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Management of Abortion
Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
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I had sex wid my gf yesterday and that to without protection and that was her first time but I did not cum inside her. Is it safe or I recommend her to take ipill. Her periods passed 3 days ago. Help me.
I want to delay my period for 15 days. My previous date was 15th December. Please advise me medicine for that.
I want to know the type of diet I can take during pregnancy to avoid extra wait gain and to come back in shape after delivery soon. Right now I am 63, ht 5'5" age 30, second pregnancy with hypothyroidism for last 7 years on 100 mg thyronorm.
I took a pregnancy test as I was very scared on Thursday 23Rd of March both urine and blood. Both turned out to be negative. I am on birth control pill Crisanta and I took it two month back to back without any break. I am on my 7 pill free days week. 2 days have passed. Still no period? When should I expect my periods? And shall I take another blood pregnancy test?
Unexplained infertility is infertility that is idiopathic in the sense that its cause remains unknown even after an infertility work-up, usually including semen analysis in the man and assessment of ovulation and fallopian tubes in the woman.
In unexplained infertility abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility. Aberrant reproductive immunology such as decreased maternal immune tolerance towards the embryo may also be a possible explanation. However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.
In india up to 25% of infertile couples have unexplained infertility.
- Potential methods in unexplained infertility include oral ovarian stimulation agents as well as (IUI), intracervical insemination (ICI) and in vitro fertilization (IVF).
- In women who have not had previous treatment, ovarian stimulation combined with IUI achieves approximately the same live birth rate as IVF.
- On the other hand, in women who have had previous unsuccessful treatment, IVF achieves a live birth rate approximately 2-3 times greater than ovarian stimulation combined with IUI.
- IUI and ICI has higher pregnancy rates when combined with ovarian stimulation in couples with unexplained infertility, for IUI being 13% unstimulated and 15% stimulated, and for ICI being 8% unstimulated and 15% stimulated. However, the rate of twin birth increases substantially with IUI or ICI combined with ovarian stimulation, for IUI being 6% unstimulated and 23% stimulated, and for ICI being 6% unstimulated and 23% stimulated.
- According to oral ovarian stimulation agents should not be given to women with unexplained infertility. Rather, it is recommended that in vitro fertilization should be offered to women with unexplained infertility when they have not conceived after 2 years of regular unprotected sexual intercourse. IVF avails for embryo transfer of the appropriate number of embryos to give good chances of pregnancy with minimal risk of multiple birth.
- A review of randomized studies came to the result that IVF in couples with a high chance of natural conception, as compared to IUI/ICI with or without ovarian stimulation, was more effective in three studies and less effective in two studies.
- There is no evidence for an increased risk of ovarian hyperstimulation syndrome (OHSS) with IVF when compared with ovarian stimulation combined with IUI.
Prognosis in unexplained infertility depends on many factors, but can roughly be estimated by e.g. the Hunault model, which takes into account female age, duration of infertility/subfertility, infertility/subfertility being primary or secondary, percentage of motile sperm and being referred by a gynecologist, sexual medicine specialist or N infertility specialist.