不孕症和辅助生殖技术.pptVIP

Infertilityand

assistedreproductivetechniques(ART)

不孕症和辅助生殖技术Zi-JiangChen，M.D,Ph.D

InfertilityandARTDefinitionprimaryinfertility原发性不孕secondaryinfertility继发性不孕

InfertilityandARTIncidencerate发病率WHO(1990)about8.3%~14.3%inChinaabout10%Maleorfemalefactorabout30%~40%forrespectivelyMaleandfemalefactorabout20%~30%Nodemonstrablecausesabout10%

InfertilityandARTFactorsofinfertilityoocyte卵子abnormalovulation，lackofovaryreserve排卵异常，卵巢储备缺乏reproductivetract生殖道异常fallopian、uterus、pelvic,etc输卵管、子宫、盆腔等异常

InfertilityandART3.nidation着床异常4.sperm精子异常5.others其它immunologicalcauses免疫因素repeatedabortion重复流产inheritedcauses遗传因素systemiccauses,etc全身全身因素等

InfertilityandARTFamiliarCausesabnormaloocyte卵子异常1fallopianfactor输卵管因素2cervicalfactor宫颈因素3endometriosis(adenomyoma)内异症（子宫腺肌病）4myomaofuterus子宫肌瘤5abnormalsperm精子异常6immunologicalcauses免疫因素7

InfertilityandARTOtherfactors其它因素1.age年龄21~25isthebest；2.nutrition营养chronicdisease；excessivefatorthin;3.cigarette,alcoholandanaesthetic;烟、酒和麻醉剂4.psychologicalfactors心理因素5.pollution污染

InfertilityandART病因在何方病变性质病变类别病变部位评估其可治性Aims目的

InfertilityandARTDiagnosisFemale:historyofpresentillness现病史physicalexamination体格检查adjuvantexamination辅助检查(Bultrasonography,HSG,AsAB,E2,FSH,LH,T0,Prolactin,TSH)

InfertilityandARTDiagnosisMale:semenanalysis精液分析FSH,LH,PRL,T0,TSHBultrasonography,AsAB,PESA,

InfertilityandARTTreatmentE2(1)adjustmentofthecycle调整月经周期developmentoftheuterus促进子宫发育improvementofthecervicalmucus改善宫颈粘液

InfertilityandARTTreatmentE2(1)adjustmentofthecycle调整月经周期1)Progynova补佳乐1~2mg/d×21d