M Magdy EL-Sheikh FRCOG London, FRCS Glasgow Director ART unit Dr Soliman Fakeeh hospital Jeddah Saudi Arabia

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3 M Magdy EL-Sheikh FRCOG London, FRCS Glasgow Director ART unit Dr Soliman Fakeeh hospital Jeddah Saudi Arabia

4 The versatile nature reproduction Reproduction as a sign of life Reproduction as a sign of good health Reproduction as an evidence on the ability to give Reproduction and economy

5 Reproductive medicine is everybody s business You Me Doctor Media Educated Non educated Government Farmer Religion.etc

6 Fertility and cultural richness The pregnant from Katal Huyuk ca 7000 BC The pregnant from Malta 4000 BC

7 Facts of our Life Amun////Anubis

8 Reproduction central role

9 Motherhood and the ability to give Rome museum

10 Development of fertility therapy over the years Tradition and science Amulets Spirits Magic X Rays

11 Female Reproductive System oviduct ovary uterus cervix vagina Video of fertilization

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13 Sexual Reproduction in Human testis sperms meiosis fertilization meiosis ovary eggs (ova) zygote embryo fetus baby

14 The aim of ART unit DSFH Education of patients Acquiring up to date technology Supply of technology to patients at a suitable cost Innovation in the field

15 Male Factors Female Factors Both Coital Unexplained

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17 How fertile? The monthly possibility of pregnancy in normal fertile couples is 20% Zeinaman et al Estimates of human fertility and pregnancy loss fertil Steril 1996, 65: 503

18 Factors affecting fertility

19 Natural fertility and age III

20 The relationship between advanced maternal age and aneuploidy for chromosomes X, Y, 13, 15,16,18, 21,22 III From Munne et al

21 obesity

22 Smoking III

23 When things go wrong. (Infertility) Infertility is defined as failure to achieve pregnancy after one year period of normal marital relationship

24 Proper investigations Suitable and needed investigations Most up to date equipments and expertise Very active laboratories and fast feedback Quality control

25 Development of fertility investigations Comprehensive Female tests Male tests Couple tests

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27 Ia

28 The introduction of ultrasonography

29 Tubal patency

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33 Iatrogenic tubal disease

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37 III

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39 Earlier Attempts at in vitro fertilization

40 IN Vitro Fertilization IVF era

41 Steptoe and Edwards hard work

42 The success of IVF

43 The difficult birth of modern ART

44 The birth of the first IVF {test tube} baby in the middle east 1987 The pregnancy was achieved at DR Soliman Fakeeh hospital and followed by many others

45 The introduction of transvaginal Ultrasonography to the middle east By the team of DSFH 1987

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48 Intra cytoplasmic sperm injection ICSI era Pregestational diagnosis PGD era

49 ICSI and PGD

50 The Birth of the first ICSI baby in the middle east 1994 By DSFH team

51 ICSI and sever male factor infertility ICSI and testicular tissue ICSI and frozen testicular tissues

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53 In Vitro fertilization for the fertile couple Genetic disorders Cancer Stem cells

54 Reproductive medicine and fetal abnormalities Chromosomal disorders Gender selection Genetic disorders

55 Statistics Cancer One in every members of our race could be a victim of one type of cancer. One in every 900 individuals between the ages of years have survived cancer (2007) One in every 250 have survived cancer by 2010

56 Statistics Breast cancer in females life time risk is 11%, (RCOG Guide line 12) new cases in 2007 in USA Leukaemia and Lymphomas in children rate of 1 in new cases in 2007 in USA (Wallace review 2005)

57 Reproductive medicine and preservation of fertility in cancer patients Storage of human gametes Storage of ovarian tissues Storage of human embryos Reimplantation technology In vitro maturation of gametes Stem cells usage in cancer patients

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59 The introduction of new freezing methods to the middle east Vitrification techniques The birth of the first baby from vitrification in the middle east 2006 DSFH team

60 Laboratory Techniques Sperms Oocytes Follicles Fertilized oocytes Divided embryos Ovarian tissues Whole ovaries Testicular tissues Blastocysts

61 Leukaemia party

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63 Future is being written

64 Thank you