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DefinitionDefinitionSigns and symptomsSigns and symptomsProcess of conceptionProcess of conceptionTypes of infertilityTypes of infertilityCauses of infertilityCauses of infertilityDiagnostic studiesDiagnostic studiesComplicationComplicationTreatmentTreatmentPreventionPreventionSummarySummaryReferencesReferences

Definition

In vitro fertilization (IVF) is a procedure in which eggs (ova) from a woman's ovary are removed, they are fertilized with sperm in a laboratory procedure, and then the fertilized egg (embryo) is returned to the woman's uterus.

Signs and symptomsSigns and symptomsMost men with fertility problems have no signs or symptoms. Most men with fertility problems have no signs or symptoms. Some men with hormonal problems may note a change in their voiceSome men with hormonal problems may note a change in their voice or pattern of hair growth, enlargement of their breasts, or difficulty or pattern of hair growth, enlargement of their breasts, or difficulty with sexual functionwith sexual function

Infertility in Infertility in womenwomen may be signed by irregular menstrual periods may be signed by irregular menstrual periods

or associated with conditions that cause pain during menstruationor associated with conditions that cause pain during menstruation

or intercourse.or intercourse.

Process of conceptionProcess of conception

* *Every month the pituitary gland in a woman's brain sends a Every month the pituitary gland in a woman's brain sends a signal to her ovaries to prepare an egg for ovulation. The pituitary signal to her ovaries to prepare an egg for ovulation. The pituitary hormones — follicle-stimulating hormone (FSH) and luteinizing hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — are involved in stimulating the ovaries to bring an hormone (LH) — are involved in stimulating the ovaries to bring an egg to ovulationegg to ovulation..

** A large boost in LH carries a message to the ovarian follicle to A large boost in LH carries a message to the ovarian follicle to release its egg (ovulate). A woman is most fertile at the time of release its egg (ovulate). A woman is most fertile at the time of ovulation — around day 14 of her menstrual cycle — although the ovulation — around day 14 of her menstrual cycle — although the exact time of ovulation varies among women due to different exact time of ovulation varies among women due to different lengths of menstrual cycles.lengths of menstrual cycles.

** The egg is then captured by a fallopian tube and is viable for about 24 hours, but its best chance of being fertilized is within the first 12 hours following ovulation. For pregnancy to occur, a sperm must unite with the egg in the fallopian tube during this time.

** Sperm are capable of fertilizing the egg for up to 72 hours and must be present in the fallopian tube at the same time as the egg for conception to occur. If fertilized, the egg moves into the uterus two to four days later. There it attaches to the uterine lining and begins a nine-month process of growth.

Types of infertilityTypes of infertilityInfertility was divided into two types:

Type I: never achieving a recognized pregnancy ,Type II: conception but no live birth .

Infertility is broken down into male factor, female factor.

Type of infertility common in lesbians? A new study suggests that lesbians may be more likely to suffer from a common cause of infertility

DIAGNOSTIC STUDIESDIAGNOSTIC STUDIES

1.1. Hormonal Studies (Hormonal Studies (EstradiolEstradiol , , FSH, FSH, LHLH , ...) , ...)

2.2. Endometrial Biopsy Endometrial Biopsy 3.3. Ultrasound Testing Ultrasound Testing 4.4. Laparoscopy Laparoscopy 5.5. Semen Analysis Semen Analysis 6.6. The Postcoital Test (PCT)The Postcoital Test (PCT) 7.7. Hysterosalpingogram (HSG)Hysterosalpingogram (HSG)

Female infertility

Causes of infertility

Ovulation problems

• Annovulation : lack of ovulation •Oligoovulation : infrequent ovulation •Luteal phase defects

Tubal problems

affect their ability to pick up the egg

Infection

Sexually transmitted diseases , Previous pelvic infection , infection from internal organs

Surgery

Previous ectopic pregnancy

Endometriosis

Uterine problems

Fibroids

Uterine Polyps

Male infertility

no sperm in the ejaculatepoor sperm quantity or quality AgeAge Emotional stressEmotional stresssmokingsmoking

TREATMENT OF INFERTILITY

Ovulation induction:

1. Clomid (Clomiphene)/ Tamoxifen: Clomid blocks the estrogen receptors on the hypothalamus causing them to “think” there is estrogen deficiency

2. Bromocriptine / Cabergoline / Quinagolide: reduce prolactin secretion

3. hMG (pergonal, menogon) : hMG contains both FSH and LH hormones

4. FSH (metrodin) : stimulates the ovaries to produce multiple follicles .

5. LH (luteinizing hormone) : Gonal F and Puregon

6. hCG (profasi and pregnyl ):

7. pulsatile GnRh (Fertiral )

ComplicationComplication

→Complications of being infertile often involve strong Complications of being infertile often involve strong emotions and may trigger negative feelings between you and emotions and may trigger negative feelings between you and your partner. These may include:your partner. These may include:

DepressionDepressionGuiltGuiltAngerAngerStressStressDisappointmentDisappointmentFear of losing partner because of infertilityFear of losing partner because of infertilityDiminished confidence and self-esteemDiminished confidence and self-esteem

PreventionPrevention

For male:For male:

Most types of male infertility aren't preventable. However, avoid drug Most types of male infertility aren't preventable. However, avoid drug and tobacco use and excessive alcohol consumption, which may and tobacco use and excessive alcohol consumption, which may contribute to male infertility. Also, high temperatures can affect sperm contribute to male infertility. Also, high temperatures can affect sperm production and motilityproduction and motility

For female:For female:

A woman can increase her chances of becoming pregnant in a A woman can increase her chances of becoming pregnant in a number of ways: number of ways:Exercise moderatelyExercise moderatelyAvoid weight extremesAvoid weight extremesAvoid alcohol, tobacco and street drugsAvoid alcohol, tobacco and street drugs

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Referenceswww.ansewr.com

Boggs, William M., and Rosella D. Smith. The Journey to Fertility: A Couple's Guide to In Vitro Fertilization. Timonium, MD: Wilrose Books, 2001

http://www.emedicin.com/emerg/topic507.htm

http://www.umm.edu/ency/article/001600.htm

Burroughs.A,etal.(2001)8thBurroughs.A,etal.(2001)8th maternity nursing, maternity nursing, an an introductory text. W.B. Saunders company. Philadelphia introductory text. W.B. Saunders company. Philadelphia London new York st. LouisLondon new York st. Louis