tailieunhanh - Ebook Textbook of clinical embryology: Part 2 - Cambridge medicine

(BQ) Part 2 book "Textbook of clinical embryology" presents the following contents: Treatment of male and female infertility, social aspects of using reproductive technology, Assisted peproductive technology (ART), ART - skills, techniques and present status,. | Chapter 17 Treatment of male and female infertility Tim Child Once a couple experiencing fertility problems have undergone appropriate and timely investigations then in the majority of cases a diagnosis can be made. A minority will have the rather unsatisfactory diagnosis of exclusion unexplained infertility . A treatment plan can then be made. The patients should attend the consultation together. Pre-pregnancy counselling Women who are trying to become pregnant should be informed that drinking no more than one or two units of alcohol once or twice a week and avoiding episodes of intoxication reduce the risk of harming a developing fetus. Men who drink up to three or four units of alcohol per day are unlikely to affect their fertility. Excessive alcohol intake can affect semen quality. Women who smoke should be informed that this is likely to reduce their fertility and should be offered referral to a smoking cessation programme. Passive smoking may also affect female fertility. While there is an association between male smoking and reduced semen quality the impact of this on fertility is unclear. Dietary supplementation with folic acid before conception and up to 12 weeks gestation reduces the risk of having a child with a neural tube defect. The recommended dose is mg per day though for women with diabetes on anti-epileptic medication or who have previously had a child with a neural tube defect a dose of 5 mg per day is recommended. A female body mass index BMI over 29 is associated with a longer time to conception and a higher rate of miscarriage. Women who are not ovulating and who have a BMI over 29 are likely to improve their chances of conception by losing weight. Similarly there is a correlation between male obesity and reduced fertility. Women with low BMI of less than 19 and who have irregular or absent menstruations are likely to improve their fertility by increasing their weight. While there is an association between elevated scrotal temperature and