Glossary of biomedical terms
for BioSense Corporation
Fertility - Ovulation - NFP - FAM - women's health
  Glossary of biomedical terms for BioSense Corporation Fertility - Ovulation - NFP - FAM - women's health  


A simple description and pictorial representation of the female reproductive organs is available at the American Medical Association's web site "Atlas of the Body: Female Reproductive Organs": http://www.medem.com/MedLb/article_detaillb.cfm?article_ID=ZZZ8QKJ56JC&sub_cat=2

A more detailed treatment of Sexual Reproduction in Humans is given in http://www.ultranet.com/~jkimball/BiologyPages/S/Sexual_Reproduction.html>




A

Amenorrhea:

Abnormal absence of menstrual blood flow [derived from Greek a, without + Greek men, month + rrhea from Greek rrhoia, a flow]

Anovulation:

Absence of ovulation caused by malfunctioning HPO axis, an increasingly common problem. Presents variously as irregular menstruations, amenorrhea, and excessive facial and body hair (hirsutism). Serious consequences are infertility and a greater risk for developing gynecological cancers. The health system must manage anovulatory patients to avoid these consequences. One of the causes is obesity, which leads to overproduction of estrogens.

ART or assisted reproductive technologies:

Used to treat infertility patients. ART refers to all techniques involving direct retrieval of oocytes (eggs) from the ovary. Artificial insemination (AI), IVF (in vitro fertilization), and other techniques. Web reference: http://www.ebiztechnet.com/cgi-bin/getit/links/Health/Reproductive_Health/Infertility/Education/
Assisted_Reproductive_Technologies/

Axis:

A concept used in gynecological endocrinology in connection with the hormones that regulate the processes we are concerned with. For example, the hypothalamic-pituitary-ovarian (HPO) axis is the regulatory (feedback) system that governs menstrual cycles. In this system, which includes the brain and the reproductive tract, the brain's hypothalamus secretes the hormone GnRH, and the pituitary releases the gonadotropin hormones LH and FSH; in response, the ovary secretes androgens, estrogen, progesterone, and other factors. These ovarian secretory products modulate hypothalamic and pituitary output of the brain. Similarly, the hypothalamic-pituitary-adrenal (HPA) axis is the system that regulates the adrenal glands (two glands on top of the kidneys), basically as follows: the hypothalamus secretes primarily CRH (corticotropin-releasing hormone), the pituitary secretes ACTH (adrenocorticotropic hormone) , and the adrenal secretes cortisol, although there are also other modulatory factors at each level. The system works through body fluids, primarily blood circulation.


B

Barrier methods of birth control:

Contraceptives that block sperm from entering the uterus. These are the male and female condoms, diaphragm, cervical cap, and spermicide.

BBT or the basal body temperature method:

A method for monitoring fertility in which women chart their temperature every morning before getting out of bed. The BBT increases after ovulation, by about two tenths of a degree. The BBT is sometimes called the waking temperature because it must be taken immediately upon awakening, before any activity, so as to signify the body temperature at rest (basal temperature). The hormone progesterone is responsible for the post-ovulation rise in the BBT, but the BBT also responds to other stimuli that cause false temperature rises, such as fever, restless sleep, antidepressants or drinking alcohol.

Billings ovulation method (BOM):

An NFP method in which the fertile days are identified exclusively by observations of cervical fluid at the vaginal opening. Developed by the Australian Drs. John and Evelyn Billings. An international survey in 1987 indicated that at least 50 million couples were using the method, and the number is said to be increasing from year to year. It has also been estimated that 80% of natural family planning world-wide is now the Billings ovulation method. In 1978 an international conference in Melbourne was attended by delegates from 48 countries. See also the cervical mucus method.

Biosensor:

A sensor or transducer that utilizes a biochemical or biological material in the process of measurement of a chemical or physical property of the monitored system.


C

Calendar method:

An untenable method for predicting fertility for women with regular menstrual cycles to attempt to predict their fertility by charting their menstrual cycles on a calendar. The method has been discredited because of two factors: its unwarranted assumption of regularity of menstrual cycles, and the long period of abstinence demanded by it. Also called the rhythm method, its one-time well-known status has caused a skeptical bias in America to all NFP or FAM methods, although the other methods are very different.

Cervical cancer:

Studies have indicated that the risk of dysplasia and carcinoma in situ of the uterine cervix increases with the use of oral contraceptives (OCs) for more than a year. Invasive cervical cancer may be increased after 5 years of use, reaching a two-fold increase after 10 years. It is well recognized, however, that the number of partners a woman has had and the age at first intercourse are the most important risk factors for cervical neoplasia. Other complicating factors include exposure to human papilloma virus, the use of barrier contraception, and smoking. These factors have made conclusions about cervical cancer difficult, but the CDC has concluded that there is no increased risk of invasive cervical cancer in users of oral contraception, and that an apparently increased risk of carcinoma in situ is due to enhanced detection of disease (because oral contraceptive users have more frequent Pap smears). Another study has found that there is a minimal risk for invasive squamous cell carcinoma but a significantly increased risk for invasive adenocarcinoma. This concern is an important reason for annual Pap smear surveillance, and it is considered reasonable to perform the Pap smears every 6 months in women using OCs for 5 years or more who are also at higher risk because of their sexual behavior [e.g., multiple partners and history of STDs]. Studies have shown that the sexually promiscuous woman at all ages has an increased risk of developing cervical neoplasia; this risk seems to be the highest in the third decade of life. In many countries, cervical cancer is the most common cause of cancer death among women, and "reducing cervical cancer deaths in developing countries will require new public health approaches" [Medscape Women's Health 6(6), 2001 at http://womenshealth.medscape.com/Medscape/WomensHealth/journal/2001/v06.n06/
wh1206.blum/wh1206.blum-01.html].

Cervical cap:

A firm rubber cap intended to fit securely on the cervix. Used with contraceptive jelly, the cervical cap is a barrier method of birth control that is reversible and available only by prescription.

Cervical mucus:

The fluid secreted by the inner walls of the cervical canal and exuded by the cervix. The amount and the properties of the fluid change depending on the phase of the menstrual cycle, e.g., from practically nonexistent during the so-called dry days early in the cycle to the relatively copious amounts of clear slippery fluid during the fertile days. Cervical mucus is essential for the ability of the sperm to function properly: sperm survival and sperm transport within the woman's reproductive system are critically dependent upon the presence of a healthy mucus. To quote a noted expert, Professor Erik Odeblad: "Complications arising from the use of the Pill are very frequent. Infertility after its use for 7-15 years is a very serious problem. S crypts are very sensitive to normal and cyclical stimulation by natural oestrogens, and the Pill causes atrophy of these crypts. Fertility is impaired since the movement of sperm cells up the canal is reduced. Treatment is difficult." He also wrote: "After 3 to 15 months of contraceptive pill use, there is a greater loss of the S crypt cells than can be replaced. ... A pregnancy rejuvenates the cervix by 2-3 years, but for each year the Pill is taken, the cervix ages by an extra year." Web reference: http://www.billings-ovulation-method.org.au/act/pill.html

Cervical mucus method:

A method of determining a woman's fertility by observing changes in her cervical mucus. The Billings ovulation method and the Creighton model ovulation method are both cervical mucus methods.

Cervical palpation:

Feeling the cervix with the middle finger of the thus trained woman-user of FAM or NFP to determine cervical position. This is not a widely used procedure, and is not involved in the Billings and Creighton ovulation methods.

Cervical position:

Three facets of the cervix (its height, softness and the size of its opening, the cervical os) assessed for fertility significance by specially trained users of this method of NFP or FAM.

Cervix:

The narrow lower part of the uterus (womb), with an opening that connects the uterus to the vagina and contains special glands called the crypts that produce mucus, which helps to keep bacteria out of the uterus. Sometimes called the neck of the womb, it protrudes into the vagina. The region around the cervical protrusion is known as the vaginal fornix. The sanitary vaginal tampon is inserted so as to reach into the posterior fornix. Likewise the BioSense sensor.

Climacteric:

The time of change that leads to menopause. The physiological midlife changes for women and men.

Colposcope:

A viewing instrument with a bright light and magnifying lens that is used to examine the vagina and cervix stained with special solutions. Colposcopy: Examination of the vaginal and cervical epithelia by means of a colposcope. [Greek kolpos, vagina, womb + -scopy, suffix that signifies viewing; seeing; observation: as in microscopy. From Greek -skopi, from skopein, to see.] Colposcopy is the diagnostic test to evaluate patients whose Pap smear screening produced abnormal cytological smear results. For more details see http://lib-sh.lsumc.edu/fammed/atlases/colpoat.html.

Combined oral contraceptives:

Birth control pills that contain the hormones estrogen and progestin (progesterone). See Pill, the: for more details.

Conception:

The moment when the pre-embryo attaches to the lining of the uterus and pregnancy begins; the term is also used to describe the fertilization of the egg.

Condom:

A sheath of thin rubber, plastic, or animal tissue that is worn on the penis during sexual intercourse. It is an over-the-counter, reversible barrier method of birth control, and it also provides some, even if not perfect, protection against sexually transmitted infections. The pregnancy rate is 5 - 15%. See also female condom.

Contraception:

The prevention of pregnancy; birth control.

Contraceptive creams and jellies:

Substances containing spermicide, which immobilizes sperm, preventing it from joining with the egg; used with diaphragms or cervical caps. These are over-the-counter, reversible barrier methods of birth control.

Contraceptive film, foam or suppository capsule:

Inserted deep into the vagina, they contain a spermicide to immobilize sperm, preventing it from joining with an egg; over-the-counter, reversible barrier methods of birth control. Most effective when used with a condom. The film is a square of tissue that melts into a thick liquid and blocks the entrance to the uterus. The foam blocks the entrance to the uterus with bubbles. The suppository is a solid that melts into a liquid.

Corpus luteum:

The yellow gland in the ovary formed by the ruptured follicle after ovulation. If the released egg becomes fertilized, the corpus luteum supports the early pregnancy (by continuous production of progesterone). If fertilization does not occur - a much more likely eventuality - the corpus luteum degenerates in time for the menstrual bleeding.

Creighton model ovulation method:

An NFP method of vaginal-cervical mucus self-evaluation according to criteria developed by Thomas Hilgers, M.D. at St. Louis and Creighton Universities. The criteria are called the vaginal discharge recording system (VDRS) and require that women check for the mucus by wiping the outside of their vaginas with bathroom tissue, checking the mucus for color, stretch and consistency. The last day of mucus that is either clear on appearance, stretches an inch or more, and/or causes the sensation of lubrication is called the peak mucus day. The method is similar to the Billings ovulation method.


D

Depo-Provera (R):

A progestin hormone (synthetic progesterone) that is injected into the buttock or arm every 12 weeks to prevent pregnancy. It is a reversible method of birth control available only by prescription.

Diaphragm:

A soft rubber dome intended to fit securely over the cervix. Used with contraceptive cream or jelly, the diaphragm is a reversible barrier method of birth control available only by prescription.


E

Egg:

The reproductive cell in women; the largest cell in the human body. The female gamete; an ovum. Also called egg cell.

Embryo:

The organism that develops from the pre-embryo and begins to share the woman's blood supply about nine days after fertilization. Approximately one-half of all human embryos are abnormal [http://www.columbialabs.com/html/crinwom/infertility/fertilization.htm]. "There is fortuitously a biologically based selection bias against abnormal human embryos. A signal is obviously recognized by the mother which helps explain why so many embryos fail to implant. An abnormal embryo that manages to implant is often miscarried in the first 10 weeks of pregnancy. Early abortions are almost always the result of abnormal development of the fetus. This is why progesterone is not usually recommended for threatened abortion. It is only if the physician can confirm using ultrasound that the fetus is viable will he prescribe progesterone to help maintain the pregnancy."

Emergency contraception:

The use of oral contraceptives or IUDs to prevent pregnancy after unprotected intercourse.

Endocrinologist:

A specialist in the functioning of hormones.

Endometrium:

The lining of the uterus that develops every month in order to nourish a fertilized egg. The lining is shed during menstruation if there is no fertilization.

End-organ effect:

A concept of biomedicine, which has to do with monitoring of the effects of stimuli, usually chemical stimuli such as drugs, on a biological system, that is either a part of or the complete body of an animal, or a human subject. While the fate of a chemical compound can be monitored by detecting it in body fluids (blood, urine, saliva, etc.), it can also be monitored by measuring the effect on a certain part of the body, called the end organ because the stimulus ends up there. The same applies to stimuli and reactions that the body generates by itself. BioSense explores electronic monitoring of end-organ effects.

Estrogen:

A hormone commonly made in women's ovaries. It is one of the primary hormones that control the menstrual cycle. Increasing estrogen levels in the first part of the menstrual cycle produce significant changes in the cervical fluid and the cervix, which are indicative of the fertile state near the day of ovulation.

Estrus:

The periodic state of sexual excitement in the female of most mammals, excluding humans, that immediately precedes ovulation and during which the female is receptive to mating. Also called heat. Ovulation occurs toward the end of the estrous period. An anestrous animal is not in heat and cannot be fertilized. As the renowned endocrinologist, Professor James Brown, points out: "In animals, Nature has ensured a maximum fertilization rate (but not 100%) by restricting intercourse to the most fertile day[s] of their cycle by the phenomenon of oestrus." British spelling of estrus is oestrus.


F

Fallopian tube:

One of two narrow tubes that, after ovulation, carries the egg from one of the two ovaries to the uterus. The two fallopian tubes are attached to the upper part of the uterus on either side, and are about 4 inches (10 cm) long. They are about as thick as a piece of spaghetti. Each tube forms a narrow passageway that opens like a funnel into the abdominal cavity, near the left and the right ovary. The ends of the fallopian tubes are draped over the two ovaries and they serve to catch the ovulated egg, for the egg to travel into the uterus. Each fallopian tube is lined by millions of tiny hairs (called the cilia) that beat rhythmically to propel the egg forward. The fallopian tube is not just a pathway - it performs other functions too, including nourishing the egg and the early embryo. Also, the sperm fertilize the egg in one of the fallopian tubes.

Fecundability and fecundity:

Fecundability is the probability of achieving pregnancy within one menstrual cycle (about 20% or maybe 25% in normal couples). Fecundity is the ability to achieve a live birth. Fecundability is strongly influenced by the age of the partners, and it is maximal at about age 24. There is a slight decline at ages 24 - 30, and a rapid decline after age 30.

Female condom:

A polyurethane sheath with flexible rings that is inserted deep into the vagina like a diaphragm. It is an over-the-counter, reversible barrier method of birth control that may also provide protection against sexually transmitted infections.

Fertile phase or fertile window:

The days of the menstrual cycle during which sexual intercourse or insemination may result in pregnancy. It includes several days leading up to and including ovulation. The exact number of the fertile days is not known. It is currently believed to be 6 days, although evidence shows that there are only 3 days of high probability of conception (while the other three days are likely due to inadequate methods of ovulation monitoring used in earlier studies). The unequivocal determination of the fertile window is a pivotal task for BioSense. The fertile window is an empirical factor, which should be consistent with the fertilizable lifetimes of the gametes (the egg and the sperm). Those are also uncertain but currently accepted figures are up to 12 (or maybe 24) hours for the egg, and at most 3 days for the sperm.

Fertility:

The female of any mammalian species, including the human female, can conceive only during a limited period of time (a window of a few days), and only if all conditions are perfect. The fertile window occurs repeatedly at intervals that are more or less regular (28 + or - 9 days or so) but their variability is substantial to the extent that planned pregnancy is a challenge. A normal healthy couple will statistically take at least 3 or 4 months to conceive even if the concept of the fertile window is known to them. An increasing percentage of couples experience difficulties in achieving pregnancy, and reproductive specialists have found that a large percentage of women had no idea of when they could conceive.

FAM (fertility awareness method):

A method of determining a woman's fertility status through self-assessment of certain fertility signs: waking temperature (also called the basal body temperature or BBT), cervical fluid, and cervical position. While NFP users abstain, FAM users apply one of the barrier methods of contraception for vaginal intercourse during the "unsafe days" of a woman's fertile phase. The "unsafe days" are, of course, the fertile days, i.e., the days of the fertile window.

Fertilization:

The joining of an egg and sperm.For fascinating details, explore the developmental biology site http://zygote.swarthmore.edu/chap4.html. You will see, e.g., a photo showing the "sun in the egg": the microtubules (stained with fluorescent antibodies to tubulin) radiating from the centrosome associated with the male pronucleus and reaching towards the female pronucleus. "This vivid image conveyed the discovery of the moment at which a new life was formed. The metaphor expressed awareness that the force of natural powers was greater than the sum of two cells."

Fetal sex pre-selection:

Two approaches have been demonstrated in the scientific literature. One approach employs the tools and methods of assisted reproductive technologies (ART), manipulating the genetic material of the sperm prior to artificial insemination so as to facilitate fertilization by the selected one of the two genders of the spermatozoa. The other approach attempts to enhance the probability of conceiving the desired gender by appropriate timing of the conception event with respect to ovulation. This is a highly controversial subject despite the fact that a substantial body of work on it has been published.

Thus, a 2001 publication by respected experts from a premier infertility treatment institute (G.Hodgen et al.) has put forward evidence that male spermatozoa (Y-chromosome-bearing sperm) survive longer than female spermatozoa (X-chromosome-bearing). This is consistent with earlier finding by Auckland, New Zealand researchers that boys tend to be conceived earlier in the fertile period than girls.


A 1991 Johns Hopkins University meta-analysis of six NFP studies concluded that the data showed "a statistically significant lower proportion of male births among conceptions that occur during the most fertile time of the cycle", meaning near ovulation. Indeed, the Auckland study by Professor John France's group found that 65% of male infants were conceived 2 to 5 days before ovulation while "71% of the born girls were conceived from intercourse timed between 1 day before to 1 day after the estimated time of ovulation".

A similarly high level of interest in embryo sexing (fetal sex pre-selection, or sex ratio) exists in the livestock industry, and researchers have experimented with the timing of insemination method. A tool such as the BioSense Corporation's BioMeter is indispensable for this approach to embryo sexing, because of the required accuracy.


Fetus:

The organism that develops from the embryo at the end of about seven weeks of pregnancy and receives nourishment through the placenta.

Follicles:

Small fluid-filled spherical structures in the ovaries that contain the eggs. At ovulation, the matured dominant follicle ruptures the surface of the ovary and releases the egg, which is sucked into the fallopian tube so as to be propelled towards the uterus. Upon the egg-release, the follicle becomes luteinized (changes into a yellow "body" or corpus luteum) and starts producing progesterone.

FSH or follicle stimulating hormone:

The hormone produced by the pituitary gland in the brain that stimulates the ovaries to produce mature ova (eggs) and the hormone estrogen.


G

Gametes:

The reproductive cells - eggs and sperms. [From Greek gamete, wife, and gametes, husband, from gamein, to marry, from gamos, marriage.]

Gestation:

The period of development in the uterus from conception until birth. The act of carrying young in the womb from conception to delivery, i.e., pregnancy. [Gestation is from Latin gestatio: a bearing, carrying, from gestare to bear, carry.] Since the expression is also linguistically related to the word jest, we observe that a now-obsolete meaning is also the act of wearing clothes or ornaments. And if that is not enough, it also once meant an exercise in which one is borne or carried, as on horseback or in a carriage, "without the exertion of one's own powers", i.e., passive exercise. Joking aside (extra jocum, remotum joco, as the Latin speaker would say), the gestation period is the period during which an embryo develops, the length of time between fertilization of an ovum and parturition (birth). MedTerms.com also advises that for humans the full gestation period is normally 9 months. Which is where the experts' (not the women's!) fun begins because the reference is to lunar months, the average time between successive new or full moons, equal to 29 days, 12 hours, 44 minutes, 2.87 seconds. Also called synodic month. Lunar month is the period of one revolution of the moon, particularly a synodical revolution; but several kinds are distinguished, etc., etc., ewtc.

One concerned obstetrician, Dr. David J R Hutchon, teaches [http://www.obgyn.net/us/cotm/9807/cotm_9807.htm]: "Aristotle, the father of scientific thinking, wrote that there was a certain definite term of gestation for all animals, which varied from animal to animal according to its size and life expectancy. However in man, wrote the philosopher, 'the human foetus is expelled both in the seventh and the tenth months, and at any period of pregnancy between these; moreover, when the birth takes place in the eighth month, it is possible for the infant to live.' " Hutchon confirms this with hard data, in a scattergram that "shows a good fit between 37 and 42 weeks". He also informs that it was Harmanni Boerhaave - a botanist who read in the Bible that pregnancy should last 10 lunar months - who in 1744 formulated a way of calculating the expected date of delivery. The rule was later given publicity by Franz Naegele in 1812, for whom the 40 weeks or 10 lunar months rule is named today. However, "Boerhaave was not actually measuring the length of pregnancy, and the word 'gestation' is used to describe the measurement of time from the last menstrual period to reflect this, so ? there is no pretence that this method is determining fetal age."

In the December 2001 issue of Obstetrics and Gynecology, a team of physicians proposes that "patients be given an assigned week of delivery at 32 weeks' gestation, individualized for each clinical situation. For most pregnancies, the assigned week of delivery might be between 39.5 and 40.5 weeks' gestation." According to these obstetricians, "the problem is that the term 'due date' has caused tremendous anxiety and tension over the last 3 decades ? [and] clinicians literally spend more time explaining why a person isn't really due on their due date than [they] spend on testing for AIDS, neural tube defects, and high blood sugars, and explaining what labor is like."

The obstetricians do not draw any parallel between Aristotle's observation of the difference between animals and Homo Sapiens and the difference between the animals' estrus and the human freedom from it (see the estrus entry, above). Just as with the baroque-era Boerhaave, the modern obstetricians' approach is not concerned with the length of the menstrual cycles or the certainty of the dates. Yet, it is evident that the EDD can be projected quite well from the ultrasonic measurements of the unborn baby's head, which could solve the anxiety and tension problems of prospective mothers - if the obstetricians chose to. While the expectant mother could not perform such ultrasonic measurements by herself, even if she wanted to, it will be interesting to see if BioSense can provide a simple alternative of better EDD assessment. The details of the gestation process are represented at Discovery.com's "The Visible Embryo", http://www.visembryo.com/baby/index.html. See also under Parturition.

Gonadotropins:

The hormones secreted by the pituitary gland of the brain that stimulate the function of the ovaries and testes (the gonads) to produce the gametes and the sex steroid hormones. They include the mentioned FSH and LH. The word gonadotropin is derived from the Greek gonad (an animal organ producing gametes = eggs and sperm; from Greek gonos for procreation or seed) and the Greek tropic for affecting or attracted to something specified, as in gonadotropic.

Gonads:

The organs that produce reproductive cells - the ovaries of women, the testes of men.

Gonorrhea:

A sexually transmitted bacterium that can cause sterility, arthritis, and heart problems. [Greek gonorrhoia, flow of seed (from the mistaken belief that the discharge contained semen): gono-, from gonos, seed, procreation + -rhoia, -rrhea, flow.]

Gynecology:

Sexual and reproductive health care for women. [From Greek gynh, gynaiko, a woman or female + -logy, from Greek -logia, science; theory; study (from logos, word, speech.] We note that a related word is gynaeolatry, meaning the adoration or worship of woman.


H


Hormone:

A chemical substance produced in one organ and carried by the blood to another organ where it exerts an effect. An example is FSH, which is produced in the pituitary gland of the brain and travels via the blood circulation to the ovary, where it stimulates the growth and maturation of follicles. Hormones are naturally occurring substances with specific effects on physiological activities. Hormones are also involved in the complicated interaction between the different aspects of the organism that has resulted in the discipline called psychoneuroimmunoendocrinology, which directly applies to women's health issues, and which may be thought of as the scientific underpinnings of holistic medicine. In brief, chemical contraception uses synthetic steroid (ovarian) hormone analogs to suppress the production of one or both of the brain gonadotropic hormones (FSH and LH), which interferes with the normal regulation of the menstrual cycle. For more on how hormones work, see http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/moaction/change.html.

Hormone replacement therapy (HRT):

The use of synthetic hormones, particularly estrogen, to replace the menopausal woman's diminished natural supply of hormones. Prescribed to alleviate menopausal symptoms such as hot flashes, as well as to prevent osteoporosis. Menopause and HRT - initially as "estrogen replacement" or unopposed estrogen - didn't come into vogue as a topic of concern for the medical profession until the 1960s. It is interesting to note that in countries in Asia and South America where women eat either wild yams or soybeans, sources of progesterone, the term "hot flush" doesn't even exist in their languages. They also rarely suffer from the host of female problems presently plaguing Western women.

Hypothalamus:

A small part of the brain located just above the pituitary gland. It regulates basic animal functions, and is involved in the regulation of the menstrual cycle including the timing of ovulation. It produces the GnRH (gonadotropin releasing hormone), a hormone which stimulates the pituitary gland to produce and release the gonadotropins FSH and LH, the brain hormones that lead to follicular development and ovulation. The hypothalamus acts as a computer, analysing nerve signals from other areas of the brain including those generated by emotions, and by environmental factors such as stress and nutrition. It also analyses hormonal signals (estrogen and progesterone) generated by the ovaries and other endocrine glands. The sum total of these effects determines the quality of the ovarian activity, that is when or even whether ovulation will occur. Hypothalamic dysfunction, involving a malfunctioning GnRH pulse generator, leads to anovulation and amenorrhea.


I

Implantation:

The attachment of the pre-embryo to the lining of the uterus.

Infertile phases:

The phases of the menstrual cycle (or of the estrous cycle in animals) when pregnancy cannot occur. There is a preovulatory and a postovulatory infertile phase, which together constitute the large majority of the reproductive cycle.

Infertility:

Clinical infertility is the inability of a couple to achieve a pregnancy or to carry a pregnancy to term after one year of unprotected intercourse. If the difficulty to conceive lasts less than a year, the condition is referred to as reduced fertility or sub-fertility. Clinical infertility is classified further into male infertility, female infertility, couple infertility, and unexplained infertility. Studies have shown that in the past 50 years the quality and quantity of sperm has dropped by 42% and 50% respectively. In the past 20 years the decrease in sperm counts has occurred at a rate of 2% annually. For further information refer to xeno-estrogens and the web reference therein. In the U.S. alone, of the 6.7 million women with fertility problems in 1995, 42% had received some form of infertility services. The most common services were advice and diagnostic tests, medical help to prevent miscarriage, and drugs to induce ovulation [Fam Plann Perspect. 2000 May-Jun;32(3):132-7].

IUD (intrauterine device):

A small device made of plastic, which may contain copper or a hormone, that is inserted into the uterus by a clinician. A reversible method of birth control available only by prescription.


L

LH or luteinizing hormone:

A hormone released by the pituitary gland in the brain to signal the initiation of ovulation. Basically, the brain signals to the ovary to change the selected or dominant follicle into a luteinized yellow "body" or corpus luteum.

Luteal phase:

The postovulatory phase of the menstrual cycle, from ovulation to the onset of the next menstruation. It typically lasts 13 or 14 days, although some authors put the range at 12 to 16, but the luteal phase usually does not vary more than 1 or 2 days within individual women. That relative constancy differentiates the luteal phase from the highly variable pre-ovulation phase (called the follicular phase).

Luteinized unruptured follicle syndrome or LUFS:
A condition in which the ovum remains stuck within the luteinized follicle, unable to pass through the ovarian wall to a possible conception. It is now believed to be a major cause of unexplained infertility.


M

Mammary:

Of or relating to the milk-giving gland of the female. For optimal milk production, dairy farmers need to get their cows pregnant again (re-bred) at the right time, otherwise they lose money. Determination of the optimal breeding time is the purpose of the agricultural application of the BioSense technology.

Mammogram:

X-ray photographs of the breasts that can detect cancerous tumors before they can be felt.

Menopause:

The time at "midlife" when menstruation stops; a woman's last period. This happens when the woman's stock of eggs in her ovaries has become exhausted. It usually occurs between the ages of 45 and 55. "Surgical menopause", however, which results from removal of the ovaries, may be caused to occur earlier. It is interesting to note that menopause (and hormone replacement therapy) didn't come into vogue as a topic of concern for the medical profession until the 1960s, coincident with the development of oral contraceptives.

Menstrual cycle:

The time from the first day of one period to the first day of the next period; a repeating pattern of fertility and infertility. The cyclical changes in the ovaries, cervix and endometrium, under the control of the sex hormones (LH, FSH, estrogen and progesterone).

Menstruation:

The cyclical occurrence of a flow of blood, fluid, and tissue out of the uterus and through the vagina that usually lasts from three to five days. The first day of menstrual flow is both the last day of the current menstrual cycle and the first day of the next cycle. Menstruation occurs when the ovulated egg has not become fertilized, that is when conception has not occurred.

Method effectiveness:

The reliability of a contraceptive method itself - when it is always used consistently and correctly. The reliability of different methods is also compared in terms of method failure. This is what the independent non-profit Allan Guttmacher Institute has to say: "Some of the failure is due to the methods themselves, but most is a result of the difficulties that individual women confront in incorporating the task of contraceptive use into their everyday lives; over half of all women practicing contraception use a method that requires ongoing attention (as opposed to surgical sterilization). They include women who rely on oral contraceptives as well as those using intercourse-related methods such as the condom and the diaphragm. Practicing the prevention of pregnancy, therefore, is at least as difficult as other such preventive health strategies as maintaining a proper diet, exercising and quitting smoking." Natural family planning research has shown that among the advantages of the NFP practice is that the inherent discipline enhances the sexual relationship and dialogue, which leads to high levels of satisfaction. Citation reference: http://www.alanguttmacherinstitute.org/pubs/ib19.html

"Morning-after" Pill:

Emergency hormonal contraception that is taken within 72 hours of unprotected intercourse.


N

Natural family planning (NFP):

Refers to several different methods for spacing, postponing, avoiding or enhancing the possibilities of conception, without any chemical or physiological alterations of the reproductive system (female or male). Natural family planning research has shown that among the advantages of the NFP practice is that the required discipline enhances the sexual relationship and dialogue, and that there is a reduction of "dominant attitude" in both men and women practising NFP. Contemporary methods are sometimes referred to as 'fertility awareness' (FA) since they are ultimately based on awareness of symptoms of fertility that are readily recognizable or measurable by any woman. Other people distinguish between NFP and FA in terms of the fertile phase: NFP users abstain whereas FA users employ a barrier method of contraception.

In any case, NFP and FA are distinct from the older 'calendar' methods such as Ogino-Knaus (the so-called 'rhythm' method). The American College of Obstetricians and Gynecologists refers to "family planning by periodic abstinence" and explains that this is [QUOTE] another name for the method of birth control that used to be called 'rhythm method' or 'safe period'. More recently it has also been called 'natural family planning' or 'fertility awareness'. It isn't a single method but a variety of methods. Each is designed to help a couple find out which days during a woman's menstrual cycle she is likely to be fertile or able to become pregnant [END OF QUOTE]. For the citation, see Sperm and semen, below. While the proponents of NFP warn that, without further expenditures on education, NFP will remain a fringe method in the U.S., the American College of Obstetricians and Gynecologists advises the public that [QUOTE] periodic abstinence is quite an effective means to prevent an unwanted pregnancy [END QUOTE].

Norplant (R):

A contraceptive system of six small soft capsules containing the synthetic hormone levonorgestrel that is inserted under the skin of the upper arm. A reversible method of birth control that is available only by prescription.


O

Oocyte:

A cell from which an egg or ovum develops by meiosis; a female gametocyte that develops into an ovum after two meiotic divisions.

Oral contraceptive:

The birth control pill. Also called the Pill. The Physician's Desk Reference carries the following warnings: The use of oral contraceptives is associated with increased risks of several serious conditions including myocardial infarction, thromboembolism, stroke, hepatic neoplasia, and gallbladder disease, although the risk of serious morbidity or mortality is very small in healthy women without underlying risk factors. The risk of morbidity and mortality increases significantly in the presence of other underlying risk factors such as hypertension, hyperlipidemias, hypercholesterolemia, obesity and diabetes. Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. For more about chemical contraception, see the Pill.

Osteoporosis:

A disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse. [From New Latin osteo- from Greek osteon, bone + Greek poros, passage, pore + -osis, a suffix signifying a condition, process or action, often a diseased or abnormal condition.] The adjective form is osteoporotic. Osteoporosis is largely a disease of modern civilization. Bones are complex living tissues with many nutritional and hormonal needs. Failure to meet any of these needs compromises the strength and integrity of bone tissue. Diet and environmental conditions are apparently related to this modern epidemic.

Ovaries:

The two organs that store eggs in a woman's body from her birth until her menopause. The ovaries also produce hormones, including estrogen, progesterone, and testosterone. The two almond sized ovaries are perched in the pelvis, one on each side, just within the fallopian tubes' grasp. Each month, at the time of ovulation, a mature egg is released by one ovary. This egg is picked up by the bordering fringe at the end of the fallopian tubes (called the fimbria), and drawn into the fallopian tube.

Over-the-counter:

Available without a prescription.

Ovulation:

The time when one of the two ovaries releases an egg. When ovulation occurs, the mature egg is released from its protective follicle in the ovary. This process of follicular rupture looks a bit like a small volcano erupting on the ovarian surface. At this time, the tubal fimbria, like tentacles, sweep over the surface of the ovary and actually "swallow" the egg. The egg then has a few hours lifetime (8 to 12 hours or maybe up to 24 hours) in the protective confines of the fallopian tube, for a sperm to swim up and reach it. For the mechanism of ovulation see the web reference at http://www.woomb.org/bom/science/physiology.html

Ovulation method:

See cervical mucus method. But before you go there, note this: The ovulation method might more accurately be referred to as periovulation method, peri- being the Greek prefix that means around, about, enclosing, or near. From dictionary.com we also learn that in Persian mythology, peri is a beautiful and benevolent supernatural being or fairy, earlier regarded as malevolent, a kind of female demon. But dictionary.com does not have any entry for perimenopause. And BioSense is introducing a technology with which to remove the peri- from the self-diagnostic detection of the fertile period and ovulation itself.

Ovum (in plural: ova):

The female reproductive cell or gamete of animals; egg.


P

Pap smear test:

A procedure used to examine the cells of the cervix in order to detect infection and hormonal conditions. It can also detect precancerous and cancerous cells. The Papanicolaou ("Pap") smear has been the method of choice for cervical cancer screening for over 50 years. The sensitivity limitations of the Pap smear have been well documented, and include an overall false negative rate variously reported as between 20-40%, and between 6-55%. The diagnostic test to evaluate patients with abnormal cervical cytological smear results is colposcopy (see Colposcope, above). We speculate that the BioSense technology may provide an alternative screening, with the advantage that this would be performed routinely by many women at home; abnormal result would be referred, much like the Pap result is at present.

Parturition:

The process of giving birth; childbirth. [From Late Latin parturitio, parturition-, from Latin parturitus, past participle of parturire, to be in labor.] Parturition is illustrated at http://www.mhhe.com/biosci/esp/2001_saladin/folder_structure/re/m2/s5/. The illustration's legend indicates that physicians usually calculate the gestation period (length of the pregnancy) as 280 days: 40 weeks or 10 lunar months from the last menstrual period (LMP) to the date of confinement, which is the estimated date of delivery of the infant [EDD]. Indubitably, due dates are a little-understood concept: "Truth is, even if you know the exact date when you ovulated, you still can only estimate the baby's unique gestational cycle to about plus or minus two weeks" [http://www.gentlebirth.org/archives/dueDates.html].

Statistically, the gestation time for human babies has a mean of 278 days and a standard deviation of 12 days, an uncomfortably large spread. The old Naegele Rule of a 40-week pregnancy was invented by Harmanni Boerhaave in 1744 and later given publicity by Franz Naegele in 1812. It is still believed to work fairly well as a rule of thumb for many pregnancies. However, the rule of thumb also suggests: "If your menstrual cycles are about 28 days, quite regular, and this is not your first child, your physician's dating is probably fine. If your cycles are longer or irregular, or if this is your first child, the due date your physician has given you may be off, setting you up for all kinds of problems" (induction, interventions, C-section). This is where the BioSense technology may help, making it possible to reckon the EDD with recorded ovulation data rather than merely with the LMP + 280 days. It is ironic that, in this age of technological medicine, American women worry about their birthing process not being allowed to take its own natural course on account of an ancient method of predicting the EDD. Ironically, the 40 week dogma - which is the gestational counterpart of the calendar method of birth control - does not reconcile the 295+ days of the 10 lunar months; and yet, at the same time, the U.S. has an unusually high perinatal death rate, resulting from high statistics of too early (preterm) labor. Quid agitur? See also under Gestation.

Parturition alarm:

This is a concept that has to do with the need to know when labor or delivery is beginning, because the birthing female may be in need of help. At this writing, an Internet search has produced only one such technology, a pressure-sensing girth, suitable for the horse breeder only, because it utilizes the fact that the horse mare lies on her side only in the process of parturition. In that paper, reference was made to some other method that would detect the emergence of the amniotic sac or of the foal from the vulva (vaginal orifice) but that was not a satisfactory solution. In the horse-breeding arena, about 5-6% of births require help. In human obstetrics, where most births take place in hospitals, determining the right time of confinement would be beneficial. BioSense will investigate the vaginal sensor technology with a view to developing a parturition alarm applicable to any mammal.

Pearl Index:

A measure of contraceptive efficacy for comparisons of different methods of birth control. Defined as the number of failures per 100 woman-years of exposure. In Germany, microprocessor-thermometer aided NFP was found to have Pearl Index of 0.7, comparable with that of the Pill and far superior to other artificial contraceptive methods, as follows: Pearl Index of the Pill = 0.5 - 1; Pearl Index of the spiral IUD = 2 - 4; Pearl Index of barrier methods (condoms, diaphragm, ...) = 5 - 15.

Pelvic exam:

Physical examination of the vulva, vagina, cervix, uterus, and ovaries - usually includes taking cervical cells for a Pap test and a manual exam of the internal pelvic organs.

Perfect use:

The contraceptive effectiveness of a method for women and men whose use is consistent and always correct.

Perimenopause:

The period of change leading to menopause. The kind of healthcare controversies and decisions faced by women at this stage of life is illustrated by the discussions at http://www.oxford.net/~tishy/longtermhrt.html (HRT - Long term considerations).

Perinatal:

Relating to the period around childbirth, especially the five months before and one month after birth: as in perinatal care. Also prenatal or antenatal. These two terms are actually more specific because they do not include the one month after birth, but the term perinatal appears more frequently used. Note: peri- is a prefix meaning 1. around, about, enclosing; or 2. near: as in perinatal [Greek peri: around, near + from Latin natalis, pertaining to birth.]

Periodic abstinence:

Not having intercourse during the "unsafe days" of a woman's fertile phase in order to prevent pregnancy. This differentiates NFP from FAM.

Phases of the menstrual cycle:

The preovulatory phase is called the follicular phase (during which the dominant follicle is maturing towards ovulation), and the postovulatory phase is called the luteal phase (dominated by the corpus luteum into which the now-empty follicle has transformed).

PID (pelvic inflammatory disease):

An infection of a woman's internal reproductive system that can lead to sterility, ectopic pregnancy, and chronic pain. It is often caused by sexually transmitted infections such as gonorrhea and chlamydia.

Pill, the:

Common expression for oral hormonal contraception. Also called oral contraceptive (OC). This is how the Pill works: The Pill contains steroid sex hormones. There are basically two general types of the Pill: 1. progestogen (synthetic progesterone) only, called the mini-Pill, and 2. combined progestogen-estrogen (combined Pill). One effect is to suppress the triggering mechanism in the brain, which causes the release of the gonadotropins FSH and LH, and thus to prevent ovulation. The combined Pill suppresses ovulation in about 98% of cycles. The mini-Pill suppresses ovulation in about 40% of cycles. The Pill also affects the natural functioning of the endometrium and of the cervix. The effect on the endometrium is to disrupt the normal growth pattern so that it cannot sustain an embryo. Progestogen stimulates the production of the kind of mucus that prevents sperm penetration and sperm survival. Web reference: http://www.billings-ovulation-method.org.au/act/pill.html

Pregnanediol:

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

Premenstrual syndrome (PMS) and PMDD:

PMS is a combination of emotional, physical, psychological, and mood disturbances that occur after ovulation and normally end with the onset of the menstrual flow. The symptoms include abdominal bloating, breast tenderness, headache, fatigue, irritability, anxiety, and depression. At least 30% of menstruating women experience distressing premenstrual symptoms that compel them to seek their doctor's help, and as many as 60% to 75% of women experience some of the PMS symtoms. Of these, about 2% to 10% experience severe problems and functional impairment, which is called the premenstrual dystrophic disorder or PMDD. Therapeutic treatment of PMDD in particular requires to ascertain whether the symptoms are unique to the premenstrual phase or not. This is to differentiate PMDD from clinical depression, for proper treatment. Current medical practice (both primary care and particularly psychiatry, which steps in once the primary care fails) utilizes nothing better than the discredited calendar-based rhythm method rather than a rigorous technique for ovulation detection. The BioSense technology should have a positive effect in that arena.

Progesterone:

A hormone produced in the ovaries of women that is important in puberty, menstruation, and pregnancy. It is produced by the corpus luteum in the ovary upon ovulation. It is also responsible for the post-ovulation rise in the BBT, and for the change in the cervical fluid and cervical position in the postovulatory infertile phase. Progesterone is also an important precursor in the biosynthesis of adrenal corticosteroids (hormones that protect against stress) and of other sex hormones (testosterone and estrogen). Besides being a precursor of other hormones, it also facilitates many other important physiological functions. In addition to the ovaries, it is also secreted by adrenal cortex, and by placenta. Progesterone is an essential hormone that plays a part in the development of healthy nerve cells, and brain and thyroid function. Also, progesterone stimulates osteoblast-mediated new bone formation.

Progestogen or progestin:

Any synthetic progesterone analog (structural derivative). Used in contraceptives to inhibit ovulation, and in hormone replacement therapy (HRT) for menopausal women. Progestogens counteract the cancer-promoting effect of estrogen in HRT, but the actions of progestogens differ significantly from natural progesterone in other respects. Focusing on the contraceptive use, there are numerous birth control Pills on the market, and a given brand of the Pill can be either estrogen dominant, progestogen dominant, or androgenic (testosterone-like male hormone effects), depending on the actual doses of the components and their relative potencies. This is only a relative classification that does not hold from one woman to another. Each progestogen has a different potency in terms of the progesterone effect to stop menstrual bleeding, or the androgen effect to stimulate acne and hair growth, or a partial estrogenic effect.

It is interesting to note that the progesterone analogs and estrogen are electrochemically related (estrogen is reduced progesterone). Indeed, bioconversion of the 19-nor progestins to their corresponding tetrahydro derivatives results in the loss of progestational activity and acquisition of estrogenic activities. Many experts believe that the side effect differences between different contraceptive formulations are not consistent because all contraceptives have been greatly reduced in dose from when older data on higher dose Pills were examined. Others agree that the various side effects (e.g., weight gain, feeling tired, fluid retention, breakthrough bleeding, nausea, depression, and numerous others) have been reduced but they are still manifest in some women, depending on the doses of the components in a given Pill formulation.

Further information at: http://www.wdxcyber.com/ncontr13.htm. Then, a pharmacy site, http://www.rxlist.com/cgi/generic/medrox_ad.htm, states (among other things): A statistically significant association has been demonstrated between use of estrogen-progestin combination drugs and the following serious adverse reactions: thrombophlebitis; pulmonary embolism and cerebral thrombosis and embolism. For this reason patients on progestin therapy should be carefully observed.


R

"Rhythm" method:

Also called the calendar method, it has been discredited because of two factors: its unwarranted assumption of regularity of menstrual cycles, and the long period of abstinence demanded by it. The method's one-time well-known status has caused a skeptical bias in America to all NFP or FAM methods, although they are very different. See above, under Natural family planning (NFP), and under FAM (fertility awareness method).


S

Sperm and semen:

Sperm is the male reproductive cell; it is the male gamete, also called the spermatozoon (plural: spermatozoa) or spermatozoid. Semen is the thick white fluid that contains spermatozoa and that is ejaculated by the male genital tract. During ejaculation, about one teaspoon of semen spurts out of the penis. Semen has a milky white colour, with the consistency of egg white. Sperm account for only about 2% to 3% of semen. Most of the semen consists of seminal fluid, i.e., the secretion of the seminal vesicles and the prostate gland, which provides a vehicle for carrying the sperm into the vagina. A normal ejaculation contains 200 to 500 million sperm. The sperm are very tiny. They are the smallest living cells in the human body - whereas the eggs are the largest. Basically, sperm are designed so that they can deliver their contents - the male genetic material - to the egg. That is why sperm are designed like projectiles - the male's DNA is found in the chromosomes in the sperm head nucleus, and the tail propels the sperm up towards the egg. Sperm are very fragile. Consequently, very few are able to survive the hazards of the swim through the female reproductive system in order to reach the egg. This is why a male produces such a large number of sperm. The body keeps producing sperm as long as a man has even one normal testicle. If ejaculation does not occur for many days, the sperm in the male reproductive ducts simply die. According to the American College of Obstetricians and Gynecologists, sperm retain their capacity to fertilize an egg for about 48 hours [http://www.medem.com/search/article_display.cfm?path=n:&mstr=/ZZZH6QKJ27C.html
&soc=ACOG&srch_typ=NAV_SERCH]. Most other authorities put the fertilizable lifetime of sperm at more than that. Best available evidence suggests 3 days.

Spinnbarkeit:

The somewhat archaic German gynecological word refers to the stretchability of the cervical mucus, which is generally stretchy, slippery and clear during the fertile days.

Steroid hormone:

Any hormone affecting the development and growth of sex organs. They are a group of structurally related hormones, based on the cholesterol molecule. They control sex and growth characteristics. They are highly fat soluble, not soluble in water, and are unique in that their receptor sites of action are inside the cell in the cell nucleus (the genes), rather than on the cell membrane. They penetrate the cell membrane because the membrane is made of lipids, the fat molecules. The fat solubility gives these steroid molecules some significant attributes: Their actions and fate are under tight control of the naturally fine-tuned system of metabolic enzymes. And they are not easily made into medicinal pills because those need to be water soluble, and somehow minimally altered by the metabolic enzymes. Examples of steroid hormones are estrogen, progesterone and the androgen testosterone, all present in both sexes. The sex hormones regulate the growth and function of the reproductive organs, the development of secondary sex characteristics, and the behavior of animals and people.

Steroids are the numerous naturally occurring or synthetic fat-soluble organic compounds having all the same basic structure (of 17 carbon atoms arranged in four rings). Steroids include the adrenal and sex hormones, certain natural drugs such as the digitalis compounds active in the cardiovascular area, and the precursors of certain vitamins. They also include sterols, and bile acids, the liver-generated steroid derivatives, such as cholic acid. Sterols are steroid-based derivatives classified as alcohols. They are predominantly unsaturated solid alcohols present in the fatty tissues of animals and plants. A sterol has a hydrocarbon side-chain of 8-10 carbons at the 17-beta position and a hydroxyl group at the 3-beta position (therefore an alcohol). Cholesterol is a sterol. Because of its water soluble property at the -OH end and the fat solubility at the hydrocarbon side chain as well as the basic steroid structure, it can be incorporated into the fatty cell membranes (lipid bilayers) and interact with the water soluble substances on the outside of the membranes. While fat soluble, the steroid structure is electrochemically active. This means free radical activity, which can be medically either good (protective) or bad (destructive).

For more insight into the chemistry of steroids, try http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/basics/steroidogenesis.html. Don't be put off by the word cyclopentanoperhydrophenanthrene ring, just view the structures and ponder Mother Nature's design features! Perhaps you now have a better feel (seeing the small structural differences) for why it should be that, as was stated in the progestogen entry, each progestogen has a different potency in terms of its progesterone effect, or the androgen side effects (such as to stimulate acne and hair growth), or a partial estrogenic effect. Then you can treat yourself to photomicrographs of the sex hormones, in what the ladies - quite understandably - refer to as gorgeous colors: http://www.oxford.net/~tishy/hormonepics.html. But is it not striking how profound are the differences between the steroids here? And this is only the microscope where the image-forming simulates the much more sensitive molecular receptor response!

Stress:

The medical term is stress response, and it refers to the overall reaction of the organism to any adverse stimulus, whether it be of physical, mental or emotional kind, internal or external. The purpose is to adapt to challenge, and this goes on all the time. (C'est la vie! Real life is a never-ending series of stress responses.) Should the compensating reaction of the organism be inadequate or inappropriate, a pathological disorder may result. (Infertility, or PMS are examples.) The HPA axis, the immune system and the sympathetic nervous system are involved in the stress response. It is a matter of conventional wisdom that perturbations in the external or internal environments (stress) can interfere with normal course of the menstrual cycle. BioSense is basically involved with non-pathological stress responses through monitoring certain end-organ effects. Abnormal cyclic patterns of the end-organ effects may serve as an early warning of pathological disorders. Activation of the hypothalamus-pituitary-adrenal (HPA)-axis by physical, chemical, and psychological perturbations is known to result in elevated levels of serum corticosteroid hormones. Corticosteroids are principal effectors in the stress response and are thought to be responsible for both adaptational and maladaptational response to perturbing situations. They have profound effects on mood and behavior, and affect neurochemical transmission and neuroendocrine control. Cortisol, the predominant corticosteroid in primates, is often regarded as the "stress hormone" and consequently serves as a marker of stress. Cortisol can be measured in blood, urine, and saliva. For information about the adrenal gland and stress, go to http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/adrenal/index.html.


Subfertility:

A state of less than normal fertility but not as bad as clinical infertility. Also called reduced fertility, it refers to the inability to conceive for more than about 4 months but not more than a year (which then becomes classified as clinical infertility). Subfertile couples are naturally interested in methods and tools that can help them to overcome the difficulty to conceive. Professor Brown may be quoted: "Failing to conceive when wanted is stressful and therefore favours infertility. It should be remembered that, apart from a few conditions such as blocked fallopian tubes, absent sperm and continued anovulation, most couples will conceive eventually without help. However, the modern expectation is one of immediate results, and the main function of assisted reproduction techniques is therefore to shorten the waiting time for conception." To which we would add that BioSense aims to offer a more affordable alternative.

Sympto-thermal method:

An NFP method that combines the measurement of the BBT with the self-assessment of cervical mucus and cervical position, along with any other secondary signs of fertility.


T

Telemetry:

The science or process of making remote measurements and sending the data over radio frequencies (RF). The term telemetry stems from two Greek words meaning remote (telistos) and measure (metros). Telemetry is remote measurement or the remote collection of data, which can be physical, environmental or biological (biotelemetry). Telemetry is well advanced and is typically used to gather data from distant, inaccessible locations, or when data acquisition would be dangerous or difficult. Sensors measure physical quantities, and store or transmit the resulting signal. A transducer is a device that converts the output of a sensor into a useful format, typically a voltage or current, which changes proportionally to the sensor response. A device may act as both sensor and transducer, which is the case of the BioSense technology, whereby the tissue response to fertility status is detected as capacitive admittance (reciprocal of impedance). Most wireless medical telemetry equipment operates in the private land mobile radio service (PLMRS) band of frequencies, or as a secondary user in commercial broadcast VHF (very high frequency) TV bands. Very importantly, there is now FCC's new Wireless Medical Telemetry Service (WMTS) which designates specific radio frequency bands for medical telemetry in the U.S., including channel 37 (608-614 MHz) and two higher frequency bands. Because neither land-mobile radios nor television is allowed to operate on these frequencies, these bands are safe from the sources of RF interference that are common to medical telemetry. BioSense will utilize this in its agricultural products as well as in the human parturition (birth) alarm adaptation of its technology. In due course, this could yield a very user friendly cervical cancer screen tool, and perhaps even a new generation of the Ovulona product line.

Temperature shift:

The rise in waking temperature (BBT) that divides the preovulatory low temperatures from the postovulatory high temparatures on a biphasic chart. The postovulatory temperatures are usually at least two tenths of a degree higher than those of the previous 6 days. The temperature shift rule states that the women is "safe" (will not conceive) starting in the evening of the third consecutive day her temperature has been above the coverline. The rule reflects the inherent lack of accuracy of the BBT method.

Tissue:

A part of an organism consisting of an aggregate of cells having a similar structure and function. An aggregation of morphologically similar cells and associated intercellular matter acting together to perform one or more specific functions in the body. There are several basic types of animal tissue: muscle, nerve, epidermal (epithelial), and connective. Bone and blood are also tissues. Epithelium is the covering of internal and external surfaces of the body, including the lining of vessels and other cavities. Everything that enters or leaves the body must pass through an epithelium. It consists of cells joined by small amounts of cementing substances. Histology and cytology are the disciplines that study animal and plant tissues and cells. See: http://www.e-histology.net/tissues.html and http://www.rttinc.com/rtt/tmills/cytology.html.


U

Ultrasound scanning:

The growth of follicles, rupture of a follicle (ovulation) and development of a corpus luteum can be visualized by ultrasound scanning. In fact, the actual rupture of the follicle, the extrusion of the ovum and follicular fluid and/or the smaller size of the ovulated follicle, can all be seen. This is thus the most accurate method of detecting ovulation. Ultrasound scanning has played an important role in providing basic information on all phases of ovarian activity. For daily application, ultrasound scanning is impractical and expensive. It is therefore necessary, and usual, to assess ovarian activity and fertility status by another method, and to use ultrasound scanning as the definitive confirmation of the method, in clinical studies. (But even the ultrasound method is not 100% reliable because up to 20% ruptured follicles may not ovulate. It is prudent to seek evidence corroborating that a ruptured follicle signifies an ovulated follicle.)

Uterus:

A hollow muscular organ located in the pelvic cavity of female mammals in which the fertilized egg implants and develops, having traveled from the ovulating ovary through the fallopian tube. The uterus lies deep in the lower abdomen - the pelvis - and is just behind the urinary bladder. The uterus is shaped like a pear and is about the size of the fist. Inside the muscular walls of the uterus is a very rich lining, called the endometrium, and it is in this lining that the fertilized egg gets implanted. If, however, pregnancy does not occur, this lining is shed along with blood in the form of the menstrual flow. Also called the womb, the uterus is connected with the vagina by a narrow passage called the cervix.


V

Vagina:

The cylindrical canal leading from the external opening of the vulva to the cervix of the uterus in female mammals. From Latin vagina, meaning the sheath or scabbard. [Note: Greek kolpos, vagina, womb - see Colposcopy.] Nature's design of this passage between the uterus and the outside world is such as to chemically protect the uterus and beyond. Only during the limited period of time near ovulation is the chemical protection removed, so as to allow the sperm to enter the uterus through the cervix. At all other times, the acidity of the vagina, and the thick hostile mucus blocking the cervix, prevent any microorganism - including the sperm - from penetrating into the uterus.


X

Xeno-estrogens:

Xeno-estrogens are chemical contaminants introduced into the body from the environment. They mimic the action of estrogen produced in cells and thereby alter hormonal activity. Exposure to these compounds is responsible for many reproductive problems in humans and animals. In the U.S. alone, of the 6.7 million women with fertility problems in 1995, 42% had received some form of infertility services. The most common services were advice and diagnostic tests, medical help to prevent miscarriage, and drugs to induce ovulation [Fam Plann Perspect. 2000 May-Jun;32(3):132-7]. Xeno-estrogens are also being related to breast cancer and testis cancer. Some naturally occurring and easily degraded xeno-estrogens, such as those found in soy products, cabbage, broccoli and cauliflower, can reduce estrogen effects. Others, usually synthetic and difficult to degrade, amplify estrogen effects, causing dangerous proliferation of cells. For more information about these endocrine or hormone disruptors, go to http://www.tmc.tulane.edu/ecme/eehome/sources/links/envirohorm.html.


Z

Zygote:

The fertilized ovum (egg), a single fertilized cell resulting from fusion of the sperm and egg. After further cell division the zygote becomes an embryo. The zygote intra-fallopian transfer (ZIFT) is one of the assisted reproductive technologies (ARTs), in which a woman's egg is fertilized by her partner's sperm in a petri dish and the resulting zygote is then placed back in her fallopian tube.





A Glossary of Infertility Terms and Acronyms published by the InterNational Council on Infertility Information Dissemination is available at http://www.inciid.org/glossary.html








For information about BioSense Corporation and its BioMeter and Ovulona technologies go to http://biosense.freeservers.com.



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