Taking Charge of Your Fertility

by Toni Weschler

  Ovum transfer: A procedure in which a man’s sperm is used to fertilize the egg of a donor woman. The resulting embryo is then placed in the uterus of his partner, who may even be a postmenopausal woman.

  Pap smear: See Pap test.

  Pap test: A clinical procedure in which a sample of cells is taken from the cervix in order to check for abnormal conditions such as cervical cancer.

  Parlodel (Bromocriptine): A drug used to decrease the overproduction of the hormone prolactin.

  Patch Rule: One of the two natural birth control rules used during phases of anovulation. It states that you are safe the evening of every day that your 2-week Basic Infertile Pattern remains the same. But as soon as you see a change in your BIP, you must consider yourself fertile until the evening of the fourth consecutive non-wet day after the Peak Day.

  PC muscles: Popular term for the pubococcygeous muscles of the pelvic floor. Their function is to support the bladder, rectum, and uterus.

  PCOS: See Polycystic Ovarian Syndrome.

  Peak Day: The last day that you produce fertile cervical fluid or have a wet vaginal sensation for any given cycle. It usually occurs either a day before you ovulate or on the day of ovulation itself.

  Peak Day Rule: One of the four natural birth control rules. It states that you are safe the evening of the 3rd consecutive day after your Peak Day, as long as you also have at least three high temps above the coverline (see Thermal Shift Rule).

  Pelvic cavity: The lower portion of the body surrounded by the hips, containing reproductive and other organs.

  Pelvic Inflammatory Disease (PID): Infection involving inflammation of the internal female reproductive organs, particularly the fallopian tubes and ovaries.

  Penis: The external male organ that is inserted into the vagina during intercourse.

  Percutaneous epididymal sperm aspiration: See PESA.

  Percutaneous vas deferens sperm aspiration: See PVSA.

  Pergonal: A powerful drug used to stimulate ovulation. It often triggers the release of more than one egg.

  Perimenopause: Refers to the years prior to menopause when a woman starts experiencing symptoms of impending menopause, such as irregular cycles, hot flashes, and vaginal dryness, and continues through to the first year after menopause.

  Perineum: The membrane between the vulva and the anus that remarkably stretches during childbirth to allow a baby’s head to emerge through the vaginal opening.

  Period: See Menstruation.

  Periodic abstinence: Various methods of family planning based on voluntarily abstaining from intercourse during the fertile phase of the cycle in order to avoid pregnancy.

  PESA (Percutaneous vas deferens sperm aspiration): A procedure in which a man’s sperm is removed directly from his epididymis, usually in order to use in IVF.

  PGD (Premature Genetic Diagnosis): A procedure in which newly formed embryos, which are created during IVF, are examined at the cellular level. It is primarily done to screen out those with markers of various genetic diseases.

  PGS (Premature Genetic Screening): A procedure in which newly formed embryos, which are created during IVF, are examined at the cellular level. It is primarily done to screen out those with an abnormal number of chromosomes and is also often used, amid considerable controversy, as a high-tech form of gender selection.

  PID: See Pelvic Inflammatory Disease.

  Pituitary gland: The master gland at the base of the brain that produces many important hormones, some of which trigger other glands into making their own hormones. The pituitary functions include hormonal control of the ovaries and testes.

  PMDD (Premenstrual Dysphoric Disorder): An intense form of PMS that is often disabling, with overlapping symptoms such as anxiety, irritability, and various physical conditions such as breast tenderness and muscle ache.

  PMS: A collection of physical and emotional signs and symptoms that appear during the postovulatory (luteal) phase and disappear at the onset of menstruation. Premenstrual symptoms are experienced by most women in varying degrees.

  POA: See Premature Ovarian Aging.

  POF: See Premature Ovarian Failure.

  POI: See Primary Ovarian Insufficiency.

  Point of Change: Refers to the point when your cervical fluid changes from a basic infertile pattern (BIP) of dry or sticky to one that includes wetter types, such as creamy or eggwhite.

  Polycystic Ovarian Syndrome (PCOS): A common endocrine disorder that usually leads to irregular cycles and other hormonal problems, in which developing follicles often remain trapped inside the ovary, later becoming cysts on the internal ovarian wall. Thought to be caused by high blood insulin levels.

  Polymenorrhea: Frequent bleeding, usually due to anovulation.

  Polyp: A soft, fleshy, non-cancerous tumor, usually teardrop-shaped, attached to normal tissue by a stem. Often found in the cervix or endometrium.

  Postcoital contraception: Emergency contraceptive measure in the form of high-dose pills or insertion of an IUD within a specified time following unprotected intercourse.

  Postcoital test: The examination of cervical fluid shortly after intercourse to determine whether sperm survive in it.

  Postovulatory Phase: See Luteal Phase.

  Postpartum: Following childbirth.

  Pre-ejaculatory fluid: A small amount of lubricating fluid that is emitted from the penis before ejaculation during sexual excitement. May contain sperm.

  Pregnancy test: An early-morning urine sample or blood test to determine the presence of human chorionic gonadotropin (HCG), the pregnancy hormone. Blood tests tend to be more sensitive and can therefore be done earlier than a urine test.

  Pregnancy wheel: A calculating device used by doctors to determine a pregnant woman’s due date. It is based on the assumption that ovulation occurs on Day 14, and is therefore often inaccurate.

  Pregnanediol: A metabolite (breakdown product) of progesterone, excreted in the urine.

  Preimplantation genetic diagnosis: See PGD.

  Preimplantation genetic screening: See PGS.

  Premarin: A commonly prescribed estrogen used in hormone therapy.

  Premature menopause: A dated term for Primary Ovarian Insufficiency (see this glossary), in which women stop ovulating normally, years or even decades before menopause would normally occur.

  Premature Ovarian Aging (POA): A medical condition in which a woman has too few eggs relative to what is considered normal at her age.

  Premature Ovarian Failure (POF): An outdated term for Primary Ovarian Insufficiency.

  Premenopause: A general term for the years leading up to menopause when menstrual cycles start to vary widely.

  Premenstrual Dysphoric Disorder: See PMDD.

  Premenstrual syndrome: See PMS.

  Preovulatory Phase: The variable-length phase of the cycle from the onset of menstruation to ovulation. See Menstrual cycle.

  Primary Ovarian Insufficiency (POI): An endocrine disorder in which women don’t produce enough estrogen, and thus stop ovulating normally, years or even decades before menopause would normally occur.

  Progesterone: A hormone produced mainly by the corpus luteum in the ovary following ovulation. It prepares the endometrium for a possible pregnancy. It is also responsible for the rise in basal body (waking) temperature, and for the change in cervical fluid in the postovulatory infertile state.

  Progesterone Phase: See Postovulatory Phase.

  Prolactin: A pituitary hormone that stimulates the production of breast milk and inhibits the ovarian production of estrogen.

  Proliferative Phase: See Preovulatory Phase.

  Prostaglandins: A group of fatty acids that is believed to be responsible for severe menstrual cramps.

  Prostate gland: A gland situated at the base of the male bladder. Its nutritive secretions help make up the seminal fluid.

  Puberty: The time of life in boys and girls when the reproductive organs become functional and the secondary sexual characteristics appear.

&nbs
p; Pubococcygeous: See PC muscles.

  PVSA (Percutaneous vas deferens sperm aspiration): A procedure in which a man’s sperm is removed directly from his vas deferens, usually in order to use in IVF.

  Reproductive endocrinologist: A doctor who specializes in reproductive hormones.

  Rhythm Method: An unreliable method of family planning in which the fertile phase of the cycle is calculated according to the lengths of previous menstrual cycles. Because of its reliance on regular menstrual cycles and long periods of abstinence, it is neither effective nor widely accepted as a modern method of natural family planning.

  Rule of Thumb: A guideline in which aberrant waking temperatures are ignored, particularly when calculating the coverline.

  Scrotum: Pouch of skin containing the testes.

  Secondary fertility signs: Physical and emotional changes that may provide supplementary evidence of the fertile phase. Secondary signs include mittelschmerz (ovulatory pain), spotting, breast tenderness, and mood changes.

  Secondary infertility: When a couple is unable to get pregnant or carry a pregnancy to term after already having had a child.

  Secondary sex characteristics: Features of masculinity or femininity that develop at puberty under hormonal control. In the male, this includes deepening voice in addition to the growth of beard and underarm and pubic hair. They are influenced by androgens. In the female, such characteristics include rounding of breasts, waist, and hips, as well as the growth of underarm and pubic hair. They are influenced by estrogen.

  Secretory phase: See Postovulatory Phase.

  Selective Hysterosalpingogram: A procedure in which a catheter is used to observe the internal structure of the fallopian tubes as well as clear obstructions from them.

  Semen: The fluid ejaculated from the penis at orgasm. The viscous fluid contains sperm and secretions from the seminal vesicles and prostate gland.

  Semen Emitting Technique (SET): The use of Kegel exercises (and tissue) in order to eliminate semen from the vagina.

  Seminal fluid: See Semen.

  Seminal vesicle: One of a pair of sacs that open into the top of the male urethra. Its secretions form part of the seminal fluid.

  Seminiferous tubules: Microscopic tubes in the testes in which sperm are produced.

  Serophene: See Clomid.

  SET: See Semen Emitting Technique.

  Sexually transmitted diseases (STDs): Any infections that are transmitted by sexual contact or intercourse. They are also referred to as sexually transmitted infections (STIs).

  Sexually transmitted infections (STIs): Any infections that are transmitted by sexual contact or intercourse. Used to be referred to as sexually transmitted diseases (STDs).

  Short Luteal Phase: The second phase of the cycle that in some women is deficient in progesterone, typically leading to a phase that is not long enough to allow for successful implantation. A woman usually needs a luteal phase of at least 10 days in order to sustain a pregnancy.

  Slow-rise temperature shift pattern: A type of thermal shift in which temperatures rise by merely one-tenth of a degree per day over several days.

  Speculum: A two-bladed stainless steel or plastic instrument used to examine the inside of the vagina and the cervix.

  Sperm: The mature male sex cell analogous to the female ovum.

  Sperm count: A measure of a man’s fertility that calculates the total number of sperm per ejaculate as well as the percent of sperm that are both forwardly moving (motility) and of normal shape and size (morphology).

  Sperm washing: The process by which the motility of the sperm is dramatically increased through mixing them in a culture media and then placing them in a centrifuge.

  Spermicidal: Having sperm-destroying properties.

  Spermicides: Vaginal creams, jellies, films, or sponges that can immobilize or destroy sperm.

  Spinnbarkeit: Fertility-quality cervical fluid that is generally stretchy, slippery, and clear.

  Spotting: Small amounts of red, pink, or brownish blood occurring during the menstrual cycle at times other than the true menstrual period.

  Stair-step temperature shift pattern: A type of thermal shift in which an initial rising spurt of temperatures occurs over several days, followed by a higher pattern of temperatures usually resembling a bell curve.

  Standard Days Method: A natural method of family planning that was designed for women in developing countries. Its premise is that women are fertile from Days 8 through 19 if they have cycles that range from 26 to 32 days. But it is not any more reliable than the Rhythm Method, because it does not allow the woman to determine her potentially changing day of ovulation from cycle to cycle.

  STDs: See Sexually transmitted diseases.

  Sterility: The inability of a woman to conceive, or of a man to produce functional sperm.

  Sterilization: A procedure that renders an individual permanently unable to reproduce.

  STIs: See Sexually transmitted infections.

  Sticky cervical fluid: The type of cervical fluid that often has the texture of library paste or rubber cement. It is usually the first type of cervical fluid that appears in a woman’s cycle following menstruation. It is very difficult for sperm to survive in it.

  Subfertility: A state of less than normal fertility.

  Sympto-Thermal Method (STM): A natural method of family planning combining observation of the basal body (waking) temperature, cervical fluid, and cervical position, along with any other secondary fertility signs. The most comprehensive and effective natural method, and the one taught in this book under the name Fertility Awareness Method.

  Temperature chart: A graph showing variation in daily waking temperature. See Biphasic and Monophasic temperature pattern.

  Temperature method: See BBT Method.

  Temperature shift: see Thermal Shift.

  Temperature Shift Rule: One of the four natural birth control rules. It states that you are safe the evening of the third consecutive day your temperature is above the coverline.

  TESA (Testicular Sperm Aspiration): A procedure using delicate microsurgical instruments in which a man with close to zero sperm count can still have what sperm he does have extracted directly from his testes in order to use in IVF.

  TESE (Testicular Sperm Extraction): A procedure using a high-powered needle in which a man with close to zero sperm count can still have what sperm he does have extracted directly from his testes in order to use in IVF.

  Testes: Plural of testicle.

  Testicle: One of a pair of male sex organs that produces sperm and the male sex hormones (androgens), including testosterone.

  Testicular failure: A condition in which the amount of reproductive hormones released from the pituitary is sufficient, but the testes still fail to produce any sperm.

  Testicular mapping: A procedure done on men who have what appears to be zero or close to zero sperm count, using fine needle aspiration to see what areas of his testes actually are producing some sperm.

  Testicular Sperm Aspiration: See TESA.

  Testicular Sperm Extraction: See TESE.

  Testosterone: A hormone produced by the testes, responsible for the development of male secondary sex characteristics and functioning of the male reproductive organs.

  Thermal Shift: The rise in waking temperatures that divides the preovulatory low temperatures from the later, postovulatory high temperatures on a biphasic chart. It usually results in temperatures that are at least two-tenths of a degree higher than the previous 6 days.

  Thermal Shift Rule: One of the four natural birth control rules. It states that you are safe the evening of the third consecutive day your temperature is above the coverline, providing that the third temperature is at least three-tenths of a degree above the coverline. If not, you must wait 4 days.

  Thyroid gland: A butterfly-shaped endocrine gland in the lower part of the neck that produces thyroid hormones (including thyroxin) and regulates hormone use and balance in the body. Hyperthyroidism (an overactive thyroid
) and hypothyroidism (an underactive thyroid) are thyroid disorders that can affect a woman’s fertility.

  TPP: See Tubal Perfusion Pressure.

  Traditional Chinese Medicine: A holistic system of medicine combining the use of medicinal herbs, acupuncture, food therapy, massage, and therapeutic exercise. The main principle behind the system is to determine the underlying causes of imbalance in the “yin” and “yang” which lead to disharmony in the “qi” energy in the body. Traditional Chinese Medicine addresses the whole patient, not just the ailment or disease.

  Triphasic temperature shift: A temperature shift pattern that usually reflects a pregnancy. About 7 to 10 days after the first Thermal Shift, a second, more subtle shift often occurs due to the effect of the pregnancy hormone, HCG.

  Tubal ligation: The surgical sterilization procedure that ties a woman’s fallopian tubes to prevent the sperm and egg from uniting.

  Tubal Perfusion Pressure (TPP) measurements: A procedure in which the actual health and functioning of the fallopian tubes is analyzed by seeing how much pressure is needed to push dye through them.

  Tubal pregnancy: An ectopic pregnancy in which the fertilized egg starts to implant in the fallopian tube rather than the uterus.

  Tuboscopy: A thin telescope that is used to observe the inner structure of the fallopian tubes.

  Two-Day Method: A form of contraception that relies on a simple algorithm to help women determine what days to avoid pregnancy. It involves observing only cervical fluid, and assumes a woman is fertile if she noticed any type of secretions both on that day or on the day before.

  Ultrasound: A diagnostic technique that uses sound waves, rather than X-rays, to visualize internal body structures.

  Unchanging Day Rule: One of the two natural birth control rules used during phases of anovulation. It states that if your 2-week Basic Infertile Pattern (BIP) is dry or the same- quality sticky cervical fluid day after day, you are safe for unprotected intercourse the evening of every dry or unchanging sticky day.

  Urethra: The tube that carries urine from the bladder to the outside. The female urethra is very short, extending from the bladder to the urinary opening at the vulva. The male urethra is longer, extending along the length of the penis. It also carries the seminal fluid.