Learning Objectibves :
1.To define and describe the mechanism of ovulation
2.To review the different phases of the menstrual cycle and its physiology
" Ovulation (ovum release) occurs when estradiol levels usually peak as the ovulatory phase begins. Progesterone levels also begin to increase. Stored LH is released in massive amounts (LH surge), usually over 36 to 48 hours, with a smaller increase in FSH.
Precautions after ivf pregnancy , lifecare centre ,IVF icsiLifecare Centre
PREGNANCY Outcome following
IVF-ICSI
HURDLES IN EARLY PREGNANCY
lifecare IVF centre
lifecare centre ,Multiple Pregnancy
Pregnancy
&
Co-morbidity
obestetric & neonatal outcome following IVF-ICSI
Precautions after ivf pregnancy , lifecare centre ,IVF icsiLifecare Centre
PREGNANCY Outcome following
IVF-ICSI
HURDLES IN EARLY PREGNANCY
lifecare IVF centre
lifecare centre ,Multiple Pregnancy
Pregnancy
&
Co-morbidity
obestetric & neonatal outcome following IVF-ICSI
Update on LETROZOLE Current Guidelines for Ovulation Induction Dr. Sharda Jain Lifecare Centre
Update on LETROZOLE Current Guidelines for Ovulation Induction
LET NOT FORGET
WHY
??
LETROZOLE was withdrawn from
Indian market (2012)
“SAFETY ISSUES”
“Could Be Teratogenic In Human”?
Ovarian Hyperstimulation Syndrome(OHSS), is a Rare iatrogenic complication of ovarian stimulation occurring during the luteal phase or during early pregnancy where a patient's ovaries become swollen and fluid builds up around her abdomen
The method of ovulation induction selected by the clinician should be based upon the underlying cause of anovulation and the efficacy, costs, risks, burden of treatment, and potential complications associated with each method as they apply to the individual woman. In this presentation I have mentioned every points in detail.
The concept of folliculogensis is the most exclusive topic in understanding the ovulation induction regimens . In this ppt , trying to decode the physiological aspect of ovarian folliculogensis
It describes the Progesterone physiology. It describes the latest evidence as regards progesterone formulations, use of progesterone as Luteal phase support. It scrutinizes the value of serum progesterone in monitoring luteal phase
Invited lecture by Dr Sujoy dasgupta in the Annual Conference of the "Academy of Clinical Embryologists" (ACE) held in October 2021 in "Hybrid mode" (Kolkata and Webinar)
Vasundhara Hospital Jaipur is a premier specialty hospital for infertile couples, complete women care, high risk pregnancy management, located in heart of Jaipur.
Click to more info :- https://www.vasundharafertility.com/jaipur
Ovulation induction - not all fertility treatment is IVF by Dr Aishwarya Parthasarathy, Fertility specialist, A4 Fertility Centre, chennai
#ovulationinduction #FertilityTreamtent #a4fertilitycentre #a4hopsitals #chennai
Significant increase in live birth rate is found when IUI is done with stimulation compared with IUI in natural cycle in women with Unexplained Infertility .
Update on LETROZOLE Current Guidelines for Ovulation Induction Dr. Sharda Jain Lifecare Centre
Update on LETROZOLE Current Guidelines for Ovulation Induction
LET NOT FORGET
WHY
??
LETROZOLE was withdrawn from
Indian market (2012)
“SAFETY ISSUES”
“Could Be Teratogenic In Human”?
Ovarian Hyperstimulation Syndrome(OHSS), is a Rare iatrogenic complication of ovarian stimulation occurring during the luteal phase or during early pregnancy where a patient's ovaries become swollen and fluid builds up around her abdomen
The method of ovulation induction selected by the clinician should be based upon the underlying cause of anovulation and the efficacy, costs, risks, burden of treatment, and potential complications associated with each method as they apply to the individual woman. In this presentation I have mentioned every points in detail.
The concept of folliculogensis is the most exclusive topic in understanding the ovulation induction regimens . In this ppt , trying to decode the physiological aspect of ovarian folliculogensis
It describes the Progesterone physiology. It describes the latest evidence as regards progesterone formulations, use of progesterone as Luteal phase support. It scrutinizes the value of serum progesterone in monitoring luteal phase
Invited lecture by Dr Sujoy dasgupta in the Annual Conference of the "Academy of Clinical Embryologists" (ACE) held in October 2021 in "Hybrid mode" (Kolkata and Webinar)
Vasundhara Hospital Jaipur is a premier specialty hospital for infertile couples, complete women care, high risk pregnancy management, located in heart of Jaipur.
Click to more info :- https://www.vasundharafertility.com/jaipur
Ovulation induction - not all fertility treatment is IVF by Dr Aishwarya Parthasarathy, Fertility specialist, A4 Fertility Centre, chennai
#ovulationinduction #FertilityTreamtent #a4fertilitycentre #a4hopsitals #chennai
Significant increase in live birth rate is found when IUI is done with stimulation compared with IUI in natural cycle in women with Unexplained Infertility .
The ovarian cycle is a series of events that occur in the ovaries of females on a monthly basis. It involves the development and release of eggs (oocytes).
The ovarian cycle is essential for reproductive health, as it governs the maturation and release of eggs, and influences the conditions of the uterine lining for potential implantation.
The coordination between the ovarian and uterine cycles is crucial for successful conception and pregnancy.
Ovary: Structure and hormonal regulationN K Agarwal
Slides describe the structure of ovary, folliculogenesis, hormonal control of female reproductive cycle, mechanism of ovulation, female sex hormones and their function.
Physiology Of Menstruation
By: Nur Afiqah Binti Jasmi (11-2013-031) & Luqman Hakim Bin Mohd Jais (11-2013-170)
Dokter Pembimbing: Dr. Harianto Wijaya Sp.OG
Similar to Reproductive endocrinology of ovulation (20)
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
Reproductive endocrinology of ovulation
1. Dr Aditya Das
Fertility Consultant & Trainer
Keya FERTILITY & Embryoedu
Bhubaneswar, India
Member , Neoindia Fertility Society (NIFS)
Member , ISAR , ESHRE,ISMAAR
3. Ovulation Induction & IUI Webinar
Module 1 & 2 / 16.05.2020/8pm IST
Reprod. Endocrinology of
Ovulation
Dr Aditya Das , Keya Fertility
& Embryoedu
Founding Member , NIFS &
WHF , INDIA
4.
5. Learning Objectives
To define and describe the mechanism of ovulation
To review the different phases of the menstrual cycle and its
physiology
6. HPO axis
•Firstly the hypothalamic hormones
(GnRH)
•Secondly, the pituitary hormones
(FSH and LH)
•Finally, the ovarian steroid hormones
(estradiol and progesterone)
10. Follicular phase
- begins when estrogen levels are low
- recruitment
- selection of dominant follicle
- increasing levels of estradiol and inhibin B
Ovulatory phase
- LH surge
- Rupture of preovulatory follicle
- release of a viable oocyte
11. Luteal phase
• Now empty follicle changes to a yellow colour, becomes
corpus luteum
• Continues to secrete estrogen, but now beings to release
progesterone
• Progesterone further develops uterine lining
• If pregnant, embryo will release hormones to preserve corpus
luteum
20. Growing Follicle
1.Oocyte increasing in size
2.Multilayered granulosa cells become cuboidal
3.Aromatisation androgen to estrogen induced by FSH
4.Increase FSH receptors , induced by FSH and E2
5. Theca cell layer forms surrounding stroma
21.
22. What is Recruitment
(i) initial transition of primordial follicles from the resting pool
into the pre-antral growth phase,
(ii) the cyclic recruitment of a cohort of antral follicles (2–5 mm)
during the menstrual cycle following puberty
23. What is Selection
two different phenomena:
(i) the recruitment of a cohort of 2–5-mm antral follicles and
(ii) the preferential growth of a species-specific number of large
antral follicles from the recruited cohort.
The follicle that is selected from the recruited cohort has been
referred to as the ‘dominant’ follicle, while all other follicles of
the cohort which undergo atresia have been ‘subdominant’
24. Recruitment & Selection
Follicle ‘recruitment’ refers to the emergence of a group or
cohort of medium-size (2–5 mm) antral follicles.
‘Selection’ refers to the preferential growth of the dominant
follicle from the cohort of recruited antral follicles.
25. Follicle Divergence
At the time of selection, the growth profile of the dominant
follicle begins to ‘diverge’ as it continues to grow while the
subordinate follicles undergo atresia.
Divergence occurs when the dominant follicle reaches a
diameter of ∼10 mm on Day 6–9 of the follicular phase in
women
34. Follicle Dominance
Growth of dominant follicle is due to
1. Greater contents of FSH Receptors
2. Enhancement of FSH action due to high intrafollicular FSH
level
35. Follicle Dominance
1. Dominant follicle suppresses the growth of subordinates
through an inhibitory effect on circulating FSH concentrations
2 .Subordinate follicles not able to thrive in declining FSH and
therefore succumb to atresia
36. LH Ceiling Hypothesis
• Each follicle has an upper limit of responsiveness to LH beyond
which follicle maturation ceases and degeneration occurs.
• Thus, the dominant follicle would have a much higher ceiling than
the non-dominant ones, leading to their regression at the time of
the LH surge.
• Low-dose stimulation with low-dose LH : enhances
steroidogenesis without inhibiting cell proliferation
• High dose LH : suppresses granulosa proliferation, atresia of
immature follicles and premature luteinization of preovulatory
follicles.
37. LH Surge
• Dominant follicle continues to secrete estrogen.
• The persistent high level of estrogen
(greater than 200 pg/ml for approx 50 hrs
induces an abrupt release of LH from the pituitary gland
• Negative feedback turns into positive feedback
• this hormonal surge then triggers ovulation.
38.
39. LH Surge
• LH surge precedes ovulation by 35–44 hr
• peak sLH precedes ovulation by 10–12
40.
41. • acidic FSH isoforms provoke the formation of inhibin-B and
inhibin-A in the granulosa cells of follicles with a diameter of
3–13 mm with high efficacy.
• inhibin-B peak occurs in the circulation around the mid-
follicular phase.
43. • Inhibin-B shows a peak in the circulation around cycle day 7,
simultaneous with selection of the dominant follicle
• estradiol and inhibin-A only start to increase a few days later
suggesting that inhibin-B is mainly responsible for
downregulating pituitary FSH release.
• Inhinin B : an important physiological hormone in follicular
selection
44. AMH in Ovulation
• expressed by granulosa cells of the ovary
• limits the formation of primary follicles by inhibiting excessive
follicular recruitment by FSH.
• reduces aromatase activity and sensitivity of follicles to FSH
stimulation.
• elevated serum AMH may indicate a higher threshold for
response to ovulation induction in women PCOS.
• - J Clin Endocrinol Metab. 2016 Sep; 101(9): 3288–3296.
45.
46. • in PCOS, baseline serum AMH levels were higher among women
who did not respond to ovulation induction,
• absolute level of AMH could not be found above which women did
not respond
• AMH levels were significantly lower among women who ovulated.
• women with higher baseline AMH levels required higher doses of
clomiphene or letrozole to achieve ovulation.
• AMH may be a marker of ovarian resistance to ovulation induction.
48. USG : Signs of Ovulation
• Disappearance or sudden decrease in follicle size.
• Increased echogenicity inside the follicle, indicating corpus luteum
formation.
• Free fluid in pelvis (or pouch of Douglas).
• Replacement of “triple‐line appearance” of endometrium by
homogenous, hyperechoic “luteinized” endometrium.
49. Ovulation Trigger
• End point of any ovulation induction protocol is to indentify
the best time for triggering ovulation.
• Most crucial step
• Critical timing for HCG administation depends on the criteria for follicular
maturity
1. Follicular diameter
2. Serum E2 (500-1500pg/ml)
3. Endometrial thickness (9-10mm)
• Always time HCG with follicle size
Gnt follicles mature at 15-18 mm
CC follicles mature at 18-20 mm (Sperof,f 2005)
50. HCG as Ovulation Trigger
• Substitute for LH surge
• Control the timing of ovulation
• Timing of SI. / IUI / OR
• HCG has a half-life of about 35 h: support the initial part of the
luteal phase.
51. HCG as Ovulation Trigger
• Cochrane Database of Systematic Reviews
• “ Evidence is inadequate to recommend or refute the use of u
hCG as an ovulation trigger in anovulatory women treated with
CC ”
52. IUI Timing
• around the moment of ovulation.
• 24 0r 36 H after HCG : IUI 36 h after hCG has marginally better
pregnancy rates than 24 h.
• Timing of insemination may be kept at 24 or 36 h after hCG
injection to suit the convenience of the clinic or care provider.
(Rahman et al, 2011)
• Since different time intervals between hCG and IUI did not
result in different pregnancy rates, a more flexible approach
might be allowed.
53. Luteal Phase Endocrinology
- CL formed from the pre-ovulatory follicle under the action of
the mid-cycle LH surge.
- LH controls luteal structure and function alongwith
progesterone .
54. - If conception does not take place, luteolysis occurs as a
physiological apoptotic process.
- HCG , secreted after implantation rescues the corpus luteum
and extend its lifespan.
55. - In OI cycles, the negative feedback effect of the ovarian
steroids on the pituitary is markedly potentiated, leading to
the suppression of endogenous LH secretion during the whole
menstrual cycle.
- Marked suppression of LH secretion disrupts CL function
regardless of the treatment regimen.
56. Luteal Follicular Transition Phase
• 2days prior to menstruation
• Demise of CL leads to decrease in negative feedback by luteal
steroids and inhibin A
• Incresae in GnRH pulse frequency
• Increase rise in FSH
57. STUDIES REVEAL
• 1/3 rd of infertility is due to male partners
• 1/3 rd of infertility is due to female partners.
• Remaining part is unknown and called as idiopathic infertility.
58. RATIONALE : OI in IUI
“ Disorders of ovulation or Anovulatory patients
comprise of 30-40% of all female factor infertility “
“ May present with oligomenorrhoea / amenorrhea “
59. WHO Classification
• Group I : Hypothalamic Pituitary Failure
(Hypogonadotropic Hypogonadism)
• Group II :Hypothalamic Pituitary Dysfunction
( Normogonadotropic , PCOS)
• Group III : Ovarian Failure
(Hypergonadotropic Hypogonadism)
60. RATIONALE : OI in IUI
• Normogonadotrophic anovulation
most common category of anovulatory infertility
• Within this group, polycystic ovary syndrome (PCOS) is by far the most
prevalent cause
61. Ovarian Stimulation Or Induction
• Ovulatory Patients : Contolled Ovarian Stimulation or Superovulation
• Anovulatory Patients : Ovarian Induction
62. Ovarian Stimulation Or Induction
• Superovulation is useful in
• Transient anovulation
• Mild or moderate oligoasthenospermia
• Cervical factor
• Mild endometriosis
• Unexplained infertility
63. Take Home Messages / Module 1
• Aim: to restore normal fertility to anovulatory women
• Generate normo-ovulatory cycles
• Mimic physiology and induce a single or more than one dominant
follicle
• Avoid multiple pregnancy and OHSS
• Within a tight therapeutic margin