On this page you can find interesting topics in the field of Infertility.

INFERTILITY,  KEY TERMS AND DEFINITIONS

Artificial Insemination.

Method to place sperm in the female reproductive tract by means other than sexual intercourse. If the sperm are from the husband, the technique is called artificial insemination husband (AIH). If the sperm are from another man, the method has been called artificial insemination donor (AID). Other terms are donor insemination and therapeutic donor insemination (TDI). >>more

Infertility 

Infertility is defined as failure of a couple of reproductive age to conceive after 12 months or more of regular coitus without using contraception. Infertility is considered primary when it occurs in a woman who has never established a pregnancy and secondary when it occurs in a woman who has a history of one or more previous pregnancies. Fecundability is defined as the probability of achieving a pregnancy within one menstrual cycle. It is estimated that 10% to 20% of couples are infertile. >> more

Male infertility

Male infertility factor accounts for 30% or more of all causes encountered in the evaluation of couples. Therefore evaluation of the male partner should begin at the same time as the female partner. Invasive or expensive diagnostic procedures or therapies for female infertility should not be pursued until the male has been evaluated. It is common for couples to have both male and female factors contributing to their subfertility. >> more

Sexual Dysfunction 

Almost two-thirds of the women may have had sexual difficulties at some time. Fifteen percent of women experience pain with intercourse, 18-48% experience difficulty becoming aroused, 46% note difficulty reaching orgasm, and 15-24% are not orgasmic. >> more

Ovulation detection methods

Menstrual history is often all that is required. A well-documented clinical diagnosis of oligomenorrhea or amenorrhea warrants therapy without further testing. Conversely, while clinical symptoms of ovulation such as mittelschmerz (midcycle discomfort associated with ovulation) and moliminal signs are reassuring, more objective data are necessary to confirm ovulation. >> more

Anovulation and The Polycystic Ovary

Who Should Be Tested for Hyperinsulinemia?

Do all anovulatory patients require testing for hyperinsulinemia? Both lean and obese women with polycystic ovaries can be found to have hyperinsulinemia, but not all hyperandrogenic women withpolycystic ovaries (lean and obese) have hyperinsulinemia.  However, it is more common and severe in overweight women and androgenic effects are more intense. Furthermore, lean women with hyperinsulinemia do not appear to have the same risk of future diabetes mellitus, although clinical follow-up may in time document an onset later in life of noninsulin-dependent diabetes mellitus compared to an earlier onset in obese women. >>more

MANAGEMENT OF HYPERPROLACTINEMIA

Expectant Treatment

Women with radiologic evidence of a microadenoma or functional hyperprolactinemia who do not wish to conceive may be followed without treatment by measuring prolactin levels once yearly. Many of these women have deficient estrogen, and low estrogen levels in combination with hyperprolactinemia have been shown to be associated with the early onset of osteoporosis. If the woman has low estrogen levels, exogenous estrogen should be administered. Either replacement estrogen-progestin therapy, as is used for postmenopausal women, or oral contraceptives can be utilized. Corenblum and Donovan reported that a group of women with both functional hyperprolactinemia and prolactin-secreting pituitary microadenomas who were treated with either cyclic estrogen and progestin or oral contraceptives for several years did not have an increase in the size of the adenomas or a marked increase in prolactin levels. Mean prolactin levels actually declined with both treatment regimens. >>more