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Evaluation and Interpretation of Female Infertility

Yıl 2022, Cilt: 24 Sayı: Special Issue, 49 - 55, 30.10.2022

Serdar Özer Alev Özer Hakan Kıran

https://doi.org/10.18678/dtfd.1181438

Öz

Infertility is a problem that affects one out of seven couples and is defined as the inability to achieve pregnancy despite unprotected intercourse for 1 year. One of the most important enemies of infertile patients is time. In order to reveal the possible causes of infertility, importance should be given to the systematic, rapid, and cost-effective evaluation, and the evaluation should be started with the least invasive examinations. In the evaluation of an infertile woman, a detailed medical history, reproductive history, family history, and physical examination are required to reveal the anatomical and physiological causes of infertility. This evaluation process is also the most suitable period for giving pre-pregnancy counseling, providing necessary counseling for preventive medicine practices, and conducting genetic research and consultations if necessary. In the evaluation of infertility, the presence of ovulation, the structure and function of the female genital system, and semen analysis in the male partner should also be evaluated. During all these evaluation processes, the psychological morbidity caused by the inability to have children should also be taken into consideration and the couples should also be supported in this respect. In this review, it was aimed to present the steps to be followed in the evaluation of an infertile woman in the light of current literature.

Anahtar Kelimeler

Biochemical tests genital system imaging infertility ovulation

Kaynakça

  • Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril. 2021;116(5):1255-65.
  • Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):293-308.
  • Thurston L, Abbara A, Dhillo WS. Investigation and management of subfertility. J Clin Pathol. 2019;72(9):579-87.
  • Chinta P, Rebekah G, T Kunjummen A, S Kamath M. Revisiting the role of serum progesterone as a test of ovulation in eumenorrheic subfertile women: a prospective diagnostic accuracy study. Fertil Steril. 2020;114(6):1315-21.
  • DeVilbiss EA, Stanford JB, Mumford SL, Sjaarda LA, Kim K, Zolton JR, et al. Sporadic anovulation is not an important determinant of becoming pregnant and time to pregnancy among eumenorrheic women: A simulation study. Paediatr Perinat Epidemiol. 2021;35(1):143-52.
  • McCarthy JJ Jr, Rockette HE. Prediction of ovulation with basal body temperature. J Reprod Med. 1986;31(8 Suppl):742-7.
  • Younis JS, Iskander R, Fauser BCJM, Izhaki I. Does an association exist between menstrual cycle length within the normal range and ovarian reserve biomarkers during the reproductive years? A systematic review and meta-analysis. Hum Reprod Update. 2020;26(6):904-28.
  • Lass A. The fertility potential of women with a single ovary. Hum Reprod Update. 1999;5(5):546-50.
  • Kaunitz AM. Current options for injectable contraception in the United States. Semin Reprod Med. 2001;19(4):331-7.
  • Knudsen HJ, Rasmussen K. The "forgotten" intrauterine device: a cause of infertility. Arch Gynecol Obstet. 1993;253(3):143-4.
  • Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2018;89(3):251-68.
  • Haggerty CL, Ness RB. Epidemiology, pathogenesis and treatment of pelvic inflammatory disease. Expert Rev Anti Infect Ther. 2006;4(2):235-47.
  • Leiva R, Bouchard T, Boehringer H, Abulla S, Ecochard R. Random serum progesterone threshold to confirm ovulation. Steroids. 2015;101:125-9.
  • Wathen NC, Perry L, Lilford RJ, Chard T. Interpretation of single progesterone measurement in diagnosis of anovulation and defective luteal phase: observations on analysis of the normal range. Br Med J (Clin Res Ed). 1984;288(6410):7-9.
  • Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility. Optimizing natural fertility: a committee opinion. Fertil Steril. 2017;107(1):52-8.
  • McGovern PG, Myers ER, Silva S, Coutifaris C, Carson SA, Legro RS, et al. Absence of secretory endometrium after false-positive home urine luteinizing hormone testing. Fertil Steril. 2004;82(5):1273-7.
  • Bauman JE. Basal body temperature: unreliable method of ovulation detection. Fertil Steril. 1981;36(6):729-33.
  • Ecochard R, Boehringer H, Rabilloud M, Marret H. Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation. BJOG. 2001;108(8):822-9.
  • Practice Committee of the American Society for Reproductive Medicine. Current clinical irrelevance of luteal phase deficiency: a committee opinion. Fertil Steril. 2015;103(4):e27-32.
  • Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(2):273-88.
  • McNeil MA, Merriam SB. Menopause. Ann Intern Med. 2021;174(7):ITC97-112.
  • Tsiligiannis S, Panay N, Stevenson JC. Premature ovarian insufficiency and long-term health consequences. Curr Vasc Pharmacol. 2019;17(6):604-9.
  • National Institute for Health and Care Excellence. Fertility: Evidence Update March 2015: A summary of selected new evidence relevant to NICE clinical guideline 156 ‘Assessment and treatment for people with fertility problems’ (2013). London: NICE; 2015.
  • Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020;114(6):1151-7.
  • Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12(6):685-718.
  • Magnusson Å, Oleröd G, Thurin-Kjellberg A, Bergh C. The correlation between AMH assays differs depending on actual AMH levels. Hum Reprod Open. 2017;2017(4):hox026.
  • Iliodromiti S, Kelsey TW, Wu O, Anderson RA, Nelson SM. The predictive accuracy of anti-Müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. Hum Reprod Update. 2014;20(4):560-70.
  • Lutchman Singh K, Muttukrishna S, Stein RC, McGarrigle HH, Patel A, Parikh B, et al. Predictors of ovarian reserve in young women with breast cancer. Br J Cancer. 2007;96(12):1808-16.
  • ACOG Committee Opinion No. 773: the use of antimüllerian hormone in women not seeking fertility care. Obstet Gynecol. 2019;133(4):e274-8.
  • Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab. 2013;98(8):3332-40.
  • Tur-Kaspa I, Gal M, Hartman M, Hartman J, Hartman A. A prospective evaluation of uterine abnormalities by saline infusion sonohysterography in 1,009 women with infertility or abnormal uterine bleeding. Fertil Steril. 2006;86(6):1731-5.
  • Papaioannou S, Bourdrez P, Varma R, Afnan M, Mol BW, Coomarasamy A. Tubal evaluation in the investigation of subfertility: a structured comparison of tests. BJOG. 2004;111(12):1313-21.
  • Soares SR, Barbosa dos Reis MM, Camargos AF. Diagnostic accuracy of sonohysterography, transvaginal sonography, and hysterosalpingography in patients with uterine cavity diseases. Fertil Steril. 2000;73(2):406-11.
  • Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW. Tubal flushing for subfertility. Cochrane Database Syst Rev. 2007;18(3):CD003718.
  • Luciano DE, Exacoustos C, Luciano AA. Contrast ultrasonography for tubal patency. J Minim Invasive Gynecol. 2014;21(6):994-8.
  • Oei SG, Helmerhorst FM, Bloemenkamp KW, Hollants FA, Meerpoel DE, Keirse MJ. Effectiveness of the postcoital test: randomised controlled trial. BMJ. 1998;317(7157):502-5.
  • Jacobson TZ, Duffy JM, Barlow D, Farquhar C, Koninckx PR, Olive D. Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev. 2010;(1):CD001398.
  • Kallen CB, Arici A. Immune testing in fertility practice: truth or deception? Curr Opin Obstet Gynecol. 2003;15(3):225-31.
  • Gump DW, Gibson M, Ashikaga T. Lack of association between genital mycoplasmas and infertility. N Engl J Med. 1984;310(15):937-41.

Kadın İnfertilitesinin Değerlendirilmesi ve Yorumlanması

Yıl 2022, Cilt: 24 Sayı: Special Issue, 49 - 55, 30.10.2022

Serdar Özer Alev Özer Hakan Kıran

https://doi.org/10.18678/dtfd.1181438

Öz

İnfertilite, her yedi çiftten birisini etkileyen bir sorun olup 1 yıl boyunca korunmasız cinsel ilişkiye rağmen gebelik elde edilememesi olarak tanımlanır. İnfertil hastaların en önemli düşmanlarından birisi zamandır. İnfertilitenin olası nedenlerini ortaya çıkarmak için yapılacak değerlendirmenin sistematik, hızlı ve maliyet-etkin olmasına önem gösterilmeli ve değerlendirmeye en az invaziv olan tetkiklerle başlanmalıdır. İnfertil bir kadının değerlendirilmesinde, infertilitenin anatomik ve fizyolojik nedenlerini ortaya çıkarmak için ayrıntılı bir tıbbi öykü, üreme öyküsü, aile öyküsü ve fizik muayene gereklidir. Bu değerlendirme süreci aynı zamanda gebelik öncesi danışmanlık verilmesi, koruyucu hekimlik uygulamaları için gerekli danışmanlığın verilmesi, gerektiğinde genetik araştırma ve konsültasyonların yapılması için de en uygun dönemdir. İnfertilitenin değerlendirilmesinde ovülasyonun varlığı, kadın genital sisteminin yapısı ve işlevi ve aynı zamanda erkek partnerde semen analizi de değerlendirilmelidir. Tüm bu değerlendirme süreçleri boyunca çiftlerde çocuk sahibi olamamanın neden olduğu psikolojik morbidite de göz önüne alınmalı ve aynı zamanda çiftler bu açıdan da desteklenmelidir. Bu derlemede, infertil bir kadının değerlendirilmesinde izlenecek olan adımların güncel literatür bilgileri ışığında sunulması amaçlanmıştır.

Anahtar Kelimeler

Biyokimyasal testler genital sistem görüntüleme infertilite ovulasyon

Kaynakça

  • Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril. 2021;116(5):1255-65.
  • Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):293-308.
  • Thurston L, Abbara A, Dhillo WS. Investigation and management of subfertility. J Clin Pathol. 2019;72(9):579-87.
  • Chinta P, Rebekah G, T Kunjummen A, S Kamath M. Revisiting the role of serum progesterone as a test of ovulation in eumenorrheic subfertile women: a prospective diagnostic accuracy study. Fertil Steril. 2020;114(6):1315-21.
  • DeVilbiss EA, Stanford JB, Mumford SL, Sjaarda LA, Kim K, Zolton JR, et al. Sporadic anovulation is not an important determinant of becoming pregnant and time to pregnancy among eumenorrheic women: A simulation study. Paediatr Perinat Epidemiol. 2021;35(1):143-52.
  • McCarthy JJ Jr, Rockette HE. Prediction of ovulation with basal body temperature. J Reprod Med. 1986;31(8 Suppl):742-7.
  • Younis JS, Iskander R, Fauser BCJM, Izhaki I. Does an association exist between menstrual cycle length within the normal range and ovarian reserve biomarkers during the reproductive years? A systematic review and meta-analysis. Hum Reprod Update. 2020;26(6):904-28.
  • Lass A. The fertility potential of women with a single ovary. Hum Reprod Update. 1999;5(5):546-50.
  • Kaunitz AM. Current options for injectable contraception in the United States. Semin Reprod Med. 2001;19(4):331-7.
  • Knudsen HJ, Rasmussen K. The "forgotten" intrauterine device: a cause of infertility. Arch Gynecol Obstet. 1993;253(3):143-4.
  • Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2018;89(3):251-68.
  • Haggerty CL, Ness RB. Epidemiology, pathogenesis and treatment of pelvic inflammatory disease. Expert Rev Anti Infect Ther. 2006;4(2):235-47.
  • Leiva R, Bouchard T, Boehringer H, Abulla S, Ecochard R. Random serum progesterone threshold to confirm ovulation. Steroids. 2015;101:125-9.
  • Wathen NC, Perry L, Lilford RJ, Chard T. Interpretation of single progesterone measurement in diagnosis of anovulation and defective luteal phase: observations on analysis of the normal range. Br Med J (Clin Res Ed). 1984;288(6410):7-9.
  • Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility. Optimizing natural fertility: a committee opinion. Fertil Steril. 2017;107(1):52-8.
  • McGovern PG, Myers ER, Silva S, Coutifaris C, Carson SA, Legro RS, et al. Absence of secretory endometrium after false-positive home urine luteinizing hormone testing. Fertil Steril. 2004;82(5):1273-7.
  • Bauman JE. Basal body temperature: unreliable method of ovulation detection. Fertil Steril. 1981;36(6):729-33.
  • Ecochard R, Boehringer H, Rabilloud M, Marret H. Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation. BJOG. 2001;108(8):822-9.
  • Practice Committee of the American Society for Reproductive Medicine. Current clinical irrelevance of luteal phase deficiency: a committee opinion. Fertil Steril. 2015;103(4):e27-32.
  • Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(2):273-88.
  • McNeil MA, Merriam SB. Menopause. Ann Intern Med. 2021;174(7):ITC97-112.
  • Tsiligiannis S, Panay N, Stevenson JC. Premature ovarian insufficiency and long-term health consequences. Curr Vasc Pharmacol. 2019;17(6):604-9.
  • National Institute for Health and Care Excellence. Fertility: Evidence Update March 2015: A summary of selected new evidence relevant to NICE clinical guideline 156 ‘Assessment and treatment for people with fertility problems’ (2013). London: NICE; 2015.
  • Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020;114(6):1151-7.
  • Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12(6):685-718.
  • Magnusson Å, Oleröd G, Thurin-Kjellberg A, Bergh C. The correlation between AMH assays differs depending on actual AMH levels. Hum Reprod Open. 2017;2017(4):hox026.
  • Iliodromiti S, Kelsey TW, Wu O, Anderson RA, Nelson SM. The predictive accuracy of anti-Müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. Hum Reprod Update. 2014;20(4):560-70.
  • Lutchman Singh K, Muttukrishna S, Stein RC, McGarrigle HH, Patel A, Parikh B, et al. Predictors of ovarian reserve in young women with breast cancer. Br J Cancer. 2007;96(12):1808-16.
  • ACOG Committee Opinion No. 773: the use of antimüllerian hormone in women not seeking fertility care. Obstet Gynecol. 2019;133(4):e274-8.
  • Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab. 2013;98(8):3332-40.
  • Tur-Kaspa I, Gal M, Hartman M, Hartman J, Hartman A. A prospective evaluation of uterine abnormalities by saline infusion sonohysterography in 1,009 women with infertility or abnormal uterine bleeding. Fertil Steril. 2006;86(6):1731-5.
  • Papaioannou S, Bourdrez P, Varma R, Afnan M, Mol BW, Coomarasamy A. Tubal evaluation in the investigation of subfertility: a structured comparison of tests. BJOG. 2004;111(12):1313-21.
  • Soares SR, Barbosa dos Reis MM, Camargos AF. Diagnostic accuracy of sonohysterography, transvaginal sonography, and hysterosalpingography in patients with uterine cavity diseases. Fertil Steril. 2000;73(2):406-11.
  • Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW. Tubal flushing for subfertility. Cochrane Database Syst Rev. 2007;18(3):CD003718.
  • Luciano DE, Exacoustos C, Luciano AA. Contrast ultrasonography for tubal patency. J Minim Invasive Gynecol. 2014;21(6):994-8.
  • Oei SG, Helmerhorst FM, Bloemenkamp KW, Hollants FA, Meerpoel DE, Keirse MJ. Effectiveness of the postcoital test: randomised controlled trial. BMJ. 1998;317(7157):502-5.
  • Jacobson TZ, Duffy JM, Barlow D, Farquhar C, Koninckx PR, Olive D. Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev. 2010;(1):CD001398.
  • Kallen CB, Arici A. Immune testing in fertility practice: truth or deception? Curr Opin Obstet Gynecol. 2003;15(3):225-31.
  • Gump DW, Gibson M, Ashikaga T. Lack of association between genital mycoplasmas and infertility. N Engl J Med. 1984;310(15):937-41.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Davetli Derleme
Yazarlar

Serdar Özer 0000-0002-3604-2777

Alev Özer 0000-0002-0934-0226

Hakan Kıran 0000-0003-3032-5861

Yayımlanma Tarihi 30 Ekim 2022
Gönderilme Tarihi 15 Mayıs 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 24 Sayı: Special Issue

Kaynak Göster

APA Özer, S., Özer, A., & Kıran, H. (2022). Evaluation and Interpretation of Female Infertility. Duzce Medical Journal, 24(Special Issue), 49-55. https://doi.org/10.18678/dtfd.1181438
AMA Özer S, Özer A, Kıran H. Evaluation and Interpretation of Female Infertility. Duzce Med J. Ekim 2022;24(Special Issue):49-55. doi:10.18678/dtfd.1181438
Chicago Özer, Serdar, Alev Özer, ve Hakan Kıran. “Evaluation and Interpretation of Female Infertility”. Duzce Medical Journal 24, sy. Special Issue (Ekim 2022): 49-55. https://doi.org/10.18678/dtfd.1181438.
EndNote Özer S, Özer A, Kıran H (01 Ekim 2022) Evaluation and Interpretation of Female Infertility. Duzce Medical Journal 24 Special Issue 49–55.
IEEE S. Özer, A. Özer, ve H. Kıran, “Evaluation and Interpretation of Female Infertility”, Duzce Med J, c. 24, sy. Special Issue, ss. 49–55, 2022, doi: 10.18678/dtfd.1181438.
ISNAD Özer, Serdar vd. “Evaluation and Interpretation of Female Infertility”. Duzce Medical Journal 24/Special Issue (Ekim 2022), 49-55. https://doi.org/10.18678/dtfd.1181438.
JAMA Özer S, Özer A, Kıran H. Evaluation and Interpretation of Female Infertility. Duzce Med J. 2022;24:49–55.
MLA Özer, Serdar vd. “Evaluation and Interpretation of Female Infertility”. Duzce Medical Journal, c. 24, sy. Special Issue, 2022, ss. 49-55, doi:10.18678/dtfd.1181438.
Vancouver Özer S, Özer A, Kıran H. Evaluation and Interpretation of Female Infertility. Duzce Med J. 2022;24(Special Issue):49-55.
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