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Infertility PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Infertility”.

This medical PowerPoint presentation is about infertility, a medical condition where a person is unable to conceive or carry a pregnancy to full term despite having regular, unprotected sexual intercourse for a year or more. It can affect both men and women, and it can be caused by a variety of factors, including hormonal imbalances, problems with ovulation or sperm production, age, genetic factors, lifestyle factors, infections, or structural abnormalities in the reproductive system.

Infertility can have significant psychological and emotional impacts, including stress, anxiety, depression, and relationship strain. It is important for individuals experiencing infertility to seek medical evaluation and support from healthcare professionals who specialize in reproductive health.

Treatments for infertility may include medications, surgery, assisted reproductive technologies such as in vitro fertilization (IVF), and lifestyle changes such as weight management and avoiding alcohol and tobacco use. The specific treatment options will depend on the underlying cause of infertility and individual circumstances.

Tags : infertility, reproductive system, Obstetrics and Gynecology, Obstetrics and Gynecology PowerPoint presentation

Published on : Jun 20, 2023 | Views : 1097 | Downloads : 11

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Slide 1-

Infertility
Slide 2-

Male sperm production
Slide 3-

Male sperm production
Slide 4-

Female reproductive tract
Slide 5-

Fertilization: sperm meets egg
Slide 6-

Implantation
Slide 7-

7 Infertility Definition: - The inability of a sexually active couple, not using any contraception, to conceive during 1 year (age < 35) or 6 months (age >35)
Slide 8-

Fecund ability: - is the chance of conception in one menstrual cycle (15-25%) Incidence increases with age Infertility
Slide 9-

Primary infertility a couple that has never conceived Secondary infertility infertility that occurs after previous pregnancy regardless of outcome Infertility
Slide 10-

10 The Causes of Infertility and their Approximate Frequency
Slide 11-

Workup History is KEY Focused Physical Exam Labs and Specialized Tests
Slide 12-

12 Sexual dysfunction Mumps / STD Trauma Past medical history Past surgical history cigarettes/ alcohol Common medications Ketoconazole Cimetidine Spironolactone History
Slide 13-

Heavy smoking Development of impotence (decrease blood flow to the penis) Abnormal semenogram : Decreased sperm count, alteration in motility , and increase in the abnormal forms.
Slide 14-

Physical Exam Male Infection Hernia Vas deferens Androgen deficiency Testicular mass Varicocele
Slide 15-

basic evaluation 1-Semen analysis2-Uterine/tubal evaluation3-Determination of ovulation
Slide 16-

Causes of Male Infertility Abnormality in sperm production Abnormality in sperm function Obstruction in the ductal system
Slide 17-

17 Male Infertility Semen Analysis 3 days of abstinence, collection technique, 72 days for sperm to be ejaculated Vol > 2ml Concentration > 20x 106 / mL Motility > 50% Morphology > 15% normal Note: SA best performed in andrology lab; If abnormal always repeat
Slide 18-

Causes for Abnormal SA No sperm Klinefelter’s syndrome Ductal obstruction Hypogonadotropic-hypogonadism Few sperm Genetic disorder Endocrinopathies Varicocele Abnormal Count
Slide 19-

for all sub fertile men is not necessary. When sperm concentration is less than 10 million per mL, measurement of the serum testosterone and (FSH) levels is indicated. If the total testosterone level is normal, no further endocrine testing is needed. If the total testosterone level is low, the serum luteinizing hormone and prolactin levels can be checked to evaluate for a pituitary cause. Hormone testing
Slide 20-

Genetic studies Karyotype – 5.8% of infertile men has chromosomal abnormalities – 16% in azoospermia – Klinefelter syndrome, trisomy 21, mixed gonadal dysgenesis, Yq microdelection – Not detected on routine karyotype testing – 3 distinct loci on the long arm Specific gene defects (C.F mutation)
Slide 21-

testicular biopsy • A diagnostic testicular biopsy is indicated only in men (azoospermia, a normal testicular volume and normal FSH)(grade B recommendation)
Slide 22-

History Duration Previous pregnancies Ht / BMI Full menstrual history Androgenising signs Pelvic pain Past surgical history Medications / cigarettes / alcohol PID Thyroid signs STD Ep
Slide 23-

Ruptured tube in EP
Slide 24-

Evaluation of Ovulation
Slide 25-

Ovulation A history of regular menstruation suggests regular ovulation Absence of PMS symptoms may suggest anovulation
Slide 26-

Diagnostic studies to confirm Ovulation Basal body temperature Inexpensive Accurate Thermogenic potential of progesterone (.4-.8) Serum progesterone After ovulation rises Can be measured Progesterone 3-4 ng/mL Urinary ovulation-detection kits Measures changes in urinary LH
Slide 27-

Checking for Ovarian Reserve age related increase of FSH Day 3 FSH: >10-15 mIu/mL Clomiphene Challenge Test (CCT) Day 3 & Day 10 FSH (after clomid 50mg day 5-9) Physiology:
Slide 28-

Anovulation
Slide 29-

AnovulationSymptoms Evaluation Irregular menstrual cycles Amenorrhea Hirsuitism Acne Galactorrhea PCO POF Follicle stimulating hormone Lutenizing hormone Thyroid stimulating hormone Prolactin Androstenedione Total testosterone DHEAS
Slide 30-

Anatomic Disorders of the Female Genital Tract
Slide 31-

Uterine Factors Hysterosalpingography (HSG) HSG v Hysterscope: Sens 98%, Spec 35% All polyp vs submucous myomas Ultrasound/Sonohysterography SIS 75 sens, spec 90%
Slide 32-

32 Congenital Anomalies
Slide 33-

Acquired Disorders Acute salpingitis Alters the functional integrity of the fallopian tube N. gonorrhea and C. trachomatis Intrauterine scarring Can be caused by curettage Endometriosis, scarring from surgery, tumors of the uterus and ovary Fibroids, endometriomas ,Trauma
Slide 34-

34 Hysteroscopy
Slide 35-

Hysteroscopy
Slide 36-

Leiomyoma
Slide 37-

Leiomyoma
Slide 38-

Tubal Factor Risk factors PID; 12%,24%,75%, Ectopic 6 fold HSG 2-5 days after menses 1-3 % infection rate high risk Increase preg rate Possibility of Treatment
Slide 39-

39 Tubal Factor Peristalsis Ciliary dysfunction Narrowing Blockage
Slide 40-

Endometriosis
Slide 41-

41 Endometriosis
Slide 42-

42 Lap / Dye
Slide 43-

43 Pelvic Infection and Tubal Disease
Slide 44-

44 Septate uterus
Slide 45-

Cervical Factor Postcotial test (Sims-Huhner) Intercourse (2-12 hrs) for test Look at: pH, Sperm, Spinnbarkeit, Ferning Cellularity, Sperm Shaking, sperm Agglutanation Has seen better days
Slide 46-

Ferning
Slide 47-

Unexplained infertility 15-25 % of infertile couples will have a completely normal workup
Slide 48-

Treatment of Infertile
Slide 49-

Emotional Impact Infertility places a great emotional burden on the infertile couple. The quest for having a child becomes the driving force of the couples relationship. The mental anguish that arises from infertility is nearly as incapacitating as the pain of other diseases. It is important to address the emotional needs of these patients.
Slide 50-

Therapy Male factor Urology consult Surgery Donor sperm insemination Intrauterine insemination (IUI) In Vitro Fertilization- Embryo Transfer (IVF-ET) IVF with ICSI (intracytoplasmic sperm injection)
Slide 51-

Anovulation Clomiphene citrate Antiestrogen Combines and blocks estrogen receptors at the hypothalamus and pituitary causing a negative feedback Increases FSH production stimulates the ovary to make follicles
Slide 52-

52 Ovulation Induction PCOS 1st line Clomiphene – 60% pregnant after 6 months 2nd line Metformin FSH Surgical Ovarian Drilling
Slide 53-

53 Ovarian Drilling
Slide 54-

54 Ovarian Induction Hypothalamic amenorrhoea FSH Pulsatile GnRH Hyperprolactinaemia Carbergolide
Slide 55-

treatment - with estrogen has been observed to lower elevated - FSH levels in women with POF, - donor oocytes POF
Slide 56-

Superovulatory Medications If no response with clomid then gonadotropins- FSH (e.g. pergonal) can be administered intramuscularly This is usually given under the guidance of someone who specializes in infertility This therapy is expensive and patients need to be followed closely Adverse effects Hyperstimulation of the ovaries Multiple gestation Fetal wastage
Slide 57-

Anatomic Abnormalities Surgical treatments Septoplasty Tuboplasty Myomectomy Surgery may be performed laparoscopically hysteroscopically If the fallopian tubes are beyond repair one must consider in vitro fertilization
Slide 58-

Myoma resection
Slide 59-

Septal resection
Slide 60-

Tubal cannulation
Slide 61-

61 Endometriosis
Slide 62-

Assisted Reproduction Indications for ART: Tubal disease Male-factor infertility Endometriosis Premature ovarian failure Polycystic ovarian syndrome Immunologic infertility Unexplained infertility
Slide 63-

63 IVF (In Vitro Fertilisation) ICSI (Intra Cytoplasmic Sperm Injection)
Slide 64-

Assisted Reproduction: Cryopreservation Freezing, thawing and using: Sperm Embryos Oocytes
Slide 65-

65 Treatment Options
Slide 66-

From the lowest highest We choose IUI IVF ICSI Clinical therapy
Slide 67-

IUI----intrauterine insemination Send sperms directly into the uterine cavity First choice for male immunological infertility
Slide 68-

IUI
Slide 69-

69 Intrauterine Insemination Indications Unexplained Mild male factor Success/Cycle Natural 10-15% Stimulated 15-20%
Slide 70-

IVF---- in vitro fertilization Not only overcomes the difficulty of AsAb-attached sperms penetrating the cervical mucus, but also make sure there are enough sperms contacting with ovum.
Slide 71-

IVF
Slide 72-

72 In Vitro Fertilisation Indications Prolonged unexplained Tubal factor Severe male factor
Slide 73-

ICSI----intracytoplasmic sperm injection The most effective method for severe immunological infertility But with the highest cost tens of thousands of dollars!
Slide 74-

Intracytoplasmic Sperm Injection(ICSI)
Slide 75-

Complications Multiple pregnancy Ovarian hyperstimulation syndrome (OHSS) Ovaries may enlarge and cause pain and bloating Higher risk in PCOS women Bleeding or infection Low birth weight Birth defects
Slide 76-

THANK YOU