Post on 03-Feb-2016
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Dr.José Arturo Mora Rodriguez Residente 2 año de Biologia de la reproducción
Profesor Titular: Dr. Hector Godoy Morales Profesor Adjunto :Dr. Alfredo Ulloa Aguirre
IO/OE con Gonadotropinas tx 1960-1980
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Embarazo alto orden fetal
Reducir las perdidas fetales
The Practice Committee of the American Society for Reproductive Medicine and the PracticeCommittee of the Society for Assisted Reproductive Technology. Fertility and Sterility Vol. 92, No. 5, November 2009
Día 3 Día 5
The Practice Committee of the American Society for Reproductive Medicine and the PracticeCommittee of the Society for Assisted Reproductive Technology. Fertility and Sterility Vol. 92, No. 5, November 2009
TE Un solo embrión.
Clivaje o blastocisto debe ser transferido
The Practice Committee of the American Society for Reproductive Medicine and the PracticeCommittee of the Society for Assisted Reproductive Technology. Fertility and Sterility Vol. 92, No. 5, November 2009
No mas 2 embriones en estado de división
No mas de 2 blastocistos
The Practice Committee of the American Society for Reproductive Medicine and the PracticeCommittee of the Society for Assisted Reproductive Technology. Fertility and Sterility Vol. 92, No. 5, November 2009
3 embriones en etapa-división
2 blastocistos
The Practice Committee of the American Society for Reproductive Medicine and the PracticeCommittee of the Society for Assisted Reproductive Technology. Fertility and Sterility Vol. 92, No. 5, November 2009
5 embriones en etapa-división.
3 blastocisto
The Practice Committee of the American Society for Reproductive Medicine and the PracticeCommittee of the Society for Assisted Reproductive Technology. Fertility and Sterility Vol. 92, No. 5, November 2009
No hay limite embriones
The Practice Committee of the American Society for Reproductive Medicine and the PracticeCommittee of the Society for Assisted Reproductive Technology. Fertility and Sterility Vol. 92, No. 5, November 2009
Maximizar tasas de embarazo
Minizar
embarazos multiples
Edad paciente
Concentración de E2
Desarrollo folicular
Dosis de Gonadotropina
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Tasa de embarazo
Tasa de embarazo alto orden fetal
Tasa de aborto
Tasa de nacidos vivos
Tasa de nacidos vivos de embarazo de alto orden fetal
peso de nacidos de embarazo orden fetal
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Estudio retrospectivo
Incluyeron 1574 ciclos
Instituto Jones (Unidad Medicina Reproductiva ) Norfolk , virginia
Agosto 1998 a diciembre 2008
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Criterios exclusion Perdida de embarazo recurrente
Numero ciclos x paciente de 1 a 12 con una media de 2.2
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Evaluacion infertilidad - E2, FSH , LH , TSH , Prl( 3 día )
- Histerosalpingografia ( Permeabilidad )
- Espermatobioscopia
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Problemas tiroideos y con hiperprolactinemia se inicio tratamiento.
Miomas submucosos fueron extirpados
Infertilidad masculina severa - Evalucación urológica
- Pruebas Geneticas ( Cariotipo anormal o microdelecciones de Y )
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Estimulo con gonadotropinas ( con o sin citrato de clomifeno ) fue seguido con CP o IIU
Uso de AGnRH pacientes con alto riesgo de luteinización ( SOP o elevacion de LH en ciclo previo )
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Uso de Gonadotropinas urinarias y recombinantes sola o en combinación con LH en estados hipogonadismo hipogonadotropico.
Dosis inicial 25 UI FSH Step-Up
Edad paciente Diagnostico
infertilidad Respuesta ciclos
previos
Decidir inicio de dosis y aumento
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
USG Basal y E2 ( Quiste funcional )
Examen ecografico cada 1-4 días con concentraciones de E2 y LH
Cancelación de ciclo falta respuesta 6-8 días
3 foliculos de mas de 16 mm y E2 mayor de 1500 pg/ml
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
SAS Version 9.1
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011
Abbaa Sarhan. Gonadotrophin ovulation induction and enhancement outcomes: analysis of more than 1400 cycles Reproductive BioMedicine Online 2011