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Therapy for the woman

letto 4481 volte | autore: Fertilita.org

         

It is the most important aspect, and at the same time, the  most difficult of human reproduction.  It is important to realise that in order to undertake good and effective therapy, especially when you turn to Assisted Reproduction, it is important to go to doctors specialised in this field because an ordinary doctor is not enough. Here, we will make a list of the most utilised therapies, advising that the choice of technique should vary from case to case.

Therapy for the woman
Generally, medical therapy (based only on drugs), surgical therapy and Assisted Reproduction techniques can be used for the woman but also for the man.

  • condition: ovulation abnormalities (hormonal deficit)
    therapy: generally this has an indication of ovarian stimulation with programmed sexual intercourse
  • condition: polycystic ovarian syndrome (hyperandrogenism and lack of ovulation.  Insulin disturbances)
    therapy: the objective of one of the therapies is to block the male hormones (androgen) and diminish their production.  Small quantities of anti-androgens can in fact be used for this.  Depending on the dosages of these drugs during treatment, there are no serious side effects.  These drugs, like ciproterone acetate, can be found in oral contraceptives.  If you discover that because of polycystic ovarian syndrome (PCOS) you have  hyperinsulinemia it is important to adjust your diet and drugs.  If, however, there is lack of ovulation simple ovarian stimulation should be performed.
  • condition: luteal or progesterone deficit
    therapy: sustenance of the luteal phase during ovarian stimulation with the oral or vaginal administration of progesterone to balance an elevated level of estradiol and increase the level of progesterone that may be low.  Progesterone, in particular, plays a fundamental role in the maintenance of pregnancy.  It is also possible to sustain the luteal phase through the administration of HCG (human chorionic gonadotropin) in intervals during the second part of the cycle
  • condition: tubal causes
    therapy: the tubal factor was the very first indication for in vitro fertilisation in 1978 resulting in the birth of English, Louise Brown.  Because the permeability of the tubes is a basic condition required for natural conception, their impermeability is an indication for Assisted Reproduction, the only alternative being tubal micro-surgery.  This is performed when the tubes present with little or moderate damage that does not allow the ovule to travel easily form the ovaries to the uterus.  Today the convenience of this therapy is increasingly reduced compared to Assisted Reproduction which in the most serious cases gives better results
  • condition: endometriosis
    therapy
    : endometriosis can become a problematic factor especially if it is extensive.  At an initial stage, it generally does not compromise infertility, but when it is situated in one or both of the ovaries, the cysts that are formed can represent a serious obstacle for fertilisation especially if adhesions form.  The therapy is sometimes surgical followed by pharmacological treatment, or more frequently Assisted Reproduction.
  • condition: uterine causes
    therapy: many revisions of international literature have been made in recent years regarding the association between uterine factors (polyps, myoma, malformations and synechias) and infertility and diminished reproductive capacity, and it has been acertained that the treatment of these uterine alterations increases the possibility of  pregnancy.  Many studies demonstrate how treatment of these pathologies with a hysteroscopy improves reproductive capacity and the percentage of pregnancies from 32% to 87%.
  • condition: chromosomal abnormalities
    therapy: it is difficult to cure chromosomal abnormalities with real therapies
  • condition: infection
    therapy: pharmacological
  • condition: unexplained sterility
    therapy: simple ovarian stimulation
    Assisted Reproduction

lunedì 8 giugno 2009


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