课件：不孕不育病英文.ppt

Word shop1,1.Vagin/i:vaginitis阴道炎 epiraginitis外阴炎 2.Cervix:ceritis Cervical Intraepithelial Neoplasia（CIN）宫颈上皮内瘤病变 3.Endometri：endometrium子宫内膜 endometritis子宫内膜炎 endometriosis子宫内膜异位症 endometrial carinoma子宫内膜癌 4.Endo-:endocrine内分泌的endometriosis子宫内膜异位症 5.Ovary:ovum ovulation(v.)排卵 ovulate（n.)排卵 ovulatory(n.)排卵期 6.-scopy：Endoscopy 内窥镜 laparoscopy(lapar/o-:abdomen)腹腔镜 hysteroscopy（hyster/o-uterus）宫腔镜 hesterosalpingogram（hester/o-uterus；salping/o-oviduct）子宫输卵管造影技术,2019,-,1,Word shop2,7.vagin/o-vagina；recto-rectum直肠：Vaginorectoabdominal examination直肠阴道指诊 8.bi-two：bimanual examination双合诊 9.Hyp/o:hypothalamic下丘脑的、hypofunction功能下降、hypothyroidism甲减 10.Test/i-:testis睾丸、Testicular睾丸的、Testosterone 睾酮 11.Pituitary脑垂体 epididymis附睾 12.Bulbourethral尿道球部的、foreskin=prepuce包皮 13.prostate 前列腺 prostatic 前列腺的 14.ejaculation射精 anejaculation 不射精 ejaculatiory duct射精管 15.Gonado:Gonadotropic促性腺的Gonadotropin促性腺激素,2019,-,2,Word shop3,16.Sperm/a:spermatic精子的，精液的 17.Spermat/o:Spermatozoid游动的精子 spermatogenic精子生成的 18.teratozoospermia（terat/o-malformation）畸形精子症 hematospermia（hemat/o-blood）血精 prospermia 早泄 azoospermatism无精子症 oligospermia(olig/o-low)少精子症 asthenospermia精子活力不足 19.Immun/o:Immunosuppressive免疫抑制 Immunological免疫的 20.insemination受孕、seminiferous输精的 21.dys:dysfunction功能下降 dysaphrodisia性欲障碍dysplasia发育异常 22.Hyper:Hypersexuality性生活减少,2019,-,3,23.-cele:Varicocele 精索静脉曲张(cele-肿物) 24.crypt/o-secret：cryptorchidism隐睾症 enorchismus隐睾症 25.anti-：Antigenicity抗原性 26.blood-testis-barrier血睾屏障,Word shop4,2019,-,4,Female Infertility,2019,-,5,Contents,Definition Anatomy External genitalia Internal genitalia Epidemiology Pathogenesis Examination Therapy ART,2019,-,6,Infertility,Definition: Infertility is defined two years of unprotected intercourse without pregnancy because of the female factor. (WHO, one year) Types: Primary infertility Secondary infertility,2019,-,7,Female reproductive systematic anatomy,1、External genitalia:mons pubis，labium majus，labium minus，clitoris,vaginal vestibule,2019,-,8,Female reproductive system,2、Internal genitalia:vagina,uterus,oviduct,ovary.,Uterus,Ovary,Vagina,Cervix,Oviduct,2019,-,9,Epidemiology,The morbidity is different in different countries and regions. In china, the incidence is 7%10%.,Causes Percentage Female factors 40-55 % Male factors 25-40 % Both male and female factors 10 % unexplained factors 10 %,2019,-,10,What causes infertility?(Reason),1、Endocrine factors e.g. Ovulatory dysfunction , Sheehan syndrome , polycystic ovary syndrome(PCOS). 2、Infectious factors e.g. vaginitis , cervicitis , endometritis , pelvic inflammatory disease(PID).,Ovulatory adj. 排卵的 polycystic adj. 多囊的,2019,-,11,3、Immunologic factors 4、Genetic factors e.g. Tuener syndrome , sex chromosome anomaly. 5、Dysplastic factors e.g. atresia of vagina, longitudinal vaginal septum.,What causes infertility?(Reason),Immunologic adj. 免疫学的的 chromosome n.染色体 anomaly n.异常 Dysplastic adj. 发育不良的 longitudinal adj. 纵向的,2019,-,12,What cause infertility?,6、Endometriosis(EMT): The rate of infertility of patients with EMT is 40%.About 25%-35% of the women who cannt get pregnant are diagnosed with EMT.If someone are diagnosed with EMT and want a baby,she should receive treatment of EMT firstly.,Endometriosis n. 妇产 子宫内膜异位 Endometri： endometrium子宫内膜 endometritis子宫内膜炎 endometriosis子宫内膜异位症 endometrial carinoma子宫内膜癌,2019,-,13,7、 Too many artificial abortion(人工流产）: Abortion is harmful to the uterus.If the endometrium is severely damaged,infertility would happen.,What causes infertility?,2019,-,14,8、Age: Age is a growing cause of fertility problems.With age growing,womens ovaries become less able to release ovums and her ovums（卵子） may not as healthy as the youger ones.,What causes infertility?,2019,-,15,Examination,1、Physical examination:Womens most important part of physical examinnation is pelvic examination.Vagino-recto-abdominal examination and bimanual examination in pelvic examination are usually applied into clinical activities. 2、Laboratory test:For example,the volume of estrogen and progesterone in the blood can reflect ovarys function. Immunologic examination is also important.,laparoscopy(lapar/o-:abdomen)腹腔镜 Vaginorectoabdominal（vagin/o-vagina；recto-rectum直肠）examination直肠阴道指诊 estrogen n.雌激素 progesterone n.孕激素,2019,-,16,Examination,3、Assistant imaging:Doctors can see that whether there is something abnormal in or on the uterus and ovary through B-ultrasonic（B型超声的） examination.It also can be used to evaluate the size of follicle.Hysterosalpingogram is used to test the patency of oviduct. 4、Laparoscopy and hysteroscopy:Under the laparoscope and hysteroscope,we can see pelvic cavitys situation inside directly.EMT can also be diagnosed by laparoscopy.,follicle n.卵泡 hysteroscopy（hyster/o-uterus）n.宫腔镜 hesterosalpingogram（hester/o-uterus；salping/o-oviduct）子宫输卵管造影技术,2019,-,17,Examinations,5、Basal body temperature(BBT):After ovulation,the temperature will rise 0.3-0.5 degrees centigrade. Temperature rising is a symbol of ovulation.,2019,-,18,Therapy,1.Remove the causes: cervicitis,endometritis, vaginitis should be cured. 2.Induction of ovulation:Doctors often choose clomiphen,Gonadotropin therapy,HCG,Bromocriptine. 3.Assisted reproductive technology (ART): (1) Intrauterine insemination (IUI):Washed sperms, sperms that have been removed from most other components of the seminal fluids, is injected directly into a womans uterus.,cervicitis n. 子宫颈炎 endometritis n.子宫内膜炎 vaginitis n.阴道炎 Intrauterine n.子宫内的 Insemination n.授精,2019,-,19,(2) In vitro fertilization and embryo transfer(IVF-ET):means fertilization outside of the body. IVF is the most effective ART.Its often used when a womans oviducts are blocked or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once they mature, the eggs are removed from the woman. They are put in a dish in the lab along with the mans sperm for fertilization（受精）. After 3 to 5 days, healthy embryos are implanted in the womans uterus.,Therapy,2019,-,20,Therapy,(3) Intracytoplasmic sperm injection (ICSI): is often used for couples in which there are serious problems with sperm. Sometimes it is also used for older couples or for those with failed IVF attempts. In ICSI,a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or oviducts.,Intracytoplasmic adj. 胞浆内的,2019,-,21,Therapy,(4)Gamete Intrafallopian Transfer (GIFT) involves transferring eggs and sperm into the womans oviducts. So fertilization occurs in the womans body. Some practices show that GIFT can be a good choice.,2019,-,22,Assisted reproductive technology,ART procedures sometimes involve the use of donor eggs , donor sperm, or previously frozen embryos. Donor eggs are sometimes used for women who can not produce eggs. Also, donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby. An infertile woman or couple may also use donor embryos. These are embryos that were either created by couples in infertility treatment or were created from donor sperm and donor eggs. The donated embryo is transferred to the uterus. The child will not be genetically related to either parent.,2019,-,23,Male Sterility,2019,-,24,Definition Anatomy Epidemiology Pathogenesis of Male sterility Examination Therapy,Contents,2019,-,25,Definition,Male sterility(WHO) is defined two years of unprotected intercourse without pregnancy because of the Male Factors.,2019,-,26,睾丸, testes 生殖管道,genital ducts,附属腺,accessory glands 外生殖器,external genitalia,前列腺,睾丸,尿道球腺,附睾,输精管,射精管,尿道,包皮,精囊腺,Anatomy,2019,-,27,Pathogenesis of Male sterility,2019,-,28,One of the most familiar factors，15% male sterility are related to this. Causative agent: Mycoplasma(支原体）, Chlamydia（衣原体）, Gonococcus（淋球菌）, Syphilis Helicoid（梅毒螺旋体）, Virus .ect,.The infection of genital tracts and gonads,2019,-,29,Influence the Composition of semen,2019,-,30,Endocrine factors,The Hypothalamic Pituitary Testicular axis The important Male reproductive endocrinology control system,The hypothalamus-pituitary gland diseases,1 Kallmann syndrome Points：Low gonadotropic hormone &gonad hypofunction,Hypothalamic adj. 下丘脑的 gonadotropic adj. 促性腺的 Testicular adj. 睾丸的 axis n. 轴 hypothalamus n. 下丘脑 pituitary adj. 脑垂体的,2019,-,31,A、Secondary sex characteristic is not obvious,small testis or enorchismus B、Short penis，redundant prepuce C、Azoospermatism，or Cant ejaculation,Sign,enorchismus n.隐睾病 Azoospermatism n.无精子症,2019,-,32,Testis size show the growth situation of seminiferous tubule less than 12ml is abnormal,Prader measure model,seminiferous adj. 输精的,2019,-,33,2019,-,34,Hyperprolactinemia（High PRL） Reason：hypothalamus or/and pituitary tumor disease, drugs, and metabolic disease FSH（Follicle-Stimulating Hormone）、LH（Luteinizing Hormone） in low secretion，reduce T（testosterone） Male lactation，sexual hypoactivity，Erectile Dysfunction（ED)，the density of sperm decline,Endocrine factors,Hyperprolactinemia n. 高泌乳素血症 metabolic adj.新陈代谢的 Stimulate vt. 刺激 testosterone n.睾酮 lactation n.泌乳 hypoactivity n.活动减少 Erectile adj. 勃起的,2019,-,35,Thyroid disease,For instance:Hypothyroidism Hypophysis function of secreting gonadotropic hormone declines. pubertal delay，sexual dysplasia，sexual dysfunction，sexual hypoactivity，testis sperm production dysfunctionOligospermia,Endocrine factors,Pubertal n.青春期 Oligospermia n.少精子症,2019,-,36, Immunological Factors,Sperm has antigenicity Blood-testis barrier is damaged, sperms were exposed to the immune system, stimulate the body to produce antisperm antibodies（AsAb） Reason：inflammation，surgery，injury，varicocele,Blood-testis barrier n.血睾屏障 antisperm antibodies n.抗精子抗体,2019,-,37, Genetic factors,Abnormal chromosome number and structure,2019,-,38,Sex chromosome aneuploidy 47，XXY(most)；48，XXXY；49，XXXXY；47，XXY/46，XY(Mosaicism) small testises，slender body，smooth skin，no or few beard、armpit hair、pubes，prominentia laryngeal is unobvious. sexual desire decline，sexual function is bad，most of them have azoospermatism, Genetic factors,aneuploidy n.非整倍性,2019,-,39,Genital malformation 外阴畸形,2019,-,40,Testicular dysplasia 1 cryptorchidism Testicular falling path stranded in abnormal position rate 0.7% to 0.8% at the age of 1 y-o 8.5% of male infertility patients Touch no testes in the scrotum, and we can touch the small testes in the groin, Genetic factors,cryptorchidism n.隐睾症,2019,-,41,The harm of cryptorchidism sterility：high Testicular temperature canceration：Incidence of 48%,2019,-,42, Varicocele,Testicular vein in spermatic cord occured cirsoid plexus reflux or blood backflow caused by venous valve damage leading to make vein enlarge and bend. The incidence of about 20% 95% have occurred on the left,Varicocele n.精索静脉曲张 cirsoid adj. 曲张的 plexus n. （血管、淋巴管、神经等的）丛 reflux n. 逆流,2019,-,43,Varicocele assistant examination,Ultrasound and color doppler ultrasound if vein diameter was measured 2mm,it could be diagnosed varicocele(somebody supports that vein diameter 3mm ), Varicocele,2019,-,44,Varicocele causes sterility： 1 High Testicular Temperature The suitable temperature for DNA polymerase in germ cell is 33)。 The suitable temperature for sperm cell protein-synthesis is 34 We found that the side of varicocele is 0.6 to 0.8 warmmer than the normal side)。, Varicocele,polymerase n. 聚合酶 protein n.蛋白质 synthesis n. 综合,2019,-,45,It mainly expresses in the following four aspects ： . Dysaphrodisia： including sexual apathy 、 sexual aversion、 hypersexuality etc. . Penile erection dysfunction ： including ED、 mentulagra etc. .Defective ejaculation ： including prospermia、 gonacratia 、 Dont ejaculation 、 retrograde ejaculation 、 Painful ejaculation 、 hematospermia etc., Sexual dysfunction,Dysaphrodisia n.性欲障碍 gonacratia n.遗精 apathy n. 冷漠；冷淡 retrograde adj. 倒退的 hypersexuality n.性欲亢进 hematospermia n.血精症 mentulagra n.阴茎异常勃起 prospermia n. 射精过早,2019,-,46, Erectile Dysfunction(ED) The penis can not achieve and maintain an enough erection for satisfactory sexual intercourse classify ： 1 Organical ED 2 psychogenic ED 3 mixed ED, Sexual dysfunction,2019,-,47,Erect：勃起 Arteries expend Veins shrink,Flaccid 弛软 Arteries shrink Veins expend,Less blood is pumped into corpora cavernosa and more is pumped out,More blood is pumped into corpora cavernosa(阴茎海绵体） and less is pumped out,2019,-,48, ejaculatory dysfunction Ejaculation is the last stage of the sexual response, after the ejaculatory duct, prostate and seminal vesicle glands contraction, urethra and pelvic floor muscles have a severe contraction, then semen is shoot out from the urethral meatus 1 prospermia 早泄 2 Anejaculation 不射精症 3 retrograde ejaculation 4 painful Ejaculation, Sexual dysfunction,2019,-,49, Sperm can not be discharged into the female reproductive tract,1、Defective ejaculation(射 精 障 碍) 2、Deformity of urethra(尿 道 畸 形) 3、Erectile Dysfunction(勃起功能障碍) 4、Trauma(外 伤),2019,-,50,会阴的,阴囊的,阴茎阴囊间的,阴茎近端,干体中 间的,阴茎末端,冠状的,阴茎头的,hypospadia n. 尿道下裂,副冠状的,2019,-,51,coronal 冠状（裂）,proximal penile 阴茎近端（裂）,penoscrotal 阴茎阴囊（裂）,2019,-,52,Focus on the quality of semen,Recently，Spanish scientists have a 10-years study (sample size:273 male college students from 18 to 23 years old in 2001 and 2002 , and 215 after 10 years , the same characteristics of men) shows: spermatozoids average concentration from 72 million spermatozoids per milliliter in 2001 to 52 million in 2011, ten years to a 38% drop in sperm concentration. The study found that young mens sperm concentration is also in a ratio of 2% per year on average.,2019,-,53,Semen Analysis 1. Specimen collection It is appropriate to abstinence 2-7days Quiet and comfortable environment masturbation and collection total sperm Keep warm，25-37,abstinence n. 禁欲 masturbation n.自慰,2019,-,54,2. Visual observation appearance ： gray or milk white ， faint yellow ， jellylibe viscosity ： viscose silk2cm,Semen Analysis,viscosity n. 粘度,2019,-,55,3.Volume of semen,Normal value ：1.5ml influence factor ：collection status 、the time of abstinence、the function of Accessory Genital Gland significance ：the amount of semen continuely reduces - obstruction障碍,Semen Analysis,2019,-,56,condom,2019,-,57,4.Semen liquidation,Normal value ：competed liquidation60min influence factor ： temperature 、 mixing 、 wrong judgment result ：sometimes there are some gelatinous granule in semen significance ：time longer- dysfunction of prostate,Semen Analysis,2019,-,58,5.semen pH,Normal value ：7.28.0 significance ：pH7.0- spermaduct obstruction PH too high- inflammation,Semen Analysis,2019,-,59,6.Sperm density,Normal value：15106/ml total sperm count ：