Patient  Preparation For Assisted Reproductive Technology ART part 3

Patient Preparation For Assisted Reproductive Technology ART part 3 PowerPoint PPT Presentation


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Hydrosalpinx. A 50% reduction in live birth rateThe success rate increases to normal after tubal repair or salpingectomy Hydrosalpinges which are visible on US. Camus et al. Hum Reprod 1999; 14:1243. Shelton et al. Hum Reprod 1996;11:523.. IVF without any after US guided

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Patient Preparation For Assisted Reproductive Technology ART part 3

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1. Patient Preparation For Assisted Reproductive Technology (ART) part 3

2. Hydrosalpinx A 50% reduction in live birth rate The success rate increases to normal after tubal repair or salpingectomy Hydrosalpinges which are visible on US

3. IVF without any after US guided aspiration . IVF& drainage of a hydrosalpinx at oocyte retrieval. Laparoscopic Salpingectomy then IVF Laparscopic Salpingeostomy & tubal occlusion then IVF.

4. Hydrosalpinges Prior To IVF Laparoscopic salpingectomy should be considered for all women with hydrosalpinges prior to IVF treatment. Further RCT are required to assess other surgical treatments for hydrosalpinx, such as salpingostomy, tubal occlusion or needle drainage of a hydrosalpinx at oocyte retrieval.

5. Counseling before laparoscopy for any of these procedures is recommended

6. Occlusion of the proximal tube seems to be equally efficacious Hydrosalpinges Prior To IVF

8. Management Of Associated Condition Obesity , Habits &Psychology Endometrioma& severe endometriosis Hydrosalpinges Fibroid &polyp PCO Uterine problems & Dummy for ET

9. Uterine Abnormalities A saline sono-hysterogram (SIS) or hysteroscopy should be done if there is a further question of uterine disease. Higher pregnancy rate following hysteroscopic excision of small (mean 16 mm) polyps, underlining

12. Office Hysteroscopy (OH) & IVF At the time of laparoscopy For those not screened by HSG or SIS Before IVF/ICSI After one ART implantation failure After repeated implantation Failure

13. Office Hysteroscopy (OH) & IVF 1000 patients underwent OH before IVF Uterine pathology in 38% Endometrial polyps (32 Submucous myomas (3%) Intrauterine adhesions (3%). Pregnancy rates are improved with removal of the polyp.

17. Uterine Abnormalities A uterine septum should be incised before going on to IVF because of the higher risk of spontaneous abortion.

21. Uterine Fibroids Submucus fibroids markedly reduce the pregnancy rate with IVF Studies have been conflicting regarding the role of intramural myomas At the present time, advise is excision if they are large or distort the cavity.

22. IVF/ICSI: Couple Preparation Counseling &Patient information Basal Vaginal U/S. Testing Ovarian Reserve& Endocrine Evaluation. Management of associated condition Male Assessment. General evaluation Preventive Treatment.

23. Management Of Associated Condition Obesity & Habits Endometrioma& severe endometriosis Hydrosalpinges Fibroid &polyp PCO Uterine problems & Dummy for ET

24. Embryo Transfer Dummy

27. Preventive Treatment : Day 1 For both partners Doxycyclin 100mg 1x2x7d. Diflucan or Flucoral one caps. Flagentyl 4 tablet Folic acid 0.5mg& Aspirin 75mg /day are contiued

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