ABSTRACT
OBJECTIVE: Adenomyosis associated with subfertility is a situation of a dilemma for the treating clinician as the treatment is highly controversial and there remains an overall lack of consensus regarding the value of conservative surgery with or without medical management to improve reproductive out-comes. Hence we proposed this classification based on mapping of the size of adenomyoma, its location, distance from the endometrial cavity, and any associated endometriosis by studying 100 women with adenomyosis undergoing IVF. METHODS: We did a prospective study over 2 years in 100 women with adenomyosis who underwent IVF. They were classified into 4 categories based on our management-based proposed classification and the pregnancy outcomes were studied in each group. RESULTS: According to our classification, 56% of women belonged to grade 1, 24% to grade 2, 8% to grade 3, and 12% to Grade 4 Adenomyosis. The Pregnancy rates were 71% in Grade 1, 66% with Medical management, and 33% with surgical management in Grade 2, Grade 3 were offered surrogacy, and 66% in Grade 4 Adenomyosis. CONCLUSIONS: Our classification is simple and allows cost-effective management based on the location and ex-tent of the disease with the help of ultrasonography.
Subject(s)
Adenomyosis , Infertility, Female , Humans , Female , Adenomyosis/classification , Adenomyosis/complications , Adenomyosis/therapy , Infertility, Female/classification , Infertility, Female/therapy , Infertility, Female/etiology , Pregnancy , Adult , Prospective Studies , Reproductive Techniques, Assisted/classification , Pregnancy Rate , Fertilization in VitroABSTRACT
Postpartum anovulation is a natural process that is observed in most mammals, including women. In lactating dairy cows, the interval from calving to first ovulation typically averages 4 to 5 weeks, but a substantial proportion of cows have not resumed estrous cyclicity by 60 days postpartum. Extended delay in resumption of first postpartum ovulation is known to exert long-lasting detrimental effects on fertility in dairy cows including the lack of spontaneous estrus and subsequent timely insemination postpartum, but when anovular cows have the estrous cycle synchronized for artificial insemination (AI), still pregnancy per AI is reduced and the risk of pregnancy loss increased. Many risk factors exist for extended postpartum anovulatory periods such as negative nutrient balance and diseases, and these risk factors are also known to depress fertility by themselves. A key feature in anovular cows when inseminated is that they develop the ovulatory follicle under subluteal or low concentrations of progesterone. Progesterone from the corpus luteum is pivotal for follicle development, oocyte competence, embryo growth, and endometrial function; however, many of these effects exerted by progesterone are mediated either by secretion of gonadotropins influencing follicular function and oocyte competence or by endometrial histotroph secretion influencing embryo/conceptus growth and developmental biology
Subject(s)
Female , Animals , Cattle , Cattle/embryology , Infertility, Female/classification , Infertility, Female/complications , Infertility, Female/diagnosis , Ovulation , ProgesteroneABSTRACT
Postpartum anovulation is a natural process that is observed in most mammals, including women. In lactating dairy cows, the interval from calving to first ovulation typically averages 4 to 5 weeks, but a substantial proportion of cows have not resumed estrous cyclicity by 60 days postpartum. Extended delay in resumption of first postpartum ovulation is known to exert long-lasting detrimental effects on fertility in dairy cows including the lack of spontaneous estrus and subsequent timely insemination postpartum, but when anovular cows have the estrous cycle synchronized for artificial insemination (AI), still pregnancy per AI is reduced and the risk of pregnancy loss increased. Many risk factors exist for extended postpartum anovulatory periods such as negative nutrient balance and diseases, and these risk factors are also known to depress fertility by themselves. A key feature in anovular cows when inseminated is that they develop the ovulatory follicle under subluteal or low concentrations of progesterone. Progesterone from the corpus luteum is pivotal for follicle development, oocyte competence, embryo growth, and endometrial function; however, many of these effects exerted by progesterone are mediated either by secretion of gonadotropins influencing follicular function and oocyte competence or by endometrial histotroph secretion influencing embryo/conceptus growth and developmental biology (AU)
Subject(s)
Animals , Female , Cattle , Infertility, Female/classification , Infertility, Female/complications , Infertility, Female/diagnosis , Cattle/embryology , Ovulation , ProgesteroneABSTRACT
Se ofrece la experiencia adquirida y los resultados obtenidos en el diagnóstico de este tipo de infertilidad en los últimos 5 años, en 416 pacientes. Se encuentra un total de 111 pacientes con factor orgánico como única causa de infertilidad, para el 26,6%, y 53 pacientes con factor orgánico asociado a otros factores funcionales, para el 12,7%, lo que hace un total de 164 pacientes, para el 39,5% en que dicho factor estaba presente. Se señala que el factor tubárico presenta el 27,3% y el factor tuboperitoneal el 16,8%; ambos presentan el 44,1%. Se analiza la interrupción de embarazo como un antecedente importante en la producción de infertilidad absoluta de causa orgánica
Subject(s)
Infertility, Female , Infertility, Female/classification , Infertility, Female/diagnosisSubject(s)
Fertilization in Vitro , Ovulation Induction , Infertility, Female/classification , Infertility, Female/physiopathology , Infertility, Female/chemically induced , Infertility, Female/metabolism , Infertility, Male/surgery , Infertility, Male/classification , Infertility, Male/diagnosis , Infertility, Male/physiopathology , Infertility, Male/therapySubject(s)
Infertility, Female/classification , Infertility, Female/physiopathology , Infertility, Female/chemically induced , Infertility, Female/metabolism , Ovulation Induction , Fertilization in Vitro , Infertility, Male/surgery , Infertility, Male/classification , Infertility, Male/diagnosis , Infertility, Male/physiopathology , Infertility, Male/therapyABSTRACT
Factores hormonales del ciclo menstrual. Trastornos de la menstruación, amenorrea y hemorragia uterina:clasificación, fisiopatología y terapéutica. Esterilidad femenina y masculina. Factores endócrinos, diagnóstico y tratamiento
Subject(s)
Menstruation Disturbances , Infertility, Female , Amenorrhea/classification , Amenorrhea/diagnosis , Amenorrhea/etiology , Menstrual Cycle , Menstruation Disturbances/classification , Menstruation Disturbances/complications , Menstruation Disturbances/diagnosis , Menstruation Disturbances/etiology , Menstruation Disturbances/therapy , Menstruation Disturbances/drug therapy , Uterine Hemorrhage/classification , Uterine Hemorrhage/diagnosis , Uterine Hemorrhage/etiology , Infertility, Female/classification , Infertility, Female/diagnosis , Infertility, Female/physiopathology , Infertility, Male/classification , Infertility, Male/diagnosis , Infertility, Male/etiology , Menstruation , Premenstrual Syndrome/diagnosis , Premenstrual Syndrome/physiopathology , Premenstrual Syndrome/drug therapyABSTRACT
Factores hormonales del ciclo menstrual. Trastornos de la menstruación, amenorrea y hemorragia uterina:clasificación, fisiopatología y terapéutica. Esterilidad femenina y masculina. Factores endócrinos, diagnóstico y tratamiento