Infertility 不孕症 2006网上教材
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The document discusses infertility and assisted reproductive technologies. It defines infertility as unprotected intercourse without pregnancy for two years. Female factors that can cause infertility include problems with ovulation, the fallopian tubes, uterus, or cervical issues. Male factors include abnormal sperm production or function. Treatments discussed include ovulation induction, surgery, assisted reproductive technologies (ART) like intrauterine insemination (IUI), in vitro fertilization (IVF), and gamete intrafallopian transfer (GIFT). Complications of ART like multiple gestations and ovarian hyperstimulation syndrome are also mentioned.
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Infertility affects approximately 14-20% of couples in the US. Common causes include female ovulatory disorders (30-40%), male factor issues (30%), and tubal damage (16%). A thorough evaluation involves a detailed history and physical exam of both partners, as well as tests to evaluate ovarian function, tubal patency, uterine health, and male factors. Treatment options depend on the underlying cause, but may include ovulation induction, intrauterine insemination, surgery, and assisted reproductive technologies like in vitro fertilization. Infertility can have significant emotional impacts and its evaluation and treatment require a multi-disciplinary approach.
Ovarian Hyperstimulation Syndrome
Ovarian Hyperstimulation Syndrome (OHSS) is a condition characterized by ovarian enlargement and fluid accumulation in the abdomen and chest. It occurs most commonly as a complication of ovulation induction treatments. The document discusses risk factors, pathogenesis, classification, complications, prevention, and treatment of OHSS. Prevention focuses on predicting risk through endocrine and ultrasound monitoring to determine the optimal time for ovulation trigger and modifying stimulation protocols if needed. Treatment involves fluid management, symptom relief, and in severe cases hospitalization and close monitoring.
Hyperprolactinemia
Hyperprolactinemia is caused by increased levels of the hormone prolactin, which is regulated by the hypothalamus. Elevated prolactin levels can be caused by hypothalamic or pituitary tumors, systemic diseases, or certain drugs. Common symptoms of hyperprolactinemia in females include menstrual irregularities and galactorrhea, while males commonly experience symptoms related to mass effects of pituitary tumors such as headaches and visual abnormalities. Treatment options for hyperprolactinemia depend on the size and invasiveness of any pituitary tumors, and may involve dopamine agonists such as bromocriptine or surgery.
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This document discusses infertility, including its definition, causes, diagnostic evaluation, and management. It notes that infertility is defined as the inability to conceive after one year of unprotected intercourse. The causes of infertility can be male factors related to sperm production or transport, female factors related to ovulation or egg/hormone problems, or combined factors in both partners. Diagnostic evaluation involves medical histories, physical exams, sperm analysis, hormone testing, imaging of reproductive organs, and other tests to identify treatable causes. Management depends on the underlying causes and may include lifestyle changes, surgery, assisted reproductive technologies like IVF, or alternatives to childbirth like adoption.
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- hCG is a hormone produced in pregnancy that helps maintain the corpus luteum to support early pregnancy.
- It is used to induce ovulation by mimicking LH and causing follicles to rupture and release eggs, increasing chances of pregnancy.
- Indications for use include anovulation, PCOS, and irregular periods.
- It is administered via intramuscular or subcutaneous injection in dosages of 5,000 to 10,000 IU when monitoring shows a mature follicle after ovulation induction treatment.
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Diagnosis and management of basic infertility
This document provides guidance for general gynecologists on evaluating and managing basic infertility. It highlights that a thorough history and physical exam should be done before starting any workup. The workup should generally start after 6 months of trying unless certain risk factors are present. Key parts of the initial workup include a semen analysis, confirming ovulation with a mid-luteal progesterone test, and checking tubal patency with HSG or sonohysterography. Empirical clomiphene citrate therapy is not recommended. IUI is only appropriate if the gynecologist understands patient selection and timing of referral for more advanced treatments. Lifestyle changes should be the first approach for overweight PCOS patients.
Infertility
The document discusses infertility, defining it as 1 year of unprotected intercourse without pregnancy. It describes how infertility is classified and evaluated in both males and females. Common causes of infertility are then outlined for both sexes, including factors related to ovulation, the fallopian tubes, uterus, and immune or idiopathic issues. The prevalence of different causes is provided. Clinical evaluation steps and potential investigations for males and females are also summarized. Finally, treatment options are reviewed for resolving infertility in males and females.
Female infertility
it describes in detail about causes, investigations and management of female infertility.in the end of presentation, it includes a video demonstration to describe the management options of assisted conception.
Infertility Treatment
This document discusses various pharmacological treatments for infertility. It begins by defining infertility and discussing its prevalence in the population. It then covers hormonal causes of female infertility and various drug treatments for specific conditions like anovulation, PCOS, and corpus luteal phase defect. Key drugs discussed include clomiphene citrate, gonadotropins, hCG, GnRH agonists and antagonists, and bromocriptine. Surgical treatments and assisted reproduction techniques are also briefly mentioned.
Diagnosis and management of male infertility
This document provides an overview of the diagnosis and management of male infertility. It discusses evaluating the patient's history including reproductive, medical, surgical, medication/toxin exposure and family histories. Physical exam and lab tests including semen analysis and hormones are also important. Common causes of male infertility discussed include varicocele, cryptorchidism, infections, cancers, medications/toxins and genetic factors. Lifestyle factors that can impact fertility are also addressed.
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The document discusses infertility, its causes and treatments. It defines infertility as the inability to conceive after one year of regular unprotected sex. Approximately 10-15% of couples experience infertility, with female factors accounting for 60% of cases, male factors 30% and both male and female factors in 10% of cases. Common female causes include problems with ovulation, fallopian tubes or cervical factors. Common male causes include abnormal sperm production or function. Treatments aim to address the specific cause, and may include ovulation induction medications, surgery, assisted reproduction technologies like IUI or IVF.
Infertility
This document provides information on infertility, including its definition, causes, risk factors, diagnosis and investigations, and management options. It defines infertility as not conceiving after one year of unprotected sex. The most common causes are male factors (30%), ovulatory disorders (25%), and tubal damage (20%). Risk factors include advanced age, smoking, alcohol, weight factors, and certain infections or exposures. Diagnosis involves medical history, physical exams, and tests like semen analysis, ovulation assessments, and imaging. Treatment may include lifestyle changes, medications, surgery, and assisted reproductive technologies like IUI, IVF, and ICSI.
Optimal protocols for Ovulation induction (Assisted Reproductive technologies)
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Presentation given in Tirupati, India in 2018 on Ovulation Induction for assisted reproductive technologies. Dealing with infertility using Intra uterine insemination (IUI) and In vitro fertilization (IVF)Current Management of Anovulatory Infertility
Presentation given at the weekly departmental seminar of the LAUTECH teaching hospital, Ogbomoso. Nigeria
Infertility; Causes and Management
This document discusses infertility, including its definition, causes, evaluation, and management. It notes that infertility affects approximately 1 in 7 couples in the UK. Evaluation involves assessing both partners for potential medical causes through history, examination, tests, and procedures. Treatment options range from lifestyle changes to surgery to assisted reproductive technologies (ART) like IVF, depending on the underlying cause. The majority of young couples without known issues will conceive naturally within 2 years.
MALE & FEMALE INFERTILITY
This document discusses infertility, including definitions, incidence, and causes. It provides details on evaluating male and female infertility. For males, investigations include semen analysis and hormone testing. For females, ovulation is evaluated through basal body temperature charts, cervical mucus tests, hormone levels, and endometrial biopsies to check for anovulation, luteal phase defects, or tubal/uterine issues. Treatment options of medical management and surgery are also mentioned.
Pri. and secondary infertility
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Infertility 不孕症 2006网上教材
The document discusses infertility and assisted reproductive technologies. It defines infertility as unprotected intercourse without pregnancy for two years. Female factors that can cause infertility include problems with ovulation, the fallopian tubes, uterus, or cervical issues. Male factors include abnormal sperm production or function. Treatments discussed include ovulation induction, surgery, assisted reproductive technologies (ART) like intrauterine insemination (IUI), in vitro fertilization (IVF), and gamete intrafallopian transfer (GIFT). Complications of ART like multiple gestations and ovarian hyperstimulation syndrome are also mentioned.
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The document discusses infertility, defining it as the inability to conceive after one year of unprotected intercourse. It notes that infertility affects 10-15% of couples and discusses the main causes, which include female factors in 50% of cases, male factors in 35% of cases, and unexplained causes in 10-15% of cases. The major sections of the document cover ovulation disorders, tubal and peritoneal factors, uterine factors, cervical factors, and male factors in infertility.
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- hCG is a hormone produced in pregnancy that helps maintain the corpus luteum to support early pregnancy.
- It is used to induce ovulation by mimicking LH and causing follicles to rupture and release eggs, increasing chances of pregnancy.
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- It is administered via intramuscular or subcutaneous injection in dosages of 5,000 to 10,000 IU when monitoring shows a mature follicle after ovulation induction treatment.
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Diagnosis and management of basic infertility
This document provides guidance for general gynecologists on evaluating and managing basic infertility. It highlights that a thorough history and physical exam should be done before starting any workup. The workup should generally start after 6 months of trying unless certain risk factors are present. Key parts of the initial workup include a semen analysis, confirming ovulation with a mid-luteal progesterone test, and checking tubal patency with HSG or sonohysterography. Empirical clomiphene citrate therapy is not recommended. IUI is only appropriate if the gynecologist understands patient selection and timing of referral for more advanced treatments. Lifestyle changes should be the first approach for overweight PCOS patients.
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The document discusses infertility, defining it as 1 year of unprotected intercourse without pregnancy. It describes how infertility is classified and evaluated in both males and females. Common causes of infertility are then outlined for both sexes, including factors related to ovulation, the fallopian tubes, uterus, and immune or idiopathic issues. The prevalence of different causes is provided. Clinical evaluation steps and potential investigations for males and females are also summarized. Finally, treatment options are reviewed for resolving infertility in males and females.
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it describes in detail about causes, investigations and management of female infertility.in the end of presentation, it includes a video demonstration to describe the management options of assisted conception.
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This document discusses various pharmacological treatments for infertility. It begins by defining infertility and discussing its prevalence in the population. It then covers hormonal causes of female infertility and various drug treatments for specific conditions like anovulation, PCOS, and corpus luteal phase defect. Key drugs discussed include clomiphene citrate, gonadotropins, hCG, GnRH agonists and antagonists, and bromocriptine. Surgical treatments and assisted reproduction techniques are also briefly mentioned.
Diagnosis and management of male infertility
This document provides an overview of the diagnosis and management of male infertility. It discusses evaluating the patient's history including reproductive, medical, surgical, medication/toxin exposure and family histories. Physical exam and lab tests including semen analysis and hormones are also important. Common causes of male infertility discussed include varicocele, cryptorchidism, infections, cancers, medications/toxins and genetic factors. Lifestyle factors that can impact fertility are also addressed.
Female infertility,Prof.Salah Roshdy
This document discusses female infertility. It defines primary and secondary infertility and outlines the typical initial investigations for an infertile couple, including investigating male factors, testing for ovulation, and testing tubal patency using procedures like laparoscopy and hysteroscopy. Some of the key causes of female infertility discussed include ovulatory disorders like polycystic ovary syndrome, tubal damage, endometriosis, and unexplained infertility.
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This document discusses infertility, including its definition, causes, examinations, and treatment methods. It notes that infertility is defined as two years of unprotected intercourse without pregnancy. The main causes of infertility are listed as female factors (40-55%), male factors (25-40%), and both male and female factors (10%). Examinations for infertility include history, physical exam, laboratory tests such as hormone levels and semen analysis, and imaging like ultrasounds and HSG. Treatment methods covered include ovulation induction, surgery, assisted reproductive technologies (ART) like IUI, IVF-ET, and GIFT.
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This document provides information on infertility, including its definition, causes, risk factors, diagnosis and investigations, and management options. It defines infertility as not conceiving after one year of unprotected sex. The most common causes are male factors (30%), ovulatory disorders (25%), and tubal damage (20%). Risk factors include advanced age, smoking, alcohol, weight factors, and certain infections or exposures. Diagnosis involves medical history, physical exams, and tests like semen analysis, ovulation assessments, and imaging. Treatment may include lifestyle changes, medications, surgery, and assisted reproductive technologies like IUI, IVF, and ICSI.
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This document discusses infertility, including definitions, incidence, and causes. It provides details on evaluating male and female infertility. For males, investigations include semen analysis and hormone testing. For females, ovulation is evaluated through basal body temperature charts, cervical mucus tests, hormone levels, and endometrial biopsies to check for anovulation, luteal phase defects, or tubal/uterine issues. Treatment options of medical management and surgery are also mentioned.
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Seminar Presentation Molina Dayal MD 9-13
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This document discusses the authors' experience with ovarian hyperstimulation syndrome (OHSS) in 580 in vitro fertilization (IVF) cycles. It provides information on:
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- Their findings that OHSS does not occur without hCG trigger and symptoms resolve within 10-12 days without pregnancy.
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3. More research is needed to better understand unexplained RPL and identify potential underlying causes that current tests cannot detect. Larger randomized controlled trials of treatments and multicenter studies are needed to expand knowledge of RPL.
Infertility Hysteroscopy
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UNEXPLAINED INFERTILITY & INTRAUTERINE INSEMINATION Dr. Sharda jain Lifecare...
UNEXPLAINED INFERTILITY & INTRAUTERINE INSEMINATION DR. SHARDA JAIN , DR. JYOTI AGARWAL
DR. JYOTI BHASKAR
DEFINITION
Unexplained infertility means that couple does not conceive after 1year of unprotected vaginal sexual intercourse, with basic infertility evaluation showing no obvious abnormality.
INCIDENCE
15%to 20% of infertile couples
UNEXPLAINED IS PRIMARILY A
DIAGNOSIS OF EXCLUSION
Management of INFERTILITY in PCOD Difficulties & Solutions Made Easy , Dr....
This document discusses the management of infertility in patients with polycystic ovarian syndrome (PCOS). It begins by outlining the types of patients seen, including those with anovulatory infertility, obesity, and menstrual irregularities. The challenges of PCOS treatment in women aged 20-40 are then presented, including concerns about infertility, pregnancy loss, and risks during pregnancy like preeclampsia and gestational diabetes. Treatment options for infertility in PCOS patients are then discussed, including clomiphene citrate, gonadotropins, laparoscopic ovarian drilling, and metformin. Protocols for ovarian stimulation with clomiphene citrate and gonadotropins are also presented.
Recurrent pregnancy loss 1
1) Recurrent pregnancy loss is defined as three or more consecutive pregnancy losses before 20 weeks of gestation. A thorough investigation should be conducted to identify potentially treatable causes.
2) Common etiological factors include uterine anomalies, immunological issues such as antiphospholipid syndrome, endocrine disorders such as thyroid disease or diabetes, genetic factors, and thrombophilic disorders.
3) Evaluation involves a detailed history, physical exam, ultrasound, hormonal and immunological testing. Uterine anomalies require hysteroscopy or laparoscopy. Treatment depends on the underlying cause but may include surgery, medication, lifestyle changes, or cerclage. The goal is to identify modifiable risk factors.
PROTOCOLS Intra Uterine Insemination (sharing personal experience)
This document provides information on intrauterine insemination (IUI), including prerequisites, indications, steps, and factors affecting success rates. It summarizes that IUI is a relatively simple and inexpensive fertility treatment that involves placing sperm directly into the uterus. Success rates are affected by factors like total motile sperm count, with counts over 5 million critical. Density gradient preparation is superior to swim-up for abnormal semen. DNA fragmentation levels also impact rates. Guidelines on when to consider IVF instead of further IUI cycles include age over 37, more than 4 failed cycles, severe male factors, and certain ovarian response patterns.
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This document discusses infertility, including its definition, causes, examinations, and treatment methods. It notes that infertility is defined as two years of unprotected intercourse without pregnancy. The main causes of infertility are listed as female factors (40-55%), male factors (25-40%), and both male and female factors (10%). Examinations for infertility include medical history, physical exam, laboratory tests such as hormone levels and semen analysis, and imaging like ultrasounds and hysterosalpingograms. Common treatment methods for female infertility include ovulation induction, surgery to repair fallopian tubes, and assisted reproductive technologies (ART) like IUI, IVF, and GIFT.
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This document discusses infertility, including its definition, causes, examinations, and treatment methods. It notes that infertility is defined as two years of unprotected intercourse without pregnancy. The main causes of infertility are listed as female factors (40-55%), male factors (25-40%), and both male and female factors (10%). Examinations for infertility include history, physical exam, laboratory tests such as hormone levels and semen analysis, and imaging like ultrasounds and HSG. Treatment methods covered include ovulation induction, surgery, assisted reproductive technologies (ART) like IUI, IVF-ET, and GIFT. Complications of ART are also outlined.
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Infertility can be caused by female or male factors and is defined as the inability to conceive after one year of regular unprotected sex. Common causes include problems with ovulation, the fallopian tubes, sperm quality, or other issues. Treatment may include fertility drugs to stimulate ovulation, surgery to repair damaged reproductive organs, artificial insemination (IUI), in vitro fertilization (IVF), or other assisted reproductive technologies (ART) like GIFT or ZIFT. The goal of treatment is to address the underlying cause of infertility and increase the chances of conception and pregnancy.
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2) Risk factors include younger age, lower weight, use of gonadotropins for ovulation induction, and conception during treatment.
3) Symptoms range from mild abdominal discomfort to life-threatening complications due to shift of fluid from blood vessels into third spaces. Mild cases resolve on their own while severe cases require hospitalization and management of fluid and electrolyte balance.
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Polycystic Ovary Syndrome (PCOS) is a common cause of irregular periods and infertility in women of reproductive age, affecting 5-10% of women. It is associated with increased levels of androgens and insulin resistance. Women with PCOS have an increased risk of health issues like endometrial cancer and cardiovascular disease. The syndrome was first described in 1935 and involves bilateral polycystic ovaries seen on imaging. Hyperinsulinism correlates with increased androgen levels in women with PCOS.
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This document summarizes evidence-based guidelines for investigating infertile couples. It finds that while many tests have been advocated, the necessity and cost-effectiveness of many have not been proven. It recommends conventional semen analysis, assessment of ovulation with progesterone tests, and HSG or laparoscopy to assess tubal patency as useful initial tests. Tests like post-coital testing, hysteroscopy, and sperm penetration assays provide little predictive value on pregnancy rates and are less useful. A simplified approach focusing on proven essential tests can significantly reduce time and costs in evaluating infertility.
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Infertility 不孕症 2006网上教材
The document discusses infertility and assisted reproductive technologies. It defines infertility as unprotected intercourse without pregnancy for two years. Female factors that can cause infertility include problems with ovulation, the fallopian tubes, uterus, or cervical issues. Male factors include abnormal sperm production or function. Treatments discussed include ovulation induction, surgery, assisted reproductive technologies (ART) like intrauterine insemination (IUI), in vitro fertilization (IVF), and gamete intrafallopian transfer (GIFT). Complications of ART like multiple gestations and ovarian hyperstimulation syndrome are also mentioned.
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The document discusses office-based hysteroscopic procedures including using the Versapoint and Essure sterilization systems. It finds that 70-80% of fibroids under 3cm and polyps under 4cm can be removed in an office setting using Versapoint. Essure sterilization can also be performed in an office without anesthesia using the Bettocchi approach, with an average pain score of 2.5 and procedure time of 10-15 minutes depending on parity. Placement is verified after 3 months using transvaginal ultrasound instead of X-ray or HSG.
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Infertility 不孕症 2006网上教材
The document discusses infertility and assisted reproductive technologies. It defines infertility as unprotected intercourse without pregnancy for two years. Female factors that can cause infertility include problems with ovulation, the fallopian tubes, uterus, or cervical issues. Male factors include abnormal sperm production or function. Treatments discussed include ovulation induction, surgery, assisted reproductive technologies (ART) like intrauterine insemination (IUI), in vitro fertilization (IVF), and gamete intrafallopian transfer (GIFT). Complications of ART like multiple gestations and ovarian hyperstimulation syndrome are also mentioned.
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