Review article
Diagnostics and treatment of infertility
Renato Bauman
; Klinika za ginekologiju i porodništvo, Opća bolnica “Sveti Duh”, Zagreb, Hrvatska
Abstract
Infertility represents a huge health problem in developed countries. Infertility is defined as lack of desired pregnancy with regular and contraceptive-free intercourses within a period of at least a year. It affects approximately 15% of reproductive population.
This article gives the review of possible causes and modern diagnostic procedures and options
in infertility treatment. The main non-invasive tool in the diagnostic algorhythm in infertile
patients is transvaginal ultrasound. We present the fields of interest of this sonographic
approach and the possible benefits of color Doppler and three dimensional imaging.
Methods of detection of tubal patency are presented, including non-invasive methods as sonohysterosalpingography and the invasive golden standard in infertility investigation – laparoscopy and hysteroscopy. If the etiology of infertility is known then the invasive diagnostic
procedures are followed by operative treatment. Laparoscopy is the standard procedure
in patients with endometrosis and tubal factor.
Assisted reproduction is used if previous conservative and invasive methods of treatment do not result in pregnancy. Intrauterine insemination is used in subfertile couples with proven
tubal patency. In vitro fertilization is used in couples with male factor, tubal factor, endometriosis
and idiopathic infertility. Success of in vitro fertilization procedures can be measured
according to the started cycle, per aspiration procedure or per embryo transfer. In vitro fertilization in Croatia started only four years after the first baby was born after IVF in the world. In Sveti Duh Hospital in the period from 2001-2004 we performed 378 aspirations
in stimulated cycles with 269 fresh embryo transfers which resulted in 96 pregnancies (25% per aspiration and 35% per embryo transfer).
Keywords
assisted reproduction; hysteroscopy; infertility; laparoscopy; ultarsound
Hrčak ID:
45848
URI
Publication date:
1.12.2009.
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