Infertility

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The Internet has, without question, assumed a place in the life of most physicians and many patients. Though users vary in skill of use and sophistication of inquiry, some issues are common to all. The quandary about which websites may safely be trusted is one such issue. Health website quality guidelines, easily accessed on the Internet, aid users in their decisions.

The ubiquitous use of the World Wide Web to facilitate learning has been a benefactor of change, revolutionising the way in which education can be delivered and received. This technological advancement has woven together communities of learners and permitted access to huge repositories of information while eliminating distance as an obstacle to learning (Table I).

Ultra-fast freezing of ovarian tissue from women who have lost their fertility as a result of cancer treatment can lead to it being used in transplants with the same success rate as fresh tissue, a researcher told the 25th annual conference of the European Society of Human Reproduction and Embryology.

For the first time, researchers have been able to identify genetic predictors of the potential success or failure of IVF treatment in blood. Dr. Cathy Allen, from the Rotunda Hospital, Dublin, Ireland, told the 25th annual conference of the European Society of Human Reproduction and Embryology today (Wednesday 1 July) that her research would help understand why IVF works for some patients but not for others.

Ms Vanneste and her team studied each cell from 23 three or four day-old IVF embryos from young (less than 35 years old), fertile couples who had asked for preimplantation genetic diagnosis (PGD). PGD is carried out where one or both parents have a known genetic abnormality, in this case an X-linked disorder or the microdeletions (loss of a tiny piece of a chromosome) that can cause such disorders as the cancer predisposition syndrome neurofibromatosis type 1.

Survivors of childhood cancer run particular risks when pregnant and should be closely monitored, the 25th annual conference of the European Society of Human Reproduction and Embryology heard today (Wednesday 1 July). Dr. Sharon Lie Fong, of the Department of Obstetrics and Gynaecology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands, said that, although such women may have conceived spontaneously and considered themselves to be perfectly healthy, their deliveries should always take place in a hospital.

Making decisions is often one of the most difficult tasks you will face as an infertile couple. Should we stop treatment ? Should we consider adoption ? Should we switch doctors ? Should we move on to IVF ? How many embryos should we transfer ? Should we ask for an assisted hatch or a blastocyst transfer ?

The right to have a baby is something most of us take for granted , and we often lose sight of the fact that 1 in 10 married couples will not be able to have the child they want. Infertility is a very common problem , and if you stop to think about it, you will realize that you know at least one person who is infertile amongst your own group of friends or relatives. However, it remains one of those taboo topics which no one wants to talk about, even though it interferes with one of the most fundamental and highly valued human activities - building a family.

How can one go about empowering patients with information in developing countries which have limited resources ? A free public health library can provide information directly to patients, and encourage them to make their own decisions, in partnership with their doctor. It can also serve as a resource center for doctors, who can use it to develop their own patient educational materials.

Making IVF Affordable

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!

Surgical Sperm Retrieval

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)