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Reproductive Pathophysiology 2: Pregnancy and Female Infertility

Reproductive Pathophysiology 2: Pregnancy and Female Infertility. Nancy Long Sieber, Ph.D. E-162b Human Pathophysiology October 22, 2012. 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

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Reproductive Pathophysiology 2: Pregnancy and Female Infertility

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  1. Reproductive Pathophysiology 2:Pregnancy and Female Infertility Nancy Long Sieber, Ph.D. E-162b Human Pathophysiology October 22, 2012

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

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

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

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

  6. Ectopic Pregnancy

  7. Lithopedion (Stone child)Calcified remains of an extrauterine pregnancy http://www.radpod.org/2007/09/17/lithopedion/ Credit: Dr Ahmed Haroun

  8. A Molar Pregnancy Hydatidiform mole. http://www.waybuilder.net/sweethaven/MedTech/FraPkr02.asp?iCode=010305_010306

  9. Genetics of Molar Pregnancies Figure 1 Karyotype derivation of complete and partial hydatidiform moles and rare biparental repetitive complete hydatidiform mole CHM=complete hydatidiform mole. PHM=partial hydatidiform mole. biCHM=rare biparental complete hydatidiform mole. P... Gestational trophoblastic disease Michael J Seckl , Neil J Sebire , Ross S Berkowitz The Lancet Volume 376, Issue 9742 2010 717 - 729 http://dx.doi.org/10.1016/S0140-6736(10)60280-2

  10. Development of tissue layers in the embryo http://www.hopkinsmedicine.org/craniofacial/LynmProject/BSC/BSC2.HTM#FIGURE1

  11. Neural Tube Defects http://www.cfsan.fda.gov/~dms/sbifidap.gif

  12. Fig. 20.48

  13. OK

  14. Cephalic vs. Breech Presentation http://www.breechbaby.info/images/fgwh2606.GIF

  15. Breech Presentation http://www.moondragon.org/obgyn/pregnancy/breech.html

  16. 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

  17. 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.

  18. Lupus and Pregnancy • Disease flares and drugs may suppress fertility. • Problems with excessive blood clotting increase risk of miscarriage and premature birth. • It’s unclear whether pregnancy makes lupus worse or better.

  19. Spinal Cord Injury and Sexuality and Pregnancy • Most women with spinal cord injury continue to be sexually active. • Women with spinal cord injuries can have healthy babies, and about half deliver vaginally. • Concerns during pregnancy include: autonomic dysreflexia, urinary tract infections, premature labor, abnormal presentation (i.e. breech), failure of labor to progress, and effects of drugs on the fetus

  20. Common causes of Infertility in Women • Tubal Obstruction • Ovulatory disorders • Polycystic Ovary Disease • Endometriosis

  21. Obstruction of the Fallopian Tube Normal Obstructed http://www.healthsquare.com/fgwh/wh1c0603.jpg

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

  23. Polycystic Ovary Disease • Characterized by irregular menstrual periods, and failure to ovulate. • Appears to be due high constant levels of LH • No LH surge, which is needed for ovulation, so the ova and follicles remain in the ovary. • High LH stimulates high levels of testosterone, leading to hirsutism. • Also characterized by obesity and insulin resistance

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

  25. Endometriosis • Characterized by appearance of endometrial tissue outside the uterus. • The misplaced endometrial tissue responds to reproductive hormones the same way the uterine lining does, and therefore there is thickening of tissues during the follicular phase, and bleeding during menstruation. • Women with endometriosis have fertility rates that are about 1/2 those without the disease. However, the mechanism by which this disorder causes infertility is unclear.

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

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

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

  29. Use of Assisted Reproductive Technology http://www.cdc.gov/ART/ART2007/section1.htm

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