Infertility

IVF and related assisted reproductive technologies (ART) offer great hope to infertile couples the world over. Because these techniques are so expensive, however, they are out of the reach of the vast majority of couples, and especially those in the developing world. This is because IVF programmes are too technology-intensive at present - anything which is complicated is bound to be expensive.

Some couples worry that a test tube baby is "weak" or abnormal (and others still believe that the child is grown in a test tube for 9 months and then handed over to the parents!). Fortunately, with increasing awareness, many couples now know that there is nothing "artificial" about a test tube baby.

Given the fact that IVF is still more of an art than a science; that “luck” still plays a very important role; and that we still cannot predict who will get pregnant when, you are likely to be completely confused by conflicting information and contradictory opinions . Whom can you trust? How can you decide? And the fact that you and your spouse may have completely different priorities and opinion can make a bad situation even worse!

For patients with azoospermia, surgical sperm harvesting techniques need to be used to retrieve the sperm. This is called surgical sperm retrieval or recovery, and a number of methods have been devised to recover sperm from the male reproductive tractor men with obstructive azoospermia, (because of duct blockage or absence of the vas deferens), sperm are usually recovered from the epididymis.

Dr Margarete Sandelowski, Professor at University of North Carolina at Chapel Hill, has done some very exciting work in exploring how couples cope with their infertility. She observed that infertile couples often find that they are trapped in a maze; and they exhibit 6 patterns of pursuit in their quest to exit the maze.

If you need treatment for fibroids, there are a number of options available to you. Your choices should be guided by the medical problems the fibroids are causing, your desire to have children, and your feelings and thoughts about surgery or other options. I think it is important for you to know all the options available.

Throughout history, menstruation has been associated with myth and superstition. Menstrual blood was felt to cure leprosy, warts, birthmarks, gout, worms and epilepsy. It has been used to ward off demons and evil spirits. Menstruating women have been separated from their tribes in order to prevent a bad influence on the crops or the hunt. As recently as 1930, the cause of abnormal menstrual bleeding was felt to be an undue exposure to cold or wet just prior to the beginning of the period.

Our Knowledge of Reproductive medicine has been expanded rapidly since the birth of Louise Brown, the first baby to be conceived by In vitro Fertilization in 1978. Hardly a year goes by without the development of a new or a modification of an existing method of assisted reproduction.

With more information being made available on-line, and support groups helping to increase awareness of infertility, patients have a seemingly limitless amount of information now available to them. One direct result of the ongoing information revolution is that patients today are becoming more knowledgeable and empowered than ever before.

Infertility is the inability to conceive after a year of unprotected intercourse in women under 35, or after six months in women over 35, or the inability to carry a pregnancy to term. Couples who have known barriers to fertility, such as endometriosis, polycystic ovarian syndrome, male factor infertility, irregular cycles, etc., do not need to sit out the traditional waiting period to seek expert care for infertility.

A thorough history should include information about past surgical history, medical history, exposures to tobacco, alcohol, environmental toxins, a history of sexually transmitted diseases, a careful menstrual history, a history of any past pregnancies, a through review of all organ systems, and any other relevant information.

Pelvic pain Menopause PMS Infertility Recurrent Pregnancy Loss Prolactin Polycystic Ovaries Pelvic SurgeryEndometriosis Fibroids Reversal of Tubal Ligation Ectopic Pregnancy Multiple Gestation Endometrial Polyps Preimplantation Genetic Diagnosis (PGD)

Extend Fertility™ and Reproductive Medicine Associates of New York (RMA of NY) today announced initial results in the ongoing Extend Fertility-sponsored multi-site study designed to further the science and efficacy of oocyte cryopreservation or “egg freezing.”

The purpose of this proposal is to outline suggested clinical pathways for the management of infertility and common reproductive endocrinology problems. The goal is to create an approach that provides the greatest success while using limited resources in the most cost-effective fashion.

A fact that makes reproductive medicine unique is a specific and quantifiable end point- a healthy baby. Each infertile couple and each and every assisted reproduction technology (ART) program are vitally interested in success rates. The stakes are high. Truly, success breeds success.

Polycystic ovary syndrome is characterized by enlarged ovaries, multiple peripherally arranged cysts and increased stromal density(1). Polycystic ovary syndrome is responsible for approximately 25-30% of infertility in women, which is mainly anovulatory(2). Ovulation can be induced with antiesterogens in many women but a proportion fail to respond and even in those who ovulate, the pregnancy rate is often low and the miscarriage rate is high.

Pregnancy loss is a frustrating and challenging problem for couples and clinicians alike. Although medical textbooks specifically target the recommended "work-up" towards those patients labeled as "recurrent" or "habitual aborters", it is important, in this author's opinion, to consider certain specific aspects of evaluation after any miscarriage.

This question is in reference to a 36 year old woman that needs to know if there is any other way to concieve once the tubes have been clipped and burned?

In women with severe clomiphene-resistant PCOS, we proposed thatthe insulin-lowering agent troglitazone (Rezulin®) could have a positive impact on the ovarian microenvironment by supporting normal follicular growth, ovulation, and successful pregnancy.

So far medicine has had nothing to offer the man with azoospermia because of testicular failure, in the way of treatment. His only treatment choices were: adoption, or donor insemination.

Researchers have been investigating the role of various genes which may play an important role in PCOS. One of these candidate genes appears to be in the area and possibly in the insulin receptor gene of chromosome 19.

One of the most publicized papers of the 1999 American Society of Reproductive Medicine/ Canadian Fertility and Andrology Society was the research presented by Dr. Oktay, Dr. Karkujaya, Dr. Gosden and Dr. Schwartz from Cornell University in New York and and from the University of Leeds in the UK. They successfully auto-transplanted frozen-banked ovarian tissue and demonstrated the resumption of ovarian function.

Ectopic pregnancy, or preembryo implantation outside the endometrial cavity (i.e., fallopian tube, cervix, abdominal or pelvic cavity), is a potentially fatal condition with an incidence of 1:150 diagnosed pregnancies.

Lowering insulin levels with metformin in women with polycystic ovary syndrome but without overt diabetes increases the likelihood of conception and reduces risk of miscarriage, researchers report here.

Serum Estradiol/Progesterone Ratio on Day of Embryo Transfer May Predict Reproductive OutcomeFollowing Controlled Ovarian Hyperstimulation and In vitro Fertilization

The association between premature ovarian failure (POF) and the FMR1 repeat number (41> CGGn< 200) has been widely investigated. Current findings suggest that the risk estimation for POF can be calculated in the offspring of women with pre-mutated FMR1 alleles.

In recent years, clinical assisted reproduction techniques (ART) are increasingly being practiced worldwide, which in turn has led to an accumulated surplus of cryopreserved embryos within fertility clinics [1,2].

Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea).

Stein and Leventhal were the first to recognize an association between the presence of polycystic ovaries and signs of hirsutism, amenorrhea, oligomenorrhea and obesity. Subsequently, it was reported that after successful wedge resection of the ovaries in women diagnosed with Stein-Leventhal syndrome, menstrual cycles became regular and these patients were able to conceive.

Polycystic ovary syndrome is characterized by anovulation (irregular or absent menstrual periods) and hyperandrogenism (elevated serum testosterone and androstenedione). Patients with this syndrome may complain of abnormal bleeding, infertility, obesity, excess hair growth, hair loss and acne.