DOCSLIB.ORG

What You Should Know About Infertility

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
What You Should Know About Infertility PATIENT HANDOUT What You Should Know About Infertility toxic substances can also impair fertili- f you and your partner have been trying to get pregnant for a year or ty. Your health care provider can longer, chances are that one or both of you may have fertility prob- explain these conditions and how they lems. Infertility is a common reproductive health problem, affecting can affect your fertility. I more than 6 million American couples—about 10% of the population Endometriosis is found in about who are in their reproductive years. The stress of infertility and its treatments 35% of infertility cases. This condition is overwhelming. Learning as much as possible can help to make the stress occurs when tissue that makes up more manageable. the lining of the uterus grows outside the uterus, usually on the ovaries or the lining of the abdomen. This mis- What Is Infertility? problems from both partners. placed tissue can cause scarring and Infertility is defined as the inability to Female Infertility.—About 35% of inflammation. The connection conceive a child within 1 year of having female infertility problems are caused by between endometriosis and infertility unprotected sexual intercourse. The damaged or blocked fallopian tubes. is not completely understood. process of conception is fairly complex. Tubal inflammation (salpingitis), usually Endometriotic cysts in the ovary Hundreds of variables must occur in a caused by the sexually transmitted dis- are often associated with infertility. precise manner for conception to occur ease chlamydia, can cause scarring in Also, the scar tissue formed by and for the pregnancy to continue suc- the fallopian tubes. This can block or endometriosis around the ovaries and cessfully for 9 months. When just one damage the tubes and prevent the fer- fallopian tubes may prevent the egg variable is impaired, it can cause infertili- tilized egg from getting to the uterus. from reaching the fallopian tubes. ty. Even the most fertile couple has only Tubal inflammation and infection may Certain medications, thyroid prob- a 20% to 25% chance of getting preg- go unnoticed, or may cause pelvic pain, lems, cancer and its treatment, and nant in any given month. unusual vaginal discharge, or fever. chronic medical conditions such as Ovulation disorders account for diabetes and lupus can also cause What Causes Infertility? approximately 25% of infertility cases fertility problems in women. Infertility may be caused by a single fac- in women. Ovulation is regulated by Male Infertility.—More than 90% of tor either in you or your partner, or a the hypothalamus and pituitary gland male infertility cases are caused by combination of factors that may prevent in a woman’s brain, along with the sex abnormal sperm production or func- conception or continuation of a preg- hormones, luteinizing hormone and fol- tion and problems in sperm delivery. nancy. About one third of cases are licle-stimulating hormone. Any disrup- Other conditions that can affect male caused by problems that affect men, tion in the communication among fertility include a man’s general health while one third can be attributed to these components can cause prob- and life-style (cigarette smoking, alco- problems that affect women. One third lems with ovulation. The most com- hol consumption, and substance of cases are due to a combination of mon symptoms of ovulation problems abuse), exposure to toxic substances, are irregular or absent menstrual peri- and testicular exposure to excessive ods. Other conditions that can interfere heat such as frequent use of hot tubs This Patient Handout was prepared by with ovulation include elevated levels of or saunas, which can hinder sperm Amanda J. Bach using materials from the hormone prolactin (the hormone production. the American Society for Reproductive that stimulates production of breast Medicine (http://www.asrm.org), the National Women’s Health Resource milk), polycystic ovary syndrome, and When Should I Seek a Center (http://www.healthywomen.org), early menopause. Benign uterine Medical Consultation? and the Mayo Clinic (www.mayoclinic.com). fibroids, pelvic adhesions, general If you and your partner have no known health and life-style, and exposure to reproductive health problems and have The Female Patient grants permission to reproduce this handout for the purpose of patient education. 1/05 Infertility not been able to conceive for 12 How Is Infertility Treated? Resources months, you should seek medical help. Treating your infertility will depend on Consider talking with a reproductive its cause, how long the problem has Association of Reproductive endocrinologist (a doctor who special- existed, your age and your partner’s Health Professionals izes in infertility) if you are age 35 years age, and what you are willing to do. (http://www.arhp.org) or older and have not been able to con- Fertility treatments make pregnancy American Society for ceive after several months of trying; possible for many couples who seek Reproductive Medicine have irregular menstrual cycles; known treatment. (http://www.asrm.org) fallopian tube problems; a history of Most infertility cases are treated miscarriage; a medical condition (such with fertility drugs or surgery to repair National Women’s Health as diabetes) that can cause fertility reproductive organs. Fertility drugs Resource Center problems; or if your partner has a are used to regulate ovulation by cor- (http://www.healthywomen.org) sperm deficiency or abnormality. recting hormonal imbalances or to International Council stimulate the normal process of ovu- on Infertility Information How Is Infertility Diagnosed? lation. Fertility drugs are injected or Dissemination For both partners, the standard infer- taken in pill form, and they can cause (http://www.inciid.org) tility evaluation should include a med- physical and emotional side effects. ical history and physical examination Your health care provider can discuss to rule out any underlying medical with you how different fertility drugs in which a single sperm is injected conditions that may be affecting fertili- work, any possible risk factors, and into a single egg and the resulting ty, as well as blood tests to determine other concerns you may have about embryo is placed in your uterus. hormone levels. A man’s evaluation fertility drug treatments. Sometimes, with IVF or ICSI, a proce- also will include a semen analysis to In-vitro fertilization (IVF) is another dure called assisted hatching is used count the number of sperm and to widely used type of infertility treat- to improve embryo implantation in the detect any abnormalities in the shape ment. In-vitro fertilization procedures uterus. Before the embryo is trans- or movement of the sperm. A involve the handling of eggs and ferred to the uterus, its outer covering woman’s evaluation also will include sperm outside the body in a laborato- is thinned with a special solution to confirmation of ovulation and a hys- ry, and often are used together with make it easier for the cells of the terosalpingogram. This is an X-ray of fertility drugs. In vitro fertilization, or embryo to emerge and implant in the the uterus and fallopian tubes that is IVF, is the most commonly used form wall of the uterus. Other ART options used to identify any blockage or other of assisted reproductive technology are available such as using donor problems. Laparoscopy is another (ART), resulting in about 45,000 births eggs or donor sperm with IVF or procedure used to diagnose the pos- each year in the United States. First, other procedures, or surrogacy, when sible cause of infertility. A thin, lighted you take fertility drugs to ensure you the fertilized egg is placed into anoth- viewing device called a laparoscope is have enough eggs for the procedure; er woman’s uterus and she carries inserted through a small incision in then the eggs are removed from your the pregnancy to term. the abdomen to examine the uterus, ovaries and combined with sperm in a ovaries, and fallopian tubes for abnor- laboratory dish. If fertilization occurs, Coping With Infertility malities or scarring. Endometriosis is the resulting embryos are transferred Infertility causes emotional, physical, commonly found using laparoscopy. into your uterus. Gamete intrafallopian and financial stress that most couples Unexplained Infertility.—For about transfer, or GIFT, is similar to IVF, but aren’t prepared to deal with. You and 10% to 15% of couples, a specific the combined eggs and sperm are your partner will experience a lot of reason for their infertility is not found. immediately placed into your fallopian unfamiliar and uncomfortable feelings A diagnosis of unexplained infertility is tubes so fertilization can occur natu- during this time, and it is important to made when all other causes have rally. Zygote intrafallopian transfer, or understand that the feelings you have been ruled out by the standard infer- ZIFT, is similar to GIFT, but fertilization are real and natural reactions to infertility tility examination of both the man and is ensured before the zygote is trans- and the stress of treatment. Do not woman. This does not mean that ferred to your fallopian tubes. hesitate to seek counseling and let there is no reason for their infertility; it Intracytoplasmic sperm injection, or those caring for you give you the sup- means that the reason is not known. ICSI, is a highly specialized procedure port you need. 1/05 The Female Patient grants permission to reproduce this handout for the purpose of patient education. .
Load more

Recommended publications
  • Infertility Diagnosis and Treatment
    UnitedHealthcare® Oxford Clinical Policy Infertility Diagnosis and Treatment Policy Number: INFERTILITY 008.12 T2 Effective Date: July 1, 2021 Instructions for Use Table of Contents Page Related Policies Coverage Rationale ....................................................................... 1 • Follicle Stimulating Hormone (FSH) Gonadotropins Documentation Requirements ...................................................... 2 • Human Menopausal Gonadotropins (hMG) Definitions ...................................................................................... 3 • Preimplantation Genetic Testing Prior Authorization Requirements ................................................ 3 Applicable Codes .......................................................................... 3 Related Optum Clinical Guideline Description of Services ................................................................. 3 • Fertility Solutions Medical Necessity Clinical Benefit Considerations .................................................................. 7 Guideline: Infertility Clinical Evidence ........................................................................... 8 U.S. Food and Drug Administration ........................................... 14 References ................................................................................... 15 Policy History/Revision Information ........................................... 18 Instructions for Use ..................................................................... 18 Coverage Rationale See Benefit Considerations
    [Show full text]
  • Recurrent Miscarriage
    Elizabeth Taylor, MD, FRCSC, Mohammed Bedaiwy, MD, PhD, Mahmoud Iwes, MD Recurrent miscarriage Management of pregnancy loss includes investigating causes, addressing modifiable risk factors, and providing supportive care in the first trimester of pregnancy. ABSTRACT: Early miscarriages are arly miscarriage has been re­ Genetic causes those occurring within the first 12 ported to occur in 17% to 31% The risk of miscarriage increases completed weeks of gestation. Re- E of pregnancies,1,2 and is de­ with maternal age. At age 20 to 24 current miscarriage, defined as two fined as a nonviable intrauterine the risk is approximately 10%, with or more consecutive pregnancy loss- pregnancy with either an empty ges­ risk increasing to nearly 80% by age es, affects 3% of couples trying to tational sac or a gestational sac con­ 45.5 The relationship between mis­ conceive and can cause consider- taining an embryo or fetus without carriage risk and maternal age can be able distress. The risk of miscarriage fetal heart activity within the first explained by the increasing rate of oo­ increases with maternal age. Genet- 12 completed weeks of gestation.3 cyte aneuploidy that occurs as women ic abnormalities, uterine anomalies, Recurrent miscarriage occurs in 3% grow older. In one study, oocytes and endocrine dysfunction can all of couples trying to conceive. The examined during in vitro fertilization lead to miscarriage. Other causes of American Society for Reproductive (IVF) treatment had only a 10% risk miscarriage are autoimmune disor- Medicine (ASRM) defines recurrent of being aneuploid in women younger ders such as antiphospholipid syn- miscarriage as two or more failed than age 35, but by age 43 the risk of drome and chronic endometritis.
    [Show full text]
  • Male Infertility and Risk of Nonmalignant Chronic Diseases: a Systematic Review of the Epidemiological Evidence
    282 Male Infertility and Risk of Nonmalignant Chronic Diseases: A Systematic Review of the Epidemiological Evidence Clara Helene Glazer, MD1 Jens Peter Bonde, MD, DMSc, PhD1 Michael L. Eisenberg, MD2 Aleksander Giwercman, MD, DMSc, PhD3 Katia Keglberg Hærvig, MSc1 Susie Rimborg4 Ditte Vassard, MSc5 Anja Pinborg, MD, DMSc, PhD6 Lone Schmidt, MD, DMSc, PhD5 Elvira Vaclavik Bräuner, PhD1,7 1 Department of Occupational and Environmental Medicine, Address for correspondence Clara Helene Glazer, MD, Department of Bispebjerg University Hospital, Copenhagen NV, Denmark Occupational and Environmental Medicine, Bispebjerg University 2 Departments of Urology and Obstetrics/Gynecology, Stanford Hospital, Copenhagen NV, Denmark University School of Medicine, Stanford, California (e-mail: [email protected]). 3 Department of Translational Medicine, Molecular Reproductive Medicine, Lund University, Lund, Sweden 4 Faculty Library of Natural and Health Sciences, University of Copenhagen, Copenhagen K, Denmark 5 Department of Public Health, University of Copenhagen, Copenhagen, Denmark 6 Department of Obstetrics/Gynaecology, Copenhagen University Hospital, Hvidovre, Denmark 7 Mental Health Center Ballerup, Ballerup, Denmark Semin Reprod Med 2017;35:282–290 Abstract The association between male infertility and increased risk of certain cancers is well studied. Less is known about the long-term risk of nonmalignant diseases in men with decreased fertility. A systemic literature review was performed on the epidemiologic evidence of male infertility as a precursor for increased risk of diabetes, cardiovascular diseases, and all-cause mortality. PubMed and Embase were searched from January 1, 1980, to September 1, 2016, to identify epidemiological studies reporting associations between male infertility and the outcomes of interest. Animal studies, case reports, reviews, studies not providing an accurate reference group, and studies including Downloaded by: Stanford University.
    [Show full text]
  • Diagnostic Evaluation of the Infertile Female: a Committee Opinion
    Diagnostic evaluation of the infertile female: a committee opinion Practice Committee of the American Society for Reproductive Medicine American Society for Reproductive Medicine, Birmingham, Alabama Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner to identify all relevant factors with initial emphasis on the least invasive methods for detection of the most common causes of infertility. The purpose of this committee opinion is to provide a critical review of the current methods and procedures for the evaluation of the infertile female, and it replaces the document of the same name, last published in 2012 (Fertil Steril 2012;98:302–7). (Fertil SterilÒ 2015;103:e44–50. Ó2015 by American Society for Reproductive Medicine.) Key Words: Infertility, oocyte, ovarian reserve, unexplained, conception Use your smartphone to scan this QR code Earn online CME credit related to this document at www.asrm.org/elearn and connect to the discussion forum for Discuss: You can discuss this article with its authors and with other ASRM members at http:// this article now.* fertstertforum.com/asrmpraccom-diagnostic-evaluation-infertile-female/ * Download a free QR code scanner by searching for “QR scanner” in your smartphone’s app store or app marketplace. diagnostic evaluation for infer- of the male partner are described in a Pregnancy history (gravidity, parity, tility is indicated for women separate document (5). Women who pregnancy outcome, and associated A who fail to achieve a successful are planning to attempt pregnancy via complications) pregnancy after 12 months or more of insemination with sperm from a known Previous methods of contraception regular unprotected intercourse (1).
    [Show full text]
  • Age and Fertility: a Guide for Patients
    Age and Fertility A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee. No portion herein may be reproduced in any form without written permission. This booklet is in no way intended to replace, dictate or fully define evaluation and treatment by a qualified physician. It is intended solely as an aid for patients seeking general information on issues in reproductive medicine. Copyright © 2012 by the American Society for Reproductive Medicine AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Age and Fertility A Guide for Patients Revised 2012 A glossary of italicized words is located at the end of this booklet. INTRODUCTION Fertility changes with age. Both males and females become fertile in their teens following puberty. For girls, the beginning of their reproductive years is marked by the onset of ovulation and menstruation. It is commonly understood that after menopause women are no longer able to become pregnant. Generally, reproductive potential decreases as women get older, and fertility can be expected to end 5 to 10 years before menopause. In today’s society, age-related infertility is becoming more common because, for a variety of reasons, many women wait until their 30s to begin their families. Even though women today are healthier and taking better care of themselves than ever before, improved health in later life does not offset the natural age-related decline in fertility. It is important to understand that fertility declines as a woman ages due to the normal age- related decrease in the number of eggs that remain in her ovaries.
    [Show full text]
  • World-Renowned Expert in Infertility Presents Findings to European
    World-Renowned Expert in Infertility Presents Findings to European Conference After Two Recurrent Miscarriages, Patients Should be Thoroughly Evaluated for Risk Factors Dr. William Kutteh, M.D., one of the world’s leading researchers in recurrent pregnancy loss (RPL), was invited to present his latest discoveries to theEuropean Society of Human Reproduction and Embryology (ESHRE). Dr. Kutteh’s research on recurrent pregnancy loss calls for early intervention after the second miscarriage, a change in how physicians currently treat the condition. RPL is defined as three or more consecutive miscarriages that occur before the 20th week of pregnancy. In the general population, miscarriage occurs in 20 percent of all pregnancies, but recurrent miscarriage occurs in only 5 percent of all women seeking pregnancy. Dr. Kutteh’s study, the largest of its kind on recurrent miscarriage, scientifically proved what many physicians intrinsically knew. The 2010 study, published in Fertility and Sterility-- Diagnostic Factors Identified in 1020 Women with Two Versus Three or More Recurrent Pregnancy Losses--found that even after only two pregnancy losses, a definitive cause for RPL could be determined in two-thirds of patients in the study. Dr. Kutteh’s research showed that there was no statistical difference in women with RPL who had two pregnancy losses, and those who had three or more losses, proving that earlier intervention was appropriate. Patients with RPL are now encouraged to begin testing for known risk factors for infertility after the second miscarriage. Determining Risk Factors for Recurrent Miscarriage Recurrent miscarriage causes include anatomic, hormonal, autoimmune, infectious, genetic, or hematologic issues. Expeditiously determining the causes of miscarriage can lead to more targeted treatment, and for 67 percent of patients, a successful full-term pregnancy.
    [Show full text]
  • Anovulation and PCOS
    Anovulatory Infertility and PCOS ESHRE, Kiev 2010 Adam Balen MD, FRCOG Professor of Reproductive Medicine Leeds Teaching Hospitals, UK Disclosures: Medical advisor to Ferring, Organon SP Causes of Anovulatory Infertility Learning Objectives 1. To understand the causes of anovulation 2. Knowledge of the correct diagnostic tests 3. Effective assessment and diagnosis to plan appropriate ovulation induction therapy Hypothalamus GnRH Pituitary FSH LH Oestradiol, inhibins Progesterone……. LH FSH theca cells granulosa cells testosterone aromatase oestradiol oocytte Two cell – two gonadotrophin theory of oestrogen synthesis The Menstrual Cycle pmol/l 350 80 300 70 250 60 50 200 40 nmol/l 150 & 30 100 20 50 10 IU/L 0 0 0 2 4 6 8 10121416182022242628 E2 FSH LH P4 Causes of Anovulatory Infertility Group I: weight loss, systemic illness Hypothalamic/ Kallmann’s syndrome pituitary failure hypogonadotrophic hypogonadism Hyperprolactinaemia Hypopituitarism Group II: PCOS h/p dysfunction Group III: Premature ovarian failure (POF) Ovarian failure Resistant ovary syndrome (ROS) Causes of Anovulatory Infertility Group I: weight loss, systemic illness Hypothalamic/ Kallmann’s syndrome pituitary failure hypogonadotrophic hypogonadism Hyperprolactinaemia Hypopituitarism Group II: PCOS h/p dysfunction Group III: Premature ovarian failure (POF) Ovarian failure Resistant ovary syndrome (ROS) Causes of Anovulatory Infertility Group I: weight loss, systemic illness 5% Hypothalamic/ Kallmann’s syndrome pituitary failure hypogonadotrophic hypogonadism Hyperprolactinaemia Hypopituitarism Group II: PCOS 90% h/p dysfunction Group III: Premature ovarian failure (POF) 5% Ovarian failure Resistant ovary syndrome (ROS) Investigations 1. FSH, LH, oestradiol 2. Prolactin / TFTs 3. Testosterone (SHBG) 4. AMH...... 5. GTT, lipid profile 6. Ultrasound scan 7. Semen analysis 8.
    [Show full text]
  • Module 3: Reproductive Tract Infections
    Reproductive Tract Infections Reproductive Health Epidemiology Series Module 3 2003 Department of Health and Human Services REPRODUCTIVE TRACT INFECTIONS REPRODUCTIVE HEALTH EPIDEMIOLOGY SERIES: MODULE 3 June 2003 The United States Agency for International Development (USAID) provided funding for this project through a Participating Agency Service Agreement with CDC (936-3038.01). REPRODUCTIVE HEALTH EPIDEMIOLOGY SERIES—MODULE 3 REPRODUCTIVE TRACT INFECTIONS Divya A. Patel, MPH Nancy M. Burnett, BS Kathryn M. Curtis, PhD Technical Editors Susan Hillis, PhD Polly Marchbanks, PhD U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Reproductive Health Atlanta, Georgia, U.S.A. 2003 CONTENTS Learning Objectives .........................................................................................1 Overview of Reproductive Tract Infections (RTIs) ............................................3 Prevalence of RTIs .......................................................................................3 What Are the Most Commonly Occurring RTIs in Developing Countries? ....4 Sequelae of Untreated RTIs .........................................................................4 How Are RTIs Transmitted? ........................................................................7 How Are RTIs and Their Sequelae Linked With Key Health-Related Development Programs? ...............................................8 General Model of the Epidemiology
    [Show full text]
  • Recurrent Pregnancy Loss: Diagnosis and Treatment
    Medical Coverage Policy Effective Date ............................................. 2/15/2021 Next Review Date ....................................... 2/15/2022 Coverage Policy Number .................................. 0284 Recurrent Pregnancy Loss: Diagnosis and Treatment Table of Contents Related Coverage Resources Overview .............................................................. 1 Comparative Genomic Hybridization Coverage Policy ................................................... 1 (CGH)/Chromosomal Microarray Analysis (CMA) General Background ............................................ 3 for Selected Hereditary Conditions Medicare Coverage Determinations .................. 11 Genetic Testing for Reproductive Carrier Screening and Coding/Billing Information .................................. 11 Prenatal Diagnosis Hydroxyprogesterone Caproate Injection References ........................................................ 14 Immune Globulin Infertility Services INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service
    [Show full text]
  • Epidemiology of Infertility and Recurrent Pregnancy Loss in Society with Fewer Children
    Research and Reviews Epidemiology of Infertility and Recurrent Pregnancy Loss in Society with Fewer Children JMAJ 52(1): 23–28, 2009 Harumi KUBO*1 Abstract Since there has been no improvement in the current downward trend in Japan’s birth rate, the growing population of potential patients with infertility is a significant social problem. Underlying the factors of infertility are psycho- logical factors related to the current stress of modern-day society, sexually transmitted diseases, increased smoking rates among young females, weight abnormalities such as obesity and underweight resulting from diet, an age-related decrease in reproductive function resulting from late marriage and late childbearing (social infertility), and increasing numbers of patients with polycystic ovary syndrome, endometriosis, or uterine myoma. Eighty to 90% of these factors contributing to infertility are derived from personal lifestyle and are considered to be preventable. On the other hand, 50–70% of recurrent pregnancy loss is of unknown cause, and currently there are no established standard tests or treatment policies. However, it is important to carry out close systematic investigation of the couple to determine the cause of infertility, including chromosomal or endocrine factors, blood coagulation function, uterine deformity, autoimmune diseases, and infectious diseases. Treatment specific to the cause should be provided to the patient, and the cause should be prevented if possible. It is proposed that, to prevent infertility and recurrent pregnancy loss, males and females of reproductive age undergo regular check- ups of reproductive function once a year. It is expected that this kind of effort may lead to improvement of the downward trend in the birthrate.
    [Show full text]
  • Managing Infertility When Adenomyosis and Endometriosis Co-Exist
    Managing infertility when adenomyosis and endometriosis co-exist Jinhua Leng Beijing,China 27th April 2018 • IPSEN symposium Endometriosis • Endometriosis (EM) is a common, benign, ovary hormone-dependent gynecologic disorder which affects mainly reproductive-age women • Endometriosis is considered to be responsible for infertility and pelvic pain • May affect 10% of women of reproductive age • Three types of pelvic endometriosis • Peritoneal Endometriosis • Ovarian Endometrioma • Deeply Infiltrating Endometriosis (DIE) 27th April 2018 • IPSEN symposium Adenomyosis • Adenomyosis (AD) is defined by the presence of endometrial glands and stroma in the myometrium • Prevalence: varies significantly between studies (from 5% to 70%), generally underestimated • Most frequent symptoms: dysmenorrhea, abnormal uterine bleeding, etc. • Two types: diffuse form, focal form 27th April 2018 • IPSEN symposium PEM DIE OEM AD+EM 27th April 2018 • IPSEN symposium Macroscopic and microscopic appearance of AD 27th April 2018 • IPSEN symposium MRI Features of AD—focal and diffuse 27th April 2018 • IPSEN symposium Prevalence of EM in patients with AD Adenomyosis Endometriosis Author N N(%) Leng JH et al.(2011) 72(histology) 24(33.3%) Di Donato et al. (2014) 217(ultrasound) 165(76.0%) Chapron et al. (2017) 175(MRI) 153(87.4%) Leyendecker et al. (2015) 67(MRI) 54(80.6%) Em and AD often coexist Several authors reported the prevalence of EM in patients with AD. Our study showed in 72 histologically diagnosed AD, 33.3% had concomitant EM. Chapron and another 2 authors reported in US/MRI diagnosed AD, 76-87% had coexistant EM 27th April 2018 • IPSEN symposium What is the relationship between endometriosis phenotypes and adenomyosis? EM subtype N Diffuse form Focal form PEM 40 8(20.0%) 3(7.5%) OEM 31 14(45.2%) 6(19.3%) DIE 166 59(35.5%) 110(66.3%) • Surgery findings of 175 preoperatively MRI diagnosed AD and histologically diagnosed of EM • Among EM women, diffuse AD had no correlation with EM phenotypes.
    [Show full text]
  • Population Attributable Fraction of Tubal Factor Infertility Associated with Chlamydia
    HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Am J Obstet Manuscript Author Gynecol. Author Manuscript Author manuscript; available in PMC 2018 September 01. Published in final edited form as: Am J Obstet Gynecol. 2017 September ; 217(3): 336.e1–336.e16. doi:10.1016/j.ajog.2017.05.026. Population Attributable Fraction of Tubal Factor Infertility Associated with Chlamydia Rachel J. GORWITZ, MD, MPH1, Harold C. WIESENFELD, MD, CM2,3, Pai Lien CHEN, PhD4, Ms. Karen R. HAMMOND, DNP, CRNP5, Ms. Karen A. SEREDAY, MS1, Catherine L. HAGGERTY, PhD, MPH3,6, Robert E. JOHNSON, MD, MPH1, John R. PAPP, PhD1, Dmitry M. KISSIN, MD, MPH1, Tara C. HENNING, PhD1, Edward W. HOOK III, MD7, Michael P. STEINKAMPF, MD, MA5, Lauri E. MARKOWITZ, MD1, and William M. GEISLER, MD, MPH7 1Centers for Disease Control and Prevention, Atlanta, GA 2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 3Magee-Womens Research Institute, Pittsburgh, PA 4FHI360, Durham, NC 5Alabama Fertility Specialists, Birmingham, AL 6Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA 7Department of Medicine, University of Alabama at Birmingham, Birmingham, AL Abstract Background—Chlamydia trachomatis infection is highly prevalent among young women in the United States. Prevention of long-term sequelae of infection, including tubal factor infertility, is a primary goal of chlamydia screening and treatment activities. However, the population attributable fraction of tubal factor infertility associated with chlamydia is unclear, and optimal measures for assessing tubal factor infertility and prior chlamydia in epidemiologic studies have not been established. Black women have increased rates of chlamydia and tubal factor infertility compared Corresponding author: Rachel J.
    [Show full text]