Female Infertility - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

FEMALE

INFERTILITY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Female Infertility: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84419-4 1. Female Infertility-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on female infertility. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON FEMALE INFERTILITY ................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Female Infertility........................................................................... 4 The National Library of Medicine: PubMed ................................................................................ 14 CHAPTER 2. ALTERNATIVE MEDICINE AND FEMALE INFERTILITY ................................................ 33 Overview...................................................................................................................................... 33 National Center for Complementary and Alternative Medicine.................................................. 33 Additional Web Resources ........................................................................................................... 34 General References ....................................................................................................................... 36 CHAPTER 3. DISSERTATIONS ON FEMALE INFERTILITY .................................................................. 37 Overview...................................................................................................................................... 37 Dissertations on Female Infertility .............................................................................................. 37 Keeping Current .......................................................................................................................... 37 CHAPTER 4. PATENTS ON FEMALE INFERTILITY ............................................................................. 39 Overview...................................................................................................................................... 39 Patents on Female Infertility........................................................................................................ 39 Patent Applications on Female Infertility.................................................................................... 42 Keeping Current .......................................................................................................................... 43 CHAPTER 5. BOOKS ON FEMALE INFERTILITY................................................................................. 45 Overview...................................................................................................................................... 45 Book Summaries: Online Booksellers........................................................................................... 45 Chapters on Female Infertility ..................................................................................................... 46 CHAPTER 6. PERIODICALS AND NEWS ON FEMALE INFERTILITY ................................................... 47 Overview...................................................................................................................................... 47 News Services and Press Releases................................................................................................ 47 Academic Periodicals covering Female Infertility........................................................................ 49 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 51 Overview...................................................................................................................................... 51 U.S. Pharmacopeia....................................................................................................................... 51 Commercial Databases ................................................................................................................. 52 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 57 Overview...................................................................................................................................... 57 NIH Guidelines............................................................................................................................ 57 NIH Databases............................................................................................................................. 59 Other Commercial Databases....................................................................................................... 61 APPENDIX B. PATIENT RESOURCES ................................................................................................. 63 Overview...................................................................................................................................... 63 Patient Guideline Sources............................................................................................................ 63 Finding Associations.................................................................................................................... 65 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 67 Overview...................................................................................................................................... 67 Preparation................................................................................................................................... 67 Finding a Local Medical Library.................................................................................................. 67 Medical Libraries in the U.S. and Canada ................................................................................... 67 ONLINE GLOSSARIES.................................................................................................................. 73 Online Dictionary Directories ..................................................................................................... 73 FEMALE INFERTILITY DICTIONARY ...................................................................................... 75

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INDEX .............................................................................................................................................. 105

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with female infertility is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about female infertility, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to female infertility, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on female infertility. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to female infertility, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on female infertility. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON FEMALE INFERTILITY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on female infertility.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and female infertility, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “female infertility” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Infertility and Impotence Following Renal Transplantation Source: Current Opinion in Urology. 6(2): 115-119. March 1996. Contact: Available from Rapid Science Publishers. 400 Market Street, Suite 750, Philadelphia, PA 19106. (800) 552-5866 or (215) 574-2210. Fax (215) 574-3533. Summary: Chronic renal failure is frequently accompanied by endocrine abnormalities that may result in infertility and impotence. This review article details the etiology, evaluation, and treatment of infertility and impotence in the transplant recipient. The authors note that a better understanding of the hormonal changes accompanying endstage renal disease (ESRD) and the effects of immunosuppressive agents on those changes has improved the ability to restore sexual and reproductive function to this population. The transplant recipient should be deemed a candidate for all available

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modalities for the treatment of urologic disorders. This includes injection and surgical procedures for the treatment of impotence that appear to carry only a minimal, if any, increased incidence of infection. One section covers female infertility factors, but the majority of the article focuses on male infertility and impotence issues. 1 figure. 27 references. (AA-M).

Federally Funded Research on Female Infertility The U.S. Government supports a variety of research studies relating to female infertility. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to female infertility. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore female infertility. The following is typical of the type of information found when searching the CRISP database for female infertility: •

Project Title: BIOLOGY OF PHAGE INFECTION IN CHLAMYDIA Principal Investigator & Institution: Bavoil, Patrik M.; Oral & Craniofacial Biol Scis; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-MAY-2006 Summary: (provided by applicant): Chlamydial disease of humans includes predominant ocular, genital and respiratory tract infections, with sequelae ranging from blindness, to female infertility, arthritis and asthma. Chronic infection with the respiratory pathogen, Chlamydia pneumoniae is also associated with coronary heart disease, the number one killer disease of humans. In spite of their public health magnitude, chlamydiae are reputed for their elusiveness as infectious microorganisms to clinicians and molecular biologists alike. This owes to several factors, prominent among which are a unique obligate intracellular developmental lifestyle and the fact that chlamydiae have resisted genetic manipulation to this day. We have isolated a bacteriophage, phiCPG1 from the model Chlamydia psittaci strain ?Guinea Pig Inclusion Conjunctivitis?. A member of the single-stranded DNA microviridae family, phiCPG1 is nearly identical to a ?virtual? phage of C. pneumoniae that was revealed by genome sequence analysis. The infection of an intracellular pathogen by its own parasitic bacteriophage is a unique biological phenomenon, with potentially important implications in infection and disease. Moreover, phages offer unique opportunities for the development of molecular and genetic tools for research. The objectives of this application are therefore to gain a broad understanding of Chlamydia phage biology in the context of chlamydial infection. We will determine the molecular basis of the

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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interaction of the phage with its host and comparatively evaluate gene expression in phage-free and phage-infected bacteria. The availability of well-established models of infection and disease in the guinea pig will allow for the first time to study the impact of phage infection on the natural infection of a vertebrate animal by an obligate intracellular pathogen. Finally, the information gained in these studies will be exploited toward the development of genetic methodologies in Chlamydia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CELL ONCOGENESIS

CYCLE

GENES

IN

OVARIAN

FUNCTION

AND

Principal Investigator & Institution: Kiyokawa, Hiroaki; Molecular Genetics; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2002; Project Start 01-JUN-2000; Project End 30-APR-2004 Summary: The cell division cycle is tightly controlled in a fashion coordinated with differentiation and lineage-specific function. Cyclin-dependent kinases (CDKs), activated by regulatory subunits known as cyclins, form the central machinery of the cell cycle, and their activity is regulated by a variety of extracellular signals. Perturbation of CDK regulation could result in not only deteriorated function of the tissue, but possibly tumor formation. Granulosa cells in the ovary continuously undergo serial processes of proliferation, differentiation and cell death. Recent studies have suggested that precise control of the cell cycle machinery in granulosa cells is critical for female fertility and suppression of ovarian tumors. The hypothesis evaluated in this program is: Cyclin D2/CDK4 is critical for pre-ovulatory proliferation of granulosa cells and subsequent ovulation. The ovulation triggering signal i.e. the surge of luteinizing hormone suppresses cyclin D2 expression and induces expression of the CDK inhibitors p27 and p21. These changes in the cell cycle machinery facilitate differentiation and quiescence of granulosa cells. Intriguingly, the principal investigator has shown that CDK4-deficiency or p27-deficiency in mice results in female infertility. The specific aims are: (1) Determine whether CDK4 activity governs the balance between proliferation and differentiation of granulosa cells, by examining ovaries of CDK4deficient mice after gonadotropin treatment; (2) Determine whether p27 and p21 synergistically regulate exit of granulosa cells from the cell cycle, by examining proliferation, differentiation and tumorigenesis in ovaries of mice lacking both p27 and p21; (3) Determine whether gonadotropin-dependent regulation of cyclin D2 expression is critical for ovulation, luteinization and proliferation control in granulosa cells, by examining effects of transgenic cyclin D2 expression in granulosa/luteal cells in p27(+/+) or (-/-) background. These studies using unique mouse models should provide significant insight into how complex extracellular signals orchestrate cell cycle progression and differentiation in the ovary, and contribute to molecular basis for designing therapeutic strategies against female infertility and ovarian tumors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONSTITUTIVELY ACTIVE LH RECEPTORS IN TRANSGENIC MICE Principal Investigator & Institution: Narayan, Prema; Biochem and Molecular Biology; University of Georgia 617 Boyd, Gsrc Athens, Ga 306027411 Timing: Fiscal Year 2004; Project Start 01-JAN-2004; Project End 30-DEC-2007 Summary: (provided by applicant): The long-term goals of this research are to understand the reproductive consequences of expression of constitutively active

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Female Infertility

luteinizing hormone receptors (LHR). The critical role of LHR in male and female reproduction is underscored by the developmental and reproductive defects resulting from activating and inactivating mutations in the receptor. For example, activating mutations in human LHR are associated with familial male-limited precocious puberty (FMPP) and Leydig cell hyperplasia. Transgenic and knockout mouse models have facilitated our understanding of normal and pathophysiological functions of hormones and receptors. To examine the consequences of chronic ligand-mediated LHR activity, we have generated transgenic mice expressing a yoked hormone-receptor fusion protein (YHR) with constitutive activity. Male transgenic mice produce increased prepubertal levels of testosterone, accompanied by decreased testicular size and diameter of the seminiferous tubules. Female transgenic mice exhibit increased folliculogenesis at early ages, and at three months there is increased follicular atresia and the presence of follicular cysts suggesting that constitutive LHR activity may result in premature ovarian failure. The goals of this proposal are to elucidate the endocrine and molecular basis for altered testicular development and early reproductive senescence observed in the ovary. In the first aim we will examine the developmental changes in testicular and ovarian morphology and histology and determine the effect of chronic LHR activation on testicular somatic cell development and oocyte depletion. In the second aim we will analyze the temporal changes in hormone levels and expression of key molecules in the LHR signaling pathways to determine the endocrine and molecular basis of the testicular and ovarian phenotype. These studies will contribute new information on testicular and ovarian physiology and pathophysiology and provide insight into the molecular mechanisms of FMPP, female infertility and premature ovarian failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COOPERATIVE MULTI CENTER REPRODUCTIVE MEDICINE NETWORK Principal Investigator & Institution: Myers, Evan R.; Associate Professor; Obstetrics and Gynecology; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 10-MAR-2000; Project End 28-FEB-2005 Summary: Disorders of the reproductive system, such as male and female infertility, leiomyomata, endometriosis, polycystic ovarian syndrome, and sexual dysfunction, have a major public health and economic impact. For some conditions, such as infertility, many patients are responsible for all costs associated with therapy, and unintended consequences, such as multiple gestations, are relatively common. For other conditions, such as endometriosis or leiomyomata, definitive therapy may result in the loss of childbearing potential, and long-term evidence about alternatives is scant. Relatively few interventions for these disorders have subjected to rigorous scientific evaluation. The long-term objective of this project is to improve the care of men and women with disorders affecting the reproductive system by conducting controlled trials of selected diagnostic and therapeutic interventions. The specific aims of the Data Coordinating Center (DCC) for the Cooperative Reproductive Medicine Network are (A) to develop trial protocols that address important clinical problems using scientifically valid, clinically feasible, and economically reasonable approaches through collaboration with participating Reproductive Medicine Units (RMUs) and NICHD staff, (B) to provide leadership in defining and measuring a range of important outcomes, including physiological measurements, clinical outcomes, and economic and quality of life measures, (C) to coordinate and/or provide all services necessary for conducting trials, including recruiting services, and quality control, and (D) to coordinate the

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analysis, reporting, and dissemination of trial results to the Data Safety and Monitoring Committee, the RMUs, NICHD, peer-reviewed journals, and the public. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COUPLING OF D-CHIRO-INOSITOL TO INSULIN IN PCOS WOMEN Principal Investigator & Institution: Iuorno, Maria J.; Internal Medicine; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism and chronic anovulation and it is the most common form of female infertility in the U.S. It has been demonstrated that insulin resistance accompanied by compensatory hyperinsulinemia is, in part, responsible for the hyperandrogenism and anovulation of this disorder. The cellular mechanisms of insulin resistance in PCOS are still largely unknown. D-chiro-inositol phosphoglycan (DCI-IPG) is a nonclassical mediator of insulin action that has been demonstrated to increase glucose utilization. Previous studies have shown that administering a drug similar to the native mediator to women with PCOS increases insulin sensitivity, reduces ovarian androgen production and improves ovulation in these women. Therefore, it seems likely that women with PCOS have a defect in DCI-IPG cellular activity that leads to insulin resistance. The aim of this application is to determine whether a defect in coupling between D-chiro-inositol phosphoglycan and insulin plays a role in the insulin resistance of PCOS. We propose to assess the coupling of the DCI-IPG to insulin in women with PCOS and normal women: 1) by administering diazoxide to these women in order to temporarily suppress their pancreatic insulin secretion and measure a change in activity in DCI-IPG in plasma of these women following suppression of insulin and 2) by restoring insulin following diazoxide administration using an insulin clamp and measuring the degree to which DCI-IPG activity is also restored during the clamp in normal women versus women with PCOS. Hence, both PCOS women and normal control women will be evaluated for this insulin to DCI-IPG activity relationship. It is our hypothesis that at least one mechanism of insulin resistance in PCOS is due to defective coupling between insulin and DCI-IPG activity. The results of these studies will 1) describe the physiologic, in vivo relationship between insulin and DCI-IPG in normal women; 2) provide a mechanism for insulin resistance in PCOS as it relates to the DCI-IPG insulin signaling cascade; 3) provide the groundwork for further clinical studies to explore the role of defective coupling in other insulin resistant human conditions (such obesity or type 2 diabetes); and 4) lead to novel specific therapies for the insulin resistance of PCOS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GCD MOUSE--MODEL FOR HUMAN AZOOSPERMIA Principal Investigator & Institution: Bishop, Colin E.; Professor; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2002 Summary: Germ cell development is a complex, strictly ordered process of cell division and differentiation starting with the segregation of diploid primordial germ cells (PGCs) from the somatic lineage and finishing with the production of large numbers of mature haploid spermatozoa or oocytes. It is an essential determinant of fertility in all mammals, playing a fundamental role in the perpetuation of the species, maintaining its

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genetic diversity and driving evolution. Recently, considerable progress has been made in identifying genes that play a role in the later meiotic stages of germ cell progression. However, very little is known about the pathways involved in the very earliest stages of PGC development. development. In fact, only four genes in the mouse have known, specific effects on PGCs (MGF, Kit, Ter, gcd). Mutations in each cause PGC deficiency and fertility problems. With the exception of gcd, these mutations are pleiotropic making an analysis of the specific germ cell component more difficult. The present proposal is designed to fill this gap in our knowledge, by identifying specific genes involved in the migration and proliferation of PGCs. The non-pleiotropic germ cell deficient (gcd) mouse mutant will be used as a model system. Analysis of this mutant clearly shows that disruption at a single locus, can drastically reduce the PGCs in the embryonic gonad, giving rise to male and female infertility. The male phenotype of a severe oligospermia quickly followed by azoospermia with only a few functional tubules, is very similar to the human Sertoli Cell Only syndrome (SCOS) seen in infertile human males. The specific aims of this project are designed to identify the gene underlying the gcd phenotyping using positional cloning and gene targeting. Its structure, spatio-temporal expression pattern and possible of studied by reintroducing the gene into gcd/gcd mice via transgenesis. That the cloning of gcd represents a unique opportunity to gain new insights into the fundamental biology of primordial germ lines and the intractable problem of infertility in humans. It will allow us to examine the possibility that errors in the GCD gene itself, or in a pathway which in controls, underlie a significant percentage of such cases in human. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GONADAL AND ENDOMETRIAL FUNCTION IN HUMAN REPRODUCTION Principal Investigator & Institution: Giudice, Linda C.; Professor; Gynecology and Obstetrics; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 07-APR-1997; Project End 31-MAR-2007 Summary: Our currently funded NIH U-54 SCCPRR Center has provided the foundation for a rich, interactive environment for the pursuit of and training in reproductive biology and medicine at Stanford University. It consists of an integrated group of investigators in the Department of Gynecology and Obstetrics and for this competitive renewal adds an investigator in Developmental Biology and In Situ Hybridization Core, and Bioinformatics Core). The projects are designed to investigate molecular mechanisms governing reproductive processes in the ovary, endometrium, and testis, and to benefit specifically from interactions among investigators and cores. The central endometrium, and testing, and to benefit specifically from interactions among investigators and cores. The central theme of the Center is gonadal and endometrial function in reproduction, with a focus on the human, thereby enhancing the long-term goal of translational research to clinical reproductive disorders, including infertility and poor pregnancy outcome. Projects by Hsuehi and Conti interact, as they focus on early ovarian follicle development and on the role of mechanisms governing meiosis in the female gonad, respectively. Project by Giudice investigates auto/paracrine mechanisms in human implantation, primarily involving the IGF system. It interacts extensive with Project by Conti from the perspective of signaling mechanisms and Project by Fuller due to new findings in human endometrium of the Drosophila homologs important in cell-cell interactions. In this renewal, we will welcome a new project (Fuller) that focuses on early events in meiosis in the male gonad, using the Drosophila model. It interacts with Project by Hsuehi, Conti and

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Giudice. The pilot project (Tazuke) focuses on early germ cell development in the male gonad using the Drosophila model with a translation to the human. It interacts will allow projects. The enter is highly enriched by the University environment with seminars, courses, conferences, and core facilities. Issues of female infertility and fertility are critical to the national agenda to improve women's health care. Male factors also contribute significantly to reproductive failure, and understanding their pathogenesis and treatment is very important. Our Center's goal is to investigate basic cellular and physiologic processes involve din normal reproductive function, laying the foundation to understand abnormal follicle failure, male infertility, miscarriage and ectopic pregnancy. Advances in the enter are anticipated to lead to new diagnostic and therapeutic modalities for reproductive disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMMUNOLOGIC MECHANISMS IN HUMAN FEMALE INFERTILITY Principal Investigator & Institution: Herr, John C.; Professor; Cell Biology; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-JUL-2004 Summary: Titers of anti-sperm antibodies in patient sera, follicular fluid, and/or cervical mucus have been shown to correlate with reduced fertility rats. This research project will develop a primate model for immunologic infertility based on Sperm Agglutination Antigen-1 (SAGA-1), a sperm glycoprotein that has been identified as a surface antigen involved in antibody-mediated infertility in humans. SAGA-1 was identified with a murine monoclonal antibody (mAb), S19, that agglutinates human spermatozoa, inhibits sperm-zona blinding, blocks sperm penetration of cervical mucus, and induces the shaking phenomena. SAGA-1 is also recognized by H6-3C4, a human sperm-agglutinating mAb produced using lymphocytes from an immunologically infertile women. The human H6-3C4 antibody and the function-inhibitory mAb S19 recognize carbohydrate epitopes present on the SAGA-1 glycoprotein. Microsequence analysis demonstrated that SAGA-1 is related to CDw52, a GPI-anchored protein first identified on lymphocytes and involved in signal transduction. The S19 and H6-3C4 carbohydrate epitopes are not present on the CDw252 glycoprotein. Therefore, SAGA-1 and CDw52 represent glycoforms, i.e. glycoprotein isoforms that have the same peptide sequence but possess different oligosaccharide side chains. The specific aims of this research proposal includes studies to elucidate the carbohydrate structure of the SAGA1 glycoform. The tissue-specific expression of the SAGA-1 S19 carbohydrate epitope will be investigated with immunochemical analyses. The putative role of SAGA-1 in spermzona/cell-extracellular matrix interactions will be examined using the human hemi-zona assay. To investigate SAGA-1 as an auto-, iso-, antigen involved in immunologic infertility, female macaques will be immunized with SAGA-1. Anti-SAGA-1 antibody titers in sera, cervical mucus, and oviductal fluid will be monitored and the effect(s) of these antibodies on sperm function will be determined in vitro. The proposed research will contribute to understanding the roles of SAGA-1 and the sperm glycocalyx in sperm-zona/cell-extracellular matrix interactions and will provide a non-human primate model for the study of antibody- mediated infertility. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MICRO-ASSISTED FERTILIZATION/GENETIC DEFECTS Principal Investigator & Institution: Lamb, Delores J.; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030

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Female Infertility

Timing: Fiscal Year 2002 Summary: While the problem of female infertility has been a focus of scientific political, and media attention, abnormalities in the male account for 30- 50% of all infertile cases, yet has received little attention. Most cases of male infertility are a consequence of too few or abnormal sperm, yet the factors that contribute to the problem are unknown. As a result, relative little effective therapy has been established for the male with impaired sperm production. The development of intracytoplasmic sperm injection (ICSI) with in vitro fertilization (IVF) has improve our ability to use suboptimal semen specimens to produce conceptions. ICSI has been used to achieve pregnancies for patients with genetic causes of infertility and for axoospermic patients with severe spermatogenic defects by testicular sperm extraction (TESE). It is likely that many types of "idiopathic" infertility are actually due to genetic defects. In this translational project, we will test the hypothesis that genetic instability is present in the testis of some axospermic candidates for TESE-ICSI. This will be examined at the constitutional chromosomal level using high resolution banding cytogenetics and fluorescent in situ hybridization (FISH) and at the level of specific nucleotides using microsatellite instability and Y chromosome deletion intervals. We propose to evaluate the safety of game micromanipulation in human IVF. Clinical and genetic assessment of each subfertile man and long-term genetic and developmental ealaut8ion of the children resulting from micromanipulation will be performed. The results of these studies will be evaluated in association with state-of-theart clinical and molecular laboratory examination of the male that is necessary for proper patient classification. We propose that molecular characterization of patients may provide the most important insights into ICSI outcomes. Finally, we will use neural computation to model ICSI outcomes derived from this proposal. Our long-range goal is to develop a safe and effective treatment for the infertile male patient. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR ASPECTS OF IMPLANTATION Principal Investigator & Institution: Lim, Hyunjung J.; Obstetrics and Gynecology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: Prostaglandin (PG) signaling pathway has long been implicated in various female reproductive functions including implantation, because of vasoactive, mitogenic and differentiating properties of PGs. Indeed, expression and gene targeting experiments have established a fundamental role for cyclooxygenase-2 (COX-2), the rate-limiting enzyme in PG biosynthesis, in ovulation, fertilization, implantation and decidualization. Further experiments revealed that prostacyclin (PGI2) is the major product of uterine COX-2, and among several receptor candidates, this PG utilizes PPARdelta in mediating implantation. This work demonstrated the first biologic function of PPARdelta and showed that the mouse is a powerful model to scrutinize the molecular and physiological mechanism of PPARdelta-driven implantation process. The PPAR family of transcription factors belongs to the nuclear hormone receptor superfamily. Transcriptional activation of target genes by PPAR depends on ligandinduced heterodimerization with a retinoid X receptor (RXR) and recruitment of several cofactors. Thus, uterine PPARdelta, when bound to COX-2-derived PGI2, is likely to regulate the expression of a bank of genes involved in implantation. Among the three isoforms of PPAR, PPARalpha and PPARgamma are implicated in adipocyte differentiation, fatty acid metabolism, or terminal differentiation of cancer, while information on PPARdelta is limited. Therefore, an in-depth investigation on the molecular pathway of PPARdelta is proposed in a physiologically relevant system, i.e.,

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embryo implantation. Our specific aims using the mouse are: 1) to examine whether COX- 2 is regulated by PPARdelta during implantation; 2) to identify cofactor usage by uterine PPARdelta/RXR; 3) to identify downstream target genes of PPARdelta in the uterus by chromatin precipitation; and 4) to test the involvement of PPARdelta in implantation using PPARdelta deficient mice and with mouse models with directed expression of dominant-negative PPARdelta in the uterus. Experimental approaches includes the use of mutant mice, Northern and Western blotting, in situ hybridization, co- immunoprecipitation, cell culture and transfection, chromatin precipitation, protein delivery system and generation of transgenic mice. The results obtained from these studies will provide novel information regarding the unique role of PPARdelta and will advance our understanding in human reproduction with potentials in alleviating female infertility and development of contraceptives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NATIONAL CENTER FOR RESEARCH ON FEMALE INFERTILITY Principal Investigator & Institution: Strauss, Jerome F.; Professor; Obstetrics and Gynecology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-DEC-1996; Project End 30-JUN-2002 Summary: (Adapted from applicant's description) The research focus of this Center will be the elucidation of the genetic basis of polycystic ovary syndrome (PCOS), a major cause of infertility and metabolic disease. The Center will support an interactive research program including investigators from the University of Pennsylvania, the Pennsylvania State University Milton S. Hershey Medical Center and the University of California, San Francisco. The major hypothesis is that PCOS is caused by abnormal alleles at one or several loci which cause intrinsic defects in ovarian androgen biosynthesis. A secondary hypothesis is that defects in the insulin signal transduction system lead to insulin resistance and subsequent metabolic complications, but enhanced ovarian androgen synthesis. These hypotheses will be addressed by a molecular genetic approach to the identification of PCOS-related genes based on a genome-wide linkage analysis; the exploration of biochemical and molecular differences in normal and PCO human thecal cells including an analysis of mechanisms of regulation of ovarian androgen production by insulin and a novel protein (leptin) secreted by fat; posttranslational regulation of the activity of P450c17, a key enzyme controlling androgen synthesis; and a study of the life history and metabolic sequelae of PCOS in different ethnic groups. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PHYSIOLOGY

NEUROENDO

SIGNAL

TRANSDUCTION--REPRODUCTIVE

Principal Investigator & Institution: Gregerson, Karen A.; Associate Professor; Pharmacological & Physiol Scis; St. Louis University St. Louis, Mo 63110 Timing: Fiscal Year 2002; Project Start 01-JAN-1999; Project End 30-NOV-2003 Summary: Prolactin (PRL), an anterior pituitary hormone, has profound effects on female fertility. In fact, hypersecretion of PRL is the major neuroendocrine-related pathology associated with female infertility. Unfortunately, the underlying defects which lead to the hypersecretion of PRL remain ill-defined. To provide a rational framework for understanding these defects and treating associated pathologies, it is essential to elucidate the cellular and molecular mechanisms of PRL secretion regulation. Normally PRL secretion is under tonic inhibition by hypothalamic dopamine

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Female Infertility

(DA). Periodic, physiological surges of PRL in females require a withdrawal from this dopaminergic inhibition. Since reduced responsiveness to DA is a hallmark of hyperprolactinemic syndromes, our attention has focused on the cellular and molecular basis of DA action on the lactotrope. We have discovered and extensively characterized a DA-activated inwardly-rectifying potassium channel (KDA) in normal lactotropes. KDA activation by DA leads to hyperpolarization of the lactotrope membrane and cessation of calcium-dependent action potentials, the driving force for tonic PRL secretion. In vitro studies have demonstrated a critical role for this KDA channel in the regulation PRL release by DA. Furthermore, the functional expression of KDA is dependent upon estrogen, which may explain a long-recognized modulatory action of estrogen on this system. In these regards, the KDA channel lies at the top of a hierarchy of events in dopaminergic regulation of PRL secretion. As an initial step in elucidating the molecular basis for the physiological role of KDA in lactotropes, we have cloned three different K channel gene products from female anterior pituitary tissue. Based on functional similarities between the native channel and recombinant channels expressed in Xenopus oocytes, two of the gene products are excellent candidate subunits encoding a heteromultimeric KDA. As a logical extension of these studies, we propose to evaluate the role of this effector K channel within its physiological context- the whole animalthrough transgenic technology. To this end, we will design and construct "dominantnegative" mutants, capable of inhibiting wild-type KDA function in lactotropes. We will then create a transgenic mouse model in which expression of this mutant is directed to pituitary lactotropes using the PRL promoter. These studies represent a timely and important extension of the P.I.'s work and will ultimately provide insight into the basis of disorders in PRL secretion and their impact on female fertility. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHYSIOLOGY & ACTION OF A NEW FOLLISTATIN-RELATED PROTEIN Principal Investigator & Institution: Schneyer, Alan L.; Associate Professor of Medicine; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 01-AUG-2001; Project End 31-JUL-2006 Summary: Follistatin-related protein (FSRP) is a recently discovered glycoprotein whose gene structure and activin binding properties are highly homologous to the activin binding protein follistatin (FS). FSRP was originally cloned as an overexpressed protein in a B-cell leukemia and is expressed in numerous cancer cell lines, suggesting it may be involved with, or be a useful marker for a wide array of tumors. Unlike FS, however, FSRP is most highly expressed in the placenta and testis (FS is highest in the ovary and kidney), indicating that FSRP has unique functions in these tissues. Immunocytochemical studies have demonstrated that FSRP is highly concentrated in the nucleus of all cell lines and primary cells tested, but is secreted only by cells with the highest FSRP expression levels. These observations suggest that regulation of FSRP intracellular trafficking is complex and unique, and further, that FSRP may have nuclear activities distinct from strictly non-nuclear FS. Overexpression of FSRP in transgenic mice disrupts follicular development, resulting in female infertility. Thus, the broad goal of this proposal is to determine the biological functions of FSRP in normal and pathophysiological circumstances, as well as to elucidate the biochemical features of this protein which govern its unique biology and distribution. Transgenic and knockout mice, along with several in vitro bioassays will be utilized to identify the normal and pathophysiological actions of FSRP (Specific Aim 1). Intracellular trafficking, regulation of biosynthesis, and nuclear functions of FSRP will be examined in HeLa and human

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granulosa cells using pulse chase labeling, immunoprecipitation, and affinity chromatography (Specific Aim 2). The binding affinity and ligand specificity, as well as functional domains of FSRP responsible for these activities and FSRP's nuclear localization will be examined using site directed mutagenesis and domain swapping with FS (Specific Aim 3). The results of the proposed research program will define the role(s) of FSRP in normal physiology, determine the mechanism whereby FSRP overexpression disrupts folliculogenesis, and define the novel regulatory mechanisms that results in nuclear localization and activity of a protein that is also secreted. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: UNDERSTANDING OVARIAN CONTROL IN RARE BIOMEDICAL MODELS Principal Investigator & Institution: Pelican, Katharine M.; Smithsonian Institution Victor Bldg, Ste 9200, Mrc 903 Washington, Dc 205600903 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): The candidate in this application will receive stateof-the art training while advancing scholarly knowledge on ovarian cycle control in felids (cats). Specific objectives are to investigate the mechanisms regulating ovarian activity, develop effective protocols for ovarian inhibition, and to apply these protocols to improve ovarian response to gonadotropin stimulation for AI and IVF. This, in turn, will help propagate cats valuable to biomedical research and conserve endangered felid species. Many rare cat populations are difficult to manage due to poor reproductive capacity, physical and behavioral obstacles to breeding success, and limitations on transporting animals between institutions. Unfortunately, females also experience low pregnancy success after Al and IVF due, in part, to high variability in ovarian response to exogenous gonadotropins. Controlling the ovary prior to ovulation induction improves pregnancy success in some species, but this concept has not been tested in an induced ovulator such as the cat. This project will combine basic and applied research to characterize the female response to four ovarian cycle inhibitors: 1) leuprolide acetate (Lupron), a gonadotropin releasing hormone (GnRH) agonist; 2) Antide, a GnRH antagonist; 3) levonorgestrel (Norplant), a progestogen implant; and 4) altrenogest (Regumate), an oral progestogen. The impact of ovarian cycle inhibition prior to gonadotropin stimulation will be examined at three sites: 1) the ovary during hormonal therapy, 2) the follicle and oocyte after gonadotropin stimulation, and 3) the uterus after ovulation induction and AI. Findings will be applied to rare felid models used in biomedical research and selected rare felid species to enhance propagation success. This research program is designed to provide a multidisciplinary, integrative training opportunity that will allow the candidate to advance as a reproductive physiologist with expertise in endocrinology, immunoassay development, noninvasive hormone monitoring, gamete metabolism, laparoscopy, AI, IVF, immunohistochemistry, reverse transcriptase polymerase chain reaction (RT-PCR) and histology. Research benefits include: 1) understanding mechanisms for controlling ovarian function in felids, 2) characterizing the impact of ovarian cycle inhibition prior to exogenous gonadotropin stimulation, 3) developing a research strategy for investigating complex mechanisms of female infertility, and 4) enhancing the efficiency of feline model propagation to ensure continued availability of cats for biomedical research and species conservation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Female Infertility

Project Title: UTERINE VASCULAR CHANGES & ANGIOGENESIS DURING IMPLANTATION Principal Investigator & Institution: Dey, S K.; University of Kansas Medical Center Msn 1039 Kansas City, Ks 66160 Timing: Fiscal Year 2002 Summary: Increased uterine vascular permeability and angiogenesis at the sites of implantation are critical to the process of implantation. Are critical to the process of implantation. Prostaglandins (PGs), because of their vasoactive and pro-angiogenic nature, are implicated in these events. The cyclooxygenase (COX) system, the ratelimiting step in PG synthesis, exist in two isoforms: COX-1 and COX-2. We have established that COX-2 derived prostacyclin (PGI2) via activation of PPARdelta is essential for implantation. We hypothesize that COX-2-PGIs-PPARdelta signaling participates in uterine vascular permeability and angiogenesis required for implantation via coordinated interactions of vascular endothelial growth factor (VEGF) with angiopoietins. Thus, implantation failure in COX-2 deficient mice may result from aberrant uterine expression of the VEGF and/or angiopoietin systems. Our specific aims are to determine in the mouse: (1) Expression of angiopoietins, Tie-2 receptor and their interactions in the peri-implantation mouse uterus; (2) Status of VEGF and angiopoietin systems in the peri-implantation uteri of COX-2(-/-) mice; (3) Effects of deficiency of COX-2 on uterine vascular responses and angiogenesis; and (4) COX-2-PGI2-PPARdelta signaling in uterine angiogenesis during implantation and decidualization. The results obtained from these specific aims will provide valuable and comprehensive new information (i) regarding the participation of uterine vascular permeability and angiogenesis during implantation and (ii) whether COX-2 derived PGI2 signaling via activation of PPARdelta directly influence the uterine VEGF and/or angiopoietin systems during implantation. Experimental approaches will include the use of mutant mice, RT-PCR Southern, Northern and in situ hybridization, immunohistochemistry, cross-linking, Western blotting, embryo transfers and cultures. The results of this investigation will aid in alleviating female infertility and prevention of abnormal development in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with female infertility, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “female infertility” 3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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(or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for female infertility (hyperlinks lead to article summaries): •

A case of female infertility investigated by contrast-enhanced echo-gynecography. Author(s): Davison GB, Leeton J. Source: Journal of Clinical Ultrasound : Jcu. 1988 January; 16(1): 44-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3150388&dopt=Abstract

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A new molecular variant of luteinizing hormone associated with female infertility. Author(s): Liao WX, Roy AC, Chan C, Arulkumaran S, Ratnam SS. Source: Fertility and Sterility. 1998 January; 69(1): 102-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9457942&dopt=Abstract

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A study on Trichomoniasis vaginalis and female infertility. Author(s): El-Shazly AM, El-Naggar HM, Soliman M, El-Negeri M, El-Nemr HE, Handousa AE, Morsy TA. Source: J Egypt Soc Parasitol. 2001 August; 31(2): 545-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11478453&dopt=Abstract

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Antibodies against spermatozoal surface--membrane antigens in female infertility. Author(s): Ingerslev HJ. Source: Acta Obstetricia Et Gynecologica Scandinavica. Supplement. 1981; 100: 1-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6170206&dopt=Abstract

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Apoptosis of granulosa cells and female infertility in achondroplastic mice expressing mutant fibroblast growth factor receptor 3G374R. Author(s): Amsterdam A, Kannan K, Givol D, Yoshida Y, Tajima K, Dantes A. Source: Molecular Endocrinology (Baltimore, Md.). 2001 September; 15(9): 1610-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11518810&dopt=Abstract

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Association between female infertility and agricultural work history. Author(s): Fuortes L, Clark MK, Kirchner HL, Smith EM. Source: American Journal of Industrial Medicine. 1997 April; 31(4): 445-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9093660&dopt=Abstract

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Auricular acupuncture in the treatment of female infertility. Author(s): Gerhard I, Postneek F. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1992 September; 6(3): 171-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1442162&dopt=Abstract

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Blepharophimosis and its association with female infertility. Author(s): Jones CA, Collin JR. Source: The British Journal of Ophthalmology. 1984 August; 68(8): 533-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6743620&dopt=Abstract

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Bromocriptine treatment of female infertility: report of 13 pregnancies. Author(s): Thorner MO, Besser GM, Jones A, Dacie J, Jones AE. Source: British Medical Journal. 1975 December 20; 4(5998): 694-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1203727&dopt=Abstract

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Clinical and biochemical experiences with danazol in the treatment of endometriosis in cases with female infertility. Author(s): Mettler L, Semm K. Source: Postgraduate Medical Journal. 1979; 55 Suppl 5: 27-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=537950&dopt=Abstract

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Comparable clinical outcomes of tubal embryo transfer for oligoasthenoteratozoospermia treated with intracytoplasmic sperm injection and for female infertility treated with in vitro fertilization. Author(s): Chang SY, Lien KC, Huang FJ, Kung FT, Tsai MY. Source: Changgeng Yi Xue Za Zhi. 2000 May; 23(5): 253-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10916225&dopt=Abstract

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Comparison of diagnostic accuracy of laparoscopy, hysteroscopy, and hysterosalpingography in evaluation of female infertility. Author(s): Snowden EU, Jarrett JC 2nd, Dawood MY. Source: Fertility and Sterility. 1984 May; 41(5): 709-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6232154&dopt=Abstract

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Comparison of hysterosalpingography and hysteroscopy in female infertility. Author(s): Wang CW, Lee CL, Lai YM, Tsai CC, Chang MY, Soong YK. Source: The Journal of the American Association of Gynecologic Laparoscopists. 1996 August; 3(4): 581-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9050692&dopt=Abstract

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Correlation between trichomoniasis vaginalis and female infertility. Author(s): el-Sharkawy IM, Hamza SM, el-Sayed MK. Source: J Egypt Soc Parasitol. 2000 April; 30(1): 287-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10786039&dopt=Abstract

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Cost-effectiveness of gamete intrafallopian transfer in comparison with induction of ovulation with gonadotropins in the treatment of female infertility: a clinical trial. Author(s): Wessels PH, Cronje HS, Oosthuizen AP, Trumpelmann MD, Grobler S, Hamlett DK. Source: Fertility and Sterility. 1992 January; 57(1): 163-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1730312&dopt=Abstract

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Development of embryos from natural cycle in-vitro fertilization: impact of medium type and female infertility factors. Author(s): Monks NJ, Turner K, Hooper MA, Kumar A, Verma S, Lenton EA. Source: Human Reproduction (Oxford, England). 1993 February; 8(2): 266-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8473432&dopt=Abstract

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Diagnosis and management of female infertility. Author(s): Smith S, Pfeifer SM, Collins JA. Source: Jama : the Journal of the American Medical Association. 2003 October 1; 290(13): 1767-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14519712&dopt=Abstract

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Diagnosis and treatment of female infertility on the basis of material from the Ist Clinic of Operative Gynecology of Medical Academy in Lublin in 1975-1982. Author(s): Zrubek H, Czajka R, Oleszczuk J, Semczuk M, Jakiel G, Szymanski CZ, Leszczynska-Gorzelak B. Source: Ann Univ Mariae Curie Sklodowska [med]. 1985; 40: 157-62. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3917074&dopt=Abstract

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Diagnosis of female infertility. A comprehensive approach. Author(s): Serafini P, Batzofin J. Source: J Reprod Med. 1989 January; 34(1): 29-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2649667&dopt=Abstract

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Doppler ultrasound findings in female infertility. With special reference to pelvic inflammatory disease and endocrinological factors. Author(s): Tinkanen H. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1995 October; 74(9): 762-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7572118&dopt=Abstract

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Drugs in the treatment of female infertility. Recent advances. Author(s): Quigley MM. Source: Drugs. 1986 August; 32(2): 169-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3527660&dopt=Abstract

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Dynamic echohysteroscopy: a new diagnostic technique in the study of female infertility. Author(s): Nannini R, Chelo E, Branconi F, Tantini C, Scarselli GF. Source: Acta Eur Fertil. 1981 June; 12(2): 165-71. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7293673&dopt=Abstract

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Dynamic echohysteroscopy: new perspectives for diagnostic sonography in female infertility. Author(s): Nannini R, Chelo E, Noci I, Tantini C, Scarselli GF. Source: Acta Eur Fertil. 1984 March-April; 15(2): 141-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6475462&dopt=Abstract

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Effects of the anti-oestrogens, clomiphene and tamoxifen, on the cervical factor in female infertility. Author(s): Elstein M, Fawcett GM. Source: Ciba Found Symp. 1984; 109: 173-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6394243&dopt=Abstract

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Endocrinology of female infertility. Author(s): Baird DT. Source: British Medical Bulletin. 1979 May; 35(2): 193-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=387167&dopt=Abstract

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Endometrial echo and its significance in female infertility. Author(s): Brandt TD, Levy EB, Grant TH, Marut E, Leland J. Source: Radiology. 1985 October; 157(1): 225-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3929327&dopt=Abstract

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Etiological implication of autoantibodies to zona pellucida in human female infertility. Author(s): Kamada M, Daitoh T, Mori K, Maeda N, Hirano K, Irahara M, Aono T, Mori T. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 1992 September; 28(2): 104-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1285850&dopt=Abstract

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Evolution of radiologic procedures in the study of female infertility. Author(s): Vincenzoni M, Valentini AL. Source: Rays. 1998 October-December; 23(4): 600-2. English, Italian. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10191654&dopt=Abstract

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Experience with bromocriptine for the treatment of female infertility due to hyperprolactinemia. Author(s): Lin SQ, Gu CX, Xu L, Wang HL, Ge QS. Source: Chinese Medical Journal. 1991 August; 104(8): 679-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1914636&dopt=Abstract

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Female infertility. Author(s): Hull MG, Cahill DJ. Source: Endocrinology and Metabolism Clinics of North America. 1998 December; 27(4): 851-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9922911&dopt=Abstract

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Female infertility. Author(s): Mattox JH. Source: The Journal of Family Practice. 1982 September; 15(3): 533-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7108467&dopt=Abstract

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Female infertility. Author(s): Cooke ID. Source: The Practitioner. 1979 November; 223(1337): 614-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=530917&dopt=Abstract

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Female infertility: causes and treatment. Author(s): Healy DL, Trounson AO, Andersen AN. Source: Lancet. 1994 June 18; 343(8912): 1539-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7911874&dopt=Abstract

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Female infertility: radiology and endoscopy in morphofunctional imaging. Author(s): Marano P. Source: Rays. 1998 October-December; 23(4): 597-9. English, Italian. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10191653&dopt=Abstract

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Female infertility--effect of perinatal xenoestrogen exposure on reproductive functions in animals and humans. Author(s): Gotz F, Thieme S, Dorner G. Source: Folia Histochem Cytobiol. 2001; 39 Suppl 2: 40-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11820621&dopt=Abstract

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Fluoroscopic transcervical fallopian tube catheterization for diagnosis and treatment of female infertility caused by tubal obstruction. Author(s): Thurmond AS, Rosch J, Patton PE, Burry KA, Novy M. Source: Radiographics : a Review Publication of the Radiological Society of North America, Inc. 1988 July; 8(4): 621-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3175081&dopt=Abstract

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Genes and chromosomes that cause female infertility. Author(s): Simpson JL. Source: Fertility and Sterility. 1985 December; 44(6): 725-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3935483&dopt=Abstract

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Genetic causes and workup of male and female infertility. 1. Prenatal reproductive loss. Author(s): Opitz JM, Shapiro SS, Uehling DT. Source: Postgraduate Medicine. 1979 May; 65(5): 247-52, 256. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=432156&dopt=Abstract

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Genetic causes and workup of male and female infertility. 2. Abnormalities presenting between birth and adult life. Author(s): Opitz JM, Shapiro SS, Uehling DT. Source: Postgraduate Medicine. 1979 June; 65(6): 157-62, 164, 166. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=450814&dopt=Abstract

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Genetic causes and workup of male and female infertility. 3. Details of the clinical evaluation. Author(s): Opitz JM, Shapiro SS, Uehling DT. Source: Postgraduate Medicine. 1979 July; 66(1): 129-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=471840&dopt=Abstract

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Genital tuberculosis associated with female infertility in the western Cape. Author(s): de Vynck WE, Kruger TF, Joubert JJ, Scott F, van der Merwe JP, Hulme VA, Swart Y. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1990 June 16; 77(12): 630-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2113716&dopt=Abstract

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Gonadotropin therapy of female infertility. Author(s): Dale PO, Tanbo T, Henriksen T, Magnus O, Abyholm T. Source: Acta Endocrinol (Copenh). 1989 March; 120(3): 395-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2494828&dopt=Abstract

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Gonadotropin therapy of female infertility. Analysis of results in 416 cases. Author(s): Zimmermann R, Soor B, Braendle W, Lehmann F, Weise HC, Bettendorf G. Source: Gynecologic and Obstetric Investigation. 1982; 14(1): 1-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6811376&dopt=Abstract

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Gonorrhea and female infertility in rural Uganda. Author(s): Arya OP, Taber SR, Nsanze H. Source: American Journal of Obstetrics and Gynecology. 1980 December 1; 138(7 Pt 2): 929-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7468680&dopt=Abstract

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Hormonal evaluation of female infertility and reproductive disorders. Author(s): Scott MG, Ladenson JH, Green ED, Gast MJ. Source: Clinical Chemistry. 1989 April; 35(4): 620-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2522836&dopt=Abstract

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Hyperprolactinaemia and female infertility. Author(s): Godo G. Source: Acta Med Hung. 1984; 41(4): 185-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6440115&dopt=Abstract

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Hyperprolactinemia and female infertility. Author(s): Jones EE. Source: J Reprod Med. 1989 February; 34(2): 117-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2647973&dopt=Abstract

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Hyperprolactinemia--a significant factor in female infertility. Author(s): Kredentser JV, Hoskins CF, Scott JZ. Source: American Journal of Obstetrics and Gynecology. 1981 February 1; 139(3): 264-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7468693&dopt=Abstract

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Hysterosalpingography and hysteroscopy in female infertility. Author(s): Prevedourakis C, Loutradis D, Kalianidis C, Makris N, Aravantinos D. Source: Human Reproduction (Oxford, England). 1994 December; 9(12): 2353-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7714157&dopt=Abstract

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Hysteroscopy as an aid to diagnosis in female infertility. Author(s): March CM. Source: Clinical Obstetrics and Gynecology. 1983 June; 26(2): 302-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6851287&dopt=Abstract

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Hysteroscopy in the evaluation of female infertility. Author(s): Valle RF. Source: American Journal of Obstetrics and Gynecology. 1980 June 15; 137(4): 425-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7386525&dopt=Abstract

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Imaging in the evaluation of female infertility. Author(s): Gutmann JN. Source: J Reprod Med. 1992 January; 37(1): 54-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1532209&dopt=Abstract

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Imaging of female infertility. Author(s): Thurmond AS. Source: Radiologic Clinics of North America. 2003 July; 41(4): 757-67, Vi. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12899490&dopt=Abstract

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Immunological aspects of female infertility. Author(s): Jones WR. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1973 November; 13(4): 219-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4532540&dopt=Abstract

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Impact of lifestyle choices on female infertility. Author(s): Silva PD, Cool JL, Olson KL. Source: J Reprod Med. 1999 March; 44(3): 288-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10202749&dopt=Abstract

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Interventional radiology in female infertility: technique and role. Author(s): Maubon AJ, De Graef M, Boncoeur-Martel MP, Rouanet JP. Source: European Radiology. 2001; 11(5): 771-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11372606&dopt=Abstract

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Is hysteroscopy of value in the investigation of female infertility? Author(s): Mencaglia L, Colafranceschi M, Gordon AG, Lindemann H, Van Herendael B, Perino A, De Placido G, Colacurci A, Van der Pas H, Tantini C, et al. Source: Acta Eur Fertil. 1988 July-August; 19(4): 239-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3067483&dopt=Abstract

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Laparoscopy in female infertility. Diagnosis and prognosis for subsequent pregnancy. Author(s): Nordenskjold F, Ahlgren M. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1983; 62(6): 609-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6230855&dopt=Abstract

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Laparotomy for female infertility. Author(s): Kaur T, Debdas AK. Source: J Indian Med Assoc. 1980 May 1; 74(9): 165-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7430670&dopt=Abstract

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Life-style factors and female infertility. Author(s): Buck GM, Sever LE, Batt RE, Mendola P. Source: Epidemiology (Cambridge, Mass.). 1997 July; 8(4): 435-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9209860&dopt=Abstract

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Long-acting luteinizing homone-releasing hormone (LH-RH) analogs in the treatment of female infertility. Author(s): Forsbach G, Ayala A, Zarate A, Canales ES, Soria J, Schally AV, Kastin AJ, Coy DH, Coy EJ. Source: Arch Invest Med (Mex). 1976; 7(1): 43-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=769718&dopt=Abstract

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Male and female infertility problems in the immotile-cilia syndrome. Author(s): Afzelius BA, Eliasson R. Source: Eur J Respir Dis Suppl. 1983; 127: 144-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6604647&dopt=Abstract

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Management of female infertility. Author(s): Pepperell RJ, Brown JB, Evans JH. Source: The Medical Journal of Australia. 1977 December 3; 2(23): 774-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=611377&dopt=Abstract

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Medical progress. Female infertility. Author(s): Yussman MA. Source: J Ky Med Assoc. 1972 June; 70(6): 468-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5034366&dopt=Abstract

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Microsurgery in female infertility. Author(s): Fritzsche H, Starker W, Carol W. Source: Ginekol Pol. 1986 December; 57(12): 784-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3570024&dopt=Abstract

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Molecular approach to common causes of female infertility. Author(s): Simpson JL. Source: Best Practice & Research. Clinical Obstetrics & Gynaecology. 2002 October; 16(5): 685-702. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12475548&dopt=Abstract

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MR imaging in the evaluation of female infertility. Author(s): Woodward PJ, Wagner BJ, Farley TE. Source: Radiographics : a Review Publication of the Radiological Society of North America, Inc. 1993 March; 13(2): 293-310. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8460221&dopt=Abstract

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MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Author(s): Imaoka I, Wada A, Matsuo M, Yoshida M, Kitagaki H, Sugimura K. Source: Radiographics : a Review Publication of the Radiological Society of North America, Inc. 2003 November-December; 23(6): 1401-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14615553&dopt=Abstract

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Nonsteroidal anti-inflammatory drugs and reversible female infertility: is there a link? Author(s): Stone S, Khamashta MA, Nelson-Piercy C. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2002; 25(8): 545-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12113640&dopt=Abstract

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Observation of effect of iontophoresis of traditional Chinese drug in female infertility. Author(s): Pang BC, Yan WQ, Sun ZJ. Source: J Tradit Chin Med. 1984 December; 4(4): 259-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6570495&dopt=Abstract

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Observation on the result of treatment of female infertility in 343 cases. Author(s): Zhang LL. Source: J Tradit Chin Med. 1986 September; 6(3): 175-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3807411&dopt=Abstract

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Occupational exposures and risk of female infertility. Author(s): Smith EM, Hammonds-Ehlers M, Clark MK, Kirchner HL, Fuortes L. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 1997 February; 39(2): 138-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9048320&dopt=Abstract

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Pathology of female infertility. Author(s): Honore LH. Source: Current Opinion in Obstetrics & Gynecology. 1997 February; 9(1): 37-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9090480&dopt=Abstract

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Pathology of female infertility. Author(s): Honore LH. Source: Current Opinion in Obstetrics & Gynecology. 1994 August; 6(4): 364-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7742501&dopt=Abstract

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Practical use of hormone assays in the management of female infertility. Author(s): Blasco L, Mikhail G. Source: Clinical Obstetrics and Gynecology. 1974 December; 17(4): 79-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4615865&dopt=Abstract

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Pregnancy outcome after female infertility in Kuwait. Comparison of medical and surgical treatment. Author(s): el-Ashnehi MS, Ibrahim ME, el-Tamamy H, Murad D. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1990; 69(5): 389-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2270762&dopt=Abstract

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Proceedings: Gas chromatography of urinary 17-ketosteroids in female infertility due to androgenic hyperactivity. Author(s): Gould S, Chayen R, Harell A, Toaff ME, Toaff R. Source: Isr J Med Sci. 1975 November; 11(11): 1219-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1205816&dopt=Abstract

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Prolactin suppression in the treatment of female infertility. Author(s): Pepperell RJ. Source: The Medical Journal of Australia. 1978 November 4; 2(3 Suppl): 20-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=745577&dopt=Abstract

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Psychological factors of female infertility. Author(s): Nijs P, Koninckx PR, Verstraeten D, Mullens A, Nicasy H. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1984 December; 18(5-6): 375-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6526122&dopt=Abstract

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Radio-immunoassay of salivary progesterone for monitoring ovarian function in female infertility. Author(s): Luisi M, Franchi F, Bianchi S, Gravina G, Podesta A. Source: Annales De Biologie Clinique. 1987; 45(4): 449-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3674548&dopt=Abstract

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Recent advances in female infertility care. Author(s): Toback BM. Source: Naacogs Clin Issu Perinat Womens Health Nurs. 1992; 3(2): 313-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1534486&dopt=Abstract

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Relation of female infertility to consumption of caffeinated beverages. Author(s): Grodstein F, Goldman MB, Ryan L, Cramer DW. Source: American Journal of Epidemiology. 1993 June 15; 137(12): 1353-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8333416&dopt=Abstract

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Results of donor insemination related to specific male infertility and unsuspected female infertility. Author(s): James WH. Source: British Journal of Obstetrics and Gynaecology. 1986 October; 93(10): 1112. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3790475&dopt=Abstract

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Results of donor insemination related to specific male infertility and unsuspected female infertility. Author(s): Foss GL, Hull MG. Source: British Journal of Obstetrics and Gynaecology. 1986 March; 93(3): 275-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3964602&dopt=Abstract

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Risk factors for female infertility in an agricultural region. Author(s): Greenlee AR, Arbuckle TE, Chyou PH. Source: Epidemiology (Cambridge, Mass.). 2003 July; 14(4): 429-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843768&dopt=Abstract

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Role of acupuncture in the treatment of female infertility. Author(s): Chang R, Chung PH, Rosenwaks Z. Source: Fertility and Sterility. 2002 December; 78(6): 1149-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477502&dopt=Abstract

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Salpingitis isthmica nodosa in female infertility and ectopic tubal pregnancy. Author(s): Honore LH. Source: Fertility and Sterility. 1978 February; 29(2): 164-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=624420&dopt=Abstract

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Salpingitis isthmica nodosa in female infertility and tubal diseases. Author(s): Skibsted L, Sperling L, Hansen U, Hertz J. Source: Human Reproduction (Oxford, England). 1991 July; 6(6): 828-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1757522&dopt=Abstract

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Salpingitis isthmica nodosa in female infertility. Author(s): Karasick S, Karasick D, Schilling J. Source: J Can Assoc Radiol. 1985 June; 36(2): 118-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4019552&dopt=Abstract

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Selective fallopian tube catheterisation in female infertility: clinical results and absorbed radiation dose. Author(s): Nakamura K, Ishiguchi T, Maekoshi H, Ando Y, Tsuzaka M, Tamiya T, Suganuma N, Ishigaki T. Source: European Radiology. 1996; 6(4): 465-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8798025&dopt=Abstract

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Serum prolactin and bromocriptine treatment in female infertility. Author(s): Selander K, Saarikoski S, Pystynen P. Source: Reproduccion. 1981 July-September; 5(3): 135-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7286377&dopt=Abstract

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Serum-prolactin in female infertility. Author(s): Moore DM, Singh MM, Buckingham MS, Milligan MP, Elstein M. Source: Lancet. 1978 December 9; 2(8102): 1243-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=82744&dopt=Abstract

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Sex and its problems. VII. Female infertility. Author(s): Stallworthy JA. Source: The Practitioner. 1967 July; 199(189): 112-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6044114&dopt=Abstract

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Short-term bromocriptine therapy in female infertility. Author(s): Klimek R. Source: Ginekol Pol. 1983 June; 54(6): 397-400. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6654144&dopt=Abstract

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Significance of serum inhibin in female infertility. Author(s): Tayyab M, Samiullah S, Ditta A, Jaffery G. Source: J Ayub Med Coll Abbottabad. 2001 January-March; 13(1): 24-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11706635&dopt=Abstract

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Smoking and female infertility: a systematic review and meta-analysis. Author(s): Augood C, Duckitt K, Templeton AA. Source: Human Reproduction (Oxford, England). 1998 June; 13(6): 1532-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9688387&dopt=Abstract

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Spermagglutinating activity and female infertility. A study of serum and genital tract secretions. Author(s): Pacheco-Romero JC, Gleich GJ, Loegering DA, Johnson CE. Source: Jama : the Journal of the American Medical Association. 1973 May 7; 224(6): 84952. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4739683&dopt=Abstract

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Spermatic vein ligation in varicocele: prognosis and associated male and female infertility factors. Author(s): Soffer Y, Ron-El R, Sayfan J, Caspi E. Source: Fertility and Sterility. 1983 September; 40(3): 353-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6884538&dopt=Abstract

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Stress of female infertility: relations to length of treatment. Author(s): Chiba H, Mori E, Morioka Y, Kashiwakura M, Nadaoka T, Saito H, Hiroi M. Source: Gynecologic and Obstetric Investigation. 1997; 43(3): 171-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9127130&dopt=Abstract

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Surgical causes and management of female infertility in Nigeria. Author(s): Megafu U. Source: Int Surg. 1988 July-September; 73(3): 144-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3229919&dopt=Abstract

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Surgical correction of female infertility. An analysis of results and failures in 101 cases. Author(s): Fredricsson B, Rosenborg L. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1986; 65(5): 421-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2946137&dopt=Abstract

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Surgical management of female infertility in Ilorin, Nigeria. Author(s): Anate M, Akeredolu O. Source: East Afr Med J. 1995 July; 72(7): 411-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7498019&dopt=Abstract

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Surgical treatment of female infertility: value of paradoxical oophorectomy. Author(s): Scott JS, Lynch EM, Anderson JA. Source: British Medical Journal. 1976 March 13; 1(6010): 631-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=943208&dopt=Abstract

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The association between smoking and female infertility as influenced by cause of the infertility. Author(s): Phipps WR, Cramer DW, Schiff I, Belisle S, Stillman R, Albrecht B, Gibson M, Berger MJ, Wilson E. Source: Fertility and Sterility. 1987 September; 48(3): 377-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3114008&dopt=Abstract

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The causes of male and female infertility. Author(s): Philipp E. Source: Midwife Health Visit Community Nurse. 1980 December; 16(12): 486-93. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6904795&dopt=Abstract

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The drug treatment of female infertility. Author(s): Philipp E. Source: Br J Sex Med. 1975 October; 2(5): 15, 17-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=830125&dopt=Abstract

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The effectiveness of hysteroscopic polypectomy in cases of female infertility. Author(s): Spiewankiewicz B, Stelmachow J, Sawicki W, Cendrowski K, Wypych P, Swiderska K. Source: Clin Exp Obstet Gynecol. 2003; 30(1): 23-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12731738&dopt=Abstract

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The investigation of female infertility. Author(s): Kyei-Mensah AA, Jacobs HS. Source: Clinical Endocrinology. 1995 September; 43(3): 251-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7586592&dopt=Abstract

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The investigation of male and female infertility. Author(s): Philipp E. Source: Midwife Health Visit Community Nurse. 1981 January; 17(1): 10-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6914421&dopt=Abstract

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The link between female infertility and cancer: epidemiology and possible aetiologies. Author(s): Meirow D, Schenker JG. Source: Human Reproduction Update. 1996 January-February; 2(1): 63-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9079404&dopt=Abstract

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The management of female infertility by tubal microsurgical reconstruction: a ten year review. Author(s): Teoh TG, Kondaveeti U, Darling MR. Source: Ir J Med Sci. 1995 July-September; 164(3): 212-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7672937&dopt=Abstract

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The psychology of female infertility: toward a new perspective. Author(s): Unruh AM, McGrath PJ. Source: Health Care for Women International. 1985; 6(5-6): 369-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3854322&dopt=Abstract

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The role of ultrasound in female infertility management. Author(s): Hackeloer BJ. Source: Ultrasound in Medicine & Biology. 1984 January-February; 10(1): 35-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6730066&dopt=Abstract

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The safety of bromocriptine in hyperprolactinaemic female infertility: a literature review. Author(s): Weil C. Source: Current Medical Research and Opinion. 1986; 10(3): 172-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3525009&dopt=Abstract

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The treatment of male and female infertility. Author(s): Philipp E. Source: Midwife Health Visit Community Nurse. 1981 February; 17(2): 56-62. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6914434&dopt=Abstract

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The value of plastic operations on the fallopian tubes in the treatment of female infertility. A clinical and radiological study. Author(s): Ozaras H. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1968; 47(4): 489-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4890972&dopt=Abstract

•

Three-dimensional dynamic MR-hysterosalpingography; a new, low invasive, radiation-free and less painful radiological approach to female infertility. Author(s): Unterweger M, De Geyter C, Frohlich JM, Bongartz G, Wiesner W. Source: Human Reproduction (Oxford, England). 2002 December; 17(12): 3138-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12456613&dopt=Abstract

Studies

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•

Transient hyperprolactinemia: a correctable cause of idiopathic female infertility. Author(s): Ben-David M, Schenker JG. Source: The Journal of Clinical Endocrinology and Metabolism. 1983 August; 57(2): 4424. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6863485&dopt=Abstract

•

Transvaginal sonohysterography and hysteroscopy in the evaluation of female infertility, habitual abortion or metrorrhagia. A comparative study. Author(s): Gronlund L, Hertz J, Helm P, Colov NP. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1999 May; 78(5): 415-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10326887&dopt=Abstract

•

Treatment and causes of female infertility. Author(s): Oakeshott P, Hilton S, Hay P. Source: Lancet. 1994 July 30; 344(8918): 334. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7914278&dopt=Abstract

•

Treatment and causes of female infertility. Author(s): Baird P. Source: Lancet. 1994 July 30; 344(8918): 334. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7914277&dopt=Abstract

•

Treatment and causes of female infertility. Author(s): Chapron C, Dubuisson JB, Chavet X, Morice P. Source: Lancet. 1994 July 30; 344(8918): 333-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7914276&dopt=Abstract

•

Treatment of female infertility due to tubal obstruction by operative laparoscopy. Author(s): Mettler L, Giesel H, Semm K. Source: Fertility and Sterility. 1979 October; 32(4): 384-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=158549&dopt=Abstract

•

Treatment of female infertility with recombinant human luteinising hormone: is there a benefit over other available drugs? Author(s): Shoham Z. Source: Expert Opinion on Pharmacotherapy. 2003 November; 4(11): 1985-94. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14596652&dopt=Abstract

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•

Treatment of female infertility. Author(s): Macnaughton MC. Source: Clin Endocrinol Metab. 1973 November; 2(3): 545-60. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4273050&dopt=Abstract

•

Treatment of utero-tubal factors in female infertility. Author(s): Bonnar J. Source: Ir J Med Sci. 1979 February; 148 Suppl 1: 58-65. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=500337&dopt=Abstract

•

Tubal surgery in female infertility. Author(s): Oronsaye AU, Asuen MI. Source: Trop Doct. 1981 January; 11(1): 24-28. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7222230&dopt=Abstract

•

Ultrasonography as an adjunct to hydrotubation in the management of female infertility. Author(s): Omigbodun AO, Fatukasi JI, Abudu T. Source: Cent Afr J Med. 1992 August; 38(8): 345-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1486618&dopt=Abstract

•

What the urologist should know about the female infertility evaluation. Author(s): Brugh VM 3rd, Nudell DM, Lipshultz LI. Source: The Urologic Clinics of North America. 2002 November; 29(4): 983-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12516767&dopt=Abstract

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CHAPTER 2. ALTERNATIVE MEDICINE AND FEMALE INFERTILITY Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to female infertility. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to female infertility and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “female infertility” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to female infertility: •

“Spoiling the womb”: definitions, aetiologies and responses to infertility in north west province, Cameroon. Author(s): Richards SC. Source: Afr J Reprod Health. 2002 April; 6(1): 84-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476732&dopt=Abstract

•

Auricular acupuncture in the treatment of female infertility. Author(s): Gerhard I, Postneek F. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1992 September; 6(3): 171-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1442162&dopt=Abstract

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•

Observation of effect of iontophoresis of traditional Chinese drug in female infertility. Author(s): Pang BC, Yan WQ, Sun ZJ. Source: J Tradit Chin Med. 1984 December; 4(4): 259-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6570495&dopt=Abstract

•

Observation on the result of treatment of female infertility in 343 cases. Author(s): Zhang LL. Source: J Tradit Chin Med. 1986 September; 6(3): 175-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3807411&dopt=Abstract

•

Role of acupuncture in the treatment of female infertility. Author(s): Chang R, Chung PH, Rosenwaks Z. Source: Fertility and Sterility. 2002 December; 78(6): 1149-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477502&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMD®Health: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

Alternative Medicine 35

The following is a specific Web list relating to female infertility; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Amenorrhea Source: Healthnotes, Inc.; www.healthnotes.com Endometriosis Source: Healthnotes, Inc.; www.healthnotes.com Female Infertility Source: Healthnotes, Inc.; www.healthnotes.com Female Infertility Source: Prima Communications, Inc.www.personalhealthzone.com

•

Herbs and Supplements Arginine Source: Healthnotes, Inc.; www.healthnotes.com Ashwagandha Source: Prima Communications, Inc.www.personalhealthzone.com Beta-carotene Source: Prima Communications, Inc.www.personalhealthzone.com Chasteberry Source: Prima Communications, Inc.www.personalhealthzone.com Chasteberry Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,767,00.html Siberian Ginseng Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,821,00.html

•

Vitamins Folic Acid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,887,00.html

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Vitamin B Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10067,00.html •

Food and Diet Chocolate Source: Healthnotes, Inc.; www.healthnotes.com Coffee Source: Healthnotes, Inc.; www.healthnotes.com Tea Source: Healthnotes, Inc.; www.healthnotes.com Weight Loss and Obesity Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

37

CHAPTER 3. DISSERTATIONS ON FEMALE INFERTILITY Overview In this chapter, we will give you a bibliography on recent dissertations relating to female infertility. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “female infertility” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on female infertility, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Female Infertility ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to female infertility. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

The Hen That Can't Lay an Egg (Bu Xia Dan De Mu Ji): The Stigmatization of Female Infertility in Late Twentieth Century China (Infertility) by Handwerker, Lisa, PhD from Univ. of Calif., San Francisco with the Univ. of Calif., Berkeley, 1993, 252 pages http://wwwlib.umi.com/dissertations/fullcit/9418294

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

39

CHAPTER 4. PATENTS ON FEMALE INFERTILITY Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.4 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “female infertility” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on female infertility, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Female Infertility By performing a patent search focusing on female infertility, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 4Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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The following is an example of the type of information that you can expect to obtain from a patent search on female infertility: •

Diagnostics procedures in unexplained female infertility Inventor(s): Bustillo; Maria del Carmen (Cabin John, MD) Assignee(s): Research & Education Institute, Inc. Harbor-ucla Medical Center (torrance, Ca) Patent Number: 5,005,583 Date filed: July 22, 1987 Abstract: A method for the diagnosis and treatment of infertile women, utilizing norgical, transcervical uterine lavage to recover ova for the purpose of analysis, morphologic assessment, and treatment. Excerpt(s): This invention relates to human infertility, in particular the apparent inability of certain women to conceive. There are many currently known causes of infertility, including: abnormality in the male partner, ovulatory disorder, abnormal sperm-cervical mucus interaction, tubal obstructive disease and/or endometriosis, luteal phase defect, and a variety of peritoneal, ovarian and immunologic factors. Many women, however, fail to conceive despite all current diagnostic studies for infertility being normal. One approach to treatment involves an effort to understand and remedy an infertile woman's own ability to conceive. There have been theories advanced in the art to identify the causes of infertility which cannot be explained by the causes set forth above, and a wide variety of etiologic factors are being currently investigated. Current theories include luteinized unruptured follicle syndrome, autoantibodies against the zona pellucida, or failure of implantation of the conceptus. However, none of these theories currently aid the clinician in directing treatment for unexplained infertility, and past therapies have been largely empiric in nature. Alternative approaches to treatment involve compensating for a women's inability to conceive by way of "substituting" another women's ovum. One method, for example, involves the donation of a fertilized ovum from a fertile woman to an infertile receipient woman. These include in-vitro fertilization, where the oocyte of a donor is surgically removed from the body, fertilized in a laboratory vessel (in-vitro), and then the fertilized ovum is non-surgically placed into the uterus of an infertile recipient woman (Lutjen, P, et al., "The Establishment and Maintenance of Pregnancy Using In Vitro Fertilization and Embryo Donation in a Patient with Primary Ovarian Failure," Nature, 307, 174 (1984)). Additionally, nonsurgical ovum transfer is a recently developed treatment for infertile women, involving the nonsurgical recovery of an in vivo fertilized human ovum from a fertile donor, and its nonsurgical transfer to an infertile recipient woman. These techniques are not directed to discerning the cause of the recipient woman's infertility. Web site: http://www.delphion.com/details?pn=US05005583__

Patents 41

•

Fertility regulation with transforming growth factor.beta. Inventor(s): Feinberg; Ronald F. (Cherry Hill, NJ), Kliman; Harvey J. (Woodbridge, CT) Assignee(s): Trustees of the University of Pennsylvania (philadelphia, Pa), Yale University (new Haven, Ct) Patent Number: 5,395,825 Date filed: March 10, 1993 Abstract: Therapeutic and diagnostic methods of use for the growth factor transforming growth factor.beta., are provided by this invention. In accordance with preferred embodiments, methods of determining and improving competence of a conceptus toward uterine implantation are provided as are methods for determining female infertility in mammals. Excerpt(s): In the field of mammalian reproduction, many diagnostic procedures exist to aid the reproduction practitioner in making a diagnosis and choosing an appropriate course of action. Currently, infertility in humans is defined as one year of unprotected coitus without conception. Approximately 10-15% of couples are affected by infertility. The risk of infertility is doubled for women between the ages of 35 to 44 as compared to women between the ages of 30 and 34. Approximately 600,000 couples sought professional help during the year 1968. However, in the early 1980's this number increased to over 2 million visits per year for infertility. Changes in fertility patterns will have a significant impact on the make-up of populations. It has been calculated that by the middle of the next century, the population in the United States will decline without immigration. Furthermore, the percent of people over the age of 65 will increase to over 23% in the next 100 years, resulting in an older and smaller work force. In the United States, the majority of infertility can be accounted for by problems in the female. Evaluating a female for infertility can be complex. Examination of the fallopian tubes is an important early step in mammalian fertility evaluation due to the increased evidence of pelvic inflammatory disease. Currently, a hysterosalpingogram (HSG) is the procedure of choice to examine the patency of the fallopian tubes. In addition to HSG, hysteroscopy which is the direct examination of the uterus by a fiber optic device, is important to determine the presence of endometrial polyps, submucous leiomyomas, and other abnormalities within the uterus itself. Web site: http://www.delphion.com/details?pn=US05395825__

•

Oviductal catalase binding to the membranes of spermatozoa and uses thereof Inventor(s): Lapointe; Serge (St-Nicolas, CA), Sirard; Marc-Andre (Breakeyville, CA) Assignee(s): Universite Laval (quebec, Ca) Patent Number: 5,919,127 Date filed: February 19, 1997 Abstract: The present invention relates to a novel oviductal catalase having a molecular weight of about 60 KDa and which binds to a spermatozoa membrane outer surface, wherein said catalase once bound to the spermatozoa membrane outer surface protects said spermatozoa against oxidation. A method of stabilizing spermatozoa membrane and improving spermatozoa survival during migration in oviduct and/or uterus for artificial insemination; which comprises coating spermatozoa with such a catalase enzyme. A method of improving spermatozoa survival during migration in oviduct

42

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and/or uterus in cases of female infertility due to the absence of endogenous catalase in the genital tract of the female subject; which comprises administering catalase in the female genital tract before coit or coating spermatozoa with a catalase enzyme for artificial insemination. Also provided herein are method of diagnostic of male or female infertility. Excerpt(s): The invention relates to an oviductal catalase having a molecular weight of about 60 KDa as determined by SDS-page electrophoresis under denaturing conditions and which binds to a spermatozoa membrane outer surface, uses thereof for protection and/or preservation of spermatozoa; uses thereof in artificial insemination, and a method of diagnostic of male or female infertility. Artificial insemination (AI) has changed the face of the dairy industry. Faster genetics improvement of a herd by use of high quality bull semen is now possible, at reasonable cost, for any farmer. This is feasible by using cryopreservation by which a single bull can inseminate thousands of cows. However, during the cryopreservation process the sperm undergo several tremendous changes in cell volume. Such massive shrinkage and swelling leads to ultrastructural changes in the sperm membranes, increasing their permeability, ultimately resulting in enzyme leakage and the accumulation of intracellular calcium. Even with the best preservation techniques to date, post-thaw survival is restricted to about 50% of the sperm population. Moreover, most surviving spermatozoa have characteristics which distinguish them from spermatozoa before cryopreservation. As a consequence, the functions of cryopreserved sperm are limited, as expressed by their reduced motility, viability and fertility in vivo, which can be only partially compensated by inseminating greater numbers of live spermatozoa. In fact, to obtain a normal fertility rate, the insemination must be performed with a minimum of 6.times.10.sup.6 motile sperm per straw after thawing (.about.12.times.10.sup.6 total), compared to only 2.5.times.10.sup.6 motile fresh sperm. Sperm quality is strongly related to free radical action and the protection provided by endogenous antioxidants. Over time, the loss of sperm motility in the rabbit and human is correlated with spontaneous lipid peroxidation (Alvarez J G et al., 1987, J. Androl., 8:338-348). It has also been reported that superoxide dismutase activity (SOD) activity is a good predictor of the lifetime of a human sperm sample (Alvarez J G et al., 1987, J. Androl., 8:338-348), and that total cellular SOD can be conveniently measured by sperm surface SOD activity. Indeed, a growing body of evidence indicates that a significant factor in human male infertility involves a loss of sperm function as a consequence of oxidative stress (Aitken R J, 1994, Reprod. Fertil. Dev., 6:19-24). Furthermore, fresh bull semen of lower quality (<70% motile sperm) has lower antioxidant activity than in normal semen. However, the byproduct of SOD action is the production of hydrogen peroxide (H.sub.2 O.sub.2). Hydrogen peroxide is a highly reactive oxygen species which is one of the most toxic compound to sperm. H.sub.2 O.sub.2 could be a major player in the death of sperm in the female genital tract. Web site: http://www.delphion.com/details?pn=US05919127__

Patent Applications on Female Infertility As of December 2000, U.S. patent applications are open to public viewing.5 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take

5

This has been a common practice outside the United States prior to December 2000.

Patents 43

several years.) The following patent applications have been filed since December 2000 relating to female infertility: •

OLIGOPEPTIDE LYOPHILISATE, THEIR PREPARATION AND USE Inventor(s): ENGEL, JURGEN; (ALZENAU, DE), REISSMANN, THOMAS; (FRANKFURT AM MA, DE), SAUERBIER, DIETER; (WERTER, DE), WICHERT, BURKHARD; (BIELEFELD, DE) Correspondence: Cushman Darby & Cushman; 1100 New York Avenue NW; Ninth Floor East Tower; Washington; DC; 200053918 Patent Application Number: 20020099018 Date filed: June 6, 1995 Abstract: A novel lyophilizate and method of preparation as well as the use of the lyophilizate to treat female infertility and for gonad protection. Cetrorelix is dissolved in acetic acid 30% v/v, the solution is transferred to water and freeze dried. Excerpt(s): This is a continuation-in-part application of U.S. Ser. No. 08/198,037, filed Feb. 22, 1994. The present invention relates to the preparation of a lyophilizate of a peptide and the use of the lyophilizate in the treatment of infertility and to provide male gonad protection. Cetrorelix is a decapeptide with a terminal acid amide group that is used in the form of its acetate salt. The synthesis and some pharmacological effects are described in European patent application 299 402 (U.S. Pat. No. 4,800,191). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with female infertility, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “female infertility” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on female infertility. You can also use this procedure to view pending patent applications concerning female infertility. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON FEMALE INFERTILITY Overview This chapter provides bibliographic book references relating to female infertility. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on female infertility include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “female infertility” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “female infertility” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “female infertility” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Atlas of Female Infertility Surgery; ISBN: 0815147813; http://www.amazon.com/exec/obidos/ASIN/0815147813/icongroupinterna

•

Female Infertility by Paul Johannes Keller; ISBN: 3805527918; http://www.amazon.com/exec/obidos/ASIN/3805527918/icongroupinterna

•

Female Infertility Therapy: Current Practice by Jacobs, et al; ISBN: 1853175935; http://www.amazon.com/exec/obidos/ASIN/1853175935/icongroupinterna

•

Female Infertility Ultrasound Scan by Bourne; ISBN: 0865777055; http://www.amazon.com/exec/obidos/ASIN/0865777055/icongroupinterna

•

Fulfilling the Essence: The Handbook of Traditional & Contemporary Chinese Treatments for Female Infertility by Bob Flaws; ISBN: 0936185481; http://www.amazon.com/exec/obidos/ASIN/0936185481/icongroupinterna

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•

Gonadotropin therapy in female infertility; proceedings of the conference held at Worcester, Massachusetts, May 12 and 13, 1972; ISBN: 0444150285; http://www.amazon.com/exec/obidos/ASIN/0444150285/icongroupinterna

•

Microsurgery in Female Infertility by Victor Gomel; ISBN: 0316319880; http://www.amazon.com/exec/obidos/ASIN/0316319880/icongroupinterna

•

Microsurgery in Female Infertility by Crosignani, Rubin; ISBN: 0808912585; http://www.amazon.com/exec/obidos/ASIN/0808912585/icongroupinterna

Chapters on Female Infertility In order to find chapters that specifically relate to female infertility, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and female infertility using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “female infertility” (or synonyms) into the “For these words:” box.

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CHAPTER 6. PERIODICALS AND NEWS ON FEMALE INFERTILITY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover female infertility.

News Services and Press Releases One of the simplest ways of tracking press releases on female infertility is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “female infertility” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to female infertility. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “female infertility” (or synonyms). The following was recently listed in this archive for female infertility: •

Mouse study offers new hope on female infertility Source: Reuters Health eLine Date: March 10, 2004

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•

Mouse study offers new hope for female infertility Source: Reuters Medical News Date: March 10, 2004

•

Mercury in seafood associated with both male and female infertility Source: Reuters Medical News Date: September 23, 2002

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Serono female infertility treatment recommended for European approval Source: Reuters Industry Breifing Date: August 16, 2000

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Serono gets FDA approval for Gonal-F to treat male, female infertility Source: Reuters Industry Breifing Date: June 06, 2000

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Agricultural Exposures Increase Risk Of Female Infertility Source: Reuters Medical News Date: April 15, 1997

•

Dusts, Pesticides and Nonionizing Radiation: Risk Factors For Female Infertility Source: Reuters Medical News Date: February 25, 1997 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “female infertility” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests.

Periodicals and News

49

Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “female infertility” (or synonyms). If you know the name of a company that is relevant to female infertility, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “female infertility” (or synonyms).

Academic Periodicals covering Female Infertility Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to female infertility. In addition to these sources, you can search for articles covering female infertility that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

51

CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for female infertility. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with female infertility. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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Female Infertility

The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to female infertility: Choriogonadotropin Alfa •

Systemic - U.S. Brands: Ovidrel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500249.html

Follitropin Alfa •

Systemic - U.S. Brands: Gonal-F http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203454.html

Follitropin Beta •

Systemic - U.S. Brands: Follistim http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203453.html

Ganirelix •

Systemic - U.S. Brands: Antagon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500052.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

Researching Medications

53

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

55

APPENDICES

57

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute6: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

6

These publications are typically written by one or more of the various NIH Institutes.

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Female Infertility

•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

59

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:8 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

7

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 8 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway9 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “female infertility” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 15258 392 887 10 64 16611

HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.13 Simply search by “female infertility” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

9

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

10

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 11 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 12 13

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

61

Coffee Break: Tutorials for Biologists14 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.15 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.16 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

14 Adapted 15

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 16 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

63

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on female infertility can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to female infertility. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to female infertility. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “female infertility”:

64

•

Female Infertility

Guides on female infertility Infertility http://www.nlm.nih.gov/medlineplus/infertility.html

•

Other guides Endometriosis http://www.nlm.nih.gov/medlineplus/endometriosis.html Male Genital Disorders http://www.nlm.nih.gov/medlineplus/malegenitaldisorders.html Ovarian Cysts http://www.nlm.nih.gov/medlineplus/ovariancysts.html Reproductive Health http://www.nlm.nih.gov/medlineplus/reproductivehealth.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to female infertility. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

Patient Resources

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

65

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to female infertility. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with female infertility. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about female infertility. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “female infertility” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “female infertility”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “female infertility” (or synonyms) into the “For

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Female Infertility

these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “female infertility” (or a synonym) into the search box, and click “Submit Query.”

67

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.17

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

17

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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Female Infertility

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)18: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

18

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries 69 •

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries 71 •

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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FEMALE INFERTILITY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 17-Ketosteroids: Steroids that contain a ketone group at position 17. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Acatalasia: A rare autosomal recessive disorder resulting from the absence of catalase activity. Though usually asymptomatic, a syndrome of oral ulcerations and gangrene may be present. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Action Potentials: The electric response of a nerve or muscle to its stimulation. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU]

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Affinity Chromatography: In affinity chromatography, a ligand attached to a column binds specifically to the molecule to be purified. [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Androgenic: Producing masculine characteristics. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH]

Dictionary 77

Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Aqueous: Having to do with water. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Azoospermia: Absence of spermatozoa in the semen, or failure of formation of spermatozoa. [EU]

Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form

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salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bilateral: Affecting both the right and left side of body. [NIH] Bioassays: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Broad Ligament: A broad fold of peritoneum that extends from the side of the uterus to the wall of the pelvis. [NIH] Bromocriptine: A semisynthetic ergot alkaloid that is a dopamine D2 agonist. It suppresses prolactin secretion and is used to treat amenorrhea, galactorrhea, and female infertility, and has been proposed for Parkinson disease. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, poly-

Dictionary 79

and heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Catalase: An oxidoreductase that catalyzes the conversion of hydrogen peroxide to water and oxygen. It is present in many animal cells. A deficiency of this enzyme results in acatalasia. EC 1.11.1.6. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Aggregation: The phenomenon by which dissociated cells intermixed in vitro tend to group themselves with cells of their own type. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chromosome Deletion: Actual loss of a portion of the chromosome. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often

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resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clomiphene: A stilbene derivative that functions both as a partial estrogen agonist and complete estrogen antagonist depending on the target tissue. It antagonizes the estrogen receptor thereby initiating or augmenting ovulation in anovulatory women. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Coitus: Sexual intercourse. [NIH] Coliphages: Viruses whose host is Escherichia coli. [NIH] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]

Dictionary 81

Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Consumption: Pulmonary tuberculosis. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclin: Molecule that regulates the cell cycle. [NIH] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some nonleukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU]

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Cytotoxic: Cell-killing. [NIH] Danazol: A synthetic steroid with antigonadotropic and anti-estrogenic activities that acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Danazol has been used in the treatment of endometriosis and some benign breast disorders. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dilatation: The act of dilating. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] Ectopic Pregnancy: The pregnancy occurring elsewhere than in the cavity of the uterus. [NIH]

Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus

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becomes capable of conducting electricity; an ionic solute. [EU] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an

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antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]

Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fish Products: Food products manufactured from fish (e.g., fish flour, fish meal). [NIH] Follicles: Shafts through which hair grows. [NIH] Follicular Atresia: The degeneration and resorption of an ovarian follicle before it reaches maturity and ruptures. [NIH] Follicular Cyst: Cyst due to the occlusion of the duct of a follicle or small gland. [NIH] Follicular Fluid: A fluid consisting of sex steroid hormones, plasma proteins, mucopolysaccharides, and electrolytes that is present in the vesicular ovarian follicle (Graafian follicle) surrounding the ovum. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation,

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damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Gamete Intrafallopian Transfer: A technique that came into use in the mid-1980's for assisted conception in infertile women with normal fallopian tubes. The protocol consists of hormonal stimulation of the ovaries, followed by laparoscopic follicular aspiration of oocytes, and then the transfer of sperm and oocytes by catheterization into the fallopian tubes. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Targeting: The integration of exogenous DNA into the genome of an organism at sites where its expression can be suitably controlled. This integration occurs as a result of homologous recombination. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadorelin: A decapeptide hormone released by the hypothalamus. It stimulates the synthesis and secretion of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to

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supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granulosa Cells: Cells of the membrana granulosa lining the vesicular ovarian follicle which become luteal cells after ovulation. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]

Histology: The study of tissues and cells under a microscope. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1

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isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hyperandrogenism: A state characterized or caused by an excessive secretion of androgens by the adrenal cortex, ovaries, or testes. The clinical significance in males is negligible, so the term is used most commonly with reference to the female. The common manifestations in women are hirsutism and virilism. It is often caused by ovarian disease (particularly the polycystic ovary syndrome) and by adrenal diseases (particularly adrenal gland hyperfunction). [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersecretion: Excessive secretion. [EU] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hysterosalpingography: Radiography of the uterus and fallopian tubes after the injection of a contrast medium. [NIH] Hysteroscopy: Endoscopic examination, therapy or surgery of the interior of the uterus. [NIH]

Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunologic Factors: Biologically active substances whose activities affect or play a role in the functioning of the immune system. [NIH] Immunology: The study of the body's immune system. [NIH]

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Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infertility, Female: Diminished or absent ability of a female to achieve conception. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inhibin: Glyceroprotein hormone produced in the seminiferous tubules by the Sertoli cells in the male and by the granulosa cells in the female follicles. The hormone inhibits FSH and LH synthesis and secretion by the pituitary cells thereby affecting sexual maturation and fertility. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH]

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Inorganic: Pertaining to substances not of organic origin. [EU] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interleukins: Soluble factors which stimulate growth-related activities of leukocytes as well as other cell types. They enhance cell proliferation and differentiation, DNA synthesis, secretion of other biologically active molecules and responses to immune and inflammatory stimuli. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ion Exchange: Reversible chemical reaction between a solid, often an ION exchange resin, and a fluid whereby ions may be exchanged from one substance to another. This technique is used in water purification, in research, and in industry. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iontophoresis: Therapeutic introduction of ions of soluble salts into tissues by means of electric current. In medical literature it is commonly used to indicate the process of increasing the penetration of drugs into surface tissues by the application of electric current. It has nothing to do with ion exchange, air ionization nor phonophoresis, none of which requires current. [NIH]

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Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Lactation: The period of the secretion of milk. [EU] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Lavage: A cleaning of the stomach and colon. Uses a special drink and enemas. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leuprolide: A potent and long acting analog of naturally occurring gonadotropin-releasing hormone (gonadorelin). Its action is similar to gonadorelin, which regulates the synthesis and release of pituitary gonadotropins. [NIH] Levonorgestrel: A progestational hormone with actions similar to those of progesterone and about twice as potent as its racemic or (+-)-isomer (norgestrel). It is used for contraception, control of menstrual disorders, and treatment of endometriosis. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

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Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Mammary: Pertaining to the mamma, or breast. [EU] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metrorrhagia: Uterine bleeding, usually irregular or acyclic, between periods. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Micromanipulation: The performance of dissections, injections, surgery, etc., by the use of micromanipulators (attachments to a microscope that manipulate tiny instruments). [NIH] Micromanipulators: A high precision instrument used in microinjection or chromosome dissection activities. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microviridae: A large family of lytic bacteriophages infecting enterobacteria. It contains two

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genera: Microvirus and Spiromicrovirus. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are

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unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nidation: Implantation of the conceptus in the endometrium. [EU] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Norgestrel: (+-)-13-Ethyl-17-hydroxy-18,19-dinorpregn-4-en-20-yn-3-one. A progestational agent with actions similar to those of progesterone. This racemic or (+-)-form has about half the potency of the levo form (levonorgestrel). Norgestrel is used as a contraceptive and ovulation inhibitor and for the control of menstrual disorders and endometriosis. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oligomenorrhea: Abnormally infrequent menstruation. [NIH] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Oophorectomy: Surgery to remove one or both ovaries. [NIH] Ornithosis: Infection with Chlamydophila psittaci (formerly Chlamydia psittaci), transmitted to man by inhalation of dust-borne contaminated nasal secretions or excreta of infected birds. This infection results in a febrile illness characterized by pneumonitis and systemic manifestations. [NIH] Ovarian Follicle: Spheroidal cell aggregation in the ovary containing an ovum. It consists of an external fibro-vascular coat, an internal coat of nucleated cells, and a transparent, albuminous fluid in which the ovum is suspended. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovulation Induction: Techniques for the artifical induction of ovulation. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons.

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[EU]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Paradoxical: Occurring at variance with the normal rule. [EU] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parturition: The act or process of given birth to a child. [EU] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvic inflammatory disease: A bacteriological disease sometimes associated with intrauterine device (IUD) usage. [NIH] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied

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to each other. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phonophoresis: Use of ultrasound to increase the percutaneous adsorption of drugs. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Pneumonia: Inflammation of the lungs. [NIH]

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Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitation: The act or process of precipitating. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progestogen: A term applied to any substance possessing progestational activity. [EU] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the

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nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoan: 1. Any individual of the protozoa; protozoon. 2. Of or pertaining to the protozoa; protozoal. [EU] Psittaci: Causal agent of ornithosis. [NIH] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH]

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Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Reproductive cells: Egg and sperm cells. Each mature reproductive cell carries a single set of 23 chromosomes. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Reverse Transcriptase Polymerase Chain Reaction: A variation of the PCR technique in which cDNA is made from RNA via reverse transcription. The resultant cDNA is then amplified using standard PCR protocols. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rod: A reception for vision, located in the retina. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of

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thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seafood: Marine fish and shellfish used as food or suitable for food. (Webster, 3d ed) shellfish and fish products are more specific types of seafood. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Seminiferous tubule: Tube used to transport sperm made in the testes. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senescence: The bodily and mental state associated with advancing age. [NIH] Sequence Analysis: A multistage process that includes the determination of a sequence (protein, carbohydrate, etc.), its fragmentation and analysis, and the interpretation of the resulting sequence information. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH]

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Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sperm: The fecundating fluid of the male. [NIH] Sperm Motility: Ability of the spermatozoon to move by flagellate swimming. [NIH] Spermatozoon: The mature male germ cell. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by

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clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Submucous: Occurring beneath the mucosa or a mucous membrane. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testicle: The male gonad where, in adult life, spermatozoa develop; the testis. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU]

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Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Traction: The act of pulling. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in

Dictionary 103

the bladder, and leaves the body through the urethra. [NIH] Urologist: A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Varicocele: A complex of dilated veins which surround the testicle, usually on the left side. [NIH]

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasoactive: Exerting an effect upon the calibre of blood vessels. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virilism: Development of masculine traits in the female. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH]

104

Female Infertility

X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zona Pellucida: The transport non-cellular envelope surrounding the mammalian ovum. [NIH]

Zygote: The fertilized ovum. [NIH]

105

INDEX 1 17-Ketosteroids, 25, 75 A Abdominal, 75, 94 Aberrant, 14, 75 Abortion, 31, 75, 96 Acatalasia, 75, 79 Acceptor, 75, 90, 93 Action Potentials, 12, 75 Adaptability, 75, 79 Adipocytes, 75, 90 Adrenal Cortex, 75, 87, 96 Adrenergic, 75, 82, 83, 101 Adverse Effect, 75, 99 Afferent, 75, 90 Affinity, 13, 75, 76 Affinity Chromatography, 13, 76 Age of Onset, 76, 102 Agonist, 13, 76, 78, 80, 82, 101 Algorithms, 76, 78 Alkaline, 76, 78 Alkaloid, 76, 78 Alleles, 11, 76 Alpha Particles, 76, 97 Alternative medicine, 48, 76 Amenorrhea, 35, 76, 78, 96 Amino acid, 76, 77, 94, 97, 98, 101, 102 Amino Acid Sequence, 76, 77 Anaesthesia, 76, 88 Analog, 76, 90 Analogous, 76, 102 Androgenic, 25, 76, 82 Androgens, 75, 76, 87 Angiogenesis, 14, 77 Anions, 77, 89, 101 Anovulation, 7, 77, 96 Antibodies, 9, 15, 77, 86, 87, 91, 95 Antibody, 9, 75, 77, 80, 81, 84, 86, 87, 88, 91, 92, 100 Antigen, 9, 75, 77, 80, 86, 87, 88, 91 Anti-infective, 77, 87 Anti-inflammatory, 24, 77 Antioxidant, 42, 77, 94 Aqueous, 77, 78, 81, 87 Arteries, 77, 78, 81, 91 Artery, 77, 81, 97, 103 Aspiration, 77, 85 Assay, 9, 77, 87

Autoantibodies, 18, 40, 77 Autoantigens, 77 Azoospermia, 8, 77 B Bacteria, 5, 77, 91, 98, 102 Bacteriophage, 4, 77, 102 Base, 77, 90, 101 Basement Membrane, 78, 84 Benign, 78, 82 Bilateral, 78, 96 Bioassays, 12, 78 Biochemical, 11, 12, 16, 76, 78 Biotechnology, 14, 48, 59, 78 Blastocyst, 78, 81, 83, 95 Blood Coagulation, 78 Blood vessel, 77, 78, 79, 83, 103 Branch, 71, 78, 81, 94, 97, 100, 101 Breeding, 13, 78 Broad Ligament, 78, 84 Bromocriptine, 16, 19, 27, 30, 78 C Calcium, 12, 42, 78, 80, 99 Carbohydrate, 9, 78, 96, 99 Carbon Dioxide, 79, 95 Carcinogenic, 79, 88, 96, 100 Carotene, 35, 79 Catalase, 41, 42, 75, 79 Catecholamine, 79, 82 Catheterization, 20, 79, 85, 89 Cell, 5, 6, 7, 8, 9, 11, 12, 42, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 88, 89, 91, 92, 93, 95, 96, 98, 99, 100, 101, 102, 103 Cell Aggregation, 79, 93 Cell Death, 5, 79 Cell Differentiation, 79, 99 Cell Division, 5, 7, 77, 79, 81, 91, 95, 96, 99 Cell proliferation, 79, 89, 99 Cervical, 9, 18, 40, 79 Cervix, 75, 79, 98 Cholesterol, 79, 81, 100, 101 Chondrocytes, 79, 84 Chromatin, 11, 79 Chromosomal, 10, 79 Chromosome, 10, 79, 86, 90, 91, 99 Chromosome Deletion, 10, 79 Chronic, 3, 4, 6, 7, 79, 83, 88, 90, 96, 100 Chronic renal, 3, 79, 96 Clamp, 7, 80

106

Female Infertility

Clinical trial, 4, 17, 59, 80, 97 Clomiphene, 18, 80 Cloning, 8, 78, 80 Cofactor, 11, 80, 97 Coitus, 41, 80 Coliphages, 77, 80 Colloidal, 80, 83 Colon, 80, 90 Complement, 80, 81, 85, 95 Complementary and alternative medicine, 33, 36, 80 Complementary medicine, 33, 81 Computational Biology, 59, 81 Conception, 41, 75, 81, 84, 85, 88, 96, 100 Constitutional, 10, 81 Consumption, 26, 81 Contraception, 81, 90 Contraindications, ii, 81 Contrast medium, 81, 87 Coronary, 4, 81, 91 Coronary heart disease, 4, 81 Coronary Thrombosis, 81, 91 Corpus, 81, 90, 94, 96 Corpus Luteum, 81, 90, 96 Curative, 81, 101 Cyclin, 5, 81 Cytogenetics, 10, 81 Cytokines, 81, 88 Cytoplasm, 81, 86, 98 Cytotoxic, 82, 88, 99 D Danazol, 16, 82 Decidua, 82, 95 Depolarization, 82, 99 Deuterium, 82, 87 Diagnostic procedure, 39, 41, 48, 82 Dilatation, 75, 82 Diploid, 7, 82, 95 Direct, iii, 41, 51, 82, 98 Dissociation, 75, 82, 89 Dopamine, 11, 78, 82, 92 Drug Interactions, 52, 82 Duct, 79, 82, 84, 98 E Ectopic, 9, 26, 82 Ectopic Pregnancy, 9, 82 Effector, 12, 80, 82 Ejaculation, 82, 99 Elective, 27, 82 Electrolyte, 82, 96 Electrophoresis, 42, 83

Embryo, 11, 14, 16, 40, 75, 78, 79, 83, 88, 96, 100 Embryo Transfer, 14, 16, 83, 96 Empiric, 40, 83 Endocrine System, 83, 92 Endocrinology, 13, 15, 18, 19, 29, 31, 33, 83 Endogenous, 42, 77, 82, 83, 102 Endometrial, 8, 18, 41, 83 Endometriosis, 6, 16, 35, 40, 64, 82, 83, 90, 93 Endometrium, 8, 82, 83, 91, 93 Endoscopy, 19, 83 Endothelial cell, 83, 84 End-stage renal, 3, 80, 83, 96 Energy balance, 83, 90 Environmental Health, 58, 60, 83 Enzymatic, 76, 78, 79, 80, 83 Enzyme, 10, 11, 41, 42, 79, 82, 83, 95, 99, 101, 103 Epinephrine, 75, 82, 83, 92, 93, 102 Epitope, 9, 83 Ergot, 78, 84 Estrogen, 12, 80, 84, 96, 99, 101 Estrogen receptor, 80, 84 Ethnic Groups, 11, 84 Eukaryotic Cells, 84, 88 Exogenous, 13, 83, 84, 85, 102 Extracellular, 5, 9, 84 Extracellular Matrix, 9, 84 Extracellular Space, 84 Extraction, 10, 84 Extrapyramidal, 82, 84 F Fallopian tube, 20, 27, 30, 41, 84, 85, 87, 98 Family Planning, 59, 84 Fat, 11, 75, 79, 81, 84, 90 Fertilization in Vitro, 84, 96 Fetus, 75, 84, 95, 96, 100, 103 Fibroblast Growth Factor, 15, 84 Fish Products, 84, 99 Follicles, 84, 88 Follicular Atresia, 6, 84 Follicular Cyst, 6, 84 Follicular Fluid, 9, 84 Free Radicals, 77, 82, 84 G Gamete Intrafallopian Transfer, 17, 85 Gas, 25, 79, 85, 86 Gastrin, 85, 86 Gene, 5, 8, 10, 12, 76, 78, 85, 99 Gene Expression, 5, 85 Gene Targeting, 8, 10, 85

Index 107

Genetic Engineering, 78, 80, 85 Genetics, 5, 42, 81, 85 Genital, 4, 20, 28, 42, 64, 85 Genotype, 85, 95 Germ Cells, 7, 85, 91, 93, 100, 101 Gestation, 85, 94, 95, 100 Gland, 75, 84, 85, 87, 90, 94, 95, 97, 99 Glomerular, 85, 98 Glucose, 7, 85, 89 Glycoprotein, 9, 12, 85 Gonad, 8, 43, 85, 101 Gonadal, 8, 85, 100 Gonadorelin, 85, 90 Gonadotropin, 5, 13, 20, 21, 46, 85, 90 Governing Board, 86, 96 Graft, 86 Grafting, 86, 88 Granulocytes, 86, 99, 103 Granulosa Cells, 5, 13, 15, 86, 88, 90 Growth, 41, 76, 77, 79, 84, 86, 89, 95 H Habitual, 31, 86 Haemorrhage, 75, 86 Haploid, 7, 86, 95 Haptens, 75, 86 Heredity, 85, 86 Heterogeneity, 75, 86 Hirsutism, 86, 87 Histology, 6, 13, 86 Homologous, 12, 76, 85, 86, 99, 101 Hormonal, 3, 13, 21, 85, 86 Hormonal therapy, 13, 86 Hormone, 5, 6, 10, 11, 13, 15, 23, 25, 31, 78, 83, 85, 86, 88, 89, 90, 96, 99, 101 Hormone therapy, 86 Host, 5, 77, 80, 86 Hydrogen, 42, 75, 78, 79, 82, 86, 87, 90, 92, 93, 97, 101 Hydrogen Peroxide, 42, 79, 87, 90, 101 Hyperandrogenism, 7, 87 Hyperplasia, 6, 87 Hypersecretion, 11, 87 Hypertrophy, 87 Hypothalamic, 11, 87 Hypothalamus, 85, 87, 95 Hysterosalpingography, 16, 21, 30, 87 Hysteroscopy, 16, 21, 22, 31, 41, 87 I Id, 34, 64, 70, 72, 87 Idiopathic, 10, 31, 87 Immune function, 87, 88 Immune response, 77, 86, 87, 101, 103

Immune system, 87, 88, 91, 103 Immunoassay, 13, 25, 87 Immunoglobulin, 77, 87, 92 Immunohistochemistry, 13, 14, 87 Immunologic, 9, 40, 87 Immunologic Factors, 40, 87 Immunology, 18, 75, 87 Immunosuppressive, 3, 88 Immunosuppressive Agents, 3, 88 Implantation, 8, 10, 14, 40, 41, 81, 88, 93 Impotence, 3, 88 In situ, 10, 11, 14, 88 In Situ Hybridization, 8, 10, 11, 14, 88 In vitro, 9, 10, 12, 16, 79, 83, 88 In vivo, 7, 40, 42, 88 Incision, 88, 89 Indicative, 45, 88, 94, 103 Induction, 13, 17, 76, 88, 93, 96 Infarction, 81, 88, 91 Infection, 4, 87, 88, 90, 91, 93, 100, 102, 103 Inflammation, 77, 88, 95 Inhibin, 27, 88 Initiation, 88, 102 Inorganic, 89, 92 Inositol, 7, 89 Inotropic, 82, 89 Insight, 5, 6, 12, 89 Insulin, 7, 11, 89, 102 Insulin-dependent diabetes mellitus, 89 Interleukins, 88, 89 Internal Medicine, 7, 83, 89 Interstitial, 84, 89, 98 Intestinal, 79, 89 Intoxication, 89, 103 Intracellular, 4, 12, 42, 88, 89, 96, 99 Intrinsic, 11, 75, 78, 89 Intubation, 79, 89 Invasive, 30, 89 Ion Exchange, 89 Ionization, 89 Ions, 78, 82, 86, 89 Iontophoresis, 24, 34, 89 K Kb, 58, 90 Kidney Failure, 83, 90 L Lactation, 90, 96 Laparoscopy, 13, 16, 22, 31, 90 Lavage, 40, 90 Leptin, 11, 90 Leukemia, 12, 90 Leuprolide, 13, 90

108

Female Infertility

Levonorgestrel, 13, 90, 93 Library Services, 70, 90 Ligaments, 81, 90 Ligation, 28, 90 Linkage, 11, 90 Lipid, 42, 89, 90, 94 Lipid Peroxidation, 42, 90, 94 Localization, 13, 87, 90 Localized, 86, 88, 90, 95 Luteal Phase, 40, 90 Lutein Cells, 90, 96 Lymph, 79, 83, 90, 91 Lymph node, 79, 90, 91 Lymphatic, 88, 90, 91, 100 Lymphocyte, 77, 91 Lymphoid, 77, 91 Lytic, 91, 99 M Mammary, 91, 101 Mediate, 82, 91 Mediator, 7, 91 MEDLINE, 59, 91 Meiosis, 8, 91, 101 Membrane, 12, 15, 41, 42, 80, 82, 83, 84, 91, 92, 95, 96, 99, 101, 102 Menstrual Cycle, 90, 91, 96 Menstruation, 76, 82, 90, 91, 93 Mental, iv, 4, 58, 60, 82, 91, 97, 98, 99, 102 Mental Health, iv, 4, 58, 60, 91, 97 Mental Processes, 82, 91, 97 Meta-Analysis, 27, 91 Metrorrhagia, 31, 91 MI, 32, 73, 91 Micromanipulation, 10, 91 Micromanipulators, 91 Microorganism, 80, 91, 94, 103 Microviridae, 4, 91 Migration, 8, 41, 92 Miscarriage, 9, 92 Modification, 76, 85, 92, 97 Molecular, 4, 5, 6, 8, 10, 11, 15, 23, 41, 42, 59, 61, 78, 81, 92, 96, 101 Molecule, 76, 77, 78, 80, 81, 82, 83, 92, 93, 98, 99 Monitor, 92, 93 Monoclonal, 9, 92 Morphological, 83, 92 Morphology, 6, 92 Motility, 42, 92 Mucosa, 92, 96, 101 Mucus, 9, 40, 92 Myocardium, 91, 92

N Need, 3, 46, 65, 80, 92 Nerve, 75, 91, 92, 96, 102 Nervous System, 75, 91, 92, 101 Neural, 10, 75, 92 Neuroendocrine, 11, 92 Neurotransmitter, 76, 82, 92, 93, 99, 101 Neutrons, 76, 92, 97 Nidation, 83, 93 Norepinephrine, 75, 82, 92, 93 Norgestrel, 90, 93 Nuclear, 10, 12, 84, 93 Nucleic acid, 88, 93 Nucleus, 12, 79, 81, 82, 84, 91, 93, 97 O Ocular, 4, 93 Oligomenorrhea, 93, 96 Oocytes, 7, 12, 85, 93 Oophorectomy, 28, 93 Ornithosis, 93, 97 Ovarian Follicle, 8, 81, 84, 86, 93 Ovaries, 5, 85, 87, 93, 96, 98, 99 Ovary, 5, 6, 7, 8, 12, 13, 81, 85, 93 Ovulation, 5, 7, 10, 13, 17, 77, 80, 86, 90, 93 Ovulation Induction, 13, 93 Ovum, 40, 81, 82, 84, 85, 93, 96, 103, 104 Oxidation, 41, 75, 77, 90, 93, 94 Oxidative Stress, 42, 94 P Palliative, 94, 101 Pancreas, 75, 89, 94 Pancreatic, 7, 94 Paradoxical, 28, 94 Parasite, 94, 102 Parasitic, 4, 94 Parturition, 94, 96 Pathogen, 4, 94 Pathogenesis, 9, 94 Pathologic, 81, 94, 98 Pathologies, 11, 94 Pathophysiology, 6, 94 Pelvic, 17, 41, 83, 94, 97 Pelvic inflammatory disease, 17, 41, 94 Pelvis, 78, 93, 94, 103 Penis, 82, 94, 98 Peptide, 9, 43, 76, 84, 90, 94, 97 Perinatal, 19, 94 Peritoneal, 40, 94 Peritoneum, 78, 94 Peroxide, 42, 94 Pharmacologic, 95, 102 Phenotype, 6, 8, 95

Index 109

Phonophoresis, 89, 95 Phospholipases, 95, 99 Phospholipids, 84, 89, 95 Phosphorus, 78, 95 Physiologic, 7, 9, 76, 91, 95, 98 Physiology, 6, 13, 83, 95 Pigments, 79, 95 Pituitary Gland, 84, 85, 95 Placenta, 12, 95, 96 Plants, 76, 78, 79, 85, 92, 93, 95, 102 Plasma, 7, 77, 84, 90, 95, 99 Plasma cells, 77, 95 Plasma protein, 84, 95 Platelet Activation, 95, 99 Pneumonia, 81, 95 Polycystic, 6, 7, 11, 87, 96 Polycystic Ovary Syndrome, 11, 87, 96 Polysaccharide, 77, 96 Postsynaptic, 96, 99 Post-translational, 11, 96 Potassium, 12, 96 Potentiation, 96, 99 Practice Guidelines, 60, 96 Precipitation, 11, 96 Precursor, 82, 83, 93, 96, 102 Pregnancy Outcome, 8, 96 Prenatal, 20, 83, 96 Progesterone, 25, 90, 93, 96, 100 Progestogen, 13, 96 Progression, 5, 8, 96 Progressive, 79, 86, 95, 96, 98 Prolactin, 11, 25, 27, 78, 96 Promoter, 12, 96 Prophase, 93, 96, 101 Prostate, 97, 98 Protein C, 76, 77, 97 Protein S, 78, 97, 98 Proteins, 76, 77, 79, 80, 81, 92, 94, 95, 97, 98, 99, 102 Protocol, 85, 97 Protons, 76, 86, 97 Protozoan, 97, 102 Psittaci, 4, 93, 97 Psychoactive, 97, 103 Psychology, 30, 82, 97 Puberty, 6, 97 Public Health, 4, 6, 60, 97 Public Policy, 59, 97 Pulse, 13, 92, 97 Q Quality of Life, 6, 97

R Race, 90, 92, 93, 97 Racemic, 90, 93, 97 Radiation, 27, 30, 48, 84, 97, 98, 104 Radioactive, 87, 88, 89, 93, 98 Radiological, 20, 24, 30, 98 Radiology, 18, 19, 22, 27, 98 Reactive Oxygen Species, 42, 98 Receptor, 6, 10, 14, 15, 77, 82, 98, 99 Recombinant, 12, 31, 98 Recombination, 85, 98 Refer, 1, 80, 90, 93, 98 Regeneration, 84, 98 Renal failure, 98 Reproduction Techniques, 96, 98 Reproductive cells, 85, 98 Reproductive system, 6, 98 Resorption, 84, 98 Retinoid, 10, 98 Reverse Transcriptase Polymerase Chain Reaction, 13, 98 Ribosome, 98, 102 Rod, 80, 98 S Saliva, 98 Salivary, 25, 98 Schizoid, 98, 103 Schizophrenia, 98, 99, 103 Schizotypal Personality Disorder, 98, 103 Screening, 80, 99 Seafood, 48, 99 Secretion, 7, 11, 78, 85, 87, 88, 89, 90, 92, 99 Segregation, 7, 98, 99 Selective estrogen receptor modulator, 99, 101 Semen, 10, 42, 77, 82, 97, 99 Seminiferous tubule, 6, 88, 99 Semisynthetic, 78, 99 Senescence, 6, 99 Sequence Analysis, 4, 99 Serologic, 87, 99 Serum, 27, 28, 80, 85, 99 Sex Characteristics, 76, 97, 99, 101 Side effect, 51, 75, 99, 102 Signal Transduction, 9, 11, 89, 99 Skeletal, 76, 80, 100 Skull, 100, 101 Small intestine, 86, 100 Social Environment, 97, 100 Solid tumor, 77, 100 Soma, 100 Somatic, 6, 7, 91, 100

110

Female Infertility

Somatic cells, 91, 100 Specialist, 65, 100 Species, 7, 13, 83, 91, 92, 94, 97, 98, 100, 101, 102 Specificity, 13, 75, 100 Sperm, 9, 10, 16, 40, 42, 76, 79, 85, 98, 99, 100 Sperm Motility, 42, 100 Spermatozoon, 100 Spontaneous Abortion, 96, 100 Steel, 80, 100 Sterility, 15, 16, 17, 20, 26, 28, 29, 31, 34, 88, 100 Steroid, 82, 84, 100 Stillbirth, 96, 100 Stomach, 75, 85, 86, 90, 100 Stromal, 83, 100 Subacute, 88, 100 Subclinical, 88, 100 Submucous, 41, 101 Subspecies, 100, 101 Substance P, 96, 99, 101 Superoxide, 42, 101 Superoxide Dismutase, 42, 101 Suppression, 5, 7, 25, 101 Sympathomimetic, 82, 83, 93, 101 Synaptic, 92, 99, 101 Synergistic, 96, 101 Systemic, 52, 83, 88, 93, 101 T Tamoxifen, 18, 99, 101 Temporal, 6, 8, 101 Testicle, 85, 101, 103 Testicular, 6, 10, 101 Testis, 8, 10, 12, 101 Testosterone, 6, 101 Therapeutics, 52, 101 Tone, 101, 102 Tonic, 11, 102 Topical, 87, 102 Toxic, iv, 42, 102 Toxicity, 82, 102 Toxicology, 24, 60, 102 Toxins, 77, 88, 102 Traction, 80, 102 Transcription Factors, 10, 102 Transduction, 99, 102

Transfection, 11, 78, 102 Translation, 9, 76, 102 Translational, 8, 10, 102 Transmitter, 82, 91, 93, 102 Transplantation, 3, 80, 83, 102 Trichomoniasis, 15, 16, 102 Type 2 diabetes, 7, 102 Tyrosine, 82, 102 U Unconscious, 87, 102 Uremia, 90, 98, 102 Urinary, 25, 102, 103 Urine, 102 Urologist, 32, 103 Uterine Contraction, 75, 103 Uterus, 11, 13, 14, 40, 41, 75, 78, 79, 81, 82, 83, 87, 91, 93, 96, 98, 103 V Vagina, 79, 91, 98, 103 Varicocele, 28, 103 Vascular, 14, 88, 93, 95, 103 Vascular endothelial growth factor, 14, 103 Vasoactive, 10, 14, 103 Vasodilator, 82, 103 Vein, 28, 93, 103 Ventricle, 87, 97, 103 Vesicular, 84, 86, 103 Veterinary Medicine, 59, 103 Virilism, 87, 103 Virus, 77, 85, 102, 103 Vitamin A, 89, 98, 103 Vitro, 17, 40, 103 Vivo, 103 W White blood cell, 77, 91, 92, 95, 103 Withdrawal, 12, 103 Womb, 33, 98, 103 Wound Healing, 84, 103 X X-ray, 81, 93, 98, 104 Y Yeasts, 95, 104 Z Zona Pellucida, 18, 40, 104 Zygote, 81, 104

Index 111

112

Female Infertility