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1、Infertilityand assistedreproductivetechniques(ART)不孕癥和輔助生殖技術(shù)Zi-JiangChen，M.D,Ph.DInfertilityandARTDefinitionprimaryinfertility原發(fā)性不孕secondaryinfertility繼發(fā)性不孕InfertilityandARTIncidencerate發(fā)病率WHO(1990)about8.3%~14.3%inChinaabout10%Maleorfemalefactorabout30%~40%forre
2、spectivelyMaleandfemalefactorabout20%~30%Nodemonstrablecausesabout10%InfertilityandARTFactorsofinfertility1.oocyte卵子abnormalovulation，lackofovaryreserve排卵異常，卵巢儲備缺乏2.reproductivetract生殖道異常fallopian、uterus、pelvic,etc輸卵管、子宮、盆腔等異常InfertilityandART3.nidation著床異常4.sper
3、m精子異常5.others其它immunologicalcauses免疫因素repeatedabortion重復(fù)流產(chǎn)inheritedcauses遺傳因素systemiccauses,etc全身全身因素等InfertilityandARTFamiliarCausesabnormaloocyte卵子異常fallopianfactor輸卵管因素cervicalfactor宮頸因素endometriosis(adenomyoma)內(nèi)異癥（子宮腺肌?。﹎yomaofuterus子宮肌瘤abnormalsperm精子異常immun
4、ologicalcauses免疫因素InfertilityandARTOtherfactors其它因素1.age年齡21~25isthebest；2.nutrition營養(yǎng)chronicdisease；excessivefatorthin;3.cigarette,alcoholandanaesthetic;煙、酒和麻醉劑4.psychologicalfactors心理因素5.pollution污染InfertilityandARTAims目的1.病因在何方2.病變性質(zhì)3.病變類別4.病變部位5.評估其可治性Inferti
5、lityandARTDiagnosisFemale:historyofpresentillness現(xiàn)病史physicalexamination體格檢查adjuvantexamination輔助檢查(Bultrasonography,HSG,AsAB,E2,FSH,LH,T0,Prolactin,TSH)InfertilityandARTDiagnosisMale:semenanalysis精液分析FSH,LH,PRL,T0,TSHBultrasonography,AsAB,PESA,InfertilityandARTTr
6、eatmentE2(1)adjustmentofthecycle調(diào)整月經(jīng)周期(2)developmentoftheuterus促進(jìn)子宮發(fā)育(3)improvementofthecervicalmucus改善宮頸粘液InfertilityandARTTreatmentE2(1)adjustmentofthecycle調(diào)整月經(jīng)周期1)Progynova補佳樂1~2mg/d×21d2)diethylstilbestrol乙底酚0.25mg~0.5mg/d×21d3)progesterone黃體酮20mg/d×4~5d（Mc21
7、~25）10mg/d×6~10dInfertilityandARTTreatmentE2(2)developmentoftheuterusProgynova補佳樂2~4mg/d×21dprogesterone黃體酮20mg/d×5dcombinedwithJianRongPian×3cyclesInfertilityandARTTreatmentE2(3)improvementofthecervicalmucuscombinedwithClomifene與克羅米芬合用Progynova補佳樂1~2mg/d×7~10dfr
8、omMc10d月經(jīng)第十天開始InfertilityandARTProgressinStimulation促排用藥進(jìn)展1.Clomifene克羅米芬100mg/d×5~7d2.GnRHaandGnRHaantagonist促性腺激素釋放激素及其拮抗劑Alarelin阿拉瑞林,Dacapeptyl達(dá)必佳,Busereli
