Gynaecology

Jun 13th, 2016
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The most comprehensive notes on infertility in human beings

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INFERTILITYObjectivesUnderstand the causes of infertilityInternalize the psychosocial effects of infertilityUnderstand the various modes of managementDefinitionsInfertility Inability of a couple to conceive in 1year (sub-fertility)Sterility Intrinsic inability to achieve pregnancyFecundity Probability of achieving a life birth in one menstrual cycle.Fecundability likely hood of conception per month of exposureEpidemiologyPrevalence 13% (range between 7- 28%)Normal fertile couples with frequent intercourse, fecundability (20 25%)Approximately 90% of couples with unprotected sex will have a pregnancy within 1 year.Sterility affects 1 2% of couplesEtiologyIn 80% of cases foundIn 15 20 of cases cause not foundMale factor alone causes about 25%.CAUSES OF INFERTILITYMALEEndocrine disordersHypothalamic dysfunctionHyperprolactinaemia (drug, tumor)Pituitary failure (tumors, radiation, surgery)Exogenous androgensThyroid disordersAdrenal hyperplasiaAnatomic disordersCongenital absence of vas deferensCongenital abnormalities of ejaculatory systemObstruction of vas deferensAbnormal spermatogenesisChromosomal abnormalitiesMumps orchitisCryptorchidismChemical or radiation exposureAbnormal motilityAbsent ciliaAntibody formationVaricocoeleSexual dysfunctionRetrograde ejaculationDecreased libidoImpotence1Premature ejaculationPenile abnormalities e.g

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