(Ovarian Hyperstimulation Syndrome)
sperm injection (ICSI)
Vitro Fertilization (IVF)
Vitro Fertilization/Embryo Transfer (IVF-ET)
Genetic Diagnosis (PGD)
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Amenorrhea: The absence of menstruation.
Antibodies: 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 (ASA): 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. Either the man or the woman may produce sperm antibodies
Artificial Insemination: Any of the various techniques whereby sperm are introduced to the female by means other than sexual intercourse.
Assisted hatching: Thinning of the embryo’s outer egg shell (zona pellucida) prior to embryo transfer. Indicated for couples with advanced maternal reproductive age, elevated FSH levels, and prior repetitive IVF failures.
It can result from obstruction of the vas deferens (the duct that carries the sperm from the testicles
to the urethra) or from failure of the testes to produce sperm.
are two procedures to obtain sperm from azoospermic males.
Basal Body Temperature Test (BBT): Indirect evidence of ovulation
can be obtained with the basal body temperature chart. The temperature
can be taken orally with a special thermometer immediately upon
awakening and before any activity. This is recorded on a special
graph that enables you to visualize the different temperature shifts.
The temperature will drop to its lowest point, 1-2 days prior to
ovulation, and then rises and remains elevated until a couple of
days before impending menstruation.
If the individual is pregnant the temperature will remain elevated.
This elevation is not considered a fever because it will never exceed
38ºC (100ºF). This test is unfortunately not very reliable in every
woman, and is therefore not used universally.
Biphasic: A two-level BBT record, which shows a
rise in temperature and is suggestive of ovulation.
Capacitation: The changes that a sperm goes
through to be capable of penetrating the layers covering the egg.
It involves the sequentially timed release of a series of enzymes,
which allows the sperm to digest a passage through those layers.
Cervical Cultures: The process of obtaining samples
(of secretions) from the cervix and culturing them on special media
for different types of infectious organisms such as Chlamydia,
Gonococcus and Ureaplasma. These sexually transmitted diseases,
if present, can cause infertility
by damaging the fallopian
tubes or can interfere with implantation
of the embryo by
infecting the lining of the uterus. They are easily treated with
Cervical Mucus: Cervical mucus is secreted by
glandular cells that are present in the cervix. This
mucus protects the uterus from invasion by bacteria present in the
also plays an important role in infertility. The cervical mucus,
in response to the estrogen
hormone, becomes thin and elastic at the time of ovulation.
This allows the sperm to travel
through the cervix and the uterus to reach the egg in the fallopian
tube. It also helps the sperm to stay alive in the cervix for
a longer period of time. A thick and dense mucus could prevent the
passage of sperm through the cervix. The cervical mucus is checked
by the Postcoital
Cervical Stenosis: Narrowing of the cervical canal
in such a way that menstrual flow can partially or completely be
impeded. It is often the result of cervical injury due to surgery
such as cone biopsy done for an abnormal Pap smear. It can cause
infertility by hampering the normal passage of sperm through the
cervix, and can often be treated by intrauterine
insemination that bypasses the cervix altogether.
Chromosome: The nuclear structure of every living
cell. Every human cell has normally 46 chromosomes. These chromosomes
are made up of genes that govern all of the body’s functions, and
are also responsible for all the physical characteristics of an
individual. Human gametes (i.e.
eggs and sperm) contain only 23 chromosomes. When unified during
fertilization, the total number of 46 chromosomes is thus restored.
Abnormalities of chromosomes can result in miscarriages or congenital
abnormalities. Age affects the quality of chromosomes in an egg
and that is why infertility and miscarriages are more common in
older women. For instance, the incidence of Down’s Syndrome increases
when a woman gets older.
Corpus Luteum: A special gland that forms on the
surface of the ovary at the site of ovulation and produces progesterone
during the second half of the cycle. The follicle after it ruptures
and releases the egg. It is necessary to prepare the uterine lining
by the fertilized egg.
Cryopreservation (Embryo Freezing): A procedure
used to preserve (by freezing) and store embryos
or gametes (sperm).
Diethylstilbestrol (DES): A synthetic
prescribed in the 1950s, 1960s, and early 1970s to women to prevent
miscarriage. Many 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 was banned in 1971 by the FDA in
the U.S. for pregnant women. DES daughter/son: the daughter/son
of a woman who used DES. Research is also looking into effects on
Donor Oocyte: Women with diminished ovarian
reserve or premature menopause have an extremely low likelihood
of establishing a pregnancy. For that reason, eggs from a young
donor can be utilized. Donor egg pregnancy rates, in our experience,
have been greater than 70% per cycle.
Ectopic Pregnancy (also called Tubal Pregnancy):
A normal pregnancy results when the embryo implants inside the uterus.
occurs outside the uterus, an ectopic pregnancy ensues. Such an
abnormal pregnancy can be located in the tubes, the ovaries, the
cervix or inside the abdomen.
Egg: The mature female gamete. Also called an oocyte.
Egg Retrieval: Minimally invasive procedure to retrieve
eggs for IVF
using ultrasound guided needle aspiration through the vagina. Typically
takes 15 to 30 minutes. Painless because of intravenous and local
Embryologist: A scientist who specializes is
Embryo Replacement: Introduction of a thawed embryo into
a woman’s uterus after in vitro fertilization.
Endometrial Biopsy: A procedure that involves
taking a small sample of tissue from the inside lining of the uterus
(called the endometrium). An endometrial biopsy is done for many
reasons. In a case of investigation for infertility, it is performed
to evaluate the endometrium
for its readiness to accept the embryo. An endometrial biopsy is
also performed for abnormal uterine bleeding to diagnose hormonal
imbalances or an anatomic cause for the bleeding, such as polyps, hyperplasia
(abnormal benign growth of the endometrium) or cancer.
Epididymus: The organ in the man where sperm are
stored, nourished, and mature after manufacture.
Estrogen: The primary female hormone produced mainly
by the ovary from puberty to menopause.
Estrogen is responsible for the normal growth and differentiation
of both the follicle
and the egg. It also
plays an important role in preparing the endometrial lining where
would occur in case of pregnancy. Estrogen also changes the quality
and texture of the cervical mucus,
making it thinner and more elastic. This allows the normal passage
of sperm through the cervix towards
the uterus and
the tube where it meets the egg.
Fallopian Tube: A pair of tubes that conduct the
egg from the ovary to the uterus. Normal fertilization
takes place within this structure.
Fetus: A fertilized egg is called a zygote. Further
cellular division and differentiation yields an embryo. Once
organic differentiation occurs, i.e., the embryo acquires human-like
features, it is called a fetus.
Fibroid Tumors (or Myomas): Benign tumors of the
muscle of the uterus. Fibroids
develop in one of every four women sometime during their lifetime.
If present inside the uterine cavity, they can interfere with implantation.
Fibroids can also cause problems if they become large in size and
impinge or put pressure on the uterine lining. They are treated
by surgical removal, either via Laparoscopy,
or a major abdominal surgery.
Fimbria: Finger-like outer ends of the Fallopian
tubes that sweep the egg into the fallopian
Follicle: The fluid-filled sac on the ovary that
has nurtured the egg and from which the egg is released during ovulation,
Follicle Stimulating Hormone (FSH): A hormone
produced and released from the pituitary
gland that stimulates the ovary to ripen a follicle for ovulation.
This hormone also stimulates sperm production in the male.
Gamete Intrafallopian Transfer (GIFT): A technique
that may be used in lieu of in
vitro fertilization for women with patent (clear and open) tubes.
After egg retrieval the eggs are mixed with the husband’s sperm
and then immediately injected through the fimbria
into the woman’s fallopian tubes for In Vivo Fertilization. Procedure
is done through Laparoscopy.
Gestation: The period of fetal development in
the womb from implantation
GnRH: Gonadotropin releasing hormone is the single
most important hormone controlling ovarian function. It is secreted
by the hypothalamus
and controls LH and
FSH secretion by the
gland, which in turn directly controls ovarian function. Absent
or abnormal secretion of GnRH results in irregular cycles and lack
of ovulation. GnRH is secreted in an episodic manner by the hypothalamus
to be able to carry its functions.
Gonorrhea: A sexually transmitted disease than
can cause tubal disease and infertility.
If caught early, it is totally curable without a bad sequel as far
as fertility potential is concerned. Common symptoms include pelvic
pain, vaginal discharge and fever.
Human Chorionic Gonadotropins (hCG): The major hormone
secreted by the placenta. In the early stages
of pregnancy continued survival of the Corpus Luteum
(the follicle that released the egg) is totally dependent on HCG,
and in turn, the survival of the pregnancy is dependent upon hormones
secreted by the Corpus Luteum.
Hyperstimulation (Ovarian Hyperstimulation
Syndrome – OHSS): A potentially life-threatening side effect
induction with injectable fertility medications such as hMG
and urofollitropins. A woman’s ovaries become enlarged and produce
an overabundance of eggs. Blood hormone levels rise, fluid may collect
in the lungs or abdominal cavity, and ovarian cyst may rupture,
causing internal bleeding. Bloodclots sometimes develop. Symptoms
include sudden weight gain and abdominal pain. Cycles stimulated
with these drugs must be carefully monitored with ultrasound
scans. OHSS may be prevented by withholding the hCG injection
when ultrasound monitoring indicates that too many follicles
Hypothyroidism: A condition in which the
thyroid gland produces an insufficient amount of thyroid hormone.
The resulting lowered metabolism interferes with the normal breakdown
of “old” hormones and causes lethargy. Men will suffer from a lower
sex drive and elevated prolactin,
and women will suffer from elevated prolactin and estrogen,
both of which will interfere with fertility
Hysterosalpingography (hSG): An x-ray
dye test used to visualize the uterus and
tubes. It involves the injection of a radio-opaque dye through the
into the uterus and
tubes. A series of x-rays is taken and the contour and patency of
the uterus and tubes are assessed.
Hysteroscopy: This is a procedure that involves
the introduction of a thin telescope-like instrument through the
the uterine cavity. It enables the direct visualization of the uterine
cavity and its lining, thereby providing an opportunity to diagnose
abnormalities such as polyps, fibroids
Idiopathic Infertility: The term used to explain
when the cause of infertility
cannot be explained.
Implantation: The embedding of the fertilized
egg in the endometrium.
Intracytoplasmic sperm injection (ICSI):
vitro fertilization method to allow men with low sperm count,
motility, or abnormal forms to achieve fertilization. Direct injection
of a single sperm into
Intramuscular Injection: Injection into the
muscle of the backside. Method to administer human menopausal gonadotropins
Intrauterine insemination (IUI): Painless,
quick, office procedure where concentrated sperm is placed into
the uterus with a small flexible catheter. Indicated for infertile
couples with abnormal semen analyses, or in conjunction with ovulation
In Vitro Fertilization/Embryo Transfer
(IVF-ET): A procedure in
which an egg is removed transvaginally from an ovarian follicle
and fertilized artificially in the laboratory and placed intrauterine
through a specialized catheter for embryo transfer.
Kallman’s Syndrome: A congenital hypothalamus
dysfunction which has multiple symptoms including the failure to
Karyotyping: A chromosome
analysis in which cells are studied to look for abnormalities. Testing
a fetus may show if there is a chromosomal reason for the pregnancy
loss, which causes about 50% of miscarriages.
Testing the parents can help determine if there is an underlying
chromosomal problem that increases the chances of repeated losses,
which occurs in about 3% of couples with recurrent
Klinefelter’s Syndrome: A genetic abnormality
characterized by having one Y (male) and two X (female) chromosomes
or a mosaic (a combination of 46XY and 47XX). Klinefelters often
causes a fertility problem, though some men will produce sperm.
ART and donor inseminations
are possible. This condition can be passed on
Laparoscopy: The process involves the introduction
of a thin telescope- like instrument through the belly button into
the pelvis for direct visualization of the pelvic organs. At the
same time, dye can be injected through the cervix, and its flow
can be traced into and through the fallopian
tubes under direct vision.
Luteinizing hormone (LH): A hormone secreted
by the pituitary
gland involved in the control of ovulation.
The role of LH is to trigger ovulation and help prepare the endometrial
lining for implantation.
Lupron: Known medically as a GnRH-ag onist
(see GnRH). Lupron is a commonly used medication in IVF
and also for the treatment of severe endometriosis
or large uterine fibroids. Lupron taken continuously either by daily
subcutaneous (under the skin) injections or monthly intramuscularly
depot injections will suppress the pituitary-ovarian axis. Simply
stated, it will make the ovaries “go to sleep” and stop functioning,
therefore stopping the secretion of hormones such as estrogen
Lupron is frequently used in IVF to prevent premature ovulation.
Luteal phase defect: Inadequate progesterone
production or effect that does not allow normal implantation.
Cause of recurrent
pregnancy loss. Diagnosed by two consecutive out of phase endometrial
biopsies, or repetitively low serum progesterone levels in the mid-luteal phase.
Meiosis: The cell division, peculiar to reproductive
cells, which allows genetic material to divide in half. Each new
cell will contain twenty-three chromosomes. The spermatids (immature
sperm) and ova (eggs) each contain twenty-three chromosomes, so
when they combine (fertilize), the baby will have a normal complement
Microsurgical Epididymal Sperm Aspiration (MESA):
A surgical Procedure to remove sperm from the epididymus
in men who have an obstruction of the vas deferens or epididymus
(or congenital absence of the vas deferens).
Also in a procedure for obtaining sperm from men who have had a
Morula: The stage of cell division prior to blastocyst.
It is a solid mass of blastomeres formed by cleavage of a fertilized
Myoma: Also called fibroid. Benign tumors arising
from the muscular wall of the uterus. Location can be on the outside
of the uterus (subserosal),
in the uterine wall (intramural), or pressing into the uterine cavity
(submucosal). Fibroids cause uterine enlargement, heavy and abnormal
vaginal bleeding, bladder pressure, need for frequent urination,
and pelvic pain. May interfere with reproduction, especially if
submucosal in location.
Myomectomy: Surgical removal of fibroids either
or by an abdominal approach.
Oocyte: The egg produced in the ovaries each month.
Also called the ovum (gamete).
Oligo-Ovulation: Infrequent ovulation.
Oligospermia: Low sperm count.
Ovarian Failure: The inability of the ovary to
respond to any hormone – this us usually due to menopause.
Ovarian reserve: The number and quality of eggs
remaining in a woman. Ovarian reserve diminishes over time, especially
in the transition from the late 30’s to the early 40’s. Ovarian
reserve can be assessed with measurement of follicle stimulating
hormone (FSH) on cycle day 3, or by Clomiphene citrate challenge
Ovulation: The release of a mature egg from the
surface of the ovary. Ovulation is triggered when a follicle
measures between 16 and 20 mm.
Ovulation Induction: Use of medication to recruit
and develop many eggs. Clomiphene citrate, Lupron, and
injectable FSH are
used for ovulation induction and IVF. Frequently coupled with intrauterine
Ovulatory Dysfunction: A problem with the ovary where
the egg is not matured or released properly.
Pelvic Inflammatory Disease (PID): Infection of the
pelvic organs that may result in scarring of the fallopian
tubes and /or pelvic adhesions.
Pituitary Gland: A gland located at the base
of the brain, below the hypothalamus,
which controls almost every endocrine gland in the body and therefore,
controls human growth, development and reproduction.
Placenta: The organ that is responsible for the
nourishment of the developing embryo.
Polycystic Ovarian Syndrome: The formation of
cysts in the ovaries that occurs when the follicle
stops developing. This is due to a hormonal imbalance in the ovary.
Polyp: Benign growth of the lining of the uterus or
It looks like a small solid balloon and can interfere with normal
and cause infertility,
abnormal bleeding and theoretically miscarriages.
Post-Coital Test (PCT): A test to determine
whether the sperm can move properly through the cervical mucus.
Preimplantation Genetic Diagnosis (PGD):
An advanced technique that involves checking the cells (via biopsy)
of a developing embryo for genetic and chromosomal abnormalities
and thus helping to prevent serious transmissible genetic diseases.
Progesterone: The hormone secreted by the Corpus Luteum
that makes the uterus prepare its lining to receive the egg.
Prolactin: A hormone secreted by the pituitary
gland. Its major role is to control milk production. Excess
secretion can interfere with normal ovulation. This is why Prolactin
levels are checked in every woman during the evaluation process
Reproductive Endocrinologist (RE): Obstetrician-Gynecologists
with advanced education (usually a two year fellowship), and research
in Reproductive Endocrinology. These highly trained and qualified
physicians treat Reproductive Disorders that affect children, women,
men, and the mature woman.
physicians describing themselves as Reproductive Endocrinologists
have not completed certification with the American Board of Obstetrics
and Gynecology in the Sub-Specialty of Reproductive Endocrinology
Retrograde ejaculation: Frequently seen in men
with diabetic complications or neurologic injury. Low semen volume
is noted because most of the ejaculate
refluxes 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.
Can be treated with medication, isolation of sperm from urine and
inseminations, or IVF.
Retroverted Uterus: Uterus that
is tilted back toward the rectum.
Rh Factor: Any of one or more genetically determined
antigens present in the red blood cells of most persons and capable
of inducing intense immunologic reactions. Some women develop a
sensitization to Rh during pregnancy. If a woman is Rh negative
and her husband is Rh positive, she is a candidate for Rh incompatibility
problems. After the first pregnancy, the Rh factor enters the Rh-negative
mother’s circulatory system during the delivery (or miscarriage)
of a child who has inherited the Rh factor from his father. The
mother’s body then produces antibodies
against it. If she becomes pregnant with another Rh-positive baby,
the antibodies cross the placenta
and attack the baby’s red blood cells, causing mild to serious anemia
in the baby. The medication Rhogam (called “Anti-D” in Britain and
New Zealand) is given to prevent these problems.
Rhogam (Anti-D): An immunization given to Rh-negative
women after a miscarriage, stillbirth, or live birth to prevent
production of antibodies
in any Rh-positive babies they may have in future pregnancies.
Salpingitis: An inflammation of one or both
Scrotum: The pouch at the base of the penis that
contains the testicles.
Secondary Infertility (SI): The inability of a
couple to achieve a second pregnancy. 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 (or more) but is unable to conceive another.
Semen: The sperm and
seminal secretions ejaculated during orgasm by the male.
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.
Sonohystogram: An ultrasound/sonogram in which
saline is injected into the uterus. It
is used to check for abnormalities. It has some similarity to a
in purpose, but does not require iodine dye injection or radiation.
Sperm Count: The number of sperm in ejaculate.
Also called sperm concentration or sperm density and given as the
number of sperm per milliliter.
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. The higher the percentage of misshapen
sperm, the less likely fertilization
can take place.
Sperm Washing: A laboratory technique for separating
separating motile sperm from non-motile sperm, for use in assisted
reproduction. The washing technique for near normal specimens is
mixing the ejaculate
after liquefaction with the appropriate washing medium followed
by centrifugation. The supernatant is discarded and the sediment
(sperm rich fraction) is re-suspended in more washing medium. This
process is repeated 2-3 times maximum. In the final wash, the sediment
is re-suspended in 0.5 cc of medium, loaded into a syringe and deposited
in the uterus. “Sperm Rise” or “Swim-up” technique: Two to five
cc of medium are carefully layered on top of 0.2-0.5 cc of semen.
Motile sperm cells “swim-up” into the culture medium. After some
time (30-90 minutes) the medium (containing motile sperm cells)
is carefully harvested and centrifuged. If necessary, fresh medium
is layered on top of the seminal fluid again to harvest more sperm
cells. Discontinuous gradient centrifugation: This technique utilizes
a dense liquid phase to separate sperm cells from seminal fluid
and debris. Different compounds commercially available can be utilized.
Semen is deposited on top of this fluid and subjected to centrifugation.
Motile sperm cells migrate to the bottom of the tube, which are
used for IUI
after further washing.
Split Ejaculate: A method used to concentrate the
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
Spontaneous Abortion: A miscarriage that is
caused by nature. It can have several causes, such as a genetically
Systemic Lupus Erythematosus (SLE): An inflammatory
connective tissue disease of unknown cause that occurs chiefly in
women, is characterized by fever, skin rash, and arthritis, often
by acute anemia, by small hemorrhages in the skin and mucous membrane,
by inflammation of the pericardium, and in serious cases by involvement
of the kidneys and central nervous system. If needed for arthritic
symptoms or by women with the lupus anticoagulant, daily doses of
aspirin and the steroid prednisone seem to reduce overall risk of
pregnancy complications. Pregnancy complications in women with lupus
can include blood clotting problems and a high risk of preterm delivery.
Testicular Sperm Aspiration (TESA): A needle
biopsy of the testicle used to obtain small amounts of sperm. A
small incision is made in the scrotal skin and a spring loaded needle
is fired through the testicle.
Usually does not result in enough sperm to freeze
for later use.
Testicular Mapping: A diagnostic procedure to
identify “pockets” of isolated sperm production in the testicles
of men who have very low sperm production
Testosterone: The main hormone secreted by
and responsible for male characteristics, such as beard growth,
deep voice, and sperm maturation.
TSH: A hormone secreted by the pituitary
gland that controls the thyroid gland.
Elevated levels imply abnormally low thyroid function. The level
of this hormone in blood is checked in most women with infertility
because certain thyroid diseases may be associated with infertility
Tubal Ligation: Surgical sterilization of a woman
by obstructing or tying the fallopian
tubes. Tubal Patency: Unobstructed Fallopian Tubes.
Tubal Reversal: The process by which the fallopian
tubes are “untied” or reunited after a postpartum tubal ligation, thereby allowing
a woman to conceive.
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. Karotyping will reveal that this woman has
only one female (X) chromosome instead of two or a mosaic (46XX
Ultrasound: Radiographic method for measurement
of ovarian follicle growth and uterine lining thickness during ovulation
induction and in vitro fertilization. Follicles, which contain eggs,
are easily visualized. Transvaginal ultrasound is also used to guide
embryo transfer catheter for perfect placement of embryos during
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.
Uterine Septum: The presence of a thick membrane
that separates the uterine cavity either partially or completely
into two separate cavities. A septum can interfere with normal implantation
and cause recurrent
Varicocele: An abnormal dilatation of the veins surrounding the testes. They are present in 25% of infertile males. Because of this blood pooling, testicular temperature is raised, which is detrimental to sperm.
Vas Deferens: The segment of the tube that connects
to the urethra in males.
Vasectomy: The surgical separation of both vas deferens.
A procedure used for birth control/sterilization.
Vasogram: An X-ray examination of the vas deferens.
Viscosity: The thickness of semen.
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.
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.
Zona Pellucida: A translucent non-cellular layer, which
surrounds the egg and embryo.
Just prior to implantation
the zona will be broken and the embryo released to implant in the
In some women, especially in women over the age of 37, the zona
is thicker and therefore harder for the embryo to hatch. Embryologists
can thin the zona pellucida just prior to embryo transfer
in IVF cycles (assisted hatching).
Zygote Intrafallopian Transfer (ZIFT): An Assisted
Reproductive Technology (ART) in which eggs are removed from a woman’s
ovaries, fertilized with the man’s sperm in a lab dish, and the
resulting Zygotes are transferred into the woman’s fallopian
tubes during a minor surgical procedure.