PRESENTED BY:-Abhilasha VermaM.Sc. Prev. 2015-16SMS Nursing College (Jaipur)

PRESENTATIONON

FEMALE INFERTILITY

DEFINITION:

“ Infertility refers to inability to achieve pregnancy after 12 months of having unprotected sexual intercourse with average frequency of 3 to 4 times per week without use of any birth control measure”

TYPES OF INFERTILITY:

PRIMARY INFERTILITYSECONDARY

INFERTILITY

ETIOLOGY:

1. •MALE FACTORS

2. •FEMALE FACTORS

FEMALE FACTOR

OVARIAN FACTORS

TUBAL & PERITONEAL FACTORS

UTERINE FACTORS

CERVICAL FACTORS

VAGINAL FACTORS

COMBINED FACTORS

MALE FACTOR INFERTILITY

DEFECTIVE SPERMATOGENESIS

OBSTRUCTION OF EFFERENT DUCT

FAILURE TO DEPOSITE SPERM

SEMINAL FLUID ERRORS

RISK FACTORS• Age• Smoking• Over weight• Over exercising• STDs• Frequency & timing of sexual intercourse• Mental stress

DIAGNOSTIC INVESTIGATIONS• History collection• General physical examinations• Gynaecological examinations• Cervical mucus study• Hormone estimation• Endometrial biopsy• Sonography• Rubin’s test• Hystero Salpino Graphy [ HSG]

MANAGEMENTGENERAL INSTRUCTIONS-• Maintenance of body weight.• Avoid smoking & alcohol.• Maintain ideal coital frequency.[ 3-4 times / week in fertile period]• Use of LH surge kit.• Avoid lubricants, spermicidal jellies and creams.• Avoid fertility impairing medications.• Psychological support.

MANAGEMENT OF FEMALE INFERTILITY

MEDICATIONS ART SURGERY

SURGERY• Surgical removal of tumor

BALLOON TUBOPLASTY

FIMBRIOPLASTY

ADHESIONOLYSIS

ASSISTED REPRODUCTIVE TECHINQUES

“Assisted reproductive techniques involving direct retrieval of oocyte from ovary , manipualtion of gametes and embroyos outside body for purpose of establishing pregnancy”

TYPES OF ART1. IUI [ Intra Uterine Insemination]

2. IVF- ET [ In vitro fertilization & Embryo Transfer]

3.GIFT [ Gamete Intra fallopian Transfer]

4.ZIFT [ Zygote Intra Fallopian Transfer]

5. ICSI [ Intra Cytoplasmic Sperm Injection]

INTRA UTERINE INSEMINATION

IVF-ET

INVITRO FERTILIZATION AND EMBRYO TRANSFER [ IVF-ET]

GAMETE INTRA FALLOPIAN TRANSFER ( GIFT)

• GIFT is similar to IVF but the difference is that in IVF technique fertilization done in vitro & embryo is transferred and in GIFT sperm and oocytes are mixed in vitro & fertilization done in vivo. Done in case if male don’t have capacities to ejaculate deeply.

ZYGOTE INTRA FALLOPIAN TRANSFER ( ZIFT)

• Egg cells removed and fertilized in laboratory and zygote placed in fallopian tube following day 1 of IVF.

INTRA CYTOPLASMIC SPERM INJECTION ( ICSI)

• Sperm injected directly into egg cell.• Done in case of male factor infertility.

THANK YOU