妇产科学五年制大课课件之24不孕症与辅助生殖技术(英文)-鹿欣

4. Others: thyroid or adrenal dysfunction;
Pelvic factors 盆腔因素
1. Tubal factors:
injury, blockage, adhesion
2. Uterine factors:
cogenital anatomic abnormalities endometrium disorder, tumor
10-20 %
10 %
Ovulatory dysfunction 排卵障碍
1. Hypothalamic dysfunction;
2. Pituitary Insufficiency;
hypothalamus pituitary
ovary
3. Ovarian factor (peripheral defect);
Female Reproductive Physiology 女性生殖生理

1. 下丘脑-垂体-卵巢轴内分泌调节
Femal ( H-P-O)
Male (H-P-T)
hypothalamus pituitary
ovary
2. 卵巢周期性排卵 子宫 4. 4.
子宫
GnRH
FSH,LH
GnRH
FSH,LH
E/P ovary 3.输卵管
5. 宫颈 6. 下生殖道
T
Normal Gestation -----the beginning of human
Follopian tube Uterine
ovary Cervix Extra-genital tract
sperm
oocyte
Causes 原因
Causes Female factors Male factors Both male and female factors Immunologic unexplained factors Percentage 40 % 30-40 %
3. Cervical factors:
infection, cogenital abnormalities
4. Extra-genital tract factors;
infection, cogenital abnormalities

Etiology
Ovulatory dysfunction
20
30
40
50
60
70
Female conceiving
Risk of Smoking


Smoking Risk
Lung cancer Respiratory Heart disease Miscarriage Osteoporosis Ectopic pregnancy Infertility Early menopause


Other
PCOS=polycystic ovarian disease POF= premature ovarian failure PID= pelvic inflammatory disease


Male Factors 男方因素
Knowledge of Risk
99% 99% 96% 39% 30% 27% 22% 17%

Female Reproductive duct anatomy 女性生殖道解剖
Female
ovary 卵巢 fallopian 输卵管 uterus 子宫 cervix 宫颈 Vagina 阴道
Male Reproductive duct anatomy 男性生殖道解剖
Male
testis 睾丸 epididymis 附睾, prostate 前列腺 vas deferens 输精管 seminal vesicals 精囊 bulbourethral glands 尿道球腺 ejaculatory duct 射精管 urethra 尿道
Infertility and Assisted Reproductive Technologies 不孕症与辅助生殖技术
XIN LU Obstetrics & Gynecology Hospital Fudan University
Contents

Infertility Definition; Causes; Examinations and Diagnosis; Treatment; Assisted Reproductive Technologies (ART) ; Intrauterine insemination ( IUI); In vitro fertilization and embryo transfer (IVF-ET); Intracytoplasmic sperm injection (ICSI); Gamete intrafallopian transfer (GIFT);
Age and Infertility 年龄与不孕


age
Fertility rate per 1,000
fert百度文库lity abortion
11.9% 15.0% 24.6% 51.0%
<30 yr 74% 30-35 yr 62% >35 yr 54% >40 yr female male
10

Definition of Infertility 不孕症定义
Infertility is defined one year of unprotected intercourse without pregnancy. (WHO) Primary Infertility : no previous pregnancies 原发不孕 have occurred; Secondary Infertility: a prior pregnancy has 继发不孕 occurred;
Related Disorders
PCOS Hypothalamic-pituitary Age-related POF PID Congenital Leiomyomas Asherman syndrome Endometriosis



Tubal disease Uterine abnormalities