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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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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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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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.
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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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Introduction
Natural conception
Epidemiologic figures
Factors affect the natural conception rate
Causes of subfertility
Female causes of subfertility
ovulation
Ovarian problems
Marker of ovarian reserve
Tubal blockage
Endometrial factors
Uterine factors
Cervical factors
History and PE
Investigations
Treatment
Male subfertility
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Primary hypogonadism
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Defective ejaculation
History and PE
Investigations
Surgical sperm retrieval
Cryopreservation of gametes
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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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There are three main methods for endometrial preparation in frozen embryo transfer cycles:
1) Natural cycles which rely on endogenous hormones but have limitations like irregular cycles.
2) Hormonally manipulated cycles using GnRH agonists and exogenous estrogen and progesterone to control timing, but GnRH agonists are not always needed.
3) Non-GnRH agonist manipulated cycles using exogenous estrogen and progesterone alone, which is a simple and effective alternative to GnRH agonist protocols.
The document discusses various hormone replacement protocols and finds no significant differences in outcomes between natural, GnRH agonist, and non-GnRH agonist methods of endometrial preparation.
ENDOMETRIAL PREPARATION IN FROZEN EMBRYO TRANSFER CYCLES
This document discusses different methods for endometrial preparation in frozen embryo transfer (FET) cycles. It describes natural cycle FET, which can be done through a true natural cycle or modified natural cycle with an HCG trigger. It also outlines artificial/hormone replacement cycle FET, where estrogen and progesterone are administered without GnRH agonists in patients with remaining ovarian function. The key points are that the endometrium must be adequately prepared prior to embryo transfer, and the age of the embryos after thawing should correspond to the developmental age of the endometrium. The best method varies between patients and there is no clear consensus.
Assisted reproductive techniques
This document discusses various assisted reproductive technologies (ART) such as in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), and zygote intrafallopian transfer (ZIFT). It provides a brief history of ART and describes techniques like ovarian stimulation protocols, oocyte retrieval, fertilization, embryo culture, and preimplantation genetic diagnosis. Potential indications for ART include tubal factor infertility, endometriosis, and male factor infertility. Success rates are influenced by factors like maternal age and ovarian reserve.
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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.
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Hormonal causes of infertility
This document discusses various hormonal causes of infertility in cattle, including ovarian atrophy, follicular atresia, silent heat, delayed ovulation, ovarian cysts, and persistent corpus luteum. Ovarian atresia occurs when follicles fail to grow and ovulate due to hormonal imbalances. Ovarian cysts develop from unovulated follicles and can cause anestrum. Persistent corpus luteum refers to the corpus luteum persisting beyond its normal lifespan, also resulting in anestrum. Diagnosis and treatment options aim to induce ovulation or luteinization and reestablish normal estrus cycles. Left untreated, these hormonal issues can increase costs through extended calving intervals and reduced fertility.
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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Infertility can be caused by factors affecting the male or female reproductive systems. Common causes of male infertility include varicocele, infections, genetic issues, and problems with sperm production or function. Common causes of female infertility include problems with ovulation, fallopian tube damage or blockage, uterine issues, cervical issues, and immunological factors. Treatments depend on the underlying causes but may include lifestyle changes, medication, surgery, assisted reproductive technologies (ART) like IVF, or adoption. The prognosis for achieving pregnancy varies but ranges from 30-60% within 2 years depending on the diagnosis and treatments utilized.
Male and Female Subfertility
Introduction
Natural conception
Epidemiologic figures
Factors affect the natural conception rate
Causes of subfertility
Female causes of subfertility
ovulation
Ovarian problems
Marker of ovarian reserve
Tubal blockage
Endometrial factors
Uterine factors
Cervical factors
History and PE
Investigations
Treatment
Male subfertility
Hypothalamic-pituitary disease
Obesity
Primary hypogonadism
Sperm transport disorders
Defective ejaculation
History and PE
Investigations
Surgical sperm retrieval
Cryopreservation of gametes
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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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There are three main methods for endometrial preparation in frozen embryo transfer cycles:
1) Natural cycles which rely on endogenous hormones but have limitations like irregular cycles.
2) Hormonally manipulated cycles using GnRH agonists and exogenous estrogen and progesterone to control timing, but GnRH agonists are not always needed.
3) Non-GnRH agonist manipulated cycles using exogenous estrogen and progesterone alone, which is a simple and effective alternative to GnRH agonist protocols.
The document discusses various hormone replacement protocols and finds no significant differences in outcomes between natural, GnRH agonist, and non-GnRH agonist methods of endometrial preparation.
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This document discusses different methods for endometrial preparation in frozen embryo transfer (FET) cycles. It describes natural cycle FET, which can be done through a true natural cycle or modified natural cycle with an HCG trigger. It also outlines artificial/hormone replacement cycle FET, where estrogen and progesterone are administered without GnRH agonists in patients with remaining ovarian function. The key points are that the endometrium must be adequately prepared prior to embryo transfer, and the age of the embryos after thawing should correspond to the developmental age of the endometrium. The best method varies between patients and there is no clear consensus.
Assisted reproductive techniques
This document discusses various assisted reproductive technologies (ART) such as in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), and zygote intrafallopian transfer (ZIFT). It provides a brief history of ART and describes techniques like ovarian stimulation protocols, oocyte retrieval, fertilization, embryo culture, and preimplantation genetic diagnosis. Potential indications for ART include tubal factor infertility, endometriosis, and male factor infertility. Success rates are influenced by factors like maternal age and ovarian reserve.
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This document discusses embryo transfer as the final step of assisted reproductive technology where embryos are placed in the female uterus. It describes factors that affect embryo transfer success including implantation capacity, endometrial receptivity, and technique. The document outlines techniques for embryo transfer including assisted hatching, embryo glue, catheter type and loading, ultrasound guidance, and ensuring no blood or mucus blockage. Successful embryo transfer requires a gentle, non-traumatic procedure performed with attention to numerous technical details.
Embryo Transfer
Embryo transfer involves collecting embryos from a donor cow and transferring them to recipient cows. The donor cow is given follicle stimulating hormones to cause it to superovulate and produce multiple embryos. The embryos are then collected from the donor cow approximately 7 days after artificial insemination. The embryos are evaluated and the highest quality embryos are transferred into recipient cows that have been synchronized to the same stage of estrus as the donor cow through the use of hormones. Embryo transfer allows for the propagation of genetics from superior cows and makes it possible to export or store embryos indefinitely.
In vitro fertilization and embryo transfer in humans
The document discusses infertility treatment techniques like in vitro fertilization (IVF) and embryo transfer. It describes the IVF process which involves collecting eggs and sperm, fertilizing the eggs in vitro, and implanting the resulting embryos into the uterus. Embryo transfer is defined as implanting embryos developed in vitro or from another female's uterus. The success rates of IVF depend on factors like the woman's age and number of eggs collected. IVF has led to the birth of the first "test tube baby" and advances in reproductive technology.
Assisted Reproductive Technology
This document provides an overview of assisted reproductive technology (ART) including various methods such as artificial insemination, in vitro fertilization, intracytoplasmic sperm injection, assisted hatching, zygote intrafallopian transfer, gamete intrafallopian transfer, freezing of embryos and gametes, and sex selection. It discusses the indications, procedures, success rates and complications of these different ART methods.
In vitro fertilization embryo transfer
This document summarizes in vitro fertilization (IVF) and embryo transfer. [1] IVF involves removing eggs from a woman, fertilizing them with sperm in the lab, and then transferring the fertilized eggs (zygotes) into the uterus a few days later. [2] Reasons for IVF include infertility, which is increasingly prevalent worldwide. [3] The history, methodology, success rates, factors, and limitations of IVF are discussed over several stages: ovarian stimulation and monitoring, egg retrieval, fertilization, embryo transfer, and potential outcomes.
In vitro fertilization
The document summarizes the history and process of in vitro fertilization (IVF). It discusses how IVF was developed as a treatment for infertility and involves fertilizing an egg outside of the body. The summary includes:
- The key stages of an IVF cycle including ovarian stimulation, egg retrieval, fertilization in vitro, embryo transfer, and indications for IVF such as tubal disease or male factor infertility.
- Milestones in the history of IVF including the first successful case in 1978 and development of techniques like ICSI.
- Risks and side effects of ovarian stimulation and factors considered for embryo transfer like number based on patient age and prior attempts.
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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.
Infertility
Infertility is defined as the inability to conceive after one year of unprotected intercourse. It can be caused by issues with ovulation, the fallopian tubes, uterus, cervix, or vagina in women or by low sperm count or quality, obstruction, or ejaculation issues in men. Diagnostic evaluation involves medical histories, physical exams, and lab tests of both partners. Treatment may include medications to stimulate ovulation, artificial insemination, in vitro fertilization, gamete intrafallopian transfer, or zygote intrafallopian transfer depending on the causes of infertility.
Infertility
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.
Infertility
1. The document discusses infertility, including its definition, types, prevalence, causes, investigations, and management for both female and male infertility.
2. For female infertility, common causes include ovulatory disorders, tubal/peritoneal factors, and endometriosis. Investigations evaluate ovulation and tubal patency. Treatments target the underlying cause and may include drugs, surgery, or assisted reproductive technologies.
3. For male infertility, common causes are genetic defects, hormonal issues, varicocele, infections, and lifestyle factors. Investigations include semen analysis and hormone levels. Treatments include correcting underlying issues, surgery, hormones, and assisted reproduction.
Infertility
This document summarizes a seminar on male reproductive system disorders presented by Nikhil Vaishnav. It defines infertility as failure to conceive within one year of unprotected sex. There are two types of infertility - primary where couples have never conceived, and secondary where difficulty conceiving occurs after an initial conception. Infertility affects 1 in 7 couples and can be due to issues with sperm production, obstruction, ejaculation problems, or seminal fluid abnormalities in the male partner. Causes include genetic factors, infections, medications, lifestyle, and endocrine or structural abnormalities. Diagnosis involves medical history, exams, semen analysis, and hormone or genetic testing. Treatment focuses on improving general health, avoiding medications, using fertility drugs or therapies
Ambiguous genitalia .....
Ambiguous genitalia refers to a condition where an infant's genitals do not appear clearly male or female. It occurs in about 1 in 2,000 births and is often due to congenital adrenal hyperplasia. A team approach is needed for diagnosis and management, including karyotyping, medical history, physical exam, imaging, and sometimes biopsy. The goals of treatment are to ensure sexual function, fertility, and psychological well-being. Hormone therapy and surgery may be used to treat the condition.
Subfertility/infertility
subfertility definition
infertility causes ,diagnosis and management
including female infertility and male infertility
INFERTILITY.pptx
This document discusses infertility in both males and females. It defines primary and secondary infertility and lists various factors that can cause infertility in males and females. For males, it discusses abnormalities of sperm, erection, ejaculation and seminal fluid. For females, it discusses disorders of ovulation, fallopian tubes, cervix and recurrent pregnancy loss. It also discusses diagnostic tests and treatments for infertility including fertility drugs, assisted reproductive technologies like IVF, and surrogacy.
INFERTILITY.pptx
This document discusses various factors that can cause infertility in males and females. It describes abnormalities that can impair sperm production or function in males such as low sperm count, abnormal sperm morphology or motility. It also discusses erection or ejaculation issues. In females, it mentions disorders of ovulation, fallopian tube abnormalities, cervical issues, or recurrent pregnancy loss as factors. Some diagnostic tests and treatments for infertility are also outlined such as semen analysis, ovulation predictor kits, fertility drugs, artificial insemination, IVF etc.
Subfertility
This document discusses subfertility, which is defined as the failure to conceive within 1 year of unprotected regular sexual intercourse. It describes various factors that can affect fertility in both men and women, including ovulation disorders, tubal damage, age, sexually transmitted diseases, endometriosis, and male factors like varicocele and low semen quality. The management of subfertility involves taking a history, examination, and investigations to determine the cause, followed by treatments tailored to the specific diagnosis, such as clomiphene citrate for ovulation disorders or surgery for tubal disease.
Subfertility (Infertility)
Obstetrics and Gynecology, Presentation on Subfertility/Infertility. Includes all aspects and treatment.
Source: Ten Teachers OBGYN
Infertility Overview, Approach and Evaluation
This presentation covers the topic such as Male & Female Infertility Overview, approach & evaluation. Infertility is a condition in couples, failed to get a successful pregnancy after twelve months of timed unprotected intercourse or therapeutic donor insemination.
Eden fertility center serves as a unique fertility clinic with advanced facilities and state-of-the-art equipment to ensure excellent patient care. We deliver possibly the most advanced fertility treatments in Newport Beach & Fullerton CA
Eden Centers for Advanced Fertility offers patients the most advanced treatment solutions & also gives excellent quality patient care. We are a group of highly trained specialists who've innovative concepts for fertility treatment depending on three main principles: individualized personal care, excellent medical service & effective benefits.
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Egg Freezing - Oocyte Preservation
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Understanding Infertility, Evaluations, and Treatment Options
Understanding Infertility, Evaluations, and Treatment OptionsFertility Specialists Medical Group (FSMG)
Presentation covers 3 topics: 1) Definition of infertility with brief review of female reproduction. 2) Discussion of how fertility status is evaluated with a description of some of the tests that are performed. 3) Review of several treatment options. By Dr. Arlene Morales of Fertility Specialists Medical Center (FSMG) http://ivfspecialists.com/Basics of IVF for GP
- Infertility is a problem through out and increasing rates noticed.
- The successful birth of a “Test Tube Baby”, Louise Brown occurred in 1978 in Oldham General Hospital, U.K.
- Roberts G. Edwards; the physiologist who developed the treatment was awarded the noble prize in Medicine in 2010.
Infertility
slides includes definition of infertility, types, causes, risk factors, diagnostic procedure and treatment and Artificial Reproductive technology
Fertility Options: IVF Overview
Mark Perloe, MD Atlanta, 404-843-2229 Learn about the factors that can adversely affect fertility and the tests that can help pinpoint problems. Fertility treatment options including IVF and other high tech options are presented.
medical management of infertility,think before surgery!!!!
Nowdays infertility is major issues world wide,It covers both male and female infertility causes,investigation and related treatments.it also includes recent options available at infertility centres.
Precocious puberty
Dr.Tai Al Akawy
Consultant pediatrician at Alexandria University Children Hospital , Faculty of Medicine
Egypt
infertility.pptx
This document discusses the management of infertility. It begins with definitions and classifications of infertility. Evaluation involves a medical history and physical exam for both males and females. Common causes of infertility in males include infection, trauma, and exposure to toxins, while common causes in females include disorders of ovulation, fallopian tube damage or blockage, endometriosis, and uterine issues. Treatment options discussed include counseling, lifestyle changes, ovulation induction with clomiphene or aromatase inhibitors, gonadotropins, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection. The goal is to stimulate follicle development and ovulation or perform fertilization procedures to increase the chances of conception.
Similar to Infertility 不孕症 2006网上教材 (20)
Understanding Infertility, Evaluations, and Treatment Options
Understanding Infertility, Evaluations, and Treatment Options
medical management of infertility,think before surgery!!!!
medical management of infertility,think before surgery!!!!
More from guest9dc181
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.
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.
Infertility Hysteroscopy
The document discusses the use of hysteroscopy in evaluating and treating infertility. It provides evidence-based guidelines on when hysteroscopy is recommended and not recommended in infertility workup. It also reviews evidence on techniques for diagnostic and operative hysteroscopy, including indications, preparation, distension media, findings, and treatment of various intrauterine issues like polyps, fibroids, adhesions that may cause infertility. Complications are also discussed.
Infertility Stem Cell 1
The document discusses various ethical, legal and social issues (ELSI) related to stem cell and advanced biomedical research. It notes that societies' prevailing views on life, ethics and values will influence how such research is conducted and its results applied. While sciences aim for progress, society must properly address ELSI to avoid lost opportunities or deterring research. Key issues include what constitutes life and humanity, commercialization of human materials, intellectual property rights, and religious and legal views on topics like embryo use and cloning. Countries differ in their stances with no global consensus. Infrastructure and guidelines are needed to help navigate these complex issues.
Infertility Stem Cell 2
The document discusses several topics related to women in stem cell science:
1. Women are underrepresented among senior stem cell scientists but make up about 40% of junior faculty. More work is needed to improve the pipeline for underrepresented minority women.
2. Women lag behind men in starting companies and obtaining patents from their research, reducing opportunities for their discoveries to reach patients and for them to receive credit.
3. Workplace culture must better support balancing family and work obligations to retain women scientists.
4. The document analyzes how science both reflects and reinforces gender theories, and discusses debates around stem cell derivation and the moral status and sexing of embryos.
Ovarian Hyperstimulation Syndrome
1) Ovarian hyperstimulation syndrome (OHSS) is a potential complication of ovulation induction characterized by ovarian enlargement and fluid accumulation in the abdomen and chest.
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.
Ovary Hyperstimulation 1
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.
Laparoscopy 4
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.
Laparoscopy 2
This document discusses whether surgery improves fertility outcomes for women with endometriosis. It reviews several studies that have looked at IVF success rates and spontaneous pregnancy rates after surgery for mild versus severe endometriosis. The document also presents unpublished data from a study of 261 women who underwent laparoscopic excision for stage III/IV endometriosis, finding a 79.7% spontaneous pregnancy rate. It concludes that while surgery is generally recommended for stage I/II endometriosis, the role of surgery for stage III/IV endometriosis remains controversial in improving fertility outcomes due to a lack of large, prospective studies.
Hysteroscopy 0
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.
Laparoscopy 1
1) Laparoscopic ablation of minimal or mild endometriosis in women with subfertility aims to increase pregnancy rates but evidence from randomized trials is limited and inconclusive.
2) Two randomized trials found slightly higher pregnancy rates with ablation but the number needed to treat was high at 8 women to achieve one additional pregnancy.
3) A prospective cohort study found no significant difference in fecundity rates between women with minimal/mild endometriosis and unexplained infertility.
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.
Ovarian Hyperstimulation Syndrome
1) Ovarian hyperstimulation syndrome (OHSS) is a condition characterized by ovarian enlargement and fluid accumulation in the abdomen and sometimes lungs, due to controlled ovarian hyperstimulation for fertility treatments.
2) Risk factors include younger age, lower weight, use of gonadotropins like hMG for fertility treatments, high estrogen levels, and pregnancy.
3) Symptoms range from mild abdominal bloating to severe cases involving kidney failure. Prevention focuses on modifying fertility drug protocols and cycles based on estrogen level monitoring.
(2006)Endocrine Pituitary Gland
The document summarizes the hypothalamic control of the pituitary gland and the hormones produced by its anterior and posterior lobes. The posterior lobe produces ADH and oxytocin, which regulate water balance and labor, respectively. The anterior lobe produces GH, PRL, ACTH, MSH, TSH, LH, FSH, and beta-LPH, which regulate growth, lactation, skin pigmentation, and reproduction. The hypothalamus controls pituitary function through releasing and inhibiting hormones.
Gyn Hyperprolactinemia
Hyperprolactinemia is a condition of elevated levels of the hormone prolactin in the blood. Prolactin is normally produced by the pituitary gland and its main functions are to induce breast development during pregnancy and stimulate lactation. Common causes of hyperprolactinemia include pregnancy, medications that affect dopamine levels, hypothyroidism, and pituitary tumors. Symptoms in women include galactorrhea (non-pregnancy related breast milk production), menstrual irregularities, and infertility. Treatment options aim to suppress prolactin levels and reduce tumor size, with dopamine agonists being the first-line medical treatment.
Diagnostic Hysteroscopy Patel
1. Hysteroscopy has evolved since its beginnings in the late 19th century when instruments were first used to visualize the inside of the uterus.
2. Developments in distension media and techniques in the mid-20th century allowed hysteroscopy to become more practical as an office procedure using carbon dioxide or other media.
3. Diagnostic hysteroscopy is used to evaluate conditions like polyps, fibroids, and abnormalities like septate uteri but may sometimes require conversion to operative hysteroscopy during the same session. Care must be taken to prevent complications from inadequate visualization or improper technique.
Hyperprolactinemia 2
A 22-year-old woman presents with amenorrhea and galactorrhea. Her prolactin level is elevated at 95 μg/l and MRI reveals a small pituitary tumor. Prolactinomas are the most common cause of hyperprolactinemia and can lead to infertility and hypogonadism by disrupting the hypothalamic-pituitary-gonadal axis. Treatment options for microadenomas include dopamine agonists which can normalize prolactin levels and restore fertility.
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 tumors such as headaches. Treatment options for hyperprolactinemia depend on the size and invasiveness of tumors, and may include dopamine agonists such as bromocriptine or surgery.
Hyperprolactinemia 3
The document discusses various pituitary disorders including pituitary adenomas, hypopituitarism, and pituitary apoplexy. It focuses on specific types of pituitary adenomas including prolactinomas, non-functioning adenomas, growth hormone (GH)-producing tumors, adrenocorticotropic hormone (ACTH)-producing tumors, and thyroid-stimulating hormone (TSH)-producing tumors. For each type, it describes their clinical manifestations, diagnostic testing, and treatment options including medication, surgery, and radiation therapy.
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- 1. Infertility and Assisted Reproductive Technologies 不孕症与 辅助生殖技术 XIN LU Obstetrics & Gynecology Hospital Fudan University 2006-5-11/19
- 10. Female Factors Summary Follopian tube Uterine ovary oocyte Cervix Extra-genital tract sperm Hypothalamus Pituitary Thyroid Adrenal
- 16. Examination and Diagnoses Initial evaluation History Physical exam Irregular menses No ovulation HSG or Hysteroscopy Abnormal of uterine Normal evaluation HSG Tubal blockage Abnormal Semen analysis anovulation Tubal factor unexplained Uterine factor Male factor Further Investigate and Treatment