reproductive infertility 2: a bit more about male fertility, then a bunch about puberty, pregnancy,...
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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