China
Africa
Explore chapters and articles related to this topic
Principles of Pathophysiology of Infertility Assessment and Treatment*
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Joseph G. Schenker, Aby Lewin, Menashe Ben-David
There has been a significant progress in treatment of anovulation with different pharmacological agents in the last 20 years. The success of therapy depends on an accurate diagnosis of underlying abnormalities responsible for anovulation and the selection of agents (one most appropriate to initiate ovulation, least expensive, and with minimum harm to the patient).
Anatomy and physiology
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
Ovulation is the release of the ovum from the Graafian follicle; it is thought that the follicular fluid pressure increases, causing the release of the ovum. Inhibin has been found in follicular fluid, and it is thought that this may determine how many follicles are released at ovulation and may have links with polycystic ovary disease. Anovulation occurs in 10% of ovarian cycles, but if women have regular menstrual cycles, this indicates ovulation. Some women experience lower abdominal pain on ovulation which is known as mittelschmerz, and some may experience a small amount of bleeding which is due to falling hormone levels.
The Menstrual Cycle
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
There is a continuum of women’s potential reproductive responses to physiological and psychosocial experiences (Table 3.1). The so-called “functional” hypothalamic amenorrhea (no menstrual flow for 3–6 months) and oligomenorrhea (cycles longer than 35 days but less than 3 months) are rare in the spectrum of adaptive reproductive suppression. The most common are regular menstrual cycles with anovulation or with short luteal phases. Across a year, short luteal phases (≥2 per year) occur for 42% of women initially documented in two cycles to be normally ovulatory (Prior et al., 1990a). Anovulation is less common, and occurs for 20% of initially ovulatory women (Prior et al., 1990a). This continuum has not yet been recognized by most women’s health experts (Gordon et al., 2017), who continue to discuss only low estrogen/estradiol and ignore low or absent progesterone levels.
Clinical pregnancy rates among anovulatory and oligoovulatory women after letrozole versus hormone replacement therapy in frozen-thawed embryo transfer cycles
Published in Human Fertility, 2023
Maya Sharon-Weiner, Sivan Farladansky-Gershnabel, Hanoch Schreiber, Tal Shavit, Eliahu Levitas, Arie Berkovitz
According to our clinical approach, inclusion criteria were women with anovulatory (absence of at least three consecutive menstrual periods) or oligoovulatory (menstrual periods occurring at intervals greater than 35 days) cycles who underwent FET. This study cohort was composed of women who needed progesterone-based treatment for withdrawal bleeding, as determined by laboratory evaluation for ovulation on days 21 and 30 of the cycle (a serum progesterone level >3 ng/mL is indicative of ovulation). Regarding the baseline aetiology for oligoovulation or anovulation, we included all women with oligoovulation or anovulation, not only PCOS (the most frequent pathology causing anovulation during the reproductive years). As defined by the Rotterdam consensus, PCOS is diagnosed when at least two of these three criteria are met: (i) oligo-anovulation or anovulation; (ii) clinical or biochemical signs of hyperandrogenism; and (iii) polycystic ovarian morphology on ultrasound (as defined by at least one ovary with ≥12 follicles or volume ≥10 cm3).
The relationship of total progressive motile sperm count with the outcome of IUI? An analysis of 5171 cycles
Published in Gynecological Endocrinology, 2022
Haiyan Lin, Yu Li, Songbang Ou, Xuedan Jiao, Wenjun Wang, Thor Haahr, Peter Humaidan, Qingxue Zhang
Binary univariable and multivariable logistic regression indicated except female age, the mentioned variables above were not significantly associated with live birth since the OR values were very close to 1. (Suppl. Table 1). Female age was the one significantly associated with live birth. The cutoff female age for predicting live birth was defined as 28 years old by ROC analysis (Fig. 1). However, the AUC was 0.579 (95% CI 0.552–0.606, p = .000), and when female age was 28 years old, the sensitivity reached to 0.736 with specificity 0.386. From the characteristic comparison, two-thirds of female were beyond 28 years old. Ovarian induction protocol was dominant. Anovulation factor infertility accounted for 34.7% in the group with female age ≤28 years, which was higher than the group with female age >28 years (Table 2).
The reproductive endocrine feature and conception outcome of women with unknown etiological menstrual cycle (36–45 days) with long follicular phase
Published in Gynecological Endocrinology, 2022
Zhewei Wang, Jiongjiong Yan, Huifen Chen, Laman He, Shaohua Xu
Six participants were lost to follow up in the LMC group and ten in the NMC group including those who lost contact, or sought treatment, or experienced menstrual cycle change between the normal and long type. It is worth mentioning that among the there participants who received traditional Chinese medicine treatment (TCM) later, two experienced menstrual cycle shortened to normal. In the LMC group, the rate of ‘conversion to anovulation’ (21.6% vs. 5.2%, p < .01) was higher and the natural conception rate (41.9% vs. 66.2%, p < .01) was lower within 12 menstrual cycles. Among sixteen participants in the LMC group who converted to patient with anovulation, ten were identified as PCOS and four were identified as DOR later, whereas the other two had no definite diagnosis. In the NMC group, among four participants who converted to patient with anovulation, one were identified as PCOS and another three were not clearly diagnosed later. The spontaneous abortion rate in early pregnancy in the LMC group (29.0% vs. 9.8%, p < .05) was higher than the NMC group. After the previous pregnancy history was included, the rate of recurrent abortion in the LMC group was higher than that the NMC group (22.6% vs. 3.9%, p = .24) (Table 3).