By Gab Kovacs
The absolutely revised and up to date moment variation of this useful guide presents complete insurance of all features of subfertility, together with therapy and prognosis. each one bankruptcy is written via a famous global professional within the box and, jointly, they target to supply state-of-the-art solutions to all of the difficulties of subfertility in one quantity. The introductory bankruptcy offers a flow-chart method of systematic prognosis and therapy. truly written and straightforward to learn, the following chapters describe what inquiries to ask, the best way to examine, and what every one remedy calls for. With an multiplied overseas workforce of authors, this new version additionally deals new chapters dedicated to 3rd celebration copy and in vitro maturation of oocytes. From clinical scholars learning for examinations to advisor physicians, this quantity is a 'must-have' reference for somebody facing who've fertility difficulties.
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Extra info for The Subfertility Handbook: A Clinician's Guide
Example text
There is a linear correlation between the estrogen level, the size of the dominant follicle and the endometrium thickness. Ultrasound monitoring usually starts two or three days before expected ovulation and is repeated every other day until ovulation criteria are obtained. Ultrasound features of ovulation are: * * * * collapse of the follicle with a decrease in the size complete disappearance of the follicle presence of fluid in the cul-de-sac multiple small echo-positive structures in the follicle (blood clots).
5 ml or more Total sperm number 39 million per ejaculate or more Sperm concentration 15 million per ml or more Vitality 58% or more live Progressive motility 32% or more Total (progressive + non-progressive) motility 40% or more Morphologically normal forms 4% 26 Chapter 3. The first interview with a new couple An abnormal semen analysis test should be repeated. This is because of its low specificity and high false positivity. Ideally, the second sample should be at least three months after the first analysis, which is the duration of the spermatozoa formation cycle.
The presence and position of constriction, fibrosis, nodularity, dilatation, endometriosis, and adhesions are described before injection of the dye. The fimbriae should be freely mobile, with full access to the whole ovarian surface and no agglutination of the folds or fimbriae themselves. Adhesions reduce fertility by impairing the movement оf the fimbriae over the ovarian surface and by inhibiting the normal muscle segmentation that assists gamete and embryo transport. The testing of tubal patency is performed by passing dye (methylene blue) via a cervical cannula into the uterine cavity and laparoscopically observing how it is flowing down the tube and out through the fimbria.