Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
Premature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the co Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 omplete loss of ovarian function occurring before the age of 40 and is a diagnosis that is usually made retrospectively when a woman presents with oestrogen deficiency symptoms, amcnorrhoea of more than I year, an elevated FSH and reduced scrum oestradiol.Premature ovarian failure or premature ovari Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 an insufficiency is that phase when there is some loss of ovarian function associated with impaired fertility and impaired hormone production. While aEbook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
woman may have normal periods and be able to conceive, this phase is often associated with some degree of infertility and irregular menstrual cycles.Premature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the co Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 e.11.2CausesThere are many causes of premature ovarian insufficiency (Table 11.1), but in the majority of cases the cause remains unknown. An increasing number of young women and girls are surviving cancer treatment and there is, therefore, a growing number of women with iatrogenic ovarian failure. Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 It is estimated that 5 % of women will experience the menopause by the age of 45, 1 % before the age of 40 and 0.1 % before the age of 30.M. Savvas ([Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
•<)• H. HamodaThe Assisted Conception Unit. King’s College Hospital. London. UK e-mail: Mike.savvas@nhs.nclA.R. Genazzani and M. Brincat (eds.). FrontPremature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the co Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 insufficiencyCauses of IX)I Idiopathic Iatrogenic Auto-immune Genetic X Chromosome abnormalities Familial genetic causes Viral infection11.3Clinical PresentationWomen with premature ovarian insufficiency may present with oligo or amenorrhoea in association with climacteric symptoms, hot flushes or Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 night sweats. Sometimes these symptoms first become apparent when a woman discontinues the oral contraception pill in order to try for a pregnancy. InEbook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
many cases, the diagnosis is made by the fertility specialist, when investigating a woman with infertility but normal menstrual cycles. The blood tesPremature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the co Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 due to undiagnosed premature ovarian failure.11.4ClinicalSymptomsThe symptoms of premature ovarian infertility include irregular periods, amcnorrhoea and the typical menopausal symptoms.hl the long term, women with premature ovarian insufficiency are also at risk of osteoporosis, heart disease and Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 there is also an associated increase in overall mortality (Table 11.2).The most distressing symptom of premature ovarian failure is often loss of fertEbook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
ility with 54 % of women reporting this as the most distressing consequence of their diagnosis [1 ].11.5 Pregnancy After Premature Ovarian InsufficienPremature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the co Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 ely to conceive than a woman in her late 30s with the same diagnosis. There is no effective intervention to enhance the likelihood of spontaneous or natural conception. One study [2J has shown that 24 % of women with premature ovarian insufficiency experienced intermittent ovarian function and 4 % w Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 ent on to conceive. The vast majority of those who conceived did so in the first year indicating that the longer the period of amcnorrhoca, the less lEbook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
ikely it is that a woman will conceive naturally. Women who present with premature ovarian failure and primary amenorrhoea arc11 Premature Ovarian InsPremature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the co Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 gical symptoms Sexual dysfunction Reduced cognitive function Long-term consequences Osteoporosis Heart diseaseIncreased overall mortalityalso very unlikely to conceive as compared to those who present with secondary amenorrhoca.The average age al which women give birth has been rising in the recent Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 decades and in the UK the average age of a woman having giving birth is 29.7 years with nearly half of women being over the age of 30 (Fig. 11.1). TheEbook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
average age of first birth is currently 27.9 compared to 26.6 in 2001 (Office for national statistics 2013). An increasing number of women who have dPremature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the co Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 dicting1 POIMost women are aware of the biological advantages in having children earlier but are prevented from doing so because of complex economic, educational and social factors.Many women, therefore, wish to be reassured or at least want to know the state of their ovarian function and how much l Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 onger they have before their fertility is significantly reduced. The clinical history, assessment of ovarian reserve and response to ovarian stimulatiEbook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2
on may be used for this.11.6.1Clinical HistoryThe clinical predictions tend not to be very helpful as there may already be some degree of decline of oPremature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the co Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 ory of autoimmune disease, particularly Addison’s and autoimmune thyroiditis may also increase the likelihood that a woman will develop premature ovarian failure. Ebook Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies): Part 2 Premature Ovarian Insufficiency and Its Fertility ImplicationsMichael Savvas and Haitham Hamoda11.1TerminologyPremature menopause is defined as the coGọi ngay
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