Management of tubal infertility in the 1990s
Article Abstract:
A review is presented of recent developments in treating tubal infertility (infertility due to damaged fallopian tubes, through which the egg travels en route to the uterus), which is the underlying problem in more than 40 percent of all cases of female infertility. Microsurgical techniques have been developed to unblock tubes (salpingostomy); these are most successful when the blockage is located near the uterus. Blockage of tubes farther from the uterus is usually associated with infections of the genital tract and is harder to treat. In general, the success rate of microsurgery is highest in cases where damage is less extensive and adhesions (connective tissue that grows around the reproductive organs) are limited. A system has been developed for diagnosing the extent of tubal disease before surgery; other factors that affect the prognosis are the patient's age and the length of follow-up. Women older than 35 are less likely to benefit from surgical treatment of infertility because their rate of conception is lower than in younger women, and they also have a higher miscarriage rate. After tubal surgery, more than 60 percent of the patients who become pregnant require at least one year to do so. Results using open surgery (where the abdomen is opened surgically) and laparoscopic surgery (using a hollow tube through which instruments are passed) are compared; it is unlikely that laparoscopic surgery will replace open surgery. In vitro fertilization (IVF) is the fertilization of the egg by the sperm under laboratory conditions and the subsequent implantation of the resulting embryo into the uterus. Between 9 and 10 percent of treatment cycles lead to liveborn infants when IVF is performed. In the US, the costs per baby for IVF are approximately $50,000; this excludes associated costs, such as cesarean section, which is performed in almost half the IVF cases. Two articles in the July issue of the British Journal of Obstetrics and Gynaecology discuss the outcome of microsurgery to correct tubal infertility. Criteria for referral for IVF are discussed, with emphasis on steering patients to the treatments most likely to result in a live birth. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1991
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The action of squatting in the early postnatal period marginally increases pelvic dimensions
Article Abstract:
Squatting during delivery has been reported to enlarge the pelvis and aid in the delivery process. Forty-three women requiring x-ray pelvimetry during labor to measure pelvic size were asked to have measurements of their pelvis taken while squatting and repeated one week after delivery while in an erect position. A comparison of these measurements revealed an increase of one percent in two out of four pelvic dimensions. To confirm these results, it is suggested that measurements be made during pregnancy and labor comparing squatting and sitting positions.
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1989
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