Infertility

Evidence supporting a role for estrogen in male reproductive tract development and function has been collected from rodents and humans. These studies fall into three categories: i) localization of aromatase and the target protein for estrogen (ER-alpha and ER-beta) in tissues of the reproductive tract; ii) analysis of testicular phenotypes in transgenic mice deficient in aromatase, ER-alpha and/or ER-beta gene; and, iii) investigation of the effects of environmental chemicals on male reproduction.

Central to any consideration of techniques in the IVF lab is the quality of the gametes that the lab has to work with. Usually there is little opportunity to modify the basic quality of sperm, however, the oocyte is a direct biological end product of ovarian super-ovulation as commonly conducted in human IVF therapy.

Plasma Homocysteine, Fasting Insulin, and Serum Androgens as a Function of Sonographic Ovarian Features in Women Feferred for Infertility Assessement

The first thing that usually comes to mind when people hear the term, "infertility treatment," is the risk of multiple births. This worry has been fueled by the recent highly publicized multiple births in Iowa and Texas.

Our guest editor for this issue of Gynaecology Forum is Hans van der Slikke, who was also guest editor for the last issue of Gynaecology Forum concerned with the Internet in 2000. I typed that editorial on my PC and emailed the draft to the publishers.

Much has changed in the World Wide Web in the 3 years since the first Internet issue of Gynaecology Forum (www.obgyn.net/medforum.asp) was published in September 2000. At that time it was still necessary to cover the history of the Internet and explain the requirements needed to access it.

Suppose you want to find a good website about gynaecology and/or obstetrics and you try the search engine Google, you will get 1,060,000 hits for gynaecology and 1,260,000 for obstetrics. Both give as the first link www.obgyn.net, ‘the Universe of Women’s Health’.

Jorge Amado, a Brazilian writer, once remarked: ‘The common bond in Latin America is poverty; there are very few cultural bonds’.

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.

In 1935 Drs Stein and Leventhal described 7 women with irregular periods (oligomenorrhea), increased body hair (hirsutism) and obesity, who at the time of surgery were found to have enlarged ovaries with a smooth "pearly white" appearance.

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).

Dutch researchers find first evidence that female human embryos adjust the balance of X chromosomes before implantation in the womb. Results have implications for in vitro fertilisation and embryonic stem cell research

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.

High levels of cycling training damage sperm – what can be done to protect triathletes from infertility? The high-intensity training undertaken by triathletes has a significant impact on the quality of their sperm.

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.

Twin deliveries after assisted reproductive technology (ART) have fallen below 20% for the first time in Europe according to the tenth report summarising data on ART in Europe, which was presented at the 25th annual meeting of the European Society of Human Reproduction and Embryology in Amsterdam today (Wednesday).

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.

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.