Reproductive Infertility 2:

A bit more about male fertility, then a bunch about puberty,

pregnancy, and female infertility.

Varicocele

Effects of exogenous estrogens on male reproductive system

• Accidental over-exposure to pesticides with estrogen-like activity in an occupational setting has been associated with male infertility.

• Pesticide exposure has been shown to change the concentration, motility and morphology of sperm, but these changes have not been shown to affect fertility.

• Sons whose mothers took DES during pregnancy had only modest changes in semen quality, and no qualitative change in fertility.

                                                                  

PubertyDistribution of age of puberty within normal and abnormal populations

Among Caucasian Americans, the median age of menarche for girls is about 12.4 years, and about 12.1 years for African American girls.

Puberty occurs about 1 year later for boys.

http://jcem.endojournals.org/cgi/content/full/86/6/2364

                       Chumlea WC,, et al. Age at menarche and racial comparisons in US girls. PEDIATRICS Vol. 111 No. 1 January 2003, pp. 110-113

Fig 1. Probit plots for age at menarche for non-Hispanic white, non-Hispanic black, and Mexican American girls in the NHANES III

http://www.well-net.com/womenshealth/contraception/bbt-1.gif

Fertility

Widmaier, E.P. Raff, H. and K.T. Strang. Vander, Sherman and Luciano’s Human Physiology 9/e. McGraw-Hill. 2004

http://biology.unm.edu/ccouncil/Biology_124/Images/fertilization.jpeg

http://www.sgul.ac.uk/depts/immunology/~dash/troph/blastocyst.jpg

Ectopic Pregnancy

A Molar Pregnancy

                                                                     

Hydatidiform mole.

http://www.waybuilder.net/sweethaven/MedTech/FraPkr02.asp?iCode=010305_010306

http://www.hopkinsmedicine.org/craniofacial/LynmProject/BSC/BSC2.HTM#FIGURE1

Neural Tube Defects

http://www.cfsan.fda.gov/~dms/sbifidap.gif

Fig. 20.48

Widmaier, E.P. Raff, H. and K.T. Strang. Vander, Sherman and Luciano’s Human Physiology 9/e. McGraw-Hill. 2004

Cephalic vs. Breech Presentation

http://www.breechbaby.info/images/fgwh2606.GIF

Breech Presentation

http://www.breechbaby.info/images/fgwh2606.GIF

C-Sections

• Optimal rate: 10 – 15%

• Rate in US: 25.2%

• Both are safe in a normal pregnancy

• Overall safety difficult to compare (since C-sections are most often done when there are complications

Some Lingering Consequences of C-sections

• More post-delivery pain than a vaginal birth

• Delayed nursing and bonding

• Risk of respiratory problems, even if baby is not premature

• Increased risk of adverse outcomes in subsequent pregnancies: placental problems, uterine rupture.

Common causes of Infertility in Women

• Tubal Obstruction

• Ovulatory disorders

• Polycystic Ovary Disease

• Endometriosis

Obstruction of the Fallopian Tube

Normal Obstructed

http://www.healthsquare.com/fgwh/wh1c0603.jpg

Polycystic Ovary

http://medicineworld.org/images/blogs/2-2007/polycystic-ovary-281680.jpg

Endometriosis

http://www.whathealth.com/endometriosis/images/endometriosis.jpg

  

                        

      

http://www.aquinohotline.com/images/seps029.jpg

                                                                                              

                   

Source: Management of the Infertile Woman by Helen A. Carcio and The Fertility Sourcebook by M. Sara Rosenthal

http://www.advancedfertility.com/age.htm

Number of ART cycles reported for 2003: 112,872*

Number of live-birth deliveries resulting from ART cycles started in 2003: 35,785

Number of live babies born as a result of ART cycles carried out in 2003: 48,756

http://www.cdc.gov/ART/ART2003/section1.htm