TREATMENT OF INFERTILITY IVF - Shanyar：不孕不育与体外受精-治疗shanyar.ppt

* IUI: Success rates increase from unstimulated IUI through to stimulation with Clomid and FSH. The overall success rate, as with any subfertile couple, depend on multiple factors, most importantly female age and with IUI the quality of the sperm. Though IUI can be used for mild male factor problems, Success rates for stimulation with Clomid and then generally accepted levels of between 12 and 18% per cycle when FSH is used in the protocol. :PROTOCOLS IUI can be performed in a natural cycle, with Clomid alone, with Clomid and then FSH injection or purely with FSH. a single human chorionic gonadotrophin (hCG) injection approximately 36 hours prior to the insemination to ensure optimal timing with ovulation. COMPLICATIONS of IUI: The main complication of IUI occurs when FSH has been used and this is higher order multiple births. Most centres would expect a twinning rate of between 10 and 15% . this is normally due to inadequate monitoring and inadequate numbers of cycles being cancelled . : ADVANTAGES IUI is relatively a simple technique that is cost-effective and can be offered by both secondary and tertiary fertility centres. It is not as invasive as IVF and allows fertilization to occur within the fallopian tubes and therefore is generally acceptable to most religious groups. DISADVANTAGES: The success rates are lower than those with IVF. if the cycle fails less information is obtained than with an IVF cycle – particularly pertaining to possible egg or subsequent embryo quality. It also requires at least one healthy fallopian tube and reasonable sperm parameters. significant increase in higher order multiple birth with expected sequelae of these. INDICATIONS of IUI: ?1. Unexplained infertility ?2. Mild maleFactor ?3. Ejaculatory problems ?4. Cervical problems ? 5.Ovulatory disorders ?6. Mild endometriosis ?7. optimize the use of donor sperm . In vitro fertilization: IVF is where the mature oocyte is surgically removed from the ovary