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An overview of infertility
Published in Ruth Chambers, Fertility Problems, 2018
Causes of subfertility vary according to socio-economic and geographic factors. A minor cause of subfertility in both the male and female partners can combine to a more major problem of subfertility as a couple. The cause of subfertility is unexplained in about a third of cases.2,6 In developed countries one fifth of infertility may be caused by purely male factors, and in another fifth of cases both male and female factors contribute to the two partners being infertile as a couple.1,2 Tubal factor infertility in the woman partner occurs in 12-33% of infertile couples, mainly caused by previous episodes of pelvic inflammatory disease.8 Polycystic ovary syndrome is more common than used to be thought and may be associated with lowered fertility in some cases.
Normal and complicated pregnancy
Published in Marwan Habiba, Andrea Akkad, Justin Konje, MRCOG Part 2, 2017
Marwan Habiba, Andrea Akkad, Justin Konje
A 28-year-old woman undergoes IVF for tubal factor infertility. Two weeks after embryo transfer a blood test reveals a ßHCG of 98 iU/l and progesterone of 58 nmol/l. A repeat test 48 hours later shows a ßHCG of 210 iU/l and progesterone of 61 nmol/l; after a further 96 hours her serum ßHCG rises to 266 iU/l, whilst the progesterone level falls to15 nmol/l.
Management of hydrosalpinx
Published in David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham, Textbook of Assisted Reproductive Techniques, 2017
In the beginning of the in vitro fertilization (IVF) era, tubal factor infertility was the sole indication for the treatment. Today, other indications constitute the majority of treatments and tubal disease may account for as little as 20% in some centers. It is notable that tubal factor infertility is often reported to yield worse results than other causes of infertility. We reported tubal factor infertility to be an independently negative predictive factor of pregnancy and birth, as compared with all other indications (1), in the debate on high multiple pregnancy rates in IVF. Hydrosalpinx is the severe condition that has attained special interest in research and clinical practice. Tubal diseases like salpingitis isthmica nodosa and other types of proximal tubal occlusions have not been studied exclusively in connection with assisted reproduction technology (ART) and will not be further explored here. This chapter will focus on the problems associated with hydrosalpinx and ART, including diagnosis, prognosis, possible mechanisms, and interventions.
The pros and cons of fertility awareness and information: a generational, Swedish perspective
Published in Human Fertility, 2023
Maja Bodin, Lars Plantin, Lone Schmidt, Søren Ziebe, Eva Elmerstig
Another finding that can be useful for future educational incentives is that the knowledge about sexually transmitted infections seems to have been lost over generations. Tubal factor infertility, often caused by a STI, ranks among the most common causes of female infertility (Tsevat et al., 2017). The evidence linking Chlamydia and gonorrhoea to infertility is compelling, but only three focus groups mentioned STI as a risk factor for infertility. Similar findings have been found in previous Swedish, Danish and British studies (Bodin et al., 2018; Goundry et al., 2013; Hviid Malling et al., 2020), indicating that young adults are not fully aware of why they should protect themselves from STIs. Instead, some younger participants in our study believed that abortions negatively impact female fertility, an assumption that, with the modern and legal methods used today, can no longer be regarded as true.
Heterotopic pregnancy after bilateral salpingectomy, IVF and multiple embryos transfer. A case report and systematic review of the literature
Published in Journal of Obstetrics and Gynaecology, 2022
Grigorios Karampas, Andreas Zouridis, Evangelia Deligeoroglou, Dimitra Metallinou, Theodoros Panoskaltsis, Konstantinos Panoulis, Martin Rudnicki, Nikolaos Vlahos
In conclusion, HP after bilateral salpingectomy is an extremely rare complication of IVF-ET cycles. Tubal factor infertility, previous tubal surgery and multiple embryo transfer are the main risk factors while the underlying mechanism remains unclear. Symptoms and signs can be unspecific and even misleading. High levels of beta-hCG at early stages in combination with single intrauterine pregnancy can indicate a HP but cannot set the diagnosis. Transvaginal ultrasound scan is the main diagnostic tool for the initial differential diagnosis while MRI is performed in selective indications. In cases of HP, the EP is more frequently located in the intramural part of the fallopian tubes, the tubal stump and the ovaries while an abdominal pregnancy, though extremely rare, should be included in the differential diagnosis. Laparotomy or laparoscopy for the excision of the EP are the main therapeutic options with adequate perinatal outcome regarding the intrauterine conceptus.
The ultrastructural effects of surgical treatment of hydrosalpinx on the human endometrium: a light and electron microscopic study
Published in Ultrastructural Pathology, 2019
Tuğçe Sapmaz, Leman Sencar Gündoğdu, Mehmet Turan Çetin, Ibrahim Ferhat Ürünsak, Sait Polat
Hydrosalpinx is a gynecological disease characterized by dilated, fluid-filled, distally obstructed uterine tubes, developed due to acute salpingitis after pelvic inflammatory disease (PID). Hydrosalpinx is a commonly used term to describe a heterogeneous spectrum of pathology of distal tubal occlusion and is also considered to be a consequence of pyosalpinx, which is one of the complications of acute salpingitis.1,2 Pathological factors leading to tubal damage, such as hydrosalpinx, are the most important causes of female infertility and have a share of 14–38% in tubal factor infertility.3 The prevalence of hydrosalpinx is 10–13% when it is diagnosed by ultrasonography; on the other hand, the prevalence is up to 30% when hysterosalpingography (HSG), laparoscopy and open surgical intervention are used as diagnostic ways for hydrosalpinx.4