Conditions, Treatments, Tests, & Other Terms About Infertility
Abstinence
Refraining from sexual stimulation to the point of ejaculation.
Acrosome
A compartment at the tip of the sperm head containing enzymes which will breakdown the protective outer layer of the egg. The process of releasing these enzymes so the sperm can potentially fertilize the egg is called the acrosome reaction.
Anti-Sperm Antibodies
Antibodies specific to a male’s sperm produced by the female or male partner. These antibodies can lead to destruction of the sperm and reduced fertility.
Artificial Insemination (AI)
When artificial insemination is used the female partner determines when she will be ovulating and a semen sample is prepared. The physician or nurse performing the insemination uses a small catheter that is inserted into the uterus and deposits the prepared sperm. Advantages to this procedure are a relatively low cost ($200 400 per attempt) and minimal invasiveness.
Artificial Insemination Donor (AID)
AI using donor sperm.
Assisted Reproductive Technology (ART)
Advanced procedures used to assist in achieving pregnancy. Includes procedures such a as IVF, GIFT, and ZIFT.
Azoospermia
The absence of sperm in the semen. May be caused by the failure of sperm production.
Capacitation
A series of biochemical events that sperm undergo while traveling through the female reproductive tract. Sperm capacitation allows the sperm to acrosome react. Capacitation is necessary in order for a sperm to fertilize the egg.
Cervix
The opening to the uterus from the vagina.
Conception
The onset of pregnancy, usually marked by the implantation of an embryo into the uterine lining.
Cryopreservation
The process of preserving embryos, sperm or oocytes (eggs) by freezing.
Donor Sperm
Sperm from a man who is not a woman’s partner for the purpose of producing pregnancy.
Ejaculation
A sudden discharging of a fluid, such as semen, from a duct.
Fertilization
The combining of an egg and a sperm to create a new individual.
The Hamster Egg Penetration Test (HEPT)
See “Sperm Penetration Assayâ€
Hypo-Osmolarity test (HOS)
A diagnostic test included in a Semen Analysis which yields information about the functional integrity of the sperm membrane. Used in conjunction with the sperm viability, sperm motility and sperm agglutination results, it can predict the possible clinical presence of anti-sperm antibodies.
Implantation
The process of attachment of the embryo to the endometrial lining of the uterine wall.
Infertility
The inability of a couple to achieve conception after one year of unprotected intercourse or the inability to carry direct pregnancy to live birth. More commonly known as subfertility.
Intracytoplasmic Sperm Injection (ICSI)
Micromanipulation used in connection with IVF allows a single sperm cell to be injected directly into an egg. When the sperm count is extremely low or of poor quality, or if the sperm must be taken from the epididymis or testicle, this technique can be very useful. It has broadened the use of IVF, especially to men who, only a short time ago, had little or no chance of contributing biologically to a pregnancy. The pregnancy rates with this ICSI are about the same as conventional IVF.
In Vitro Fertilization (IVF)
If there is known female factor infertility, or sperm are not available in sufficient quantity or quality, IVF can be another option. This procedure requires that the female, working with a specialist, be administered a hormone which promotes multiple egg maturation. Estrogen levels and ultrasound readings measure the growth of the eggs and when the eggs are sufficiently mature , they are are obtained by ultrasound-directed aspiration.
The eggs are fertilized in the laboratory. The resulting embryos are then monitored until the day of retrieval (typically between three and five days). The highest quality embryos are placed into the uterus with a small plastic catheter. Advantages to this procedure include a much higher pregnancy rate and the ability to use semen samples with a very low concentration or poor motility. Disadvantages include high costs (in the range of $12,000 – 15,000) and numerous visits to the clinic. Pregnancy rates currently range from 50-70% and can further be discussed by the physician
Lubricant
A substance, such as an oil or lotion, capable of reducing friction when introduced as a film between solid surfaces. The use of certain lubricants can be damaging to semen quality and so should not be used during semen collection.
Luteinizing Hormone
A hormone produced by the pituitary, which acts upon the ovaries to prompt ovulation. About 36 hours before ovulation, the level of LH will greatly increase in the blood and subsequently the urine. This increase in LH is the "LH surge" and may be detected by testing the urine.
Male Factor Infertility
Infertility caused by semen or sperm abnormalities. This may include the production of insufficient numbers of sperm, insufficient sperm motility or sperm with abnormal morphological characteristics.
Masturbation
Self-manipulation of the genitalia commonly resulting in orgasm which is achieved exclusive of intercourse or fellatio.
Ovulation
The discharge of a secondary oocyte (egg) from the ovary. Ovulation usually occurs approximately 14 days prior to the end of the reproductive cycle.
Preimplantation Genetic Diagnosis (PGD)
PGD screens embryos for a specific gene defect that causes a particular disorder. The disorders include: Cystic fibrosis, Hunter Syndrome, X-linked lymphoproliferative disorder, spinal muscular ratrophy, Huntington’s chorea, hemophilia, thalassemia, epidermolysis bullosa, and Duchene muscular dystrophy. This approach uses IVF technology to obtain eggs from the mother, which are then fertilized in the laboratory with sperm from the father. A few days after fertilization, a cell is removed from a developing embryo to test for genetic disorders. Embryos without genetic defects are then implanted into the uterus. PGD costs from $1,000- $5,000, depending on the gene defect, while IVF costs about $12,000. Most couples spend approximately $18,000 for both procedures.
Prostate Gland
A gland found at the base of the male urethra that secretes nutrients and buffers in an alkaline fluid and is a major constituent of the ejaculatory fluid.
Semen
Composition of sperm and seminal fluid released from the male urethra during ejaculation.
Semen Analysis
The most economical method of evaluating male fertility. It is usually the first evaluation for the male investigating infertility with his partner. The major parameters of the semen analysis include the sperm concentration, progressively motile sperm count, and sperm morphology.
Reproductive Endocrinology & Infertility Specialist (REI)
A reproductive endocrinology and infertility specialist is an obstetrician-gynecologist physician who has additional training and experience specializing in the study and treatment of female reproductive hormones and infertility. The Andrology Lab works closely with the REI Specialists at the Utah Center for Reproductive Medicine (UCRM).
Sperm Motility
The percentage of all moving sperm in a semen sample. Provides information on the ability of the sperm to reach the site of fertilization and may be indicative of fertility problems.
Sperm Penetration Assay (SPA)
(Also know as the Hamster Egg Penetration Test (HEPT)) is the most accurate test in predicting fertilizing ability, and can also predict the ability of laboratory techniques to improve sperm fertilizing ability. The sperm samples are evaluated in much the same manner as with in vitro fertilization (IVF), except that the eggs (chemically treated to allow normal human sperm to penetrate them) are obtained from a hamster. The test is designed to see if functionally competent the human sperm can complete the first steps of fertilization including the penetration of the egg (nothing happens beyond this point). When test results are compared; if less than 50% of the eggs are penetrated in the non-stimulated sperm, there is a correlation of the decreased ability to fertilize. A score higher than 50% indicates that the sperm should have the ability to fertilize.
Sterile
Free from living organisms and especially microorganisms. It is also a term given to a male who has no possibility of achieving fertilization via ejaculation.
Testicles
Male sex glands which produce spermatozoa (mature sperm) and the male hormone testosterone.
Utah Center for Reproductive Medicine (UCRM)
The Andrology clinical laboratory also provides services for patients of the Utah Center for Reproductive Medicine (UCRM), which is located adjacent to the Andrology and IVF Laboratory. The UCRM is part of the Department of Obstetrics and Gynecology. The REI Specialists provide assisted reproduction techniques for female infertility patients. The Andrology Lab provides diagnostic work-up for the male partner as well as preparing fresh semen samples and/or cryopreserved back-up samples and embryology services for Artificial Insemination, IVF, ICSI, or PGD.
Uterus
A muscular organ in the female where the fertilized egg implants and the subsequent embryo and fetus develops. The lining of the uterus (endometrium) provides nutrients for the developing baby. The cavity opens through the cervix and into the vagina. The fallopian tubes extend from the top of the uterus and lead to the ovaries.
Vagina
The female organ of sexual intercourse, where the sperm are deposited. It also serves as the birth canal.
Vas Deferens
A thick-walled tube that begins at and is continuous with the tail of the epididymis within the testis and eventually joins the duct of the seminal vesicle to form the ejaculatory duct. They transports sperm from the epididymis to the urethra.
Zona Hatching (Assisted Hatching)
The Zona Pellucida is a membrane or outer shell that the embryo must hatch out of before implantation. In some women, particularly those over 37, this membrane may become hard or too thick and difficult to hatch out of. During in vitro fertilization this shell may be measured and if it is too thick, a small hole may be drilled in the outer membrane to make implantation more probable.
