性生殖精品教学（汕头大学）人类生殖障碍.pptVIP

Introduction of Infertility ※ Definition Infertility: a decrease in an ability to conceive ,counterpart with subfertility Sterility: an intrinsic inability to achieve pregnancy Fecundability: the likelihood to get pregnant in one menstrual cycle. ( WHO, one year) Primary infertility: never has a pregnancy occurred after two year’s regularly frequent unprotective intercourse. Secondary infertility: a prior pregnancy has occurred, but inability to conceive again for two or more years exposure to intercourse, no matter how the result of the pregnancy is. What are the chances of a fertile couple actively seeking pregnant in a single month or cycle? 10%-20% The accumulated pregnancy rate during two years __chances of conceiving by 6 months: 75% __chances of conceiving by 1 year:90% __10%-15%of couples will require longer than one year to conceive. 不孕不育相关概念 Epidemiology and etiology of infertility Causes Percentage Female factors 40 % Male factors 40 % Both male and female factors 10 % unexplained factors 10 % So, the initial evaluation should include both the partners. Common infertility factors Ovulation Tubal/pelvic Sperm ※ Female Infertility Causes 1. Ovulatory dysfunction: 25% 2. Tubal factors: 30%-50% 3. Pelvic factors 4. Cervical factors 5. Extra-genital tract factors 6. Others Female Factors Ovulatory dysfunction 1. Hypothalamus: amenorrhea or mensrtual disorder -- Emotional depression -- Psychological trauma -- Environmental or Climate changes 2. Pituitary diseases： --Sheehan’s syndrome -- Pituitary tumor:Hyperprolactinemia, -- Empty sella syndrome Ovary diseases: 1. Congenital dysformation: Turner’s syndrome(45,XO) 2. Polycystic ovarian syndrom(PCO) 3. Premature ovary failure(POF) 4. Ovary functional tumors 5. Insensitive to follicle stimulating hormones(FSH). 6. Other endocrinolo