复旦大学附属妇产科医院：《妇产科学》课程教学资源（PPT课件讲稿）INFERTILITY-不孕症

Infertility and Assisted Reproductive Technologies 不孕症和辅助生殖技术 XIN LU Obstetrics Gynecology Hospital Fudan University 20063

Infertility and Assisted Reproductive Technologies 不孕症和辅助生殖技术 XIN LU Obstetrics & Gynecology Hospital Fudan University 2006-3-1

Contents Infertility Definition: Causes: Examinations and Diagnosis Treatment. Assisted Reproductive Technologies(ART) Intrauterine insemination (lUl) In vitro fertilization and embryo transfer(VF-ET); Intracytoplasmic sperm injection (ICsi) Gamete intrafallopian transfer (GIFT:

Contents ◼ Infertility ◼ Definition; ◼ Causes; ◼ Examinations and Diagnosis; ◼ Treatment; ◼ Assisted Reproductive Technologies (ART) ; ◼ Intrauterine insemination ( IUI); ◼ In vitro fertilization and embryo transfer (IVF-ET); ◼ Intracytoplasmic sperm injection (ICSI); ◼ Gamete intrafallopian transfer (GIFT);

DEFINON of Infertility 不孕症定义 What is Infertility? Infertility is defined two years of unprotected intercourse without pregnancy WHO, one year) Primary Infertility no previous pregnancies 原发不孕 have occurred; Secondary Infertility a prior pregnancy has 继发不孕 occurred

DEFINITION of Infertility 不孕症定义 What is Infertility? Infertility is defined two years of unprotected intercourse without pregnancy. (WHO, one year) Primary Infertility : no previous pregnancies 原发不孕 have occurred; Secondary Infertility: a prior pregnancy has 继发不孕 occurred;

Age and Infertility年龄与不孕 age fertility abortion Fertility rate 30yr74% 11.9% per1,000 30-35yr62%15.0% >35yr54% 24.6% .>40yr 51.0% female male 10203040506070

Age and Infertility 年龄与不孕 ◼ age fertility abortion ◼ Fertility rate 35 yr 54% 24.6% >40 yr 51.0% female male 10 20 30 40 50 60 70

Female Reproductive duct anatomy女性生殖道解剖 Fallopian Uterus Female Ovary tube ovary卵巢 fallopian输卵管 Internal os uterus子宫 Cervix External os cervⅸx宫颈 Vagina阴道 Vagina aium ninus FADAM

Female Reproductive duct anatomy 女性生殖道解剖 Female ovary 卵巢 fallopian 输卵管 uterus 子宫 cervix 宫颈 Vagina 阴道

Male Reproductive duct anatomy男性生殖道解剖 Male EJACULATORY DUCT PROSTATE GLAND testis睾丸 SEMINAL VESICLE epididymis附睾 bladder URETHRA rostate前列腺 BULBOURETHRAL GLAND vas deferens输精管 urethra anus VAS seminal vesicals精囊 DEFERENS EPIDIDYMIS bulbourethral glands尿道球腺 ejaculatory duct射精管 erectile tissue urethra尿道 PENIS TESTIS

Male Reproductive duct anatomy 男性生殖道解剖 Male testis 睾丸 epididymis 附睾, prostate 前列腺 vas deferens 输精管 seminal vesicals 精囊 bulbourethral glands 尿道球腺 ejaculatory duct 射精管 urethra 尿道

Female Reproductive Physiology女性生殖生理 1.下丘脑垂体卵巢轴内分泌调节 Femal Male (H-P-O) (H-P-T) hypothalamus GnRH GnRH FSH, LH FSHLH pituitary EP ovary 4 oary3输卵管 2.卵巢周期性排卵 子宫 5.宫颈 6.下生殖道

Female Reproductive Physiology 女性生殖生理 ◼ 1. 下丘脑-垂体-卵巢轴内分泌调节 Femal Male ( H-P-O) (H-P-T) GnRH GnRH FSH,LH FSH,LH E/P T 4. 3.输卵管 2. 卵巢周期性排卵 5. 宫颈 6. 下生殖道 hypothalamus ovary pituitary 子宫4. ovary 子宫

Normal gestation a-the beginning of human Follopian tube Uterine ovary acte Cervix Extra-genital tract sperm

Normal Gestation -----the beginning of human Follopian tube Uterine ovary oocyte Cervix Extra-genital tract sperm

Causes原因 Causes Percentage Female factors 40-55% Male factors 25-40% Both male and female factors 20% Immunologic unexplained factors 10%

Causes 原因 Causes Percentage Female factors 40-55 % Male factors 25-40 % Both male and female factors 20 % Immunologic unexplained factors 10 %

Female factors女方因素 Ovulatory dysfunction (排卵障碍) Pelvic factors (盆腔因素)

Female Factors 女方因素 Ovulatory dysfunction （排卵障碍） Pelvic factors （盆腔因素）