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Reproductive Issues

Reproductive Issues Lynn M. Westphal, MD Associate Professor Director, Women’s Health Obstetrics and Gynecology Stanford University School of Medicine Cycle length Menarche: 12.8 years (9.1-17.7) Anovulatory cycles for 12-18 mo.(25% anovulatory up to 4 yrs after menarche)

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Reproductive Issues

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  1. Reproductive Issues Lynn M. Westphal, MDAssociate Professor Director, Women’s Health Obstetrics and Gynecology Stanford University School of Medicine

  2. Cycle length • Menarche: 12.8 years (9.1-17.7) • Anovulatory cycles for 12-18 mo.(25% anovulatory up to 4 yrs after menarche) • 5-7 years of increasing regularity • 28 d cycles most common (12% of women) • 24-35d is a normal range (0.5% have <21d and 1% have >35d) • Cycles lengthen again in the 40’s • Studies differ on cycle irregularity in relation to menopause: 2-4 years or 6-8 years prior • Menopause: 50.7 years

  3. Follicular Numbers • Max at 20 weeks of pregnancy: 6-7 million • 2 million at birth • 300,000 at puberty • 400 follicles will ovulate during a lifetime • 1000 oocytes undergo atresia each month regardless of stimulation • Rapid decline when reach 25,000 oocytes (37-38 years old)

  4. Multifollicular Development

  5. Oocyte Retrieval

  6. Oocyte

  7. 2PN Embryo

  8. 8 Cell Embryo

  9. Blastocyst

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