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Fertility: What can go wrong

Fertility: What can go wrong. Low sperm count or quality Failed ovulation Failed fertilization Failed or misplaced (ectopic pregnancy) implantation Malformed placenta Miscarriage . Fertility: Why it goes wrong (1). Hormonal imbalance Variation in hormone levels or hormone receptor levels

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Fertility: What can go wrong

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  1. Fertility: What can go wrong • Low sperm count or quality • Failed ovulation • Failed fertilization • Failed or misplaced (ectopic pregnancy) implantation • Malformed placenta • Miscarriage

  2. Fertility: Why it goes wrong (1) • Hormonal imbalance • Variation in hormone levels or hormone receptor levels • Environmental causes • Pituitary tumor or stress excessive prolactin levels • PCOS excessive LHlevels (no LH surge) • Anatomical problem/blockage • Innate low sperm quality or count (maybe also hormonal problem) • Testicular injury or surgery • Endometriosis • Inflammation or infection • Innate anatomical issue of reproductive tract

  3. Fertility: Why it goes wrong (2) • Chromosomal abnormality • No genetic info in egg (molar pregnancy) • Other abnormalities that cause spontaneous miscarriage • Secondary to another condition/disease • Smoking or circulatory condition placental problems • Spinal cord injury fertility probably normal, but many risks associated with delivery • Lupus flare up  inflammation & drug treatment • Endometrial lining not thick enough, or lack of appropriate receptors (does not receive correct hormonal signals) • Environmental toxins miscarriage • Menopause

  4. DISCUSSION OF GNRH ARTICLE

  5. WOMEN: Feedback loop of the early and mid follicular phases

  6. GnRH agonists: receptor desensitization by continuous administration (no pulsatile release) • Initial stimulation: “flare phenomenon” • Reduced FSH & LH after days-weeks • GnRH antagonists: block GnRH receptors • React within hours • Both result in greatly reduced release of FSH & LH, but timing is different

  7. GnRH receptors • Expressed in pituitary • Expressed in many tumors (even those not hormone-related) • GnRH agonist effect on tumors • Antiproliferative • Antimetastatic • Antiangiogenic • GnRH antagonist • Reduce LH and FSH release from pituitary • Behave like agonists on GnRH receptors in tumors (see effects above)

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