INFERTILITY CAUSES. Basic evaluation of the female

Size: px
Start display at page:

Download "INFERTILITY CAUSES. Basic evaluation of the female"

Transcription

1

2 INFERTILITY Infertility is the inability to conceive after 12 months of unprotected intercourse. There are multiple causes of infertility and a systematic way to evaluate the condition. Let s look at some of the causes. CAUSES Infertility is related to female factor in 33% cases Male factor in 20% cases Both male and female factor in 39% cases Unexplained in 8% of cases As far as evaluation is concerned, there are different ways to go about it keeping the goals of the couple in mind. Evaluation goals The infertility evaluation serves to 1. Determine the aetiology of infertility as expediently as possible, 2. Offer recommended treatment protocol to the couple, 3. Determine expected success rate and approximate cost for therapy 4. Educate the couple about their specific disorder and available alternatives. This serves to To identify potentially correctable conditions. To identify irreversible conditions that may be amenable to assisted reproduction (ART). To identify irreversible conditions those are not amenable to assisted reproduction (ART) and counsel for third party reproduction. When it comes to evaluation of infertility, it is very important for the couple to undergo it together as a unit. This makes for a healthy dynamic and encourages the mindset of taking on challenges together. Basic evaluation of the female As far as medical history is concerned, it plays a big part in evaluating the condition. It s important for you to give a complete account of your medical and other relevant history to the doctor. 1 of 10

3 History Present history The current problem/complaint, age, number of years of marriage, occupation, smoking, alcohol, and caffeine consumption. Menstrual history For age of menarche, cycle characteristics and any associated symptoms like painful menstruation or intermenstrual spotting and also history of primary or secondary amenorrhoea Obstetric history Previous pregnancies, if any, and their outcome, recurrent pregnancy loss, induced abortion, post-abortive infection or puerperal sepsis. Contraceptive history: Previous use of any contraceptive method, particularly intrauterine system, and associated problems. Sexual history Coital frequency, timing in relation to the cycle, use of vaginal lubricant, vaginal douching, loss of libido, and painful coitus. Past history Treatment for pelvic infection, tuberculosis, appendicectomy, laparotomy, caesarean sections, and cervical conisation. Family history Family history of consanguinity, diabetes mellitus, hypertension, twins delivery, and breast cancer. General history should focus on weight changes and on endocrine diseases that could interfere with gonadal functions like hypothyroidism. Physical Examination Here are some tests that one must take in the evaluation process. General Examination Vital signs (especially blood pressure), body height and weight (BMI) for over or under weights. Examination should also include the thyroid gland, secondary sexual characters, any excessive hair with/without acne on face or chest, and acanthosis nigricans. Breast Examination To evaluate its development and to exclude any pathology or presence of occult galactorrhoea. Abdominal Examination For any pathological and surgical scars. Genital Examination: Local examination followed by per-vaginal (PV) examination. 2 of 10

4 Investigations Tests on women are performed to evaluate three principles axes: ovaries, tubes, and uterus. Ovaries Ovarian function and reserve are examined by hormonal tests and ultrasonography. Hormonal Tests Day 2-Day 5 - FSH, LH, E2 Other endocrine tests: AMH, TSH, Prolactin (Independent of Menstrual cycle) Pelvic ultrasonography It provides information about the uterus, the ovaries, and to a certain extent the fallopian tubes, especially of the presence of hydrosalpinx. Measurement of antral follicle count (AFC) in early follicular phase indicates the patient s ovarian reserve. AFC is a direct ovarian reserve marker. Fallopian Tubes Tubal assessment is required to diagnose tubal infertility. When IVF is indicated (severe sperm abnormality, known severe endometriosis, women of advanced maternal age), tubal patency does not need to be verified. Different methods to assess tubal patency are hysterosalpingography (HSG), hysterosalpingo-contrast-sonography (HyCoSy), and laparoscopy with chromotubation. HSG HSG is the radiographic evaluation of the fallopian tubes. Radiography images are obtained intermittently after injection of oil-based or water-soluble contrast media. HSG should be performed between menstrual day 6 to 11 to ensure the absence of pregnancy and facilitate maximum uterine visibility with a thin proliferative phase endometrium. Uterine cavity, Fallopian tube architecture, hydrosalpinx, tubal phimosis, and peritoneal spillage are assessed. Laparoscopy Laparoscopy with chromopertubation has been considered as the gold standard for evaluating tubal patency. Laparoscopy is indicated when there is evidence or strong suspicion of endometriosis, pelvic/adnexal adhesions, or significant tubal disease requiring treatment. 3 of 10

5 Uterus Intrauterine lesions including endometrial polyps, submucosal myomas, adhesions, or uterine septum can interfere with spontaneous fertility and compromise pregnancy rates in assisted reproduction. Two-dimensional US is the first test to screen a suspected intrauterine abnormality. Other tests include SHS for polyp or intrauterine myoma assessment and 3D-US or MRI for Mullerian anomalies. Hysteroscopy remains the gold standard for evaluation of the uterine cavity. Evaluation Techniques of Female Infertility History Female Uterine anomaly? FSH, E2, Proesterone, AMH, TSH, Prolactin. Pelvic Sonography incl. AFC Ovulation Disorder? 3D-US or MRI Hysteroscopy Tube Tests? Not Required for IVF Tube Test HSG 4 of 10

6 Evaluation Of Ovulation Disorder Irregular menses Ovarian reserve test FSH, E2, AMH, AFC FSH, E2, Progesterone TSH, Prolactin, Adrogens High FSH, Low E2 Normal FSH and E2 High androgens Polycystic ovaries Abnormal TSH or High prolactin Other tests normal Normal or low FSH, Normal or low E2, High or normal prolactin, other tests normal POF PCOS after exclusion of -Congenital adrenal Hyperplasia -Androgen secreting Tumor-Cushing syndrome Thyroid dysfunction Hyperprolactinemia Hypogonadotrophic Hypogonadism Infertility is a common issue faced by men and women the world over. If you or your partner suffer from it, it is very important for both of you to tackle the issue like a team. There are plenty of treatment and corrective measures available that help you get over your condition if not bypass it. 5 of 10

7 manipalfertility.com Tel No / Toll Free: of 10

Infertility: failure to conceive within one year of unprotected regular sexual intercourse. Primary secondary

Infertility: failure to conceive within one year of unprotected regular sexual intercourse. Primary secondary Subfertility Infertility: failure to conceive within one year of unprotected regular sexual intercourse. Primary secondary Infertility affects about 15 % of couples. age of the female. Other factors that

More information

Infertility DR. RAHUL BEVARA

Infertility DR. RAHUL BEVARA Infertility DR. RAHUL BEVARA Definitions Infertility is defined as the inability to conceive after one year of unprotected coitus. Affects 10-15% of couples Primary Infertility, that is inability to conceive

More information

Neil Goodman, MD, FACE

Neil Goodman, MD, FACE Initial Workup of Infertile Couple: Female Neil Goodman, MD, FACE Professor of Medicine Voluntary Faculty University of Miami Miller School of Medicine Scope of Infertility in the United States Affects

More information

Infertility History Form

Infertility History Form Date form completed: Infertility History Form Patient s name: _ Age: Date of Birth: Occupation: Partner s name: Age: Date of Birth: Occupation: Prior marriage: Yes No # Prior marriage: Yes No # Attempted

More information

Clinical evaluation of infertility

Clinical evaluation of infertility Clinical evaluation of infertility DR. FARIBA KHANIPOUYANI OBSTETRICIAN & GYNECOLOGIST PRENATOLOGIST Definition: inability to achieve conception despite one year of frequent unprotected intercourse. Male

More information

Infertility. Rhian Allen & David Rogers.

Infertility. Rhian Allen & David Rogers. Infertility Rhian Allen & David Rogers http://www.worldofsurrogacy.com Objectives Definition & Epidemiology Female Gonadal Axis Normal Menstrual Cycle Causes Patient History Patient Examination Investigations

More information

EVALUATING THE INFERTILE PATIENT-COUPLES. Stephen Thorn, MD

EVALUATING THE INFERTILE PATIENT-COUPLES. Stephen Thorn, MD EVALUATING THE INFERTILE PATIENT-COUPLES Stephen Thorn, MD Overview The field of reproductive medicine continues to evolve rapidly by offering newer diagnostic testing and therapeutic options to improve

More information

5/5/2010. Infertility FINANCIAL DISCLOSURE. Infertility Definition. Objectives. Normal Human Fertility. Normal Menstrual Cycle

5/5/2010. Infertility FINANCIAL DISCLOSURE. Infertility Definition. Objectives. Normal Human Fertility. Normal Menstrual Cycle Infertility FINANCIAL DISCLOSURE I HAVE NO FINANCIAL INTEREST IN ANY OF THE PRODUCTS MENTIONED IN MY PRESENTATION Bryan K. Rone, M.D. University of Kentucky Obstetrics and Gynecology I AM RECEIVING COMPENSATION

More information

Evaluation of the Infertile Couple

Evaluation of the Infertile Couple Overview and Definition Infertility is defined as the inability of a couple to fall pregnant after one year of unprotected intercourse. Infertility is a very common condition as in any given year about

More information

Infertility Investigations. Patient Information

Infertility Investigations. Patient Information Infertility Investigations Patient Information Author ID: PH Leaflet Number: Gyn 048 Version: 4 Name of Leaflet: Infertility Investigations Date Produced: March 2017 Review Date: March 2019 Please be aware

More information

Infertility. Review and Update Clifford C. Hayslip MD Intrauterine Inseminations

Infertility. Review and Update Clifford C. Hayslip MD Intrauterine Inseminations Infertility Review and Update Clifford C. Hayslip MD Intrauterine Inseminations Beneficial effects of IUI not consistently documented in studies No deleterious effects on fertility 3-4 cycles of IUI should

More information

Subfertility B Y A L I S O N, B E N A N D J O H N

Subfertility B Y A L I S O N, B E N A N D J O H N Subfertility B Y A L I S O N, B E N A N D J O H N Contents Definition Causes Male Female Hx & Ex Investigations Treatment Definition Failure to conceive after a year of frequent, unprotected communion.

More information

EVALUATION OF MALE AND FEMALE INFERTILITY ANDREA BARRUECO AMERICAN CENTER FOR REPRODUCTIVE MEDICINE CLEVELAND CLINIC ART TRAINING 2018

EVALUATION OF MALE AND FEMALE INFERTILITY ANDREA BARRUECO AMERICAN CENTER FOR REPRODUCTIVE MEDICINE CLEVELAND CLINIC ART TRAINING 2018 EVALUATION OF MALE AND FEMALE INFERTILITY ANDREA BARRUECO AMERICAN CENTER FOR REPRODUCTIVE MEDICINE CLEVELAND CLINIC ART TRAINING 2018 The evaluation of an infertile couple requires an understanding of

More information

Fertility assessment and assisted conception

Fertility assessment and assisted conception Fertility assessment and assisted conception Dr Geetha Venkat MD FRCOG Director Pulse Learning Women s health 14 September 2016 Disclosure statement Dr Venkat is a director of Harley Street Fertility Clinic.

More information

Management of Female infertility Tim Chang

Management of Female infertility Tim Chang Management of Female infertility Tim Chang www.drtchang.com.au Assess and manage as a couple because: 30% infertility male factor related emotional support Role of the physician 1) diagnose and treat the

More information

NICE fertility guidelines. Hemlata Thackare MPhil MSc MRCOG Deputy Medical Director London Women s Clinic

NICE fertility guidelines. Hemlata Thackare MPhil MSc MRCOG Deputy Medical Director London Women s Clinic NICE fertility guidelines Hemlata Thackare MPhil MSc MRCOG Deputy Medical Director London Women s Clinic About the LWC 4 centres around the UK London Cardiff Swansea Darlington The largest sperm bank in

More information

Recent Developments in Infertility Treatment

Recent Developments in Infertility Treatment Recent Developments in Infertility Treatment John T. Queenan Jr., MD Professor, Dept. Of Ob/Gyn University of Rochester Medical Center Rochester, NY Disclosures I don t have financial interest or other

More information

Dr Manuela Toledo - Procedures in ART -

Dr Manuela Toledo - Procedures in ART - Dr Manuela Toledo - Procedures in ART - Fertility Specialist MBBS FRANZCOG MMed CREI Specialities: IVF & infertility Fertility preservation Consulting Locations East Melbourne Planning a pregnancy - Folic

More information

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome Polycystic Ovary Syndrome Definition: the diagnostic criteria Evidence of hyperandrogenism, biochemical &/or clinical (hirsutism, acne & male pattern baldness). Ovulatory dysfunction; amenorrhoea; oligomenorrhoea

More information

Fertility. Assessment and treatment for people with fertility problems. Issued: February NICE clinical guideline 156. guidance.nice.org.

Fertility. Assessment and treatment for people with fertility problems. Issued: February NICE clinical guideline 156. guidance.nice.org. Fertility Assessment and treatment for people with fertility problems Issued: February 2013 NICE clinical guideline 156 guidance.nice.org.uk/cg156 NICE has accredited the process used by the Centre for

More information

PRETREATMENT ASSESSMENT & MANAGEMENT (MODULE 1 B) March, 2018

PRETREATMENT ASSESSMENT & MANAGEMENT (MODULE 1 B) March, 2018 PRETREATMENT ASSESSMENT & MANAGEMENT (MODULE 1 B) March, 2018 Clinical Assessment A thorough clinical evaluation is a prerequisite for ART A thorough clinical evaluation as detailed in the female and male

More information

Patient Past Medical History

Patient Past Medical History Patient Past Medical History A. Identifying Data Date this form when completed Your name Partner's name Age Birth date Height Weight Length of marriage (or relationship) How long have you been trying unsuccessfully

More information

Infertility. Thomas Lloyd and Samera Dean

Infertility. Thomas Lloyd and Samera Dean Infertility Thomas Lloyd and Samera Dean Infertility Definition Causes Referral criteria Assisted reproductive techniques Complications Ethics What is infertility? Woman Reproductive age Has not conceived

More information

Fertility Assessment and Treatment Pathway

Fertility Assessment and Treatment Pathway Rejected referrals sent back to GP Fertility Assessment and Treatment Pathway Patients with fertility problems go to the GP GP Advice and Assessment GP to inform patient of access criteria for NHS-funded

More information

Fertility Assessment and Treatment Pathway

Fertility Assessment and Treatment Pathway Fertility Assessment and Treatment Pathway Rejected referrals sent back to GP Patients with fertility problems go to the GP GP Advice and Assessment GP to inform patient of access criteria for NHS-funded

More information

FERTILITY & TCM. On line course provided by. Taught by Clara Cohen

FERTILITY & TCM. On line course provided by. Taught by Clara Cohen FERTILITY & TCM On line course provided by Taught by Clara Cohen FERTILITY & TCM FERTILITY AND TCM THE PRACTITIONER S ROLE CAUSES OF INFERTILITY RISK FACTORS OBJECTIVES UNDERSTANDING TESTS Conception in

More information

Infertility: An Overview

Infertility: An Overview AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Infertility: An Overview A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the

More information

INFERTILITY: DIAGNOSIS, WORKUP AND MANAGEMENT FOR THE COMMUNITY PHYSICIAN

INFERTILITY: DIAGNOSIS, WORKUP AND MANAGEMENT FOR THE COMMUNITY PHYSICIAN INFERTILITY: DIAGNOSIS, WORKUP AND MANAGEMENT FOR THE COMMUNITY PHYSICIAN Caitlin Dunne, MD, FRCSC Clinical Assistant Professor Division of Reproductive Endocrinology and Infertility Department of Obstetrics

More information

Female Consultation Questionnaire

Female Consultation Questionnaire Female Consultation Questionnaire In order to schedule a consultation with the doctor, an overview of your medical history along with a copy of your medical records are requested. Dr. Zouves will review

More information

Chris Davies & Greg Handley

Chris Davies & Greg Handley Chris Davies & Greg Handley Contents Definition Epidemiology Aetiology Conditions for pregnancy Female Infertility Male Infertility Shared infertility Treatment Definition Failure of a couple to conceive

More information

New Patient Medical History

New Patient Medical History New Patient Medical History MR #: Initial Appointment Date: / / Name: Birth Date: / / Address: City: State: Zip: Best Phone # to reach you: ( ) Second contact #: ( ) Email Address: Occupation: Marital

More information

Facts About Folic Acid

Facts About Folic Acid Facts About Folic Acid How much folic acid a woman needs 400 micrograms (mcg) every day. When to start taking folic acid For folic acid to help prevent major birth defects, a woman needs to start taking

More information

Case. 24 year old female presented to your office complaining of excess hair growth on her face and abdomen. Questions?

Case. 24 year old female presented to your office complaining of excess hair growth on her face and abdomen. Questions? Hirsutism Case 24 year old female presented to your office complaining of excess hair growth on her face and abdomen Questions? Started around puberty with gradual progression Irregular menstrual cycle

More information

Ideal preparation for pregnancy

Ideal preparation for pregnancy Ideal preparation for pregnancy The following examinations are recommended before the start of a fertility treatment: 1) Rubella or varicella antibodies If an expecting mother is infected with rubella

More information

FACTSHEET FERTILITY INVESTIGATIONS

FACTSHEET FERTILITY INVESTIGATIONS FACTSHEET FERTILITY INVESTIGATIONS Most people nowadays know enough about contraception to expect a pregnancy to occur reasonably soon after contraceptive precautions are stopped. If your own fertility

More information

Reproductive Testing: Less is More G. Wright Bates, Jr., M.D. Professor and Director Reproductive Endocrinology and Infertility Objectives

Reproductive Testing: Less is More G. Wright Bates, Jr., M.D. Professor and Director Reproductive Endocrinology and Infertility Objectives Reproductive Testing: Less is More G. Wright Bates, Jr., M.D. Professor and Director Reproductive Endocrinology and Infertility Objectives 1. Review definition of infertility and impact of age 2. Stress

More information

Case 1 Dear Dr Re: Joan and John Baldwin, 2 Union Road, Clifton, Bristol. General investigation of infertility. Case 3

Case 1 Dear Dr Re: Joan and John Baldwin, 2 Union Road, Clifton, Bristol. General investigation of infertility. Case 3 General investigation of infertility What is relevant in Primary Care? Case 1 Re: Joan and John Baldwin, 2 Union Road, Clifton, Bristol Would you please see this couple. Mr and Mrs Baldwin present to the

More information

Infertility: An Overview

Infertility: An Overview AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Infertility: An Overview A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the

More information

16 East 40 th St, 2 nd Fl, New York, NY Ph fax

16 East 40 th St, 2 nd Fl, New York, NY Ph fax Page 1 of 9 16 East 40 th St, 2 nd Fl, New York, NY 10016 Ph 212-679-2289 fax 212-679-2288 Please complete the following: Fertility Evaluation Name: Date of birth: Age: Partner s Name: Date of birth: Age:

More information

GPVTS TEACHING APRIL 2016 FERTILITY

GPVTS TEACHING APRIL 2016 FERTILITY GPVTS TEACHING APRIL 2016 FERTILITY Djavid Alleemudder - Consultant Obstetrics & Gynaecology DEFINITIONS What is the definition of infertility? Failure to conceive after 12 months despite regular, unprotected

More information

The assessment and investigation of the infertile couple

The assessment and investigation of the infertile couple The assessment and investigation of the infertile couple BIRUTE ZILAITIENE, MD, PHD, PROF., FECSM DEPARTMENT OF ENDOCRINOLOGY AND INSTITUTE OF ENDOCRINOLOGY, LITHUANIAN UNIVERSITY OF HEALTH SCIENCES, KAUNAS,

More information

POST - DOCTORAL FELLOWSHIP PROGRAMME IN REPRODUCTIVE MEDICINE. Anatomy : Male and Female genital tract

POST - DOCTORAL FELLOWSHIP PROGRAMME IN REPRODUCTIVE MEDICINE. Anatomy : Male and Female genital tract POST - DOCTORAL FELLOWSHIP PROGRAMME IN REPRODUCTIVE MEDICINE DURATION OF THE COURSE : TWO YEARS Detailed syllabus: Part 1 Basic Sciences: Anatomy : Male and Female genital tract Physiology Endocrinology

More information

Secondary amenorrhoea Dr.ASMAA AL SANJARY

Secondary amenorrhoea Dr.ASMAA AL SANJARY Secondary amenorrhoea Dr.ASMAA AL SANJARY The student at the end of this lecture should be able to: Define secondary amenorrhoea. Classify the causes of secondary amenorrhoea. Describe the commonest three

More information

Cynthia Morris DO, FACOOG, FACOS Medical Director, Women s Wellness Center Fayette County Memorial Hospital

Cynthia Morris DO, FACOOG, FACOS Medical Director, Women s Wellness Center Fayette County Memorial Hospital Cynthia Morris DO, FACOOG, FACOS Medical Director, Women s Wellness Center Fayette County Memorial Hospital Touchdown to CME Eighth District Academy of Osteopathic Medicine & Surgery October 8. 2017 Goals

More information

Polycystic Ovary Syndrome HEATHER BURKS, MD OU PHYSICIANS REPRODUCTIVE MEDICINE SEPTEMBER 21, 2018

Polycystic Ovary Syndrome HEATHER BURKS, MD OU PHYSICIANS REPRODUCTIVE MEDICINE SEPTEMBER 21, 2018 Polycystic Ovary Syndrome HEATHER BURKS, MD OU PHYSICIANS REPRODUCTIVE MEDICINE SEPTEMBER 21, 2018 Learning Objectives At the conclusion of this lecture, learners should: 1) Know the various diagnostic

More information

Understanding Infertility, Evaluations, and Treatment Options

Understanding Infertility, Evaluations, and Treatment Options Understanding Infertility, Evaluations, and Treatment Options Arlene J. Morales, M.D., F.A.C.O.G. Fertility Specialists Medical Group, Inc. What We Will Cover Introduction What is infertility? Briefly

More information

12/13/2017. Important references for PCOS. Polycystic Ovarian Syndrome (PCOS) for the Family Physician. 35 year old obese woman

12/13/2017. Important references for PCOS. Polycystic Ovarian Syndrome (PCOS) for the Family Physician. 35 year old obese woman Polycystic Ovarian Syndrome (PCOS) for the Family Physician Barbara S. Apgar MD, MS Professor or Family Medicine University of Michigan Ann Arbor, Michigan Important references for PCOS Endocrine Society

More information

Questionnaire for Women

Questionnaire for Women Questionnaire for Women General Information Name Date Address Telephone Home _Work _ Cell Birth date Age _ Occupation Ethnic Background _ Height _ Weight _ Highest Education _ Partner s Name Marriage date

More information

Reproductive Endocrinology & Infertility Glossary

Reproductive Endocrinology & Infertility Glossary Reproductive Endocrinology & Infertility Glossary The following is a glossary of terms you may hear during your association with the University of Mississippi Health Care's reproductive endocrinology and

More information

Infertility F REQUENTLY A SKED Q UESTIONS. Q: Is infertility a common problem?

Infertility F REQUENTLY A SKED Q UESTIONS. Q: Is infertility a common problem? Infertility (female factors). In another one third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.

More information

At the conclusion of the first two year, the resident should be able to:

At the conclusion of the first two year, the resident should be able to: Reproductive Endocrinology/Infertility Rotations PGY-I COMPETENCY 1. Patient Care, Provide patient centered care that is compassionate, appropriate, and effective for the treatment of health problems and

More information

Bio 12- Ch. 21: Reproductive System

Bio 12- Ch. 21: Reproductive System Bio 12- Ch. 21: Reproductive System 21.1- Male Reproductive System o Male anatomy o Testes and how they relate to sperm production and male sex hormones o Hormone regulation in males 21.2- Female Reproductive

More information

Dr Mary Birdsall. Fertility Associates Auckland

Dr Mary Birdsall. Fertility Associates Auckland Dr Mary Birdsall Fertility Associates Auckland Period Problems Mary Birdsall Medical Director Fertility Associates Auckland Period Problems Basic Physiology No Periods Irregular Periods Heavy Periods

More information

Female Reproductive Physiology. Dr Raelia Lew CREI, FRANZCOG, PhD, MMed, MBBS Fertility Specialist, Melbourne IVF

Female Reproductive Physiology. Dr Raelia Lew CREI, FRANZCOG, PhD, MMed, MBBS Fertility Specialist, Melbourne IVF Female Reproductive Physiology Dr Raelia Lew CREI, FRANZCOG, PhD, MMed, MBBS Fertility Specialist, Melbourne IVF REFERENCE Lew, R, Natural History of ovarian function including assessment of ovarian reserve

More information

Infertility for the Primary Care Provider

Infertility for the Primary Care Provider Infertility for the Primary Care Provider David A. Forstein, DO FACOOG Clinical Associate Professor Obstetrics and Gynecology University of South Carolina School of Medicine Greenville Disclosure I have

More information

Polycystic Ovarian Syndrome (PCOS) LOGO

Polycystic Ovarian Syndrome (PCOS) LOGO Polycystic Ovarian Syndrome (PCOS) Ma qianhong Ob/Gyn Department LOGO Contents Epidemiology and Definition Pathophysiology, Endocrinological Features Diagnostic Criteria Treatment Prognosis Introduction

More information

Clinical guideline Published: 20 February 2013 nice.org.uk/guidance/cg156

Clinical guideline Published: 20 February 2013 nice.org.uk/guidance/cg156 Fertility problems: assessment and treatment Clinical guideline Published: 20 February 2013 nice.org.uk/guidance/cg156 NICE 2017. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).

More information

ROLE OF HORMONAL ASSAY IN DIAGNOSING PCOD DR GAANA SREENIVAS (JSS,MYSURU)

ROLE OF HORMONAL ASSAY IN DIAGNOSING PCOD DR GAANA SREENIVAS (JSS,MYSURU) ROLE OF HORMONAL ASSAY IN DIAGNOSING PCOD DR GAANA SREENIVAS (JSS,MYSURU) In 1935, Stein and Leventhal described 7 women with bilateral enlarged PCO, amenorrhea or irregular menses, infertility and masculinizing

More information

Practical Workshop about Fertility in NZ

Practical Workshop about Fertility in NZ Practical Workshop about Fertility in NZ Dr Sarah Wakeman Fertility Associates Christchurch Dr Mary Birdsall Fertility Associates Auckland Professor Wayne Gillett Otago Fertility Service and University

More information

Obstetrics and Gynecology. Infertility. Dr. Layla Zaghal. Definition

Obstetrics and Gynecology. Infertility. Dr. Layla Zaghal. Definition Obstetrics and Gynecology Infertility Dr. Layla Zaghal Definition The term infertility is no more used and has been replaced by the term subfertility ; when you tell a couple that they are infertile, it

More information

Outline. Male Reproductive System Testes and Sperm Hormonal Regulation

Outline. Male Reproductive System Testes and Sperm Hormonal Regulation Outline Male Reproductive System Testes and Sperm Hormonal Regulation Female Reproductive System Genital Tract Hormonal Levels Uterine Cycle Fertilization and Pregnancy Control of Reproduction Infertility

More information

Causes of Infertility and Treatment Options

Causes of Infertility and Treatment Options Causes of Infertility and Treatment Options Dr Mrs.Kiran D. Sekhar Former vice President-FOGSI Former Chairperson- Genetics and Foetal medicine-fogsi Founder and Medical Director-Kiran Infertility centre

More information

Fertility 101. About SCRC. A Primary Care Approach to Diagnosing and Treating Infertility. Definition of Infertility. Dr.

Fertility 101. About SCRC. A Primary Care Approach to Diagnosing and Treating Infertility. Definition of Infertility. Dr. Dr. Shahin Ghadir A Primary Care Approach to Diagnosing and Treating Infertility St. Charles Bend Grand Rounds November 30, 2018 I have no conflicts of interest to disclose. + About SCRC State-of-the-art

More information

Infertility treatment other than ART. Dr. Prue Johnstone FRANZCOG MRepMed

Infertility treatment other than ART. Dr. Prue Johnstone FRANZCOG MRepMed Infertility treatment other than ART Dr. Prue Johnstone FRANZCOG MRepMed What is Subfertility? (not infertility!) Primary subfertility Absence of conception after 12 months of unprotected intercourse timed

More information

Optimizing Fertility and Wellness After Cancer. Kat Lin, MD, MSCE

Optimizing Fertility and Wellness After Cancer. Kat Lin, MD, MSCE Optimizing Fertility and Wellness After Cancer Kat Lin, MD, MSCE University Reproductive Care University of Washington Nov. 6, 2010 Optimism in Numbers 5-year survival rate 78% for all childhood cancers

More information

Hormonal Control of Human Reproduction

Hormonal Control of Human Reproduction Hormonal Control of Human Reproduction Bởi: OpenStaxCollege The human male and female reproductive cycles are controlled by the interaction of hormones from the hypothalamus and anterior pituitary with

More information

Phases of the Ovarian Cycle

Phases of the Ovarian Cycle OVARIAN CYCLE An ovary contains many follicles, and each one contains an immature egg called an oocyte. A female is born with as many as 2 million follicles, but the number is reduced to 300,000 to 400,000

More information

AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE

AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE INFERTILITY: AN OVERVIEW A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the

More information

Fertility guide. Everything you need to know before seeking medical advice for infertility treatment

Fertility guide. Everything you need to know before seeking medical advice for infertility treatment Fertility guide Everything you need to know before seeking medical advice for infertility treatment ΙΝ Α FEW WORDS the following text is a valuable guide for those who wish to become parents but are concerned

More information

Female Reproductive Endocrinology

Female Reproductive Endocrinology Female Reproductive Endocrinology Dr. Channa Jayasena PhD MRCP FRCPath Clinical Senior Lecturer & Consultant Endocrinologist Department of Gynaecology, Hammersmith Hospital Anovulation is a common cause

More information

Infertility INA S. IRABON, MD, FPOGS, FPSRM, FPSGE OBSTETRICS AND GYNECOLOGY REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY

Infertility INA S. IRABON, MD, FPOGS, FPSRM, FPSGE OBSTETRICS AND GYNECOLOGY REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY Infertility INA S. IRABON, MD, FPOGS, FPSRM, FPSGE OBSTETRICS AND GYNECOLOGY REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY To download lecture deck Reference Comprehensive Gynecology 7 th edition, 2017 (Lobo

More information

Infertility: A Generalist s Perspective

Infertility: A Generalist s Perspective Infertility: A Generalist s Perspective Learning Objectives Fertility and Lifestyle: Patient education Describe the basic infertility workup Basic treatment strategies unexplained Heather Huddleston, MD

More information

Fertility in the 21 st Century Dr Leigh Searle

Fertility in the 21 st Century Dr Leigh Searle Fertility in the 21 st Century Dr Leigh Searle Fertility Specialist, Obstetrician, Gynaecologist FRANZCOG, PGDipOMG, MBChB Dr Kate Van Harselaar Fertility Specialist, Obstetrician and Gynaecologist Overview

More information

Stage 4 - Ovarian Cancer Symptoms

Stage 4 - Ovarian Cancer Symptoms WELCOME Stage 4 - Ovarian Cancer Symptoms University of Baghdad College of Nursing Department of Basic Medical Sciences Overview of Anatomy and Physioloy II Second Year Students Asaad Ismail Ahmad,

More information

The 6 th Scientific Meeting of the Asia Pacific Menopause Federation

The 6 th Scientific Meeting of the Asia Pacific Menopause Federation Abnormal uterine bleeding in the perimenopause Perimenopausal menstrual problems are among the most common causes for family practitioner and specialist referral. Often it is due to the hormone changes

More information

A multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of

A multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of A multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of Endometrioma and deep infiltrating endometriosis Professor C. Chapron and the Group

More information

FERTILITY SERVICES PERSONAL HISTORY

FERTILITY SERVICES PERSONAL HISTORY FERTILITY SERVICES PERSONAL HISTORY ONE FERTILITY KITCHENER WATERLOO 4271 King St E., Suite 200 KITCHENER, Ontario N2P 2X7 P 519-650-0011 F 519-650-0033 www.onefertilitykw.com Date: Age: Height: Weight:

More information

Ideal preparation for pregnancy

Ideal preparation for pregnancy Ideal preparation for pregnancy The following examinations are recommended before the start of a fertility treatment: 1) Rubella or varicella antibodies If an expecting mother is infected with rubella

More information

CASE 41. What is the pathophysiologic cause of her amenorrhea? Which cells in the ovary secrete estrogen?

CASE 41. What is the pathophysiologic cause of her amenorrhea? Which cells in the ovary secrete estrogen? CASE 41 A 19-year-old woman presents to her gynecologist with complaints of not having had a period for 6 months. She reports having normal periods since menarche at age 12. She denies sexual activity,

More information

Topics. Periods Menopause & HRT Contraception Vulva problems

Topics. Periods Menopause & HRT Contraception Vulva problems Girls stuff Topics Periods Menopause & HRT Contraception Vulva problems Menorrhagia Excessive menstrual loss occurring with regular or irregular cycles Ovulatory Anovulatory Usual blood loss 30-40ml per

More information

Assisted Reproduction. By Dr. Afraa Mahjoob Al-Naddawi

Assisted Reproduction. By Dr. Afraa Mahjoob Al-Naddawi Assisted Reproduction By Dr. Afraa Mahjoob Al-Naddawi Learning Objectives: By the end of this lecture, you will be able to: 1) Define assisted reproductive techniques (ART). 2) List indications for various

More information

NEW PATIENT HISTORY QUESTIONNAIRE

NEW PATIENT HISTORY QUESTIONNAIRE NEW PATIENT HISTORY QUESTIONNAIRE Patient Information: Date Name: Birth date: Who referred you to this clinic? Who is your primary physician? Location/Address: Do you need a referral? Yes No Would you

More information

WHY INVESTIGATE FOR INFERTILITY

WHY INVESTIGATE FOR INFERTILITY WHY INVESTIGATE FOR INFERTILITY Intrauterine Insemination 1 About this booklet This series of booklets has been developed and written with the support of leading fertility clinics across Australia, and

More information

Subfertility and Reproductive Health (January 2011)

Subfertility and Reproductive Health (January 2011) Subfertility and Reproductive Health (January 2011) The field of subfertility and reproductive endocrinology continues to face rapid developments in clinical practice and basic and translational research.

More information

Reproductive Health and Pituitary Disease

Reproductive Health and Pituitary Disease Reproductive Health and Pituitary Disease Janet F. McLaren, MD Assistant Professor Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology jmclaren@uabmc.edu Objectives

More information

Overview of Reproductive Endocrinology

Overview of Reproductive Endocrinology Overview of Reproductive Endocrinology I have no conflicts of interest to report. Maria Yialamas, MD Female Hypothalamic--Gonadal Axis 15 4 Hormone Secretion in the Normal Menstrual Cycle LH FSH E2, Progesterone,

More information

Question Bank III - BHMS

Question Bank III - BHMS Question Bank III - BHMS Sub:- Ob/Gy -Paper-II 1. Give the definition of Puberty. 2. Enumerate five important physical changes evident during puberty. 3. Write down the vaginal changes during puberty.

More information

F REQUENTLY A SKED Q UESTIONS

F REQUENTLY A SKED Q UESTIONS Polycystic heart, blood vessels, and appearance. Women with PCOS have these characteristics: Ovarian high levels of male hormones, also called androgens an irregular or no menstrual cycle Syndrome may

More information

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see: bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published. To view the latest

More information

NaProTechnology after previous IVF Galway, Ireland

NaProTechnology after previous IVF Galway, Ireland NaProTechnology after previous IVF 2004-2012 Galway, Ireland Salt Lake City, July 2012 Dr. Phil Boyle MICGP, MRCGP, CFCP IVF Report.. Sunday Times 2009 1 in 6 couples - Infertility 1.25% (1 in 80) have

More information

MULTIPLE CHOICE: match the term(s) or description with the appropriate letter of the structure.

MULTIPLE CHOICE: match the term(s) or description with the appropriate letter of the structure. Chapter 27 Exam Due NLT Thursday, July 31, 2015 Name MULTIPLE CHOICE: match the term(s) or description with the appropriate letter of the structure. Figure 27.1 Using Figure 27.1, match the following:

More information

Interim Clinical Commissioning Policy: Assisted Conception. Agreed: September 2013 Reference: N-SC/037. England

Interim Clinical Commissioning Policy: Assisted Conception. Agreed: September 2013 Reference: N-SC/037. England Interim Clinical Commissioning Policy: Assisted Conception Agreed: September 2013 Reference: N-SC/037 England 1 Interim Clinical Commissioning Policy Assisted Conception First published: November 2013

More information

Approach to ovulation induction and superovulation in women with a history of infertility. Anatte E. Karmon, MD

Approach to ovulation induction and superovulation in women with a history of infertility. Anatte E. Karmon, MD Approach to ovulation induction and superovulation in women with a history of infertility Anatte E. Karmon, MD Disclosures- Anatte Karmon, MD No financial relationships to disclose 2 Objectives At the

More information

Radiological assessment of infertility: A pictorial review

Radiological assessment of infertility: A pictorial review Radiological assessment of infertility: A pictorial review Poster No.: C-1681 Congress: ECR 2015 Type: Educational Exhibit Authors: J. P. Walsh, N. Healy, M. O'sullivan, S. Harte, M. T. Knox; Dublin/ IE

More information

Please fill out the following information and have it returned to our office prior to your consultation.

Please fill out the following information and have it returned to our office prior to your consultation. Please fill out the following information and have it returned to our office prior to your consultation. Patient s Name Partner s Name Address: City: State: Zip: Phone (day#): ( ) (eve#) ( ) (cell) ( )

More information

Chapter 7 Infertility, Contraception, and Abortion

Chapter 7 Infertility, Contraception, and Abortion Chapter 7 Infertility, Contraception, and Abortion Infertility Incidence Affects about 10% to 15% of reproductive-age population Subfertility: prolonged time to conceive Sterility: inability to conceive

More information

Lori Arnold, M.D., F.A.C.O.G Reproductive Endocrinology and Fertility

Lori Arnold, M.D., F.A.C.O.G Reproductive Endocrinology and Fertility Lori Arnold, M.D., F.A.C.O.G Reproductive Endocrinology and Fertility NEW PATIENT HISTORY A. FEMALE IDENTIFYING DATA Date this form completed Your name: _ Partner s Name: Age Birth date Height Weight How

More information

Infertility in Women over 35. Alison Jacoby, MD Dept. of Ob/Gyn UCSF

Infertility in Women over 35. Alison Jacoby, MD Dept. of Ob/Gyn UCSF Infertility in Women over 35 Alison Jacoby, MD Dept. of Ob/Gyn UCSF Learning Objectives Review the effect of age on fertility Fertility counseling for the patient >35 - timing - lifestyle - workup Fertility

More information

Infertile work up. WHICH METHOD Non invasive tools (HSG-USG) 19/11/2014. Basic test (spermogram, ovulation, hormonal test etc..)

Infertile work up. WHICH METHOD Non invasive tools (HSG-USG) 19/11/2014. Basic test (spermogram, ovulation, hormonal test etc..) G.Chauvin A.Watrelot Centre de Recherche et d Etude de la Stérilité (CRES ) Hôpital privé NATECIA Lyon-FRANCE Infertile work up Basic test (spermogram, ovulation, hormonal test etc..) Pelvic evaluation:

More information

Infertility testing. Global infertility panel. Patient information. Informations for patients

Infertility testing. Global infertility panel. Patient information. Informations for patients Global infertility panel Infertility testing Informations for patients Patient information Each of your body cells contains your genetic information called DNA. DNA carries all the information you need

More information