Guide for the couple
1st visit (PHASE 1)
Visit for:
Suspected infertility
Search for a second opinion
Recurring miscarriage
Failed attempts in other centres
Biological & instrumental analyses
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Genetic analysis
Genetic Analysis
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2nd visit (PHASE 2)
Male infertility
Female infertility
Couple infertility
Next visits (PHASE 3)
Male Therapy
Female Therapy
Therapy for repetitive abortion
Ovarian Stimulation & Monitoring (FASE 4)
Ovarian stimulation & monitoring
Techniques of PMA (PHASE 5)
Techniques of Assisted Reproduction
Pregnancy test (PHASE 6)
Pregnancy Test

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Diagnosis of female infertility

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The second visit
During the visit the results of the tests are viewed, and a diagnosis is made.  During this visit, if in vitro fertilisation is being considered, a “test of transfer” can be performed, sometimes with a  hysteroscopy.  This is a simulation of the transfer of the embryo into the uterus, which is performed in order to choose the type of catheter- a thin plastic tube – to be used and to identify the precise point in the uterus where the embryo will be deposited during actual transfer.  The simulation is not painful and is only performed if the vaginal swabs are negative

The diagnosis of female infertility
Once the diagnosis is made, it is possible to evaluate the indicated therapy for each specific problem.  The technique of Assisted Reproduction that will be adopted at the end varies depending on the conditions with which the patient presents;  Generally simple ovarian stimulation is performed with programmed intercourse in the case of anovulation, artificial insemination in the presence of cervical or unexplained causes of infertility, in vitro fertilisation in the presence of lesions on the tubes, the microinjection  of the spermatozoa into the ovule or the extraction of the spermatozoa from the testicles in the case of serious spermatic problems

Tubal causes.  Among all the causes of infertility, afflictions of the tubes make up 20% of all the cases.  Generally, they are provoked by infective factors  (such as Chlamydia), even without the patient ever being aware of them, or progressive abdominal surgery, or endometriosis – this can be present in 7% of cases, in the form of tubal factors or unknown mechanisms can cause infertility.  It is a disease that consists of the presence of “islands” of the inner part of the uterus (the endometrium) in the regions of the body (tubes, ovaries e.t.c.) which can cause the complete or partial blockage of the tubes in any part of them; at other times these can cause adhesions, that is, scars that disturb the function of the tubes.  Sometimes the effect of infections can manifest only inside the tubes, damaging  their delicate coating, without any external damage appearing.  In this case, the passage of a control liquid inside the tubes occurs normally (hysterosalpingogram, hysterosonogram and a laparoscopy):  this is one of the reasons why under examination the tubes seem normal but in reality they do not work well.

Uterine causes.  Congenital uterine malformations are responsible for a modest percentage of infertility (about 3%), but can cause early and repetitive abortions, the consequences are similar, even though rare, when infective factors cause scarring inside the uterus (uterine adhesions)

Hormonal deficit and ovulation disturbances.  Here we intend to speak, principally, about hormonal deficit that impede ovulation and constitute at least 25% of the causes of infertility; rarely, we come across hormonal deficits that affect the phase after ovulation (luteal or progesterone deficit).  The motives for which hormones are not produced adequately can be congenital, stress, and other causes that are not yet quite clear, like the so called polycystic ovarian syndrome

Other causes.  There are many but infrequent.  Chromosomal abnormalities can also cause infertility; in fact variations of form or number of the chromosomes exist (present in all cells and  containing all the information needed for the correct constitution and correct function  of the organism) which are associated with reproductive problems.

lunedì 11 maggio 2009

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