RESUMO
The overall increase in relative survival rates of adult and childhood cancer patients is related to improved chemotherapy and radiotherapy treatment protocols. However, this success is tempered by gonadotoxic effects and uterine damage. The reduced fertility and possible premature menopause can have a profound impact on patients self-esteem and quality of life. Consequently, preservation of fertility or treatments to protect the ovarian function, become a more relevant issue. Advances in assisted reproduction techniques have focused on the following: embryo cryopreservation which is restricted by time and constrains such as, sexual maturity and the presence of a stable partner. Cryopreservation of immature ovarian tissue, the most promising option, with restoration of natural fertility following auto-transplantation or maturation of oocytes in vitro in combination with assisted reproduction.
Assuntos
Infertilidade Feminina/etiologia , Neoplasias/terapia , Criopreservação , Feminino , Humanos , OvárioRESUMO
Women rely on complete and precise information given by doctors and family planning consultants for choosing a suitable contraceptive. Available hormonal contraceptives in Switzerland are presented. Personal and family history are essential for evaluating medical contraindications to combined hormonal methods. Combined pills, vaginal hormonal rings and combined patches share the same contraceptive effects, contraindications and overall cardiovascular risks. Prescribers should prefer second generation pills because of lower risks of venous thromboembolic disease. Non oral methods are generally associated with improved compliance and in the case of vaginal rings, with fewer side effects. Progestogen only contraceptives (pills, implants and intrauterine devices) can be used in patients with known intolerance and/or contraindications to estrogens.
Assuntos
Anticoncepção , Anticoncepcionais Femininos , Serviços de Planejamento Familiar , Feminino , HumanosRESUMO
In the menstrual cycle, a slight elevation of plasma FSH levels, the inter-cycle FSH signal, initiates the 1st phase of follicular recruitment. In ovarian stimulation for IVF, exogenous FSH aims at increasing the amplitude of this signal while maintaining FSH levels elevated, in order to fool the natural mechanisms of single follicular dominance. Synchronization consists in maintaining plasma FSH levels low so that all recruitable follicles remain at a resting state, prior to inducing ovarian stimulation. Practically speaking, synchronization of ovarian follicles allows to optimize clinical efforts, reduces the risk of cyst formation and ultimately, helps improving IVF outcome.