General Infertility Diagnosis & Treatment 2014

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Information about General Infertility Diagnosis & Treatment 2014

Published on February 19, 2014

Author: rrckc


PowerPoint Presentation: General Infertility Diagnosis & Treatment Definition of Infertility:  Definition of Infertility The inability to conceive after one year of unprotected intercourse. Diagnostic evaluation should be considered prior to one year for the following indications: Women over the age of 35 History of irregular periods Uterine fibroids Endometriosis Pelvic Adhesive Disease Ectopic Pregnancy Recurrent pregnancy loss Known history or carrier of any genetic disease Male factor- surgery, infection, trauma, cancer therapies Causes of Infertility for Couples:  Causes of Infertility for Couples Causes of Infertility:  Causes of Infertility Male Factor (problems with sperm or ejaculation) Tubal factor (problems with the fallopian tubes) Ovarian factor (problems with ovulation) Diminished ovarian reserve (problems with egg quality or quantity) Age-related infertility Endometriosis Uterine polyps/fibroids Endocrine disorders Obesity/Elevated Body Mass Index (BMI) Chromosomal/Genetic Disease Unexplained Infertility Facts:  Infertility Facts One in six couples experiences difficulty conceiving. Medical evaluation & treatment will identify & address infertility problems in almost every case. For one-half of infertile couples, long-established medical therapies or surgical treatment will successfully treat the problem. Others may need advanced treatment such as IVF or Assisted Reproductive Technology (IVF/ART). Initial Consultation : Initial Consultation At your first visit you will meet with a Nurse Practitioner, Physician’s Assistant, or Registered Nurse to discuss your history. You will be provided with information about the general fertility evaluation. Our physicians will evaluate each couple. A financial counselor will meet with you to discuss costs & insurance matters. Counseling services & resources for stress management/coping strategies are offered. What It Takes To Become Pregnant: What It Takes To Become Pregnant Ovulation – Eggs must have the ability to mature & be released on a regular, predictable monthly basis. Sperm – Adequate numbers of normal sperm must be able to travel to the upper part of the reproductive tract & into the fallopian tubes. They must have the integrity to penetrate & fertilize an egg. Uterus – The uterine cavity must be normal, allowing for implantation & carrying a pregnancy to term. Basic Evaluation: Basic Evaluation Male Semen Analysis Female Assessment of Ovulation/Ovarian Reserve Testing (Oocyte/egg quality) Evaluation of the Uterus & Fallopian Tubes Initial Consultation: Initial Consultation The female evaluation includes: Medical history- Medical conditions & treatment, surgeries, pregnancies, & prior fertility testing/treatment Social history- Occupation & lifestyle habits Family history- Medical, inherited/genetic disorders Complete physical & pelvic examination Tranvaginal ultrasound- Evaluation of uterus & ovaries. Antral follicle count (AFC) to aid in determination of fertility potential Laboratory testing- Screen for rubella immunity & infectious disease, thyroid function (TSH), & ovarian reserve testing (AMH, FSH, Estradiol) Initial Consultation: Initial Consultation The male evaluation includes: Medical history- Medical conditions & treatment, reproductive history, infections, surgeries, prior fertility testing & treatment Social history-occupation & lifestyle habits Family history- Medical, inherited, or genetic disorders Semen analysis Laboratory testing – to include evaluation for infectious diseases & other clinically indicated studies Goals of the Initial Consultation:  Goals of the Initial Consultation Identify the potential cause of your infertility. Determine any additional testing that may be needed to assist in determining your diagnosis & treatment plan. Discuss a preliminary diagnosis, treatment options, & probability of success. Common Diagnostic Tests: Common Diagnostic Tests Ovarian reserve testing- Follicle Stimulating Hormone (FSH) & Estradiol (E2) drawn on day 2, 3, or 4 of the menstrual cycle, & Antimullerian Hormone (AMH) Blood type, Vitamin D level, thyroid function Glucose levels, liver function, & lipids Genetic testing to screen for genetic disorders such as cystic fibrosis, sickle cell disease, spinal muscular atrophy, & other lesser known genetic diseases Chromosomal studies Other Common Diagnostic Tests:  Other Common Diagnostic Tests Hysterosalpingogram- (HSG) a radiologic study performed our physician to assess the uterine cavity and to evaluate tubal patency Sonohysterogram- (SHG) an ultrasound study with the use of saline solution performed by our physician to assess the uterine cavity Hysterosalpingogram:  Hysterosalpingogram Sonohysterogram:  Sonohysterogram Treatment of Infertility Varies with the Diagnosis:  Treatment of Infertility Varies with the Diagnosis Ovulatory Dysfunction Tubal/pelvic problem Male factor Uterine/cervical factors Unexplained infertility Common Treatment Options:  Common Treatment Options OVULATION INDUCTION Oral or injectable medications - used to correct or enhance ovulatory function. Medications are usually started on day 3 of a menstrual cycle. Vaginal ultrasound & hormone levels - used to monitor the ovarian response to medications. Determine when ovulation will occur. Aid in timing intercourse &/or Inseminations (IUI) . Fertility Treatment:  Fertility Treatment Oral medications- Clomiphene citrate- Clomid/Serophene Letrozole- Femara Injectable gonadotropins- (FSH/LH) Follistim, Gonal f, Menopur, Bravelle Ovulation trigger- Ovidrel, HCG Intrauterine Insemination :  Intrauterine Insemination Initial Consult/Plan Development:  Initial Consult/Plan Development We will review information obtained in the visit & through testing to hopefully identify the cause of your infertility. We will carefully review the plan for any additional testing & the treatment protocol outlined for you. We will discuss your diagnosis, other treatment options, & inform you of your probability of success and per cycle conception rates. Conclusion:  Conclusion We hope that this information has prepared you for your initial consultation & has provided you with a general understanding of the fertility evaluation. We look forward to meeting with you to discuss treatment strategies & to answer any additional questions that you may have regarding your evaluation & treatment. :  You are your own best advocate! Ask & Understand We look forward to seeing you soon!

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