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7/28/2019 Causes of Inferlity in WomenCauses of Infertility in Women
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Inability to conceive despite tryinghaving regular intercourse forone ye
causes could be due to female fac
male factors
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Causes InWomen
Cervical
Tubal
Uterine
Ovarian
Endometriosis
Unexplained
Age
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Laser conization- low secre
Anti-Sp
Blockage of the vagina
Imperforate hymen
Extremely narrow vagina
Painful infections in the vagina
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Uterine Causes
Infertility inWomenCongenital
Asherman Syndrome
Fibroids
Fibrosis
Endometrial Polyps
Adenomyosis
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Treatment:
Hysteroscopic resection o
adhesions can be done bu
need multiple sessions, in
to giving steroids with est
three weeks after surgery
recurrence.
Asherman Syndrome:
Intra uterine adhesion
(srepeated curettage, severe
endometritis, scars of uterine
surgery). Decreased amount of blood
loss during menstruation.
Can be diagnosed easily using
hysterosalpingogram.
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Fibroids:
Benign uterine tumor .
Adenomyosis They usually do not causeinfertility unless it affects the intrauterine cavity in
an obvious way, but if no other reason for infertility
can be found, it is better to do myomectomy
(excision of the fibroid ) and restore the
intrauterine cavity.
Myomectomy can be done either by Hysteroscopic
resection or by laparotomy
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Endometrial polyp: Its presence mimics IUCD, polyps can be diagnosed
ultrasound or hysteroscopy then polypectomy (removing the polyp) can
easily.
Adenomyosis: Symptoms include secondary dysmenorrhea, some horm
treatments could be helpful e.g. GNRH analogues, or Danazol, the decis
treatment should be taken by the treating physician.
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Chronic Pelvic
Infections
Fimbral End
Destruction
Adhesions
Short tub
Tubal Tumors
Tubal Cause Of Infertility
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Chronic Pelvic Infections:
Cause tubal congestion.
Obstruction (>3cm ) results in impeding of the oocyte
transfer, May result in pelvic adhesions that will affect tubal
movement.
Slowing it so inappropriate time for oocyte transfer interferes
with fertilization.
Tubal occlusion or pelvic adhesions that cause inability for
the fimbrial ends to catch the oocyte from the ovary or as
mentioned before abnormal movement of the tubes and
oocyte transfer. Causes for PID include infections with E.coli, or Gonococcus
infection (STD) PID affects ovarian function and tubal
movement
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Destruction of the fimbrial ends : Disabling its function
in catching oocytes into the tubes, PID or endometriosis
can cause this.Adhesions: Caused by tubal surgery done for ectopic
pregnancy, pelvic surgery done to the tubes or due to
appendicitis.
Tubal Tumors affecting it's function.
Short tubes (less than 4cm).
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Polycystic Diseases
Functional Failure
Pituitary Failure
Endocrino
Hypothalamic Fa
Ovarian Dysfunction
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Polycystic ovarian disease:
have what is called polycys
involves having follicles con
than the normal condition.
woman has normal fertili
associated with some condit
polycystic ovarian syndro
pathological.
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Women with e tubal occlusion
Male abnormal semen analysis
Women with PCOD will need IVF, should be individualized
Treatment of hormonal imbalance is the best thing
Recurrent abortions in PCO:
Increased LH level
Control before starting induction of ovulation.
Ovarian diathermy lowers LH
lower recurrent miscarriages w
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Congenital: Genetic and chromosomal causes
Ovarian agenesis. Hereditary causes for accelerated loss of ovarian
reserve.
Familial premature ovarian failure.
Chromosomal abnormalities (47XXX).
Exposure to certain factors:
Large amount of radiation exposure.
Chemotherapeutic agents as in cancer
treatment.
Viruses such as mumps.
Heavy smoking.
Congenital : enzymatic dy
17- Hydroxylase Defici
Galactosemia.
Extras :
Autoimmune causes: Preantibodies.
Lack of (or dysfunction)
ovarian receptors.
Idiopathic causes.
Surgical oopherectomy.
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Secondary disorder of Gonadotro
Regulation:
1. High prolactine level
2. Pituitary adenoma
3. Idiopathic hypothyroidism
4. side effect to medication
5. Suprapituitary Tumors
6. Pituitary Tumors, trauma such
7. Radiation exposure to the pitu
8. Idiopathic causes.
LH and FSH gonadotrophin Defici
1. Pituitary tumors.
2. Destructive pituitary lesion.
3. Pituitary ablation.
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Causes :
Rapid and sudden increase or decrease
weight.Severe psychological and neurological st
strenuous exercises.
Radiation exposure.
Medications that cause hypothalamic fa
Tumors.
Unknown causes.
Endocrinopathy
Adrenal gland dysfunction
Thyroid gland problems.
Hypothyrodism
Pancreatic problems ww
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"Endometriosis Is Presence of Endometrial Tissues Outside Endom
Affects pregnancy either by forming chocolate cyst
(endometrioma) or by causing adhesions.
Diagnos -Laparoscopy
Treatment:
Laparoscopic adhesiolysis,
Cauterization of endometriotic spots,
Salpingostomy and reanastomosis of fallopian tube problems.
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Hypotheses
Stress and worries changes in internal hormones ,decre
secretions or muscular spasm, including those lining fallopian
its obstruction, or muscles lining the vagina causing dyspareun
Stress also has its effects on the hypothalamus and ovarian fu
Couple seeking pregnancy to try, as much as possible, to allevia
worries and have trust in god and trust their treating ph
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Amman, Jordan
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