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2 results

  • Chapter 5 - Premature Ovarian Insufficiency

  • Edited by Laurie J. Mckenzie, University of Texas MD Anderson Cancer Center, Houston, Denise R. Nebgen, University of Texas MD Anderson Cancer Center, Houston
  • Book:
    Caring for the Female Cancer Patient
    Published online:
    23 October 2024
    Print publication:
    17 October 2024, pp 81-92

  • Summary

    Premature ovarian insufficiency (POI) is a heterogeneous diagnosis caused by a multitude of factors including genetic, autoimmune, iatrogenic, social, and environmental. It is defined as loss of ovarian function prior to 40 years of age with subsequent secondary amenorrhea for at least 4−6 months in conjunction with elevated follicle stimulating hormone levels on two different measurements. Prompt recognition of symptoms should encourage thorough history-taking and work-up, as some causes of POI are associated with conditions requiring additional screening or medical management. Early initiation of hormone replacement therapy is necessary to prevent long-term sequelae from chronic hypoestrogenism such as cardiovascular events, poor bone health, and cognitive dysfunction. Extensive counseling with regards to future fertility and family building options is necessary as the diagnosis of POI can be psychologically devastating to many women.

  • Chapter 16 - Endometriosis and its treatment

  • Edited by Gab Kovacs
  • Book:
    The Subfertility Handbook
    Published online:
    06 December 2010
    Print publication:
    11 November 2010, pp 176-184

  • Summary

    In vitro fertilization (IVF) and other assisted reproductive techniques are now fully accepted modalities of treatment for subfertility in our modern world. The indications for IVF have increased with the development of newer techniques such as ICSI, surgical sperm retrieval, embryo biopsy, and cryopreservation techniques, and IVF has become the cumulative step for the diagnosis and treatment for unexplained infertility. Certain indications for subfertility discussed in this chapter include tubal infertility, endometriosis, ovarian dysfunction, surrogacy, and male factor. The typical IVF cycle involves the following stages: stimulation for multiple follicular development, monitoring follicular growth and development, trigger of follicular maturation, oocyte recovery and identification, insemination/ICSI, embryo culture, embryo replacement, luteal phase support and confirmation of pregnancy. Traditionally, pregnancy rate per cycle has been used to compare results but gradually cumulative pregnancy outcome over the course of treatment may become more pertinent to the couple.