February 01, 2012

Female Infertility Treatment

Although it has more than one year without using contraception mating, as much as approximately 7% of couples do not get a descent. Various means have been taken, ranging from simple to the in vitro fertilization (IVF) and intra-sitoplama sperm injection (SSIS / ICCI), but still have not got pregnant. Apparently many molecular biological processes is still unknown and still takes a long time to learn it. Nidasi and trophoblast invasion in the early embryo growth, influenced by various factors such as paracrine hormone fluctuations, local tissue reactions occurring within the trophoblast and desidu, as well as the role of metalloproteinases and adhesive proteins. All of these factors are only found in the tissue and the levels in the serum can not be checked. Therefore, to look for causes of infertility are forced to use conventional methods, which can also help some women.

History is still a good way to look for causes of infertility in women. Many important factors associated with infertility can be asked to the patient.

Age of patients is very important to know, because with increasing age, the more difficult to get the child. Difficulty in getting a child not because the woman has become old, but more due to the reduced quality of the woman's egg cell. When done egg donation, for example in a menopausal woman, the woman would get pregnant and her pregnancy is progressing well. This suggests that instead of the uterus that causes women to not be pregnant but the ability of the woman's egg to be fertilized has been reduced
Theoretically, as long as the ovaries are normal, then it is likely to become pregnant is always there. Therefore do not occasionally say About a woman aged 40 years might not be pregnant. Pregnancy is possible, but likely not so great. By act of IVF did not give satisfactory results.

History of disease, or previous surgery can provide information about the causes of infertility. History of previous diseases such as appendicitis, peritonitis, salpingitis can cause abnormalities in the tube. In the anamnesis should also ask whether the patient is suffering from diseases such as hypothyroidism, hyperthyroidism, pituitary disease, and suprarenal, yagn DAPT cause infertility. Diabetes is also one of the causes of infertility.

Weight loss and changes in body weight (too fat, too skinny) will affect the treatment of infertility. Subcutaneous fat contain the aromatase enzyme, so that androgen is converted to estrogen. High estrogen to suppress FSH and LH expenditure. Moreover, high estrogen increases LH secretion. High LH suppresses the activity of the enzyme aromatase that androgens can not be converted into estrogen. In obese women often found insulin resistant. Insulin triggers the consistency of DHEA in the suprarenal, resulting in hyperandrogenaemia. Androgen levels in follicular fluid and serum in high and this causes the follicle atresia. Keep in mind also that DHEA is a precursor that is used to mensistensis other types of steroid hormones (estrogen, progesterone, and androgens).

Leptin cells suppress the production of neuropeptide Y in the hypothalamus. Usually, this neuropeptide reduces hunger. Because leptin in obese women suppress the production of neuropeptide Y, then the patient will always feel hungry, so the porch body will continue to grow. Leptin also triggers the FSH and LH. High LH levels of androgens to estrogens inhibit change and naturally rapid increase in androgen levels. Emaciation due to chronic malnutrition does not cause the formation of fat and leptin, so there is no expenditure of FSH and LH stimulation. The result is anovulation until amenorrhoea. Therefore, the regulation of body weight is extremely important in the treatment of female infertility.

With a history can also be known endokrinologik abnormalities. Presence of hirsutism, acne, or seborrheic indicates hyperandrogenaemia, or abnormalities in the thyroid gland function. The discovery of galactorrhea is a sign of hyperprolactinemia.

There should also note the pattern of life of patients with infertility. Alcohol, for example, can inhibit the action of the enzyme sulfatase and aromatase enzyme, resulting in interference with the hormonal system. Nicotine reduces blood flow and accelerate the destruction of genitalia tool hormones. Stress is also a causative factor for difficulty having children. Stress triggers the corticotropin releasing factor (CRF). CRF expenditure suppress LH and GH and triggers the pro-opiomelanocortin (POMC) in pituitary cells kortikotrop front. Intermedia in the pituitary, POMC this will be resolved into two parts, namely lipoprotein and endorphin. Endorphin has antigonadotrop effect and is a dopamine antagonist. In people who use marijuana frequently found morphine or menstrual disorders.

Disorders of sexual relations can cause infertility, such as incomplete penetration into the vagina, very rarely have sex, or vaginismus. Nowadays women often washes her intimate organs and the surrounding area with antiseptic fluids. This habit can cause changes in cervical mucus which becomes inhospitable to sperm. In the vagina there are various types of microorganisms. These microorganisms keep the vagina is acidic, so it serves to protect the vagina from infection. Microorganisms are also known as "good" bacteria. Cleaning the sex organs with antiseptic fluids it will cause the bacteria are "good" is dead, will cause the bacteria are "bad" breed. Using deodorant perfumes in sex organs also made a "good" bacteria die. It should be encouraged to use underwear made of cotton, and do not use the pants are too tight, so as not to cause a feeling wet all the time.

Male Infertility Treatment

Infertility is a condition of married couples more than one and a half years without contraception, no children. One-half-year figures set, since it is usually 85 percent of couples in a year and half already have children. This means, 15 percent of couples of childbearing age have this problem.

Reality shows, 40 percent of the problems that make it difficult to have children there are in women, 40 percent in men, and 30 percent in both. So, do not correct the assumption that women are responsible for the difficulty of getting children.

Although the problem of infertility had no effect on daily physical activity and not life-threatening, for many couples this is a great impact on family life. Surely psikokultural factors influencing attitudes towards the couple this problem, including efforts irrational to have children. Indeed, what the patient can not be blamed entirely, as though cutting edge of medical science can not answer satisfactorily the problem of infertility.

Examination of men with infertility doctors performed just like in people in other diseases, but accompanied by examination of sperm. These hearings to see the potential of male to fertilize. When there are problems, then do the other more in-depth examination.


As well as prevention of disease in general, the first attempt ever to be undertaken is to find the cause of infertility. 
The most common cause of male infertility is widening vein / veins around the testicles is called a varicocele. On physical examination, this is found in the form of a lump at the top of the testicles will grow real big and when to push. The more frequent contact with the left scrotum.
Most of the varicocele is not accompanied by pain, although some are complaining sore in the area. Varicocele was found in 40 percent of patients. These findings are not much different from the findings of one of the renowned infertility prevention centers at Baylor College of Medicine, United States, where 42 percent.

Other causes of infertility in men is a blockage / obstruction in the vas deferens. So although the spermatozoa produced by both, remains to be channeled. Usually this is caused by the occurrence of congenital infection and because it does not formed part of the vas deferens. This occurred in 15 percent of patients. In the remaining 20 percent, infertility caused by various factors, such as hormonal disorders, congenital abnormalities, the influence of drugs, erectile or ejaculatory disturbances, radiation, pesticide poisoning, immunological disorders, surgery in the pelvic area, and others.

By knowing the factors that cause it, some things can be done to prevent or cope with infertility.

Prevention of infertility

Some things you can do : various kinds of infections are known to cause infertility, especially infection of the prostate, testes, and vas deferens. Therefore, any infection in this area should be taken seriously.
Some substances can be toxic to the growth of sperm. Many studies have shown adverse effects of smoking on sperm count and quality. Although each study is different in determining the amount of cigarettes that effect, is enough reason for men with sperm count and quality less to quit smoking.
Alcohol in large quantities associated with lower testosterone levels which would interfere with the growth of sperm. Marijuana is also known as one of the causes of growth disorders of sperm, so the cessation of the use of marijuana and alcohol is a preventive effort to infertility.

Quite a lot of drugs that affect the sperm. Therefore, tell me more about a drug that has been and is being used to help your doctor.

The best mitigation is to deal with the cause. Unfortunately, not all causes are known and vice versa is quite a lot of people with a known cause, but can not completely overcome.
Infertility is no known cause is a significant problem because it covers 20 percent of sufferers. Abatement in the form of several kinds of drugs, which had raised the amount of experience and quality of sperm. But most of the research done by using a comparison, showed no significant improvement. Effort to find the cause of the chromosome level and success of genetic manipulation seems to be a point of hope in the future.

A blockage in the vas deferens can be ascertained only by surgery. If the blockage is so severe, with the aid of a microscope can be operated corrections. At the same operation, can also be ascertained whether or not the production of sperm in the testicles.

In accordance with the abnormalities are found, then other causes can be overcome by correcting the hormonal and cessation drugs suspected of causing sperm disorders. However, efforts in the above there are times when not managed to improve the quality and quantity of sperm, so that assisted reproduction techniques are required. Included in this is relief insemination and in-vitro insemination (IVF / IVF), which greatly helps to overcome male infertility problems.

For example, men with only 5-10 million sperm / cc (from the normal 20 million) can try artificial insemination. IVF requires only 500,000 sperm with 30-35 percent pregnancy rate. The most remarkable progress in the last 7-8 years is the technique of IVF with ICSI (Intra cytoplasmic Sperm Injection) which only requires a few spermatozoa to be injected into the mother's egg cell. The success rate is almost the same.

Obvious explanation

Such a cursory overview of infertility problems in men. Enterprises have offspring that had lasted for centuries would indeed continue. Various advances have been achieved although there is one thing that remains, that is such great expectations of the patient. Sometimes this led to the choices made without consideration mature.

Therefore, always ask your doctor a clear explanation about the therapies offered, complete with the possibility of success. This way you can be more rational conduct all examinations and treatment, excessive or hopeless despair.

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January 31, 2012

Fertility Age


What is meant by women of childbearing age is a state of female reproductive organs functioning properly between the ages of 20-45 years. In women of childbearing age took place more rapidly than in men. Peak is in the age range 20-29 years. At this age a woman has a 95% chance of getting pregnant. At the age of 30 percentage decreased to 90%. While entering the age of 40, pregnant chance reduced to 40%. After age 40 women only have a maximum 10% chance of getting pregnant. Reproductive fertility problems is very important to know. Where in the fertile women should maintain personal hygiene and care for the maintenance of state genitals diligently to clean it. 

Therefore advisable to take care of themselves.

To know the signs of infertile women, among others:

1. Menstrual Cycle

Women who have regular menstrual cycles every month is usually fertile. One menstrual cycle starting from the first day out period until the day before your period comes back, which usually lasts for 28 to 30 days. Therefore, the menstrual cycle can be the first indication to mark a woman's fertile or not. The menstrual cycle is influenced by female sex hormones are estrogen and progesterone. These hormones cause physiological changes in female body that can be viewed through several clinical indicators such as, changes in basal body temperature, changes in cervical mucus secretions (cervical), changes in the cervix, the length of the menstrual cycle (calendar method) and minor indicators of fertility such as pain stomach and breast changes.

2. The ticker fertility

Technological advances such as ovulation thermometer can also be used as a tool to detect a woman's fertility. This thermometer will record changes in body temperature when she issued a seed or egg cell. If the seed out, usually thermometer will record the temperature rise of as much as 0.2 degrees celsius for 10 days. But if the woman does not experience changes in body temperature of the fertile period, means the woman is not fertile.

3. Blood Test

Women with irregular menstrual cycles, like the coming period of three months or six months are usually infertile. If under these conditions, several blood tests need to be done to find out the cause of the menstrual cycle is not smooth. Blood tests performed to determine the content of hormones that act on a woman's fertility.

4. Physical examination

To know a woman is fertile also can be known from the organs of the body of a woman. Some organs, such as breast, thyroid gland in the neck, and reproductive organs. The thyroid gland that secretes hormones thyroxine excess will interfere with the process of releasing eggs. While breast examination is intended to find out where the content of the hormone prolactin high prolactin hormone would interfere the process of spending the egg. In addition, examination of the reproductive system also needs to be done to determine the reproductive system is normal or not.

5. Track record

Women who have experienced miscarriage, whether intentional or not, the chances of contracting the bacteria in the reproductive tract will be high. These bugs will cause damage and blockage of the reproductive tract.


There are several methods used to calculate a woman's fertile period. The most effective method is to use a different approach is usually an indicator of temperature changes combined with changes in cervical mucus. These indicators have been scientifically proven to reflect changes in hormonal and fertility status accurately.

Calculation of fertile period using the calendar system is a way of natural or nature that is used only when a woman has regular menstrual cycles. The calculation is based during the fertile time ovulation occurs on day 14 of the menstrual period to come and minus 2 days because sperm can live for 48 hours after ejaculation and added two days for the egg can live 24 hours after ovulation.

By knowing the fertile period, it will be useful for couples who have trouble getting offspring, namely by:

Assess the incidence and time of ovulation.
Predicts the days of maximum fertility.
Optimizing the time to have sex to get pregnant.
Help identify some of the problems of infertility.
Lack of knowledge about reproductive fertility, especially in women, often associated with various diseases, whereas the level of fertility every person is different - different depending on physical condition and mental. 

Infertility reproduction tools often also associated with various illnesses suffered by one of the couples who have it, of which 40% are caused by a female infertility factor while the other 40% because of man, and the remaining 20% ​​for both.

But basically the reproduction infertility in women caused by:

Hormonal dysfunction
Blockage of the Fallopian tubes
Ovary cyst
Poor sperm motility.

Therefore, women of childbearing age must conduct a medical examination (examination of the genitalia), although it has a menstrual cycle / menstrual regularly. It is not a sign that she was fertile. This means that WUS must be healthy free from venereal disease. Before marriage WUS should conduct a medical examination to determine the condition of their reproductive organs are functioning properly. By conducting a medical examination will prevent genital disease. Female genitalia are very in touch with the outside world through the hole intercourse, cervical channel, cavity / space of the uterus. Oviduct (fallopian tubes) which empties into the abdominal space. Because of this direct relationship female genital infection caused by an unhealthy sexual relationship, so that infection can be sustained exterior walking up to the abdomen in the form of infection of the lining of the abdominal wall or also called peritonitis.

Defense system of the female genitals are pretty good that the acid system, usually the other defense systems by way of the mucus that is always flowing outward causing bacteria are discarded in the form of menstruation, the defense system is very weak, so the infection is often dammed and surely spread in all directions that lead to sudden and chronic infections.


What is the age for a man considered too old to have children? Do men also have restrictions as well as women in terms of fertility?
In contrast to women, men do not have a "deadline" to have children. Although the quality, quantity, and movement of sperm dropped dramatically at the age of 50 years. Male fertility will be reduced every decade, especially after he was aged over 35 years. The number of sperm aged 50-80 years compared to only 75 percent of men aged 20-50 years.

Swimming ability of sperm was also reduced with age. Sperm mobility is best at age 25 years and lowest in the age of 55 years. From the age of 35-55 years, sperm mobility is reduced to 54 percent, no matter how much he had sex.

However, that should be of concern is the quality of sperm when a man turns the age of 50 years. In case of egg fertilization in this age, it is likely that children born will have birth defects or health problems.
So far scientific research shows, the older the age of the father as a child, the greater the risk of having a child with Down syndrome, schizophrenia, autism, and other genetic diseases. The risk of the mother to have a miscarriage is also higher.

In other words, although male fertility is not affected as women age, there are factors that decrease the quality of health of babies will be born.

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What is infertility

It is an indisputable fact that fertility in women decreases as they get older. About 20 years old woman has the best chance to become pregnant in a natural cycle, with a probability of about 25%. From the point of fertility decline gradually and so on, with a significant decrease of about 37-38 years.

So, what is infertility? For women it usually is the inability to get pregnant after Trying for about a year; for men, the inability to impregnate.

As we have seen, these are average figures. Fertility of some women can lose before, while others may remain fertile in their forties.

The whole process is associated with decreased oocyte reserve, and a reduction in oocyte quality, which is manifested as an increased number of chromosomal anomalies in oocytes.

Why is age so important?

There are various reasons why there are fewer live births in women over age 40:

* It is a fact widely recognized that the emergence of a fetus with chromosomal anomaly is much more common in older women, especially those over age 35. One of the most famous of these is a chromosomal anomaly that causes Down syndrome. Chromosomal anomalies contribute greatly to the increase in miscarriage rate for older women.

* All the energy needed for cell division and growth of the embryo is provided by the tiny organelles called mitochondria in the ovum. As women get older, their eggs contain less and less mitochondria, and as a result of the embryo has a reduced supply of energy for its development, and while it is true that the fetus will result in the mitochondria itself when it reaches a certain point of development, if the embryo does not have enough energy for up to to the point that will stop growing, which will result in failure to implant, failure in cell division, or miscarriage.

* If a woman does not have a menstrual period, or it is not regular, ovulation usually absent or irregular. The absence of ovulation will result in total sterility. Ovulation usually can be corrected by treatment with drugs. If the problem is the exhaustion of ovarian reserve, one solution could be to use donated eggs or embryos.

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January 30, 2012

Pregnancy risks over 40

There are some problems that are often found by doctors in pregnant women over the age of 40 years, such as gestational diabetes (diabetes that appears during pregnancy), high blood pressure and also the problems in the fetus. Pregnant women with older age will also be more likely to experience bladder problems in pregnant women compared with younger age. Other risks are greater miscarriage risk, the more who gave birth via Caesarean section because of conditions that are not allowed to give birth normally, and also have a higher risk of birth defects.

When her late 30's, women tend to experience medical conditions related to the reproductive system, such as uterine fibroid tumors and muscle. Uterine fibroids are growths of muscle cells or other tissue in the uterine wall, forming a tumor. And uterine fibroid tumors can cause muscle pain or vaginal bleeding during pregnancy progresses. If a pregnant woman over the age of 40 years, the severity of even more severe. The problems had been able to grow in the presence of haemorrhoids (piles), incontinence (difficulty holding urine), varicose veins, vascular problems, muscle pain, back pain, and also the birthing process more difficult and longer.

Besides the risk of having a baby with down syndrome, the risk of miscarriage and birth by caesarean section, pregnant women aged over 35 years also have a risk of babies dying while in the womb or during childbirth. Although this risk existing at each gestational age, but in women aged 35 years and over, the risk is greater,  7 out of 1000 pregnancies.

Genetic Counseling

Women who are pregnant with the age above 35 years are usually also be required to perform genetic counseling, or counseling can also be done by an obstetrician. There are three areas that are the focus at the time of genetic counseling, the history or patient's reproductive history, family medical history, and consanguinity, that is a genetic condition caused by marriages between relatives.

Reproductive history included whether the patient ever been pregnant, had experienced miscarriage, or have experienced the death of the fetus in the womb or during childbirth. Besides the use of family planning methods, long time use of family planning, and whether the patient had been exposed to harmful substances such as work environment is also important information in counseling.

Patient's family medical history is also important to determine whether the pregnancy is being undertaken, including a high-risk pregnancy or not. This includes information about the health status of patients and spouses, the siblings of the patient and spouse, if any who have died will also be asked for the cause and age at death and if anyone has died in connection with the birth (during delivery or at birth). Family health history will help doctors identify abnormalities that have occurred in families of patients and help predict likely to occur in patients.

If the patient is still considered brother and partner, it is also important to invoice the doctor / counselor, because if a husband and wife is the cousin directly, they have 1 / 16 of the same gene. This means that the possibility of genetic abnormalities in children who will be born higher than if they marry someone who is not in one family. Some African and Mediterranean ethnicity also have a tendency to lower the disease sickle cell anemia on its derivatives.
The important thing to note is, counselor or doctor will not give decisions on patients and their partners with respect to the results of counseling. They will only provide the necessary information about the patient's pregnancy and the fetus, and the decision that if the pregnancy would be continued or terminated (if the predictions of the risks that may be experienced too high) left entirely to expectant parents.

Prenatal Testing

Prenatal Testing-testing or testing during pregnancy is performed in high risk pregnancies can’t detect any abnormalities that may occur. However, chromosomal abnormalities can be detected during fetal development through a series of tests such as amniocentesis, ultrasound, chorionic villus sampling and fetoscopy. The results of this test series will provide an option for couples to continue the pregnancy or abort the fetus if it is detected abnormalities. The results of these tests will also be a guide for physicians and health personnel to perform the actions necessary during pregnancy, birth, and help the parents to make suggestions about the growth and development of the baby.
Pregnancy at the age of 40 years it sounds scary, but as mentioned earlier, most women who are pregnant at the age of 40 years of successfully running a healthy pregnancy and gave birth to a perfect baby. It is true that the risk will grow with the increasing age of the mother during pregnancy, but with the preparation of a more mature, more complete information, and help health workers more sprightly and informative about the condition of high risk pregnancies will help the expectant mother to be able to continue to believe self, healthy, and spirit while undergoing pregnancy.

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Pregnancy At 40

Many have questioned why pregnant women in their 30s or 40s are considered high risk. At the age of 40 years, there is some increased risk both for the mother (such as high blood pressure and pre-eclampsia) and also for the baby (such as the risk of Down's Syndrome) increased annually. But, without ignoring these risks, women over the age of 40 years also can really lead a healthy pregnancy and gave birth to a perfect baby.
If you are a woman over the age of 40 years and are pregnant, your doctor usually treats you with extra caution. You will be prompted for pregnancy checkups more often, and more are required to undergo a series of tests, genetic counseling and screening constraints which may occur in pregnant women age of 30. Childbirth choices are also usually more limited. You probably will not be advised to give birth in a midwife or maternity home is small, because you gave birth to a greater risk that you will be asked to give birth in a large hospital or a large maternity hospital. However, by doing good prenatal care, you can reduce the complications associated with childbirth age significantly.

The good news is, most women who get pregnant in their 40s were successfully completed a healthy pregnancy and healthy baby too. And pregnant women in their 40s are usually more careful of her pregnancy than younger women. They will further seek and absorb information well about the conditions and the risks that might occur in their pregnancy. They are usually more frequently asked about the development of their fetuses. They are also more concerned about pre-natal care and generally prepare themselves better before pregnancy, if the pregnancy was planned. Therefore scientists now believe that the risk of pregnant women in older age did not increase significantly just because of age factors.

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