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Published by Tibb-e-Islami Dawakhana (r) for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee. Copyright of Tibb-e-Islami Dawakhana (r).

Chief Executive & Physician

Professor Hakim Dilshad Hussain Tabassum

Abdominal pregnancy. An ectopic (extrauterine pregnancy) pregnancy that has implanted on structures in the abdomen other than the uterus, fallopian tubes, or ovaries. It usually implants on tissue in the abdomen known as the omentum.

Acquired immunodeficiency syndrome (AIDS). A condition caused by the HIV virus that impairs the body’s immune system and leads to severe infections and eventually death.

Acrosome. An enzyme-filled cap on the sperm head which releases acrosomal enzymes necessary to penetrate the egg’s outer covering.

Adhesions. Bands of fibrous scar tissue that bind pelvic organs together.

Adrenal glands. A pair of endocrine organs located above the kidneys that produce hormones.

Adrenal hyperplasia. An abnormal or unusual increase in the production of androgens by the adrenal glands. This disorder is the result of a genetic problem.

Amenorrhea. Absence of menstrual cycles.

Amniocentesis. A procedure in which a small amount of amniotic fluid is removed through a needle from the fetal sac at about 16 weeks into a pregnancy. The fluid is studied for chromosomal abnormalities which may affect fetal development.

ACTH (adrenalcorticoid hormone). A protein hormone produced by the pituitary gland that stimulates the adrenal gland to produce hormones.

Androgens. The “male” hormones responsible for encouraging masculine characteristics.

Anticardiolipids. A type of antibody or immunoglobulin that affects the blood clotting system and may be associated with repeated miscarriage.

Antisperm antibodies. Immune or protective proteins (immunoglobulins) which attack and destroy the sperm because they recognize it as a foreign substance. Antisperm antibodies may be present in the male in blood or sperm or in the female in blood or cervical mucus.

Anovulation. Failure or absence of ovulation.

Appendicitis. A condition where the appendix (a tubular structure attached to the large colon) becomes infected and inflamed and can be associated with the formation of adhesions in the proximity of the fallopian tube.

Assay. A medical term meaning “test.”

Assisted reproductive technologies (ART). All treatments which include laboratory handling of eggs, sperm, and/or embryos. Some examples of ART are in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), pronuclear stage tubal transfer (PROST), tubal embryo transfer (TET), and zygote intrafallopian transfer (ZIFT).

Autoimmune. A condition in which the body’s immune system attacks its own tissues, falsely recognizing them as foreign.

Azoospermia. The complete absence of sperm in the semen.

Basal body temperature (BBT). The body temperature at rest. It is taken orally each morning immediately upon awakening and recorded on a BBT chart. The readings are studied to help identify ovulation, usually occurring near the time of the rise in BBT.

Biopsy. The removal of a small tissue sample for microscopic examination.

Cerclage. Placement of a non-absorbable suture around an incompetent (weak) cervical opening in an attempt to keep it closed and thus prevent miscarriage. Also known as a cervical stitch.

Cervical canal. The passageway leading from the vagina into the uterus.

Cervical mucus. The substance in the cervix through which sperm must swim in order to enter the uterus.

Cervix. The narrow, lower part of the uterus that opens into the vagina. The cervical canal runs through the cervix and connects the vagina with the uterine cavity. The cervix produces mucus which sperm must swim through before entering the uterine cavity and then the fallopian tubes.

Chlamydia. A sexually transmitted disease that is a common cause of pelvic infections and subsequent tubal damage.

Chorionic villus sampling. A procedure in which a small sample of cells is taken from the placenta early in a pregnancy for chromosomal testing.

Chromosomes. Rod-shaped structures located in the nucleus of a cell which contain hereditary (genetic) material. Humans have 23 pairs of chromosomes (46 total). Two of the 46 are the sex chromosomes, which are the X and Y chromosomes. Normally, females have two X chromosomes and males have one X and one Y chromosome.

Congenital. Refers to certain physical traits, diseases, or malformations existing at birth (birth defects). May either be hereditary or due to an influence occurring during pregnancy.

Controlled superovulation. The administration of (ovulation drugs) that stimulate the ovaries to produce multiple eggs: also called enhanced follicular recruitment or controlled ovarian hyperstimulation.

Corneu. The area where the tube joins the uterine cavity.

Corpus luteum. A mass of yellow tissue formed in the ovary from a ruptured follicle that has released an egg. The corpus luteum secretes progesterone, a hormone that prepares the lining of the uterus (endometrium) to support a pregnancy.

Cryopreservation. Freezing sperm or embryos to store them for future use. At present, eggs cannot be cryopreserved because freezing damages them.

DES. A synthetic hormone given in part during pregnancy to prevent miscarriage. Children from treated pregnancies can have abnormalities of the reproductive system, including an increased risk of ectopic pregnancy.

Dexamethasone. A synthetic drug often used to treat an overactive adrenal gland. Decadron is a brand name.

Diagnostic laparoscopy. The insertion of a long, thin, lighted telescope-like instrument called a laparoscope into the abdomen to look for abnormalities of the internal pelvic organs.

Dilation and curettage (D&C). An outpatient surgical procedure during which the cervix is dilated and the lining of the uterus is scraped out. The tissue is often used for microscopic examination for the presence of abnormality or pregnancy tissue.

Distal tubal blockage. Blockage at the end of the fallopian tube farthest away (distal) from where it joins the uterus and near where it meets the ovary.

Donor egg. The eggs taken from the ovaries of a fertile woman and donated to an infertile woman to be used in an assisted reproductive technology procedure using IVF or GIFT.

Donor embryo transfer. The transfer of an embryo derived from the egg of a volunteer donor to an infertile recipient.

Down Syndrome. A genetic disorder caused by the presence of an extra chromosome 21 and characterized by mental retardation, abnormal facial features, and medical problems such as heart defects.

Early menopause. Also called premature ovarian failure. Cessation of menstrual periods due to failure of the ovaries before age 40. The average age of menopause in the United States is 51.

Ectopic pregnancy. A pregnancy which occurs outside the uterus, most commonly in the fallopian tube.

Efferent ducts. Tubular structures which conduct sperm from the seminiferous tubules in each testis to the epididymis.

Egg aspiration. Part of the in vitro fertilization (IVF) procedure in which eggs (oocytes) are collected from the ovaries by a fine needle inserted through the top of the vagina using ultrasound guidance. Also known as oocyte retrieval.

Egg donation. The process of fertilizing eggs from a donor with the male partner’s sperm in a laboratory dish and transferring the resulting embryos to the female partner’s uterus. The female partner will not be biologically related to the child but will be the birth mother on record. The male partner will be biologically related to the child.

Ejaculatory duct. A duct formed by the joining of the seminal vesicles with the vas deferens, through which semen is propelled at the time of ejaculation.

Electrosurgical instrument. A surgical instrument using electric current to burn, cut, and eliminate unwanted tissue.

Embryo. The earliest stage of human development arising after the union of the sperm and egg (fertilization).

Embryo transfer. Part of the in vitro fertilization (IVF) procedure in which the embryo(s) (which were fertilized in the laboratory) are transferred into the woman’s uterus through her vagina and cervix.

Empirical therapy. When medications or other treatments reportedly work for some patients, but are unproven to work consistently in large research studies. Empirical therapy is tried without proven effects.

Endometriomas. Blood-filled cysts that can occur when endometrial tissue develops in the ovary.

Endometrial biopsy. The extraction of a small piece of tissue from the endometrium (lining of the uterus) for microscopic examination. The results indicate whether or not the endometrium is at the appropriate stage for successful implantation of a fertilized egg.

Endometriosis. A condition when endometrial tissue, which normally lines the uterus, develops outside of the uterine cavity in abnormal locations such as the ovaries, fallopian tubes, and abdominal cavity. Endometriosis can grow with hormonal stimulation and cause pain, inflammation, and scar tissue. It may also be associated with infertility.

Endometrium. The lining of the uterus that is shed each month as the menstrual period. As the monthly cycle progresses, the endometrium thickens and thus provides a nourishing site for the implantation of a fertilized egg.

Epididymis. A tightly coiled system of tiny tubing where sperm collect after leaving the testis. Sperm continue to mature as they are pushed through the epididymis, which covers the top and back sides of each testis.

Estradiol. The predominant estrogen (hormone) produced by the follicular cells of the ovary.

Estrogen. The female sex hormones produced by the ovaries which are responsible for the development of female sex characteristics. Estrogens are largely responsible for stimulating the uterine lining to thicken during the first half of the menstrual cycle in preparation for ovulation and possible pregnancy. They are also important for healthy bones and overall health. A small amount of these hormones are also produced in the male when testosterone is converted to estrogen in fat cells.

Fallopian tubes. A pair of tubes attached to each side of the uterus. In normal conception, the sperm and egg meet and fertilization occurs inside the tube.

Fertilization. The fusion of sperm and egg.

Fimbria. The flared end (fingers) of the fallopian tube that sweeps over the surface of the ovary and helps to direct the egg into the tube.

Follicles. Fluid-filled sacs located just beneath the ovary’s surface which contains the eggs (oocytes).

Follicle stimulating hormone (FSH). In women, FSH is the pituitary hormone responsible for stimulating follicular cells in the ovary to grow, triggering egg development and production of the female hormone estrogen. In the male, FSH is the pituitary hormone that travels through the bloodstream to the testes and helps stimulate them to manufacture sperm.

Fructose. A sugar which is made in the seminal vesicles. The presence or absence of fructose in the semen may indicate the location of a blockage in the duct system.

Galactorrhea. Milk production by the breasts of a woman who is not nursing: caused by elevated levels of the pituitary hormone prolactin.

Gamete intrafallopian transfer (GIFT). An assisted reproductive technology that involves surgically removing eggs from a woman’s ovary, combining them with sperm, and immediately injecting the eggs/sperm mixture into the fallopian tube. Fertilization then hopefully takes place inside the fallopian tube. One disadvantage of GIFT is the inability to know whether or not fertilization took place if the woman does not become pregnant.

Gestational carrier. A woman who carries an embryo to delivery. The embryo is derived from the egg and sperm of persons not related to the carrier; therefore the carrier has no genetic relationship with the resulting child.

Gonorrhea. A sexually transmitted disease caused by the gonococcus bacteria that can cause pelvic infections, scar tissue, and subsequent tubal damage.

Hamster egg penetration test. A laboratory test that measures sperm/egg membrane fusion using zona-free hamster eggs and human sperm to test the capability of sperm to penetrate the egg during IVF.

Hepatitis B and C. Viruses that may be sexually transmitted, or transmitted by contact with blood and other bodily fluids, that can cause infection of the liver leading to jaundice and liver failure.

Human chorionic gonadotropin (hCG). A hormone that increases early in pregnancy. This hormone is produced by the placental tissue. Its detection is the basis of pregnancy tests. It can also be used as an LH substitute to trigger ovulation in conjunction with clomiphene or gonadotropin therapy. The U.S. trade names are A.P.L.â, Pregnylâ, and Profasâ.

Human immunodeficiency virus (HIV). A retrovirus that causes acquired immune deficiency syndrome (AIDS), a disease that destroys the body’s ability to protect itself from infection and disease. It is transmitted by the exchange of bodily fluids or blood transfusions.

Human menopausal gonadotropin (hMG). A fertility drug containing follicle stimulating hormone (FSH) and luteinizing hormone (LH). It is derived from the urine of postmenopausal women. The U.S. trade names are Pergonalâ, HumegonT, and RepronexT.

Hydrosalpinx. A blocked, dilated, fluid-filled fallopian tube.

Hypospadias. An abnormality in which the urethra opens on the underside of the penis. This condition may prevent the semen from being deposited into the female reproductive tract during intercourse.

Hypothalamus. A thumb-sized area in the base of the brain that controls many functions of the body, regulates the pituitary gland, and releases gonadotropin releasing hormone (GnRH).

Hysteroscopy. A diagnostic procedure in which a lighted scope (hysteroscope) is inserted through the cervix into the uterus to enable the physician to view the inside of the uterus

Hysterosalpingogram (HSG). An x-ray procedure in which a special media (a dye like solution) is injected through the cervix into the uterine cavity to illustrate the inner shape of the uterus and degree of openness (patency) of the fallopian tubes.

Immunoglobulins. Proteins having known antibody activity that are important components in the body’s immune system.

Implantation. The process whereby an embryo embeds in the uterine lining in order to obtain nutrition and oxygen. Sometimes an embryo will implant in areas other than the uterus, such as in a fallopian tube. This is known as an ectopic pregnancy.

Infertility workup. A series of evaluations and tests to determine the cause(s) of infertility.

Insemination. Placement of sperm via a syringe into a female’s uterus or cervix for the purpose of producing a pregnancy.

Interstitium. The area in the testes outside the seminiferous tubules which contains Leydig cells and other interstitial cells.

Intracervical insemination (ICI). The process of depositing a semen sample directly into the female’s cervix.

Intracytoplasmic sperm injection (ICSI). A micromanipulation technique that involves injecting a sperm directly into an egg in order to facilitate fertilization.

Intrauterine insemination (IUI). The process whereby a sperm preparation is injected directly into the uterine cavity in order to bypass the cervix and place the sperm closer to the egg. The sperm are usually washed first in order to remove chemicals that can irritate the uterine lining and to increase sperm motility and concentration.

In vitro fertilization (IVF). A method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo is transferred into the woman’s uterus where it will hopefully implant in the uterine lining and further develop. IVF may be performed in conjunction with medications that stimulate the ovaries to produce multiple eggs in order to increase the chances of successful fertilization and implantation. IVF bypasses the fallopian tubes and is often the treatment choice for women who have badly damaged or absent tubes.

Karyotype. A chromosomal analysis conducted on tissue or blood.

Libido. Sexual drive and desire.

Laparoscopy. The insertion of a long, thin, lighted, telescope-like instrument called a laparoscope into the abdomen through an incision usually in the navel to visually inspect the contents of the pelvic and abdominal cavities. Other small incisions may also be made and additional instruments inserted to facilitate diagnosis and allow surgical correction of abnormalities. The surgeon can sometimes remove scar tissue and open closed fallopian tubes during this procedure.

Laparotomy. Major abdominal surgery through an incision in the abdominal wall. This procedure necessitates a hospital stay of one to several days afterwards and bed rest for up to six weeks.

Leydig cells. The interstitial cells in the testes that produce the male hormone testosterone.

Liquifaction. The process by which semen turns from a jelly-like consistency to liquid.

Luteal phase defect. A condition present when the lining of the uterus does not mature properly in response to progesterone secretion by the ovary after ovulation.

Luteinizing hormone (LH). In women, the pituitary hormone that triggers ovulation and stimulates the corpus luteum of the ovary to secrete progesterone and androgens during the second half of the menstrual cycle. In the male, LH is the pituitary hormone which stimulates the testes to produce the male hormone testosterone.

Menopause. Natural cessation of ovarian function and menstruation. Menopause can occur between the ages of 42 and 56 but usually occurs around the age of 51, when the ovaries stop producing eggs and estrogen levels decline.

Methotrexate. A medication that destroys pregnancy-related tissue and hastens reabsorption of this tissue in a woman with an ectopic pregnancy.

Micromanipulation. A group of procedures in which the egg (oocyte) and sperm are manipulated to aid in fertilization.

Microsurgery. A type of surgery which uses magnification, meticulous technique, and fine suture material in order to get precise surgical results. Microsurgery is important for certain types of tubal surgery in the female, as well as for vasectomy reversal in the male.

Mittelschmertz. A pain in the lower abdomen that is associated with ovulation. It is usually related to the rupture of the follicle as the egg is released.

Miscarriage. The naturally occurring expulsion of a nonviable fetus and placenta from the uterus; also known as spontaneous abortion or pregnancy loss.

Motility. The percentage of all moving sperm in a semen sample. Normally 50 percent or more are moving rapidly.

Multifetal pregnancy reduction. Also known as selective reduction. A procedure to reduce the number of fetuses in the uterus. This procedure may be considered for women who are pregnant with multiple fetuses. As the risk of extreme premature delivery, miscarriage (spontaneous abortion), and other problems increases with the number of fetuses present, this procedure may be performed in an attempt to prevent the entire pregnancy from aborting.

Myasthenia gravis. A disorder of neuromuscular function characterized by muscular weakness and fatigue. It may affect any muscle of the body, but especially those of the eye, face, lips, tongue, throat, and neck.

Mycoplasma. A class of bacteria that may cause diseases that affect the reproductive system.

OIigomenorrhea. An abnormally infrequent or light menstrual flow.

Oocytes. Eggs; also called ova.

Operative laparoscopy. The insertion of a laparoscope into the abdomen through an incision in the navel to surgically correct abnormalities of the internal pelvic organs. The surgeon can sometimes cut and remove scar tissue and open closed fallopian tubes during this procedure.

Ovarian hyperstimulation syndrome (OHSS). A condition that may result from ovulation induction characterized by enlargement of the ovaries, fluid retention, and weight gain.

Ovaries. The paired female sex glands in the pelvis, located one on each side of the uterus. The ovaries produce eggs and hormones including estrogen, progesterone, and androgens.

Ovulation. The release of a mature egg from its follicle in the outer layer of the ovary. Ovulation usually occurs on day 14 or 15 of a 28-day cycle or 14 days prior to the first day of the next period.

Parathyroid. Any of four small kidney-shaped glands that lie in pairs near the thyroid gland and secrete parathyroid hormone, which is necessary for calcium and phosphorous metabolism.

Partial salpingectomy. An operation where the section of a fallopian tube containing an ectopic pregnancy is removed. This procedure attempts to preserve most of the tube for subsequent re-attachment using microsurgery in order to achieve future fertility.

Perinatologist. A maternal-fetal medicine specialist.

Peritoneum. The lining of the abdominal cavity.

Pituitary gland. A small hormone-producing gland just beneath the hypothalamus in the brain which controls the ovaries, thyroid, and adrenal glands. Ovarian function is controlled through the secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH). Disorders of this gland may lead to irregular or absent ovulation in the female and abnormal or absent sperm production in the male.

Platelets. Circulating blood components that aid in blood clotting and prevention of bleeding.

Pneumonia. Lung inflammation.

Polycystic ovarian syndrome (PCOS). A disorder in which the ovaries produce an excess amount of male hormones (androgens), and ovulation does not occur regularly. It is often associated with hirsutism, irregular menstrual cycles, infertility, and/or obesity.

Postcoital test (PCT). The microscopic analysis of a sample of cervical mucus, usually collected wilhin 18 hours after intercourse. This test determines the quality of cervical mucus and the ability of sperm to enter and penetrate the mucus.

Prednisone. A synthetic drug, similar to cortisol, often used to treat an overactive adrenal gland.

Premature ovarian failure (POF). Cessation of menstrual periods due to failure of the ovaries before age 40. Also known as early menopause.

Progesterone. A female hormone secreted by the corpus luteum after ovulation during the second half of the menstrual cycle (luteal phase). It prepares the lining of the uterus (endometrium) for implantation of a fertilized egg and allows for complete shedding of the endometrium at the time of menstruation. In the event of pregnancy, the progesterone level remains stable beginning a week or so after conception.

Prolactin. A protein hormone secreted by the pituitary gland into the blood. When elevated, it may lead to absence of menstrual periods and anovulation as well as the secretion of a milk-like substance from the breasts.

Prostaglandins. A group of acids found throughout the body, especially in semen, that stimulate smooth muscle tissue and affect blood pressure, metabolism, body temperature, and other body processes. In women, prostaglandins are hormone-like chemicals produced in large amounts by endometrial cells. They stimulate the uterine muscles to contract and are largely responsible for menstrual cramps.

Prostate gland. The gland located below the bladder in males where the ejaculatory ducts and the urethra join. It also contributes fluid to the ejaculate.

Proximal tubal blockage. Tubal blockage that occurs near where the tubes enter the uterus.

Recipient. A person who receives donated eggs, sperm, or embryos.

RESOLVE. A national infertility support group. RESOLVE’s address is 1310 Broad- way, Somerville, Massachusetts 02144-1731; (617)623-0744.

Rh sensitized. A condition whereby an Rh negative woman has been immunized (sensitized) to the Rh factor through previous exposure to this antigen. An Rh positive fetus may suffer significant intrauterine and immediate post-delivery consequences which can lead to significant handicaps and/or death.

Salpingectomy. An operation where one or both of the fallopian tubes are removed.

Salpingitis isthmica nodosa (SIN). A thickening and inflammation of the walls of the fallopian tubes near where they enter the uterus, creating a proximal obstruction.

Salpingo-oophorectomy. Removal of fallopian tube and ovary together.

Salpingostomy. A surgical procedure where the wall of the fallopian tube is opened and the ectopic pregnancy is removed. The tubal incision heals spontaneously.

SART registry. An ongoing collection of IVF results from participating clinics developed and maintained by SART, a society affiliated with the American Society for Reproductive Medicine.

Semen analysis. The microscopic examination of semen to determine the number of sperm (sperm count), their shapes (morphology), and their ability to move (motility).

Seminal plasma. The fluid in which the sperm is ejaculated. Seminal plasma makes up most of the fluid volume of semen.

Seminal vesicles. Two oblong glands located behind the bladder that join each vas deferens and empty into the urethra. They contribute more than half of the fluid volume of semen.

Seminiferous tubules. The tiny tubes in the testes where sperm cells are produced and mature.

Septate uterus. A uterus with a dividing wall of tissue (septum) within the uterine cavity.

Sexually transmitted diseases. Diseases which are transmitted through sexual contact. Some can cause pelvic infections and lead to infertility by damaging or destroying the fallopian tubes.

Speculum. A device inserted into the vagina to allow visualization of the cervix.

Sperm morphology. The shape of individual sperm as seen under a microscope. At least 50 percent of the sperm in a semen sample should have oval heads and slightly curving tails.

Sperm motility. The percentage of all moving sperm in a semen sample. Normally 50 percent or more are moving rapidly.

Sperm washing. A technique that removes sperm from the semen.

Spironolactone. A steroid hormone that directly blocks the effect of androgens on the skin. It initially was used as a diuretic. Aldactone® is a brand name.

Sonohysterography. A technique which involves injecting a special fluid into the uterus and fallopian tubes in order to observe the image of these structures produced by ultrasound on a monitor screen.

Strict morphological assessment. Microscopic evaluation of sperm shape using very rigid criteria. Normal sperm counts have greater than 14 percent normal forms.

Superovulation. A procedure to facilitate fertilization. The woman is given ovulation inducing drugs which cause her ovaries to produce multiple eggs. When the eggs are ready to be released, the woman is inseminated with her partner’s sperm or donated sperm.

Surrogate. A traditional surrogate is a woman who is inseminated with the sperm of a man who is not her partner in order to conceive and carry a child to be reared by the biological (genetic) father and his partner. In this procedure the surrogate is genetically related to the child. The biological father and his partner must usually adopt the child after its birth. Another type of surrogate is a gestational carrier. This process involves implanting a fertilized egg (embryo) into the surrogate’s uterus. In this procedure the surrogate does not provide the egg and is therefore not biologically (genetically) related to the child.

Tay-Sachs disease. A fatal heredity disorder characterized by mental retardation and paralysis. This condition is most common in offspring from Jewish couples of eastern European descent.

Testes. The two male reproductive glands located in the scrotum which produce testosterone and sperm.

Testosterone. In men, the primary male hormone produced by the testes which is responsible for the development of sperm, male physical characteristics, and sex drive. Testosterone is also produced in small quantities by the ovaries in women.

Thyroid gland. A gland located in the neck which secrets a hormone that regulates body growth and metabolism.

Transcervical cannulation. An x-ray directed technique of opening a fallopian tube which is blocked proximally (at the junction of the uterus) using a narrow, flexible tube inserted through the vagina into the uterine cornu. Also known as selective salpingography or retrograde hysterosalpingography.

Transvaginal ultrasound aspiration. An ultrasound-guided technique for egg retrieval. A long, thin needle is passed through the vagina into the ovarian follicle, and suction is applied to retrieve the egg. Also known as ultra- sound-guided egg aspiration and transvaginal egg retrieval.

Tubal (ectopic) pregnancy. A fertilized egg that implants within the fallopian tube rather than the uterine cavity. Under these conditions, the tube can rupture and bleed. Tubal pregnancies can be fatal if they are not identified and treated early.

Tubal ligation. A surgical procedure where the fallopian tubes are clamped, clipped, or cut to prevent pregnancy.

Ultrasound. A picture of internal organs produced by high-frequency sound waves.

Uterus. The hollow, muscular female reproductive organ in the pelvis where an embryo implants and grows during pregnancy. The lining of the uterus, called the endometrium, produces the monthly menstrual blood flow when there is no pregnancy.

Varicocele. A varicose or dilated vein within the scrotum that can cause infertility in some men.

Vas deferens. The two muscular tubes that carry sperm from the epididymis to the urethra.

Vasoepididymostomy. A surgical procedure to connect the vas deferens to the epididymis in order 10 bypass an obstruction in the epididymis: sometimes used for vasectomy reversal.

Zona Pellucida. The tough outer covering of an egg which functions somewhat like a shell. Sperm must penetrate this “shell” in order to fertilize the egg.

Zygote intrafallopian transfer (ZIFT). Eggs are collected and fertilized, and the resulting zygote is then transferred to the fallopian tube.

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