Transgender health in pregnancy and the postpartum period
Nadia Barghouthi, Jessica Perini in Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
Guidelines relating to fertility and pregnancy in transgender men are generally lacking. Prior to initiation of gender-affirming hormone therapy, all patients should receive counseling regarding potential fertility impairment and, if interested in preserving fertility, patients should be referred to reproductive endocrinology for discussion of oocyte preservation and reproductive options. Resumption of spontaneous ovulation can occur in many transgender men after cessation of testosterone. In caring for transgender men who are seeking fertility, planning pregnancy, or who are currently pregnant, special care should be taken to continuously affirm the patient’s gender identity while negotiating hormonal changes of pregnancy that may be discordant with his gender identity.
Evaluation and treatment of the low responder patient
David. K Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham in Textbook of Assisted Reproductive Techniques, 2001
One of the greatest challenges in clinical reproductive endocrinology is evaluation and management of patients who respond poorly to exogenous gonadotropins and who are categorized as “low responders”. Identifying potential low responders is of critical clinical importance. These patients require specialized management to optimize the number and quality of oocytes that may be available for assisted reproductive technologies (ART) procedures. Even with optimal management, their clinical pregnancy and delivery rates are diminished compared with age matched controls, and patients should be counseled accordingly. This chapter will review how low responders are defined, what screening tests are available to predict diminished gonadotropin responsiveness and oocyte quality, and basic treatment protocols that may be used to optimize outcomes for this difficult group of patients.
Evaluation and treatment of the low responder patient
David. K Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham in Textbook of Assisted Reproductive Techniques, 2005
One of the greatest challenges in clinical reproductive endocrinology is evaluation and management of patients who respond poorly to exogenous gonadotropins and who are categorized as “low responders”. Identifying potential low responders is of critical clinical importance. These patients require specialized management to optimize the number and quality of oocytes that may be available for assisted reproductive technology (ART) procedures. Even with optimal management, their clinical pregnancy and delivery rates are diminished compared with age-matched controls, and patients should be counseled accordingly. This chapter will review how low responders are defined, what screening tests are available to predict diminished gonadotropin response and oocyte quality, and basic treatment protocols that may be used to optimize outcomes for this difficult group of patients.
Simulation and professional development: added value of 3D modelization in reproductive endocrinology and infertility and assisted reproductive technologies teamwork
Published in Gynecological Endocrinology, 2019
Pierre-François Ceccaldi, Paul Pirtea, Vincent Lemarteleur, Marine Poulain, Dominique De Ziegler, Jean-Marc Ayoubi
As in other specialties of medicine, there is more to clinical performance in reproductive endocrinology, infertility, and assisted reproductive technologies (REI-ART) than simply the individual knowledge and technical skills. Simulation is commonly used during fellowship training in REI-ART, aiming to produce a virtual cycle of professional development in order to improve patient outcome. With scientific certification and the joint development of evaluation tools, the contribution of digitalization, such as 3 D printing and digital simulators, will facilitate teamwork in REI-ART and enable a better transmission of knowledge in the specialty.
Endocrine control of spermatogenesis: Role of FSH and LH/ testosterone
Published in Spermatogenesis, 2014
Suresh Ramaswamy, Gerhard F Weinbauer
Evaluation of testicular functions (production of sperm and androgens) is an important aspect of preclinical safety assessment and testicular toxicity is comparatively far more common than ovarian toxicity. This chapter focuses (1) on the histological sequelae of disturbed reproductive endocrinology in rat, dog and nonhuman primates and (2) provides a review of our current understanding of the roles of gonadotropins and androgens. The response of the rodent testis to endocrine disturbances is clearly different from that of dog and primates with different germ cell types and spermatogenic stages being affected initially and also that the end-stage spermatogenic involution is more pronounced in dog and primates compared to rodents. Luteinizing hormone (LH)/testosterone and follicle-stimulating hormone (FSH) are the pivotal endocrine factors controlling testicular functions. The relative importance of either hormone is somewhat different between rodents and primates. Generally, however, both LH/testosterone and FSH are necessary for quantitatively normal spermatogenesis, at least in non-seasonal species.
Effect of Lifestyle on Quality of Life of Couples Receiving Infertility Treatment
Published in Journal of Sex & Marital Therapy, 2013
This study investigated the effect of lifestyle on the quality of life among couples undergoing infertility treatment. The research universe consisted of 200 couples undergoing infertility treatment in Akdeniz University's Center of Reproductive Endocrinology and Assisted Reproductive Techniques. The data collection tools the authors used were a personal information form requesting sociodemographic characteristics and history of infertility, the SF-36 Quality of Life Scale, and the Healthy Lifestyle Behaviors Scale. This study revealed that the quality of life of the women in the study was lower than that of the men. The authors also found that the couples’ quality of life was reduced by variables such as advanced age, low education level, unemployment status, lower income, long duration of infertility, high body mass index, history of andrological surgery, and previous experience of assisted reproduction techniques three or more times. Last, it was determined that the couples’ quality of life improved as their healthy lifestyle behaviors increased. Demonstrating positive health behavior is likely to improve the quality of life of couples undergoing infertility treatment.
Related Knowledge Centers
- Infertility
- Subspecialty
- Obstetrics & Gynecology
- Reproductive Medicine
- Hormone
- Reproductive Surgery
- Urology