INFERTILITY

<script async src="//pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script> <!-- peace --> <ins class="adsbygoogle" style="display:block" data-ad-client="ca-pub-1597694717782005" data-ad-slot="3836701773" data-ad-format="auto"></ins> <script> (adsbygoogle = window.adsbygoogle || []).push({}); </script> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">                                                                       </span></b><br /> <div class="separator" style="clear: both; text-align: center;"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDdNRz-jTWECpJBCDNZ9s1Vg3NE72iAxhmREyE53eC28esaqxsBWbf2fumP5t0ekBO-Rtfxohq9uGTFPYKAiadPP_PdtrfEb1EKD_7A3uR5jQfeUg6WvqJoYEa0f1H9iobBOXvQt_1LCY/s1600/fertility+2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDdNRz-jTWECpJBCDNZ9s1Vg3NE72iAxhmREyE53eC28esaqxsBWbf2fumP5t0ekBO-Rtfxohq9uGTFPYKAiadPP_PdtrfEb1EKD_7A3uR5jQfeUg6WvqJoYEa0f1H9iobBOXvQt_1LCY/s1600/fertility+2.jpg" /></a></span></b></div> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">                                    <o:p></o:p></span></b></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">   </span></b><br /> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">  </span></b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">This is defined as a couple’s inability to achieve pregnancy after 1 year of unprotected intercourse. Primary infertility refers to a couple who has never had a child. Secondary infertility means that at least one conception has occuerred, but currently the couple cannot achieve a pregnancy. In the United States, infertility affects 6 million couples. It is often a complex physical problem, and its causes are usually related to azoospermia, anovulation, or tubal obstruction.<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">      Most infertility is really some degree of subfertility and 1 in 7 couples who have conceived before. The WHO (1992) defines subfertility as ‘the inability of a couple to achieve conception or to bring a pregnancy to term after a year or more of regular, unprotected intercourse’. <o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     Infertility is categorized as primary if there has been no prior conception and secondary if there has been a previous pregnancy irrespective of the outcome. Couples now have fewer than two children on average in most European countries and they tend to postpone reduction in fertility. Under normal circumstances the chance of a couple conceiving within one menstrual cycle is 20-25% given that unprotected intercourse occurs at the optimum time, the female partner is ovulating regularly and the male partner is producing sperm of sufficient quality. Approximately one-third of  cases of infertility involve problems with both partners in one-third of couples the causes of infertility remain unexplained. The most common causes are ovulation failure and sperm disorders.<o:p></o:p></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">INITIAL MANAGEMENT OF THE INFERTILE COUPLE<o:p></o:p></span></b></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     </span></b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Much of the initial management is via primary care, therefore the preliminary investigation of both partners and subsequent  referral to specialist care will be through the general practitioner. Each referral should be instigated for couples where the female partner is over 35 years and where there is amenorrhoea or significant pelvic infection.<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">                                 <b>CAUSES OF INFERTILITY<o:p></o:p></b></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">MALE INFERTILITY<o:p></o:p></span></b></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">ENDOCRINE DISORDERS<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Dysfunction of<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l4 level1 lfo1; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Hypothalamus<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l4 level1 lfo1; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Pituitary<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l4 level1 lfo1; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Adrenals<o:p></o:p></span></div> <script async src="//pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script> <!-- peace --> <ins class="adsbygoogle" style="display:block" data-ad-client="ca-pub-1597694717782005" data-ad-slot="3836701773" data-ad-format="auto"></ins> <script> (adsbygoogle = window.adsbygoogle || []).push({}); </script> <div class="MsoListParagraphCxSpLast" style="mso-list: l4 level1 lfo1; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Thyroid<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Systemic disease<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l13 level1 lfo2; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Diabetes mellitus<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l13 level1 lfo2; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Coelic disease<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l13 level1 lfo2; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Renal failure<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Testicular disorders<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l6 level1 lfo3; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Trauma<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l6 level1 lfo3; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Environmental (high temperature)<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Congenital ( hydrocele, undescended testes)<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Occupational (furnaceman, long distance lorry driver)<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Acquired ( Varicocele, tight clothing)<o:p></o:p></span></div> <div class="MsoListParagraph" style="mso-list: l12 level1 lfo4; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Cancer treatment<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Defective transport<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l12 level1 lfo4; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Obstruction or absence of seminal ducts:<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l12 level1 lfo4; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Infection<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l12 level1 lfo4; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Congenital anomalies<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l12 level1 lfo4; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Trauma<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Impaired secretions from prostate or seminal vesicles:<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l14 level1 lfo5; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Infection<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l14 level1 lfo5; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Metabolic disorders<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Ineffective delivery<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l11 level1 lfo6; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Psychosexual problems (impotence)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l11 level1 lfo6; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Drug-induced (ejaculatory dysfunction)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l11 level1 lfo6; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Physical disability<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l11 level1 lfo6; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Physical anomalies<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Hypospadias<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Epispadias<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Retrograde ejaculation (into bladder)<o:p></o:p></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">FEMALE INFERTILITY<o:p></o:p></span></b></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Defective ovulation<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Endocrine disorders<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Dysfunction of<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="margin-left: 1.0in; mso-add-space: auto; mso-list: l2 level1 lfo7; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Hypothalamus<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="margin-left: 1.0in; mso-add-space: auto; mso-list: l2 level1 lfo7; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Pituitary<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="margin-left: 1.0in; mso-add-space: auto; mso-list: l2 level1 lfo7; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Adrenals<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="margin-left: 1.0in; mso-add-space: auto; mso-list: l2 level1 lfo7; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Thyroid<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Systemic disease<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo8; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Diabetes mellitus<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo8; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Coelic disease<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo8; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Renal failure<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Physical disorders<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l7 level1 lfo9; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Obesity<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l7 level1 lfo9; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Anorexia nervous or strict dieting<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l7 level1 lfo9; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Excessive exercise<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Ovarian disorders<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l9 level1 lfo10; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Hormonal<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l9 level1 lfo10; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Ovarian cysts or tumours<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l9 level1 lfo10; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Polycystics ovary disease<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l9 level1 lfo10; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Ovarian endometiosis<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Defective transport<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l3 level1 lfo11; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Ovum<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l3 level1 lfo11; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Tubal obstruction<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Infection (gonorrhea, peritonitis, pelvic inflammatory disease)<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Previous tubal surgery<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l8 level1 lfo12; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Fimbrial adhesians<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l8 level1 lfo12; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Previous surgery<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l8 level1 lfo12; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Endometriosis<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Sperm<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Vaginal<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l10 level1 lfo13; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Psychosexual problems (Vaginismus)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l10 level1 lfo13; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Infection (causing dyspareunia)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l10 level1 lfo13; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Congenital anomaly<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Cervix<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l5 level1 lfo14; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Cervical trauma  or surgery (cone biopsy)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l5 level1 lfo14; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Infection<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l5 level1 lfo14; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Hormonal (hostile mucus)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l5 level1 lfo14; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Antisperm antibodies in mucus<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Defective implantation<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo15; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Hormonal imbalance<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo15; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Congenital anomalies<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo15; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Fibroids<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo15; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Infection<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">ASSISTED REPRODUCTIVE TECHNIQUES<o:p></o:p></span></b></div> <div class="MsoListParagraphCxSpMiddle"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     </span></b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">A range of assisted reproductive techniques is available to treat the infertile couple and it is important that the appropriate treatment option is offered. Those techniques include the followings:<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo15; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">In vitro fertilization (IVF) treatment<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo15; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Donor insemination (DI) treatment<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo15; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Gamete intrafallopian transfer (GIFT) where donated sperm or eggs are used in treatment.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo15; text-indent: -.25in;"> <!--[if !supportLists]--><span style="font-family: "symbol"; font-size: 14.0pt; line-height: 115%;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">        </span></span><!--[endif]--><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Storage of gametes or embryos<o:p></o:p></span></div> <div class="MsoNormal" style="margin-left: .5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Each of the techniques highlighted above will be discussed in details in the next article.<o:p></o:p></span></div> <div class="MsoNormal" style="margin-left: .5in;"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">OVULATION INDUCTION<o:p></o:p></span></b></div> <div class="MsoNormal" style="margin-left: .5in;"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     </span></b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">There are many reasons for ovulatory failure and although menstruation is strongly suggestive of ovulation it is not conclusive. Women with amenorrhoea or oliogomenorrhoea can be treated with ovulation inducing agents provided that the male partner has an adequate sperm count.<o:p></o:p></span></div> <div class="MsoNormal" style="margin-left: .5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Clomifene is the most commonly prescribed drug but should be prescribed only when there are no other factors contributing to infertility and there is access to ovarian ultrasound feedback that stimulates the release of GnRH; which in turn leads to an increase in FSH and ovarian follicular growth and can be effective in up to 80% of appropriately selected women.<o:p></o:p></span></div> <div class="MsoNormal" style="margin-left: .5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     Treatment should be limited to six cycles with the lowest effective dose. The side effect of clomifene include multiple pregnancy and ovarian hyperstimulation and minority of women may experience symptoms such as hot flashes, abdominal distention, nausea, vomiting, breast tenderness, headaches, hair loss and blurred vision.<o:p></o:p></span></div> <div class="MsoNormal" style="margin-left: .5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     Women with clomifene  resistant polycystic ovarian syndrome (PCOS) can be treated with human menopausal gonadotrophin (HMG) and FSH injections. Cabergoline as  opposed to bromocriptine, is rapidly becoming the treatment of choice for women suffering from anovulatory hyperprolactinaemia. This is because latter is associated with the unpleasant side effects of nausea, headaches, vertigo and drowsiness whereas the former has significantly fewer side effects.<o:p></o:p></span></div> <div class="MsoNormal" style="margin-left: .5in;"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">INTRAUTERINE INSEMINATION (IUI)<o:p></o:p></span></b></div> <div class="MsoNormal" style="margin-left: .5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">IUI is indicated where there are problems such as hostile cervical mucus, antisperm antibodies or male fertility problems such as low sperm count, premature ejaculation, retrograde ejaculation, anatomical problems or impotence. It is also useful for cases of unexplained infertility. The tubal patency of the female partner must be assured.  In order to increase the chances of success, ovulation is induced and the sperm prepared to maximize its fertilizing ability before being inserted high into the uterus.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">   <o:p></o:p></span></b></div> <br /> <div class="MsoListParagraphCxSpLast"> <br /></div> <script async src="//pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script> <!-- peace --> <ins class="adsbygoogle" style="display:block" data-ad-client="ca-pub-1597694717782005" data-ad-slot="3836701773" data-ad-format="auto"></ins> <script> (adsbygoogle = window.adsbygoogle || []).push({}); </script>

assisted reproductive techniques infertilty ovulation INFERTILITY

                                                                                                                  This is defin...

Read more »

MEDICAL MANAGEMENT OF MALE AND FEMALE FERTILTY

<script async src="//pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script> <!-- peace --> <ins class="adsbygoogle" style="display:block" data-ad-client="ca-pub-1597694717782005" data-ad-slot="3836701773" data-ad-format="auto"></ins> <script> (adsbygoogle = window.adsbygoogle || []).push({}); </script> <div class="MsoNormal"> <div class="MsoNormal">                                                                                <br /> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2__yXE9fm4uWtdSFQFw6UrLrEuu8m3LmDT3rBtlEvnWDqChopr2XJ76omrsiYgk3A5WTOb4UOP9RnNnjtBqEeYNjtYtFXtXgNrGbIEIDJtqXNY7py21FTqM21cSahmiBT5JyIkfPaDCI/s1600/fertility+3.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2__yXE9fm4uWtdSFQFw6UrLrEuu8m3LmDT3rBtlEvnWDqChopr2XJ76omrsiYgk3A5WTOb4UOP9RnNnjtBqEeYNjtYtFXtXgNrGbIEIDJtqXNY7py21FTqM21cSahmiBT5JyIkfPaDCI/s1600/fertility+3.jpg" /></a></div> </div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     </span><br /> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">The treatment of infertility is complex and often requires advanced technology. The specific type of treatment depends on the cause of the problem, if it can be identified. Many infertile couples have normal test results for ovulation , sperm production and fallopian tube patency.<o:p></o:p></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">PHARMACOLOGIC THERAPY<o:p></o:p></span></b></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     Pharmacologically induced ovulation is undertaken when women do not ovulate on their own or ovulate irregularly. Women older than 37 years are less likely to be fertile. These couples are often treated with clomiphene to stimulate ovulation. Gonadotropn treatment may also be used if conception does not occur. Various other medications are used, depending on the primary cause of infertility.<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     Blood tests and ultrasounds are used to monitor ovulation. Multiple pregnancies (i.e, twins, triplets or more) may occur with use of these medications. Ovarian hperstimulation syndrome (OHSS) may also occur. This condition is characterized by enlarged multicystic ovaries and is complicated by a shift of fluid from the intravascular space into theabdominal cavity. The fluid shift can result in ascites, pleual effusion, and edema; hypovolemia may also occur. Risk factors include younger age, history of polycystic ovarian syndrome, high serum estradiol levels, a larger number of follicles and pregnancy.<o:p></o:p></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">ARTIFICIAL INSEMINATION<o:p></o:p></span></b></div> <script async src="//pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script> <!-- peace --> <ins class="adsbygoogle" style="display:block" data-ad-client="ca-pub-1597694717782005" data-ad-slot="3836701773" data-ad-format="auto"></ins> <script> (adsbygoogle = window.adsbygoogle || []).push({}); </script> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     Artificial insemination is the deposit of semen into the female genital tract by artificial means. If sperm cannot penetrate the cervical canal normally, artificial insemination using  partner’s or husband’s semen or that of a donor may be considered. When the  sperm of the woman’s partner is defective or absent (azoospermia) or when there is a risk of transmitting a genetic disease, donor sperm may be used. Safeguards are put in place to address legal, ethical, emotional, and religious issues.Written consent is obtained to protects all paties involved, including the woman, the donor and the resulting child. The donor’s semen is frozen, and the donor is evaluated to ensure that he is free of genetic disorders and STDs, including HIV infection.<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     Certain conditions must be met before semen is transferred to the vaginal or uterus. The woman must have no abnormalities of the genital system, the fallopian tubes must be patent, and oval must be available. In the male, sperm need to be normal in shape, amount, motility, and endurance. The time of ovulation should be determined as accurately as possible so that the two or three days of which fertilization is possible each month can be targeted for treatment.<o:p></o:p></span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">    Ultrasonography and blood studies of varying hormone levels are used to pinpoint the best time for insemination and to monitor for OHSS. Fertilization seldom occurs from a single insemination. Usually, insemination is attempted between days 10 and 17 of the cycle; three different attempts may be made during one cycle. The woman may have received clomiphene or other medications to stimulate ovulation before insemination. The recipient is placed in lithotomy position on the examination table, a speculum is inserted, and the vaginal and cervix are swabbed with cotton-tipped applicator to remove any excess secretions. The sperm are washed before insertion to remove biochemical and to select the most active sperm. Semen is drawn into a sterile syringe, and a cannula is attached. The semen is then directed to the external os. In IUI, semen is placed into the uterine cavity.<o:p></o:p></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">IN VITRO FERTILIZATION<o:p></o:p></span></b></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     In vitro fertilization (IVF) involves ovarian stimulation, egg retrieval, fertilization, and embryo transfer. This procedure is accomplished by first stimulating the ovary to produce multiple eggs or ova, usually with medications, because success rates are greater with more than one embryo. Many different protocols exist for inducing ovulation with one or more agents. Patients are carefully selected and evaluated, and cycles are carefully monitored using ultrasound and monitoring hormone levels. At the appropriate time, the ova are recovered by transvaginal retrieval. Sperm and eggs are coincubated for up to36 hours, and the embryos are transferred about 48 hours after retrieval. Implantation should occur in 3 to 5 days.<o:p></o:p></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">GAMETE INTRAFALLOPIAN TRANSFER<o:p></o:p></span></b></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     </span></b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">Gamete intrafallopian transfer (GIFT), a variation of IVF, is the treatment of choice for patients with ovarian failure. GIFT is considered in unexplained infertility and when there is religion-based discomfort with IVF. The most common indications for IVF and GIFT are irreparable tubal damage, endometriosis, unexplained infertility, inadequate sperm, and exposure to DES. Success rates for GIFT vary from 20% to 30%.<o:p></o:p></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">OTHER ASSISTED REPRODUCTIVE TECHNOLOGIES<o:p></o:p></span></b></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     In intracytoplasmic sperm injection (ICSI), an ovum is collected as explained before, and one  sperm is introduced  through the egg membrane, </span><span style="font-family: "times new roman" , serif; font-size: 18.6667px;">through the zona pellucida,</span><span style="font-family: "times new roman" , serif; font-size: 14pt;"> and into the cytoplasm of the oocyte. The  egg </span><span style="font-family: "times new roman" , serif; font-size: 18.6667px;">fertilized</span><span style="font-family: "times new roman" , serif; font-size: 14pt;"> is  transferred back to  donor. ICSI  treatment  is of choice in severe male factor infertility.</span></div> <div class="MsoNormal"> <span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     Women who cannot produce their eggs (ie, premature ovarian failure) have option of using the eggs of a donor after stimulation of the donor;s ovaries. The recipient also receives hormones in preparation for these procedures. Couples may also choose this modality if the female partner has a genetic disorder that may be passed on to children.<o:p></o:p></span></div> <div class="MsoNormal"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14.0pt; line-height: 115%;">     <o:p></o:p></span></b></div> <br /> <div class="MsoNormal"> <br /></div> </div> <script async src="//pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script> <!-- peace --> <ins class="adsbygoogle" style="display:block" data-ad-client="ca-pub-1597694717782005" data-ad-slot="3836701773" data-ad-format="auto"></ins> <script> (adsbygoogle = window.adsbygoogle || []).push({}); </script>

assisted reproductive techniques female fertility male management medical MEDICAL MANAGEMENT OF MALE AND FEMALE FERTILTY

                                                                                      The treatment of infertility is complex a...

Read more »