Laparoscopy 2
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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 The document also presents unpublished data from a study of 261 women who underwent laparoscopic excision for stage III/IV endometriosis, finding a 79.7% spontaneous pregnancy rate.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.
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Endometriosis in IVF
This document discusses endometriosis and its impact on fertility and IVF outcomes. It provides information on diagnosing and treating endometriosis, including:
- Laparoscopy is the gold standard for diagnosing endometriosis. Surgical excision of endometriomas and deep endometriosis can improve pain and fertility outcomes.
- For subfertility, treatment depends on factors like disease severity, pain levels, and reproductive plans. IVF is an option if conservative treatments fail.
- Studies show endometriosis may reduce ovarian response and increase IVF cancellation rates. However, it does not significantly impact live birth, pregnancy, or miscarriage rates compared to other infertility factors
Treatment and outcome of anatomical factors for abortions
The document discusses various anatomical factors that can contribute to recurrent pregnancy loss, including uterine anomalies like septate uterus, bicornuate uterus, and unicornuate uterus. It describes how these anomalies can increase risks of miscarriage and preterm birth. The document outlines surgical treatments like hysteroscopic septal resection and metroplasty that aim to correct anomalies and improve reproductive outcomes by reducing miscarriage and preterm birth rates. It also discusses cervical insufficiency and the use of cerclage procedures to treat this issue and prolong pregnancy.
Endometriosis and Subfertility - What to do?
Lecture delivered by Dr Sujoy Dasgupta in IPCON 2823, the Mid term conference of ISOPARB (Indian Society of Perinatology and Reproductive Biology) held at Kolkata on 10 September
Secrets for success of Intra Uterine Insemination (IUI)
How does one increase the chances of success when carrying out intra uterine insemination (IUI) procedures in places carrying out assisted reproductive technologies (ART)?
Endometriosis and art
This document provides biographical information about Dr. Narendra Malhotra, an obstetrician and gynecologist from India. It lists his professional roles and accomplishments, which include being president of FOGSI, dean of ICMU, director of the Ian Donald School of Ultrasound, and editor of several medical books and journals. It also provides contact information for Malhotra Hospitals in Agra, India, where Dr. Malhotra practices and serves as a consultant for IVF procedures in several other cities.
Fertility Preserving Hysteroscopic Surgery
Lecture delivered by Dr SUjoy Dasgupta at ISAR Bengal Conference 2017, where he was invited as the Faculty
Tubal surgery vs. Assisted Reproductive Technologies (ART)
Which is better ? Tubal surgery or Assisted Reproductive Technologies (ART) when dealing with cases of infertility.
Discussion of IUI, IVF and more treatments options in relation to this topic.
Role of hysteroscopy and laparoscopy in ivf
Utilising effective tool of hysteroscopy before IVF and selecting appropriately patients for laparoscopy before IVF
Ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tubes. Common symptoms include abdominal/pelvic pain and vaginal bleeding. Diagnosis is suggested by high beta-HCG levels and an empty uterus on ultrasound. Treatment options include expectant management for stable patients, medical management with methotrexate, or surgical intervention via laparoscopy or laparotomy for unstable patients or surgical candidates. The prognosis depends on the treatment, with methotrexate associated with higher subsequent intrauterine pregnancy rates compared to surgery.
The Role of laparoscopy in the era of ART
The advancement of new perspectives in assisted reproductive technology (ART) through the use of modern infertility evaluation technique Still clinician needs to reassess how infertility should be best treated.
Recently the focus of treatment for infertility has shifted from systematic correction of each identified factor.
Uterine Fibroid Embolization
- National security adviser Condoleezza Rice underwent successful surgery on Friday, November 19, 2004.
- Rice is doing well and resting comfortably after the surgery.
- She is expected to return to work on the following Monday.
Management Of Early Stage Ca Cervix [Autosaved]
Carcinoma of the cervix is the second most common cancer in women worldwide. It commonly presents with abnormal vaginal bleeding. Diagnosis is confirmed with biopsy and staging involves imaging tests. Treatment depends on stage, patient factors, and desire for fertility preservation. For early stage disease, options include surgery (radical hysterectomy) or radiation (brachytherapy with external beam radiation). Advanced stages are treated with concurrent chemoradiation. Close follow-up is needed after primary treatment.
Ectopic pregnancy for undergraduate
This document discusses ectopic pregnancy, which occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tubes. It provides details on the classification, risk factors, symptoms, diagnosis, and treatment of ectopic pregnancy. Ectopic pregnancies are typically diagnosed through transvaginal ultrasound or serum hCG levels. Treatment options include medical management with methotrexate or surgical intervention like laparoscopy or laparotomy depending on the stability of the patient and size of the ectopic mass. The goal is to resolve the ectopic pregnancy while preserving the patient's future fertility if possible.
L42 Miscarriage & Ectopic
This document discusses miscarriage, ectopic pregnancy, and recurrent miscarriage. It defines miscarriage as pregnancy loss before 24 weeks and notes the most common sign is vaginal bleeding. For ectopic pregnancy, it describes the risk factors, symptoms, and treatments which include expectant management, medical treatment with methotrexate, or surgical treatment. Recurrent miscarriage is defined as 3 or more consecutive losses and investigations and treatments are discussed including aspirin, heparin, surgery for anatomical issues, and psychological support.
Surgical Management of Uterine Abnormality
This document discusses the surgical management of uterine abnormalities. It begins by defining congenital genital abnormalities and Mullerian anomalies. It then provides classifications for uterine anomalies and discusses their prevalence. Various uterine anomalies are described in more detail, including their associated symptoms, prevalence, and effects on pregnancy outcomes. The document discusses diagnostic challenges and various treatment approaches for different uterine anomalies, particularly for septate uteri. It concludes that management must be individualized based on each patient's anatomy and clinical situation.
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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.
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.
Ovary Hyperstimulation 3
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.
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 5
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.
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 3
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.
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.
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.
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5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
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Laparoscopy 2
- 1. Does surgery for endometriosis improve fertility outcomes? Lakshmi Ravikanti Fellow in Endoscopy and Infertility Waikato Hospital & Fertility Associates Hamilton Acknowledgment: Mr V P Singh
- 3. Is IVF outcome affected in Endometriosis? Endometriosis Vs Tubal – OR 0.56 Severe endometriosis Vs mild endometriosis-OR 0.60 Barnhart et al.FertilSteril.2002
- 4. Endometrial Receptivity or Oocyte Quality? Diaz et al. FertilSteril.2000 Healthy Oocyte Donors Healthy recipients Recipients with Endometriosis III-IV No significant difference in implantation rates or live birth rates Sibling Oocytes Uterine receptivity is NOT impaired
- 5. Endometrial Receptivity or Oocyte Quality? Simon C et al. HumRep 1994 Oocyte donors with endometriosis Vs Oocyte donors without endometriosis Significantly lower pregnancy rates from donors with endometriosis So it is likely to be the Oocyte Quality
- 7. Expectant management IVF Vs expectant management Soliman et al, Fertil Steril 1993; 59:1239
- 8. Endometriosis & COH/IUI Tummon IS et al: Fertil Steril 1997;68: 8-12
- 12. Fertility outcomes after surgery for stage III / IV Endometriosis (unpublished data) 79.7% 20.3% Total no of cases- 261
- 14. Fertility outcomes after Laparoscopic excision of grade 3 & 4 endometriosis
- 21. Wide excision of deep endometriosis from vagina
- 22. Excision of D I E from rectum
- 25. Suturing of vaginal opening
- 29. THANK YOU