New charts for ultrasound dating of pregnancy
Because fecundability rates are higher in younger women and lower in older women, counseling a 40-year-old woman to wait a year before seeking fertility services is inappropriate.In women older than 35 years, a complete evaluation after 4-6 months of trying to conceive is prudent because their response to treatment may be suboptimal due to diminished ovarian reserve.Infertility is the failure to conceive (regardless of cause) after 1 year of unprotected intercourse.
In normal infertile couples, the actual cause for infertility cannot be detected; perhaps there is dysfunctional interaction between the sperm and the oocyte, poor quality of the embryo, or a disruption at the implantation site.
In the future, identifying a mutation or the absence of a specific gene as the cause of infertility may be possible in this patient population.
This term should be differentiated from fecundability, which is the probability of achieving a pregnancy each month, and fecundity, which is the ability to achieve a live birth within 1 menstrual cycle.
The fecundability rate in the general reproductive-aged population is fairly constant and is approximately 0.22 per month.
The water and salt concentration increases, changing the physical characteristics of the mucus.
The mucus becomes thin, watery, alkaline, acellular, and elastic (spinnbarkheit) because of the increased concentration of sodium chloride, despite a fernlike pattern when the mucus is allowed to dry on a cover slide under the microscope (see the images below).
The mucus forms a netlike structure that does not allow the passage of sperm.
Mucus secretion increases during the mid follicular phase and reaches its maximum approximately 24-48 hours before ovulation.
Management of any underlying female and/or male factors affecting fertility may include medical treatment (eg, pharmacotherapy), surgical intervention, or both.Tags: Adult Dating, affair dating, sex dating