small telescope called a laparoscope.

Laparoscopic surgery:
Surgery by using a laparoscope and minimal access incisions. In this way, large skin incisions are avoided.

Major abdominal surgery where reproductive organ abnormalities can be corrected and fertility restored, such as tubal repairs and the removal of adhesions.

Late complications:
Those complications occurring a significant distance in time from the causal event.

A benign tumour derived from smooth muscle and containing a relatively small amount of fibrous tissue; most frequently seen in the uterus. Also called fibroid.  See Fibroid.

Levator ani:
The main muscle of the pelvic floor made up of different parts. These parts include pubococcygeus, iliococcygeus, coccygeus, and ischeococcygeus.

A disease characterized by the appearance of great numbers of immature and abnormal white blood cells (colorless cells of the blood who play important roles in the immune system) in the bone marrow and often in the spleen and liver; usually these cells appear in the bloodstream and may also invade other tissues.

Leydig Cell:
The testicular cell that produces the male hormone testosterone. The Leydig cell is stimulated by LH from the pituitary gland.

Live Birth Rate :
The rate of live births per cycle. Also known as “take home rate.”

Luteal Phase:
Post-ovulatory phase of a woman's cycle. The corpus luteum produces progesterone, which cause the uterine lining to thicken to support the implantation and growth of the embryo.

Luteal Phase Defect (or deficiency) (LPD):
A condition that occurs when the uterine lining does not develop adequately because of inadequate progesterone stimulation; or because of the inability of the uterine lining to respond to progesterone stimulation. LPD may prevent embryonic implantation or cause an early abortion.

Luteinized Unruptured Follicle (LUF) Syndrome:
A condition in which the follicle develops and changes into the corpus luteum without releasing the egg.

Luteinizing Hormone (LH):
A pituitary hormone that stimulates the gonads. In the man LH is necessary for spermatogenesis (Sertoli cell function) and for the production of testosterone (Leydig cell function). In the woman LH is necessary for the production of estrogen. When estrogen reaches a critical peak, the pituitary releases a surge of LH (the LH spike), which releases the egg from the follicle.

Luteinizing Hormone Surge (LH SURGE):
The release of luteinizing hormone (LH) that causes release of a mature egg from the follicle. Ovulation test kits detect the sudden increase of LH, signaling that ovulation is about to occur (usually within 24-36 hours).


A technique used to collect semen for analysis and for artificial insemination; manual stimulation of the penis leading to ejaculation.

Maturation Arrest:
A testicular condition in which at one stage of sperm production all sperm development halts throughout all testicular tubules. May result in oligospermia or azozoospermia.

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.

Heavy or prolonged menstrual flow.

The cyclical shedding of the uterine lining in response to stimulation from estrogen and progesterone.

The upper free portion of the broad ligament, above the proper ovarian ligament and investing the Fallopian tube.

A folic acid (a type of vitamin B essential for cell multiplication) antagonist used to treat various conditions of abnormal tissue growth (eg. leukemia, hydatiform mole, psoriasis).

Metrodin (Pure FSH):
An injectable form of Follicle Stimulating Hormone used to stimulate ovulation.

Menstrual spotting during the middle of the cycle.

Non-physician practitioner attending and helping during labor and delivery. Midwives are often, but not always, nurses.

Spontaneous loss of an embryo or fetus from the womb.

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.

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

The development of complications. total non-interference by attendants. All childbirths are in some form or other, “unnatural”. The term is used loosely, meaning different things by different people.


In a semen analysis, the degree to which sperm cells are able to spontaneously propel themselves. 

Epithelial tissue encountered in the mouth, vagina, anus, etc.

Multiple Pregnancies:
A pregnancy that involves more than one foetus. For example, twins, triplets, and quadruplets are all multiple pregnancies. Multiple pregnancies are a risk associated with IVF.

See Ureaplasma.

Surgery performed to remove fibroid tumors.


Natural childbirth:
A great misnomer, normally used to indicate the natural order of childbirth as in the “natural” state. In reality, this would mean total non-interference by attendants. All childbirths are in some form or other, “unnatural”. The term is used loosely, meaning different things by different people. 

The specialty of looking after new born babies.

Nurse Coordinator:
A specially trained nurse who specialises in IVF patient education. Also shows patients how to give shots and answers questions.


A specialist medical practitioner specialized in looking after pregnant women, and the delivery of the baby.

Oestradiol (E2):
A naturally occurring female hormone. In the infertility workup, this hormone is usually measured on Cycle Day 3 (Day 1 is the first day of bleeding). E2 and FSH are sometimes interpreted together to determine ovarian reserve and predict response to treatment. Tests for E2 are also done throughout IVF to monitor response to the fertility drugs.

Infrequent menstrual periods.

Oligospermia, Oligozoospermia:
A sperm count below 20 million; a low sperm count; a sperm count low enough to cause a fertility problem.

Removal of one or both ovaries.

Oocyte, Ovum:
The egg; the reproductive cell from the ovary; the female gamete; the sex cell that contains the woman's genetic information.

Operative vaginal delivery:
Vaginal delivery by the use of instruments, for instance, obstetrical forceps or vacuum.

The psychological and physical thrill that accompanies sexual climax. For the man orgasm causes ejaculation.

The female sex cells, or eggs, which are produced in the ovaries. 

Ovarian Hyperstimulation Syndrome (OHSS)
A potentially serious side effect of follicle stimulating drugs, occurring when too many follicles develop and hCG is given to release the eggs. If ultrasound monitoring shows that too many follicles have matured, OHSS may be prevented by withholding the hCG injection.

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

Ovarian Cyst:
A fluid-filled sac inside the ovary. An ovarian cyst may be found in conjunction with ovulation disorders, tumors of the ovary, and endometriosis. See also Chocolate Cyst.

Ovarian Failure:
The failure of the ovary to respond to FSH stimulation from the pituitary because of damage to or malformation of the ovary. Diagnosed by elevated FSH in the blood.

Ovarian Follicle:
The ovum together with its surrounding cells, located within the ovary.

The release of the egg (ovum) from the ovarian follicle.

Ovulation Induction:
Medical treatment performed to initiate ovulation. See also Clomiphene Citrate; Pergonal.

Ovulation Predictor Test:
A home test kit that help women detect the “LH surge” in their urine. A surge in the level of Luteinizing Hormone (LH) causes ovulation.

Ovulatory Failure (Anovulation):
The failure to ovulate.

An egg.


Complete pituitary gland failure.

Pap Smear
A screening test for pre-cancerous changes of the uterine cervix.

See Bromocriptine.

Number of babies where the gestation went to term.

The condition of being open, as with tubes that form part of the reproductive organs.

Pelvic floor dysfunction: Disorders of the pelvic floor related to physiological or anatomical abnormalities. They include incontinence, prolapse, pain syndromes, and others.

Pelvic floor: The floor of the abdominal cavity. It pertains to those structures that form the natural bottom of the pelvic and intra-abdominal cavities. For its constituents and anatomy, see text.

Pelvic Ultrasound
A relatively painless procedure in which the doctor checks for structural abnormalities or other problems in the female reproductive system. During an IVF cycle, frequent ultrasound scans are scheduled to provide essential information about the number of eggs that are developing.

Pelvic Inflammatory Disease (PID):
An infection of the pelvic organs that causes severe illness, high fever, and extreme pain. PID may lead to tubal blockage and pelvic adhesions.

Penile Implant:
A device surgically inserted into the penis to provide rigidity for intercourse. Used to treat impotence.

The male organ that becomes enlarged and erect for the purpose of depositing semen in the woman's vagina.

Pergonal (HMG):
A medication used to replace the pituitary hormones, LH and FSH. May be used to induce ovulation in women who do not respond to clomiphene citrate. Most frequently used with women who do not normally produce estrogen because of a pituitary gland or hypothalamic malfunction. May also be used with men to stimulate sperm production.

Viable fetus pre-birth, up to 7 days after birth.

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

Perineal body:
The thickened part between the anal and vaginal openings.

A smooth membrane lining the walls of the abdominal and pelvic cavities and enclosing the organs.

Persistent ectopic pregnancy:
Continued growth of living trophoblastic tissue after conservative treatment (methotrexate or salpingostomy) of an unruptured ectopic pregnancy; manifestations include ß-hCG titers that do not decline and/or pelvic pain.

A silicone device that is placed in the vagina to provide support.

Pituitary Gland:
The master gland; the gland that is stimulated by the hypothalamus and controls all hormonal functions. Located at the base of the brain just below the hypothalamus, this gland controls many major hormonal factories throughout the body including the gonads, the adrenal glands, and the thyroid gland.

The embryonic tissue that invades the uterine wall and provides a mechanism for exchanging the baby's waste products for the mother's nutrients and oxygen. The baby is connected to the placenta by the umbilical cord.

Placenta accreta:
Stuck placenta resultant from placental tissue growing into the uterine wall.

Placenta previa:
Blocking placenta. The placenta lies over the internal cervix covering the passage the baby needs to take to be born.

Polar Body:
The discarded genetic material resulting from female germ cell division. See also Meiosis.

Polycystic Ovaries (PCO or "Stein-Leventhal Syndrome"):
A condition found in women who don't ovulate, characterized by excessive production of androgens (male sex hormones) and the presence of cysts in the ovaries. Though PCO can be without symptoms, some include excessive weight gain, acne and excessive hair growth.

Post Coital Test (PCT):
A microscopic examination of the cervical mucus best performed twelve or more hours after intercourse to determine compatibility between the woman's mucus and the man's semen; a test used to detect sperm-mucus interaction problems, the presence of sperm antibodies, and the quality of the cervical mucus.

Bottom or lower.

After delivery. This period lasts until six weeks after delivery.

Posttesticular System:
The ducts that store and deliver the sperm to the opening of the penis; also includes the glands that produce seminal fluids.

The fertilised egg that is produced outside the uterus during IVF.

Premature Ejaculation:
A condition in which the man becomes so sexually excited that most of the time he ejaculates prior to penetrating the woman's vagina.

Premature Menopause
Menopause that occurs naturally before the age of 40. Also known as primary ovarian failure.

Premature Ovarian Failure:
A condition where the ovary runs out of follicles before the normal age associated with menopause.

Pretesticular System:
The male hormonal system responsible for stimulating sperm production and the development of male secondary sex characteristics.

Occurrence of a disorder in the general population.

Primary Infertility: 
Infertility in a woman who has never had a pregnancy. 

The hormone produced by the corpus luteum during the second half of a woman's cycle. It thickens the lining of the uterus to prepare it to accept implantation of a fertilized egg.

Progesterone Withdrawal:
A diagnostic procedure used to analyze menstrual irregularity and amenorrhea; uterine "bleeding" that occurs within two weeks after taking progesterone; a procedure used to demonstrate the presence or absence of estrogen and to demonstrate the ability of the uterus and reproductive tract to "bleed." Prior to ovulation induction therapy, progesterone withdrawal may be used to induce a menstrual period.

Prediction of most likely future outcome.

The hormone that stimulates the production of milk in breastfeeding women. Excessive prolactin levels when not breastfeeding may result in infertility.

Falling out of, falling down, or dropping, bulging.

A hormone secreted by the uterine lining. It is hypothesized that prostaglandins secreted by active, young endometrial implants may interfere with the reproductive organs by causing muscular contractions or spasms.

Prostate Gland:
A gland in the male reproductive system that produces a portion of the semen including a chemical that liquefies the coagulated semen twenty minutes to go one hour after entering the vagina.

The science that deals with the analysis of proteins (presence, activity, function, dysfunction) in body tissues and fluids with respect to specific diseases

A chronic skin disease characterized by reddish patches covered with silvery scales, occurring mostly on the knees, elbows, scalp, and trunk.

The time of life when the body begins making adult levels of sex hormones - (estrogen or testosterone) and the youngster takes on adult body characteristics: developing breasts, growing a beard, pubic hair, and auxiliary hair; attaining sexual maturity.


Recurrent Miscarriage
Three or more miscarriages. Also know as recurrent pregnancy loss.

Prolapse of the rectum into the vagina. This can be seen as a bulge from the lower wall of the vagina.

Recto-vaginal septum: That fascial layer which separates the vagina from the rectum.

Rectus muscle: Longitudinal abdominal muscles. These are the midline muscles leading to the well recognized dimpling in well built bodybuilders.

Rectus sheath: The fascial sheath surrounding the rectus muscles.

Refractory Period:
A period of time after orgasm during which a man or woman cannot have another; a recovery period.

Reproductive Endocrinologist (RE)
A sub-specialist doctor who is dedicated to the treatment of infertility. An RE has gone through advanced training to understand female hormones, the causes of infertility, and the latest infertility treatments. An RE is capable of handling very complex infertility cases.

Resistant Ovary:
An ovary that cannot respond to the follicle-stimulating message sent by FSH. Primitive germ cells will be present in the ovary; however, they will not respond to FSH stimulation.

Retrograde Ejaculation:
A male fertility problem that allows the sperm to travel into the bladder instead of out the opening of the penis due to a failure in the sphincter muscle at the base of the bladder.

Ringer's lactate solution:
A physiologic salt solution for replacing body fluid loss in the absence of gross abnormalities of concentration and composition (this fluid has minimal effects on normal body fluid composition and pH); this solution contains 130 mEq of sodium, 4 mEq of potassium and 2.7mEq of calcium, balanced by 109 mEq of chloride and 28 mEq of lactate.

Ruptured ectopic pregnancy:
Ectopic pregnancy that has eroded or torn through the tissue in which it has implanted, producing hemorrhage (bleeding) from exposed vessels.


Sacrospinous ligament:
Ligament attaching the ischial spine to the sacrum.

Surgical removal of the fallopian tube.

Inflammation (a tissue reaction to irritation, injury or infection, marked by localized warmth, swelling, redness and pain) of the Fallopian tube.

Surgery performed to remove adhesions that restrict the movement and function of reproductive organs.

Surgical repair made to the fallopian tubes; a procedure used to open the fimbria.

The bag of skin and thin muscle surrounding the man's testicles.

Secondary Infertility:
The inability of a couple which has successfully achieved pregnancy to achieve another. This strict medical definition includes couples for whom the pregnancy did not go to term. The common vernacular, however, refers to a couple which has one biological child but is unable to conceive another.

Second stage:
That stage of labor where the cervix has fully opened up.

Secondary Sex Characteristics:
The physical qualities that distinguish man and woman, such as beard, large breasts, and deep voice. Formed under the stimulation of the sex hormones (testosterone or estrogen), these characteristics also identify those people who have gone through puberty (sexual maturity).

The fluid portion of the ejaculate consisting of secretions from the seminal vesicles, prostate gland, and several other glands in the male reproductive tract. The semen provides nourishment and protection for the sperm and a medium in which the sperm can travel to the woman's vagina. Semen may also refer to the entire ejaculate, including the sperm.

Semen Analysis:
A laboratory test used to assess semen quality: sperm quantity, concentration, morphology (form), and motility. In addition, it measures semen (fluid) volume and whether or not white blood cells are present, indicating an infection.

Semen Viscosity:
The liquid flow or consistency of the semen.

Seminal Vesicles:
Glands in the male reproductive system which produce much of the semen volume, including fructose (sugar) for nourishing the sperm and a chemical that causes the semen to coagulate on entering the vagina.

Seminiferous Tubes:
The testicular tubules in which the sperm mature and move toward the epididymis.

Septate uterus:
A uterus divided into right and left halves by a wall of tissue (septum). Women with a septate uterus have an increased chance of early pregnancy loss.

Brand name for clomiphene citrate. (See CLOMID.)

Sertoli (Nurse) Cell:
A testicular cell responsible for nurturing the spermatids (immature sperm). Secretes inhibin, a feedback hormone, which regulates FSH production by the pituitary gland. When stimulated by FSH, the Sertoli cell initiates spermatogenesis.

Sexually transmitted infection (STI): 
An infection that is spread by sexual contact. Also called a sexually transmitted disease (STD).

Sheehan's Syndrome:
A condition caused by profuse hemorrhage at the time of delivery. The severe blood loss shocks the pituitary gland, which dies and becomes nonfunctional.

Short Luted Phase:
A condition in which the corpus luteum deteriorates prematurely, causing the menstrual period to begin approximately ten days (instead of fourteen) after ovulation. Frequently found with women undergoing ovulation induction treatment.

Sonogram (Ultrasound):
Use of high-frequency sound waves for creating an image of internal body parts. Used to detect and count follicle growth (and disappearance) in many fertility treatments. Also used to detect and monitor pregnancy.

The microscopic cell that carries the male's genetic information to the female's egg; the male reproductive cell; the male gamete.

Sperm Agglutination:
Sperm clumping caused by antibody reactions or by infection.

Sperm Antibodies:
Antibodies that attack and maim sperm. May be formed by either the man against his own sperm or by the woman against her husband's sperm.

Sperm Bank:
A place where sperm are kept frozen in liquid nitrogen for later use in artificial insemination.

Sperm cells: 
The male sex cells (spermatozoa), which are produced in the testes. 

Sperm Count:
The number of sperm in ejaculate. Also called sperm concentration and given as the number of sperm per milliliter.

Sperm Maturation:
A process during which the sperm grow and gain their ability to swim. Sperm take about ninety days to reach maturity.

Sperm Morphology:
A semen analysis factor that indicates the number or percentage of sperm in the sample that appear to have been formed normally. Abnormal morphology includes sperm with kinked, doubled, or coiled tails.

Sperm Motility:
The ability of sperm to swim. Poor motility means the sperm have a difficult time swimming toward their goal---the egg.

Sperm Penetration:
The ability of the sperm to penetrate the egg so it can deposit the genetic material during fertilization.

Sperm washing: 
A procedure used to remove components other than sperm from a semen sample prior to being used for intrauterine insemination. 

Sperm production in the testicles.

Circular muscle which closes off a hollow organ during contraction.

Spinal anesthetic:
The anesthetic solution is injected into the spinal canal immediately surrounding the spinal column. No catheter is used and the needle used is thus thinner. Spinals cannot be “topped up”.

Spinal fluid:
Fluid surrounding the spinal column and brain.

The stretchability of cervical mucus; the stringy quality that occurs at midcycle under the influence of estrogen. See also Postcoital Test.

Split Ejaculate:
A method used to concentrate the sperm for insemination; separating the semen into two portions: the first portion of the ejaculate, which is rich in sperm, and the second portion, which contains mostly seminal fluid.

Spontaneous Abortion:
See Abortion, Spontaneous.

Stein-Leventhal Disease:
Another name for polycystic ovaries.

An irreversible condition that prevents conception.

The death of a fetus between the twentieth week of gestation and birth.

Subcutaneous Injection
A shot that is inserted under the skin. Some IVF drugs are administered in this manner. Sites chosen include the upper thigh, abdomen, or upper arm.

Stimulation of multiple ovulation with fertility drugs; also known as controlled ovarian hyperstimulation (COH).

Surrogate Mother:
A woman who is artificially inseminated and carries to term a baby which will be raised by its genetic father and his partner.


Two small organs that are located at the base of the male's penis and in which sperm are produced. 

Testicular Biopsy:
A minor surgical procedure used to take a small sample of testicular tissue for microscopic examination; a test used to diagnose male fertility problems when no other means is available (this is because the biopsy procedure itself may cause testicular damage).

Testicular Biopsy:
A minor surgical procedure used to take a small sample of testicular tissue for microscopic examination; a test used to diagnose male fertility problems when no other means is available (this is because the biopsy procedure itself may cause testicular damage).

Testicular Enzyme Defect:
A congenital enzyme defect that prevents the testes from responding to hormonal stimulation. Will result in oligospermia or azozoospermia.

Testicular Failure, Primary:
A congenital, developmental, or genetic error resulting in a testicular malformation that prevents sperm production.

Testicular Failure, Secondary:
Acquired testicular damage - for example, from drugs, prolonged exposure to toxic substances, or a varicocoele.

Testicular Feminization:
An enzymatic defect that prevents a man from responding to the male hormone testosterone. The man will look like a woman, but karyotyping will reveal a normal XY male chromosome pattern, and testosterone levels will be in the normal male range.

Testicular Function:
The ability of the testicles to produce sperm and testosterone.

Testicular Stress Pattern:
A semen analysis result showing depressed sperm production, poor sperm motility, and poor sperm morphology. The pattern is consistent with secondary testicular failure or illness.

The male hormone responsible for the formation of secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for spermatogenesis.

Blood clotting and migration of clots to plug distant blood vessels.

Thyroid Conditions
Any condition in which the thyroid is not functioning properly, such as underactive or overactive thyroid. Some thyroid conditions may have an impact on fertility.

Thyroid Gland:
The endocrine gland in the front of the neck that produces thyroid hormones to regulate the body's metabolism.

A molecule that is important in inflammation. TNF binding protein blocks the activity of TNF and selectively inhibits inflammation.

The twisting of the testis inside the scrotum. Besides causing extreme pain and swelling, the rotation twists off the blood supply and causes severe damage to the testicle. Torsion of the ovary may also occur in a woman suffering from hyperstimulation, a complication of ovulation induction treatment.

Transvaginal ultrasonography:
Ultrasonography which sends into the pelvic cavity and receives ultrasonic waves through the vagina by using probe placed inside the vagina.

An infection that may produce a greenish, bad-smelling vaginal discharge.

One-third of the length of a pregnancy (3 months).

Trophoblastic tissue:
The layer of cells outside the embryo that enters into the formation of the placenta.

Tubal abortion:
Tubal pregnancy (ectopic pregnancy in the Fallopian tube) that has extruded out of the fimbrial end of the oviduct.

Tubal Ligation: 
A type of female sterilization in which the fallopian tubes are cut, clipped, or tied in order to prevent pregnancy. 

Tubocornual Anastomosis:
Surgery performed to remove a blocked portion of the fallopian tube and to reconnect the tube to the uterus. Tubouterine implantation may also be performed to remove fallopian tube blockage near the uterus and reimplant the tube in the uterus.

Tubotubal Anastomosis:
Surgery performed to remove a diseased portion of the fallopian tube and reconnect the two ends; sterilization reversal.

Turner's Syndrome:
The most common genetic defect contributing to female fertility problems. The ovaries fail to form and appear as slender threads of atrophic ovarian tissue, referred to as streak ovaries. Karyotyping will reveal that this woman has only one female (X) chromosome instead of two.


A test used instead of X rays to visualize the reproductive organs; for example, to monitor follicular development and to examine the tubes and uterus. The instrument works by bouncing sound waves off the organs. A picture displayed on a TV screen shows the internal organs.

The delineation of deep bodily structures by sending ultrasonic waves (sound waves of frequency higher than the range audible to the human ear, i.e. above 20,000 cycles per second) toward an organ or mass, which in turn bounces back (echoes); the patterns produces are graphically displayed on a fluorescent screen for interpretation.

Umbilical Cord:
Two arteries and one vein encased in a gelatinous tube leading from the baby to the placenta. Used to exchange nutrients and oxygen from the mother for waste products from the baby.

Undescended Testicles (Cryptorchidism):
The failure of the testicles to descend from the abdominal cavity into the scrotum by one year of age. If not repaired by age six, may result in permanent fertility loss.

Unexplained Infertility: 
Infertility for which the cause cannot be determined with currently available diagnostic techniques. 

Unicornuate Uterus:
An abnormality in which the uterus is "one sided" and smaller than usual.

Ureaplasma (Mycoplasma):
An infection that may cause the formation of sperm antibodies and an inflammation of the uterine lining, either of which may interfere with implantation of the embryo.

The muscular tubes carrying urine from kidneys to bladder.

The tube that allows urine to pass between the bladder and the outside of the body. In the man this tube also carries semen from the area of the prostate to the outside.

Uterine fibroids: 
Abnormal, benign (noncancerous) growths of muscle within the wall of a woman’s uterus.

Uterine polyps: 
Abnormal, benign (noncancerous) growths attached to a short stalk that protrudes from the inner surface of a woman's uterus. 

The tubular structure between bladder and the outside.

Urgency incontinence:
Urinary incontinence related to bladder muscle contractions which occur involuntarily and in the setting of an inability to suppress those contractions.

Urinary obstruction:
Inability to void.

Urodynamic assessment:
Dynamic testing of the urological system whereby pressure differentials are measured.

A physician specializing in the genitourinary tract.

Uterosacral ligaments:
Ligaments attaching the lower part of the uterus to the sacral bone. One of the main supports of the uterus and upper vagina.

The hollow, muscular organ that houses and nourishes the fetus during pregnancy.


Vacuum extraction:
Delivery accomplished by the obstetrical vacuum.

The canal leading from the cervix to the outside of the woman's body; the birth passage.

Painful spasm of pelvic floor muscles on vaginal entry, such as sexual intercourse.

Yeast, bacterial vaginosis, or trichomonas infections of the vagina. Frequent vaginitis may indicate the presence of pelvic adhesions and tubal blockage from other infections, such as chlamydia. Vaginitis may interfere with sperm penetration of the cervical mucus, and the symptoms may even interfere with the ability and desire to have intercourse.

A dilation of the veins that carry blood out of the scrotum. The resulting swollen vessels surrounding the testicles create a pool of stagnant blood, which elevates the scrotal temperature. A major cause of male infertility.

Vas Deferens:
One of the tubes through which the sperm move from the testicles (epididymis) toward the seminal vesicles and prostate gland. These tubes are severed during a vasectomy performed for birth control.

The accidental or elective surgical separation of the vasa deferential a procedure used for birth control.

VBAC: Vaginal birth after previous caesarian.

Venereal Disease:
Any infection that can be sexually transmitted, such as chlamydia, gonorrhea, ureaplasma, and syphilis. Many of these diseases will interfere with fertility and some will cause severe illness. See also PID.

Masculinization; having male secondary sex characteristics; being able to perform sexually.

Voluntary control:
Conscious control.

Painful vulva, also sometimes associated with urinary symptoms, painful intercourse and generalized pelvic pain.


X Chromosome:
The congenital, developmental, or genetic information in the cell that transmits the information necessary to make a female. All eggs contain one X chromosome, and half of all sperm carry an X chromosome. When two X chromosomes combine, the baby will be a girl. See also Y. Chromosome.


Y Chromosome:
The genetic material that transmits the information necessary to make a male. The Y chromosome can be found in one-half of the man's sperm cells. When an X and a Y chromosome combine, the baby will be a boy. See also X Chromosome.


Zona pellucida: 
The outer protein coat (shell) of an ovum, which must be penetrated by a sperm cell for fertilization to take place. 

A fertilized egg which has not yet divided.

Zygote Intrafallopian Transfer (ZIFT):
An ART in which eggs are removed from a woman's ovaries, fertilized with the man's sperm in a lab dish, and the resulting embryos are transferred into the woman's fallopian tubes during a minor surgical procedure.

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