TRANSVAGINAL SCAN AND FEMALE INFERTILITY IN NIGERIA

TRANSVAGINAL SCAN AND FEMALE INFERTILITY IN NIGERIA

FEMALE INFERTILITY
Infertility in a couple that relates to factors associated with the woman rather than the man.

DESCRIPTION OF FEMALE INFERTILITY
Many women trying to conceive for the first time panic if their periods continue for even three or four months. But the standard definition of infertility is unsuccessful conception after an entire year of unprotected intercourse. At that point, a couple should seek a comprehensive examination that includes menstrual and pregnancy history, semen analysis, ovulation tests, and sometimes a laparoscopy to detect endometriosis or pelvic adhesions. Such testing determines the causes of infertility in 70 to 85 percent of all couples.

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CAUSES AND RISK FACTORS OF FEMALE INFERTILITY
Many factors may account for infertility: abnormalities of the uterus (such as fibroids); ovarian dysfunction; endometriosis; scar tissue from previous surgery; thyroid problems or other hormonal imbalances; sexually transmitted diseases or other infections in the man or woman; and a low sperm count.
Female reproductive problems account for 40 percent of all infertility cases; male reproductive problems account for another 40 percent; and 20 percent of the time physicians cannot determine precisely what is wrong.


DIAGNOSTIC STUDIES THAT ASSIST FERTILITY

UTERINE EVALUATION
The uterus (womb) is lined by a specialized layer of cells called the endometrium. It is on this lining that embryos implant and begin to develop in pregnancy. It is critical to thoroughly evaluate the uterine cavity for potential defects or obstacles to implantation of the embryo. Examples of such include uterine scar tissue (from previous pregnancies or procedures), polyps (benign glandular growths), fibroids, or other structural defects in the uterus.

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TRANSVAGINAL ULTRASOUND EXAMINATION
Ultrasound, or sonography, involves sending sound waves into the body. These sound waves are reflected off the internal organs, and the reflections are then recorded by special instruments that create an image of the organs. No ionizing radiation (X-ray) is involved in ultrasound imaging.
This is an ultrasound examination performed by placing a probe (medical camera) into the vagina. A transvaginal ultrasound provides images that are much more clear than those obtained by placing the probe on the abdominal wall. This examination may be performed at the onset of your menstrual cycle on Day 2, 3, or 4 or it may be performed midcycle. Midcycle examinations (performed when the lining is at its thickest point) may provide more information about the quality and integrity of the endometrial cavity.
This test, which may also be performed on any day of the menstrual cycle, provides information on the overall size and volume of the ovaries. It also enables your physician to obtain an antral follicle count. Antral follicles are small (With transvaginal ultrasound, the ultrasound transducer (a hand-held probe) is inserted directly into the vagina. Transvaginal ultrasound is most commonly used to examine the uterus and ovaries and to monitor the health and development of the embryo during pregnancy. Ultrasound images can help to identify palpable masses such as ovarian cysts and fibroids, as well as ovarian or uterine cancers. IVF cycling patients are checked regularly with a transvaginal ultrasound to monitor the size and number of developing follicles.
Transvaginal ultrasound is performed very much like a gynecologic exam. The tip of the transducer is smaller than a gynecologic speculum. A protective cover lubricated with gel is placed over the transducer, which is then inserted into the vagina. Only two to three inches of the transducer end are inserted into the vagina. The images are obtained from different orientations to get the best views of the uterus and ovaries.

FALLOPIAN TUBE EVALUATION
Issues with the fallopian tubes account for approximately 30% of female infertility problems. Common problems result from tubal blockage or scarring from previous, sometimes undiagnosed, pelvic infection. Other conditions, such as abdominal infections like appendicitis, prior surgeries, prior ectopic pregnancy, or endometriosis may also lead to fallopian tube damage. Tubal blockage or scarring may occur from previous pelvic or abdominal infection, pelvic surgery, ectopic pregnancy, or endometriosis. Prior tubal ligation (tying of the tubes) for contraception would also prevent the tubes from functioning normally.

HYSTEROSALPINGOGRAPHY (HSG)
Hysterosalpingogram is a procedure in which radiographic contrast (dye) is injected into the uterine cavity through the vagina and cervix and X-ray pictures are taken as the dye is expelled from your reproductive system. The uterine cavity fills with dye, and if the fallopian tubes are open, the dye will then fill the tubes and spill out into the abdominal cavity. In this way we can determine whether the fallopian tubes are open or blocked and whether the blockage is located at the junction of the tube and the uterus (proximal) or whether it is at the end of the fallopian tube (distal).
If a blockage is detected, we will discuss with you effective treatments for tubal factor infertility.
Your HSG can also give us a better picture of the uterine cavity and detect the presence of polyps, fibroids, or scar tissue. The fallopian tubes can also be examined for defects within the tube or suggestion of a partial blockage.
The hysterosalpingogram takes only about 20 minutes to perform. During the procedure you are likely to experience some mild cramping, so you may wish to ask your doctor about taking pain medication such as Tylenol or Ibuprofen a half hour prior to the HSG . The test involves the following steps:

[1]The specialist places a speculum in the vagina and examines the cervix. Your cervix is cleaned with an antibacterial soap.
[2]A clamp may be attached onto your cervix to hold it steady. A small, bendable plastic tube is gently pushed through the opening of your cervix into your uterus, and a tiny balloon on the end of the tube is filled with air to hold it temporarily in place.
[3]The speculum is removed but the thin tube will be left in place, with one end (about 6 inches of tubing) remaining outside of your vagina.
[4]A small amount of contrast dye is injected through the tube into your uterus, and several X-ray pictures are taken. Your doctor may ask you to move your pelvis slightly or roll from side to side to provide the clearest view of your uterus. You may experience some uterine cramping as the contrast dye goes into the tube.
[5]The procedure is now complete. The balloon will be emptied of air from the outside and the tube will be gently pulled out.

After the procedure, your doctor will review the X-ray pictures and discuss the results of the hysterosalpingogram with you.
You may experience slight vaginal bleeding and cramping after the procedure, and some sticky vaginal discharge as some of the gel and fluid drains out. A pad can be used for the vaginal discharge. Do not use a tampon.
Pregnancy rates in several studies have been reported to be slightly increased in the first months following a hysterosalpingogram. This may be due to the flushing of the tubes with the contrast, which could open a minor blockage or clean out some debris that may be hindering conception.


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TREATMENT OF FEMALE INFERTILITY
The treatment of infertility has made enormous progress in the last decade as a result of advances in assisted reproductive technology, or ART. This technology combines the use of fertility drugs - hormonal therapy - with artificial insemination using any of a group of techniques: intrauterine insemination (IUI), in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), or oocyte (egg) donation.
Intrauterine insemination (IUI): In this procedure, a small amount of concentrated sperm, first "washed" to remove most of the seminal plasma that surrounds it, is placed in the uterus through a thin plastic catheter that is passed through the vagina and cervix. Usually painless, the IUI procedure takes only a few minutes to accomplish.
IUI is almost always used in combination with a fertility drug - clomiphene or Pergonal - to stimulate ovulation followed by an HCG injection to trigger the release of an egg. The timing of the IUI is determined with the help of vaginal ultrasound, previous cycle lengths, BBT temperature graphs, or urinary LH correlation kits.


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JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI].
For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.


For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact
JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.

We are located at

JOAS HOUSE, 2, Okesuna Street,
Opposite The Synagogue Church Busstop,
Bolorunpelu, Ikotun, Lagos
Postcode: 100265
Nigeria.

TEL:
08032509975,
08184590752,
08058166504,
08064981455


EMAIL:
joasmedicaldiagnostix@yahoo.com
joasmedicaldiagnostix@gmail.com



DISCLAIMER
The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us.
The informations provided in this site is subject to change without notice.
This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

7 WAYS TO KNOW IF YOUR VAGINAL DISCHARGE IS DANGEROUS AND HOW TO PREVENT IT FROM DESTROYING YOUR FALLOPIAN TUBES

PROBLEMS OF VAGINAL DISCHARGE 


Ladies, must pay attention to this advice, especially if you wish to become pregnant someday. Pay attention to any possible vaginal infection you may have. I know, this is something we do not want to discuss. If the symptoms are not too severe, we put it down to a possible yeast infection and wait it out, praying it will quickly cure itself. In the process, we may use some over the counter remedies. But what we should be doing is seeing a doctor.Why? Infections in the vaginal region can be serious. They can lead to long term problems such as infertility issues later in life. They can make it difficult to become pregnant and they may cause complications to occur once you do become pregnant. They can even signal that you are infected with a possible STD (sexually transmitted disease).

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A discharge is a fluid released from a hollow space like the vagina. The
vagina is a tube 8-12 cm long. It opens at the lips of the vulva and is closed
at the inner end by the cervix (the opening of the uterus or womb). Wetness in
the vagina is produced by mucus from the cervix and from the vaginal wall
during sexual arousal. Many different bacteria, yeasts and parasites
(microscopic forms of life or ‘bugs’) live normally in the vagina without causing
symptoms. The vagina is usually acidic because the normal bacteria produce
lactic acid. Normal bacteria help the vagina protect itself from the kinds of
bacteria that cause disease. Candida (yeast) can live in the vagina in low
numbers without causing any symptoms.
Vaginal discharge [or Discharge from the vagina] refers to secretions from the vagina . Such discharge can vary in:
[A]Consistency (thick, pasty, thin)
[B]Color (clear, cloudy)
[C]Smell (normal, odorless, bad odor)

Having some amount of vaginal discharge is normal, especially if you are of childbearing age. Glands in the cervix produce a clear mucus. These secretions may turn white or yellow when exposed to the air. These are normal variations.
The amount of mucus produced by the cervical glands varies throughout the menstrual cycle. This is normal and depends on the amount of estrogen circulating in your body. It is also normal for the walls of the vagina to release some secretions. The amount depends on hormone levels in the body.
Vaginal discharge that suddenly differs in color, odor, or consistency, or significantly increases or decreases in amount, may indicate an underlying problem like an infection.

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CAUSES
The following situations can increase the amount of normal vaginal discharge:
[1]Emotional stress
[2]Ovulation (the production and release of an egg from your ovary in the middle of your menstrual cycle)
[3]Pregnancy
[4]Sexual excitement


ABNORMAL VAGINAL DISCHARGE
Unusual mucus or other substances coming from the vagina is a common problem. The discharge is often due to infection, and frequently associated with pain, burning, itching, and painful urination. Not all infections are sexually transmitted, so don't assume that vaginal discharge means that you have an STD. There are a number of possible causes:
Inflammation of the vagina. Called vaginitis, this is the most common reason for discharges and is usually caused by infection. There are three main types of vaginal infections, all of which can be treated with oral or vaginal medications. Each infection tends to produce a distinct discharge:
[a] Thick, white cottage cheese-like discharge, itching, irritated skin—yeast infection, or candidiasis. Women with diabetes and those taking antibiotics are more likely to develop this type of infection. Most women will have at least one yeast infection at some point in their lives.
[b] Thin, yellow, foul-smelling discharge—Trichomonas, which is usually transmitted sexually.
[c] Thin, gray or white, foul-smelling discharge—bacterial vaginosis.
[d] Pelvic inflammatory disease (PID). Frequently caused by STDs that infect the cervix, uterus, ovaries, or fallopian tubes, this is the most common and serious complication of an STD and occurs in 1 million women every year. Symptoms include vaginal discharge or bleeding, lower abdominal pain, and fever. Chronic PID can result from one or more infections. The most common identifiable causes are gonorrhea or chlamydia, both of which are sexually transmitted. About 20 percent of women with PID become infertile.

[e] Genital herpes. This infection can produce vaginal discharge if it affects the cervix. The first episode of genital herpes also features fever, itching, headache, and general muscle aches.
[f] Infection of the inside of the uterus. This condition, known as endometritis, is usually caused by STDs, fibroid tumors, cancer, giving birth, or intrauterine devices (IUDs).
[g] Inflammation of the vagina due to lack of estrogen. As a woman enters menopause, her body produces increasingly erratic amounts of estrogen. This often causes the vagina to dry out and become irritated. The condition is known as atrophic vaginitis and is treatable by estrogen replacement therapy, vaginal creams, and vaginal suppositories.
[h] Other, less common causes of vaginal discharge include pregnancy, genital warts, cancer, and foreign objects in the vagina, such as a tampon that could not be removed.

Your doctor will ask you about the type of discharge and whether it occurs immediately before, after, or during menstruation or sexual activity. You should also expect to undergo a pelvic exam.

Normal discharge doesn't smell, and does not cause any irritation or itching.
A discharge is likely to be abnormal if:
[1] it smells fishy
[2] it's thick and white, like cottage cheese
[3] it's greenish and smells foul
[4] there's blood in it (except when you have a period)
[5] it's itchy
[6] you have any genital sores or ulcers
[7] you have abdominal pain or pain on intercourse
[8] it started soon after you had unprotected sex with someone you suspect could have a sexually transmitted disease.

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POSSIBLE CAUSES
[1]Bacterial vaginosis -- Bacteria that normally live in the vagina overgrow, causing a grey discharge and fishy odor that worsen after sexual intercourse. Bacterial Vaginosis is usually not sexually transmitted.
[2]Cervical or vaginal cancer (rarely a cause of excess discharge)
[3]Chlamydia

[4]Forgotten tampon or foreign body
[5]Gonorrhea
[6]Other infections and sexually transmitted diseases
[7]Trichomoniasis
[8]Vaginal yeast infection


PREVENTION
[1]Keep your genital area clean and dry.
[2]Avoid douching. While many women feel cleaner if they douche after menstruation or intercourse, it may actually worsen vaginal discharge because it removes healthy bacteria lining

===> ==> CLICK THIS LINK TO GET FREE ACCESS TO DOWNLOAD THE SECRET FERTILITY SYSTEM

JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI].

For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.

For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact

JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.

We are located at

JOAS HOUSE, 2, Okesuna Street,

Opposite The Synagogue Church Busstop,

Bolorunpelu, Ikotun, Lagos

Postcode: 100265

Nigeria.  

TEL:

08032509975,

08184590752,

08058166504,

08064981455

EMAIL:

joasmedicaldiagnostix@yahoo.com

joasmedicaldiagnostix@gmail.com

DISCLAIMER

The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us.

The informations provided in this site is subject to change without notice.

This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

RESUME OF VICTOR CHUKWULENYE EFUGHI

RESUME OF VICTOR CHUKWULENYE EFUGHI




PERSONAL DATA



SURNAME: EFUGHI

OTHER NAMES: VICTOR CHUKWULENYE

COUNTRY: NIGERIA

DATE OF BIRTH: 29TH JANUARY 1970

PLACE OF BIRTH: ABIA STATE

SEX: MALE

HOME TOWN: UMUAHIA

NATIONALITY: NIGERIA

RELIGION: CHRISTIAN

STATE OF ORIGIN: ABIA STATE

LOCAL GOVERNMENT: UMUAHIA NORTH



CONTACT ADDRESS:



JOAS HOUSE, 2 OKESUNA STREET, OFF IKOTUN-ISOLO ROAD, OPPOSITE THE SYNAGOGUE CHURCH, SYNAGOGUE CHURCH BUS/STOP,

BOLORUNPELU, IKOTUN, LAGOS, NIGERIA, WEST AFRICA.





NEXT OF KIN: MRS NKECHI EFUGHI [wife]



TELEPHONE NUMBER: +2348023069403, +23418112054





EMAIL ADDRESS: victorefughi@yahoo.com



PROFESSION: MEDICAL RADIOGRAPHER-SONOGRAPHER



QUALIFICATIONS

Meticulous accomplished medical radiographer with comprehensive experience in medical sonography (especially in areas of Obstetrics and Gynaecology[Pelvic] , Upper Abdominal, Small Parts, Breast, Vascular ,Musculoskeletal Sonography and administration, in hospitals and private imaging centres in Nigeria and Europe [Republic of Ireland].

Excellent communicator who is fluent in english, possesses working knowledge of over 14 years, strong team-working and multi-tasking skills, successfully completes examinations within short time and accuracy with great consideration to patient care and welfare.

Willing to relocate



PROFESSIONAL EXPERIENCE/ ACHIEVEMENTS



[A] CAREWAY HOSPITAL, Egbeda, Lagos, Nigeria 1995 – 2001

POSITION: Radiographer-Sonographer

[1] Operate X-ray, radiographic and fluoroscopic equipment, to produce radiographs or anatomic images of the human body for the diagnosis by radiologists of disease or injury.

[2] Record and process patient data

[3] Perform basic verification and quality control checks on radiographic and film processing equipment

[4] Provide appropriate care for the patient during the radiographic examination

[5] Apply radiation protection measures

[7] Operate ultrasound imaging equipment that transmits high frequency sound pulses through the body to produce images of those parts of the body requiring examination

[8] Monitor examination by viewing images on video screen, to evaluate quality and consistency of diagnostic images, and make adjustments to equipment, as required

[9] Observe and care for patients throughout examinations to ensure patient safety and comfort

[10]Proficiency in abdominal, obestrical, and gynecology ultrasound scan.

[11]Analyse sonograms, synthesize sonographic information and medical history, and communicate findings to the appropriate Radiologist.









[B] JOAS MEDICAL DIAGNOSTIX, Ikotun, Lagos, Nigeria 2001 -- 2008

POSITION: Senior Radiographer-Sonographer



[1] Operate X-ray, radiographic and fluoroscopic equipment, to produce radiographs or anatomic images of the human body for the diagnosis by radiologists of disease or injury.

[2] Record and process patient data

[3] Perform basic verification and quality control checks on radiographic and film processing equipment

[4] Provide appropriate care for the patient during the radiographic examination

[5] Apply radiation protection measures

[6] Train and supervise student radiographers or supervise other radiological technologists.

[7] Operate ultrasound imaging equipment that transmits high frequency sound pulses through the body to produce images of those parts of the body requiring examination

[8] Monitor examination by viewing images on video screen, to evaluate quality and consistency of diagnostic images, and make adjustments to equipment, as required

[9] Observe and care for patients throughout examinations to ensure patient safety and comfort

[10]Proficiency in abdominal, obestrical, gynecology , breast and small part ultrasound scan.

[11]Analyse sonograms, synthesize sonographic information and medical history, and communicate findings to the appropriate Radiologist.









[C] GLOBAL DIAGNOSTICS IRELAND LTD, Dublin Ireland 14 Feb 2008 – 24 July 2009

POSITION: Senior Radiographer-Sonographer



[1] Operate X-ray, radiographic and fluoroscopic equipment, to produce radiographs or anatomic images of the human body for the diagnosis by radiologists of disease or injury.

[2] Record and process patient data

[3] Perform basic verification and quality control checks on radiographic and film processing equipment

[4] Provide appropriate care for the patient during the radiographic examination

[5] Apply radiation protection measures

[6] Operate ultrasound imaging equipment that transmits high frequency sound pulses through the body to produce images of those parts of the body requiring examination

[7] Monitor examination by viewing images on video screen, to evaluate quality and consistency of diagnostic images, and make adjustments to equipment, as required

[8] Observe and care for patients throughout examinations to ensure patient safety and comfort.

[9] Perform quality control checks on ultrasound equipment to ensure proper operation and perform minor repairs and adjustments .

[10] Supervise and train student and other medical sonographers.

[11]Proficiency in abdominal, obestrical/gynecology, small parts , breast, vascular and Musculoskeletal sonography .



[12]Perform all requested sonographic examinations in a RIS/PACS environment.



[13]Use cognitive sonographic skills to identify, record, and adapt procedures as appropriate to anatomical and pathological diagnostic information and images.



[14]Use independent judgment during the sonographic exam to accurately differentiate between normal and pathologic findings.



[15]Analyse sonograms, synthesize sonographic information and medical history, and communicate findings to the appropriate Radiologist.



[16]Prepare preliminary reports and transmit them to the radiologist.





[D] JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria , August 2009 --- till date.



POSITION: Consultant Clinical Specialist Radiographer [Ultrasounds]

[1] Operate X-ray, radiographic and fluoroscopic equipment, to produce radiographs or anatomic images of the human body for the diagnosis by radiologists of disease or injury.

[2] Record and process patient data

[3] Perform basic verification and quality control checks on radiographic and film processing equipment

[4] Provide appropriate care for the patient during the radiographic examination

[5] Apply radiation protection measures

[6] Train and supervise student radiographers or supervise other radiological technologists.

[7] Operate ultrasound imaging equipment that transmits high frequency sound pulses through the body to produce images of those parts of the body requiring examination

[8] Monitor examination by viewing images on video screen, to evaluate quality and consistency of diagnostic images, and make adjustments to equipment, as required

[9] Observe and care for patients throughout examinations to ensure patient safety and comfort.

[10] Perform quality control checks on ultrasound equipment to ensure proper operation and perform minor repairs and adjustments .

[11] Supervise and train student and other medical sonographers.

[12]Proficiency in abdominal, obestrical/gynecology, small parts , breast, vascular and Musculoskeletal sonography .



[13]Perform all requested sonographic examinations in a RIS/PACS environment.



[14]Use cognitive sonographic skills to identify, record, and adapt procedures as appropriate to anatomical and pathological diagnostic information and images.



[15]Use independent judgment during the sonographic exam to accurately differentiate between normal and pathologic findings.



[16]Analyse sonograms, synthesize sonographic information and medical history, and communicate findings to the appropriate Radiologist.



[17]Prepare preliminary reports and transmit them to the radiologist.











EDUCATION



1 ] LUDES UNIVERSITY, Lugano Switzerland

Executive MSc , Diagnostic Medical Ultrasound 2009



2] QUEEN MARGARET UNIVERSITY, Edinburgh Scotland [UK]

BSc Medical Radiography 2009



3] INSTITUTE OF RADIOGRAPHY [RADIOGRAPHERS REGISTRATION BOARD OF NIGERIA] Yaba Lagos Nigeria

Pg[Certificate] in Computerized Axial Tomography 2006



4] INSTITUTE OF RADIOGRAPHY [RADIOGRAPHERS REGISTRATION BOARD OF NIGERIA] Yaba Lagos Nigeria

Pg[Diploma] in Ultrasonography 2005



5] AKI-OLU MEDICAL CONSULT/ANNAS SPECIALIST HOSPITAL, Agbado, Lagos, Nigeria

Pg[Certificate] in Ultrasonography 1994



6] FEDERAL SCHOOL OF RADIOGRAPHY, Yaba, Lagos, Nigeria

Diploma in Medical Radiography 1994



7] AJEROMI IFELODUN HIGH SCHOOL

West Africa Examination Council (Equivalent to G.C.E. ‘O’ Level) 1987



8] LOCAL AUTHORITY PRIMARY SCHOOL

First School Leaving Certificate (G2) 1982





INTERNATIONAL ACCREDITATION AND VALIDATION

I am Registered/Validated to practice in The Republic of Ireland as a Medical Diagnostic Radiographer by The Department of Health And Children, with REF: S423/92 of 23rd February 2005







CONTINUING MEDICAL EDUCATION

SEMINARS/CONFERENCES/WORKSHOPS/COURSES ATTENDED



1] 36th Annual Conference/Scientific Workshop of the Association of Radiographers of Nigeria, held in Lagos Nigeria from the 19nd – 22nd November 2003.

2] One week intensive Pattern Recognition Course, organised by The Institute Of Radiographers of Nigeria,held in Enugu Nigeria, from the 5th – 9th September 2005.

3] 2 Day Management Workshop for Chief and Director- Grade Radiographers, organised by The Institute of Radiographers of Nigeria, held in Lagos Nigeria, from the 14th – 15th July 2005.

4] 11th Congress of The World Federation for Ultrasound in Medicine and Biology, held in Seoul South Korea, from May 28 – June 1 2006.

5]16th Annual Conference of The Musculoskeletal Ultrasound Society, held in Seoul South Korea, from May 27 – 28 2006.

6] 39th Annual Conference/Scientific Workshop of The Association of Radiographers of Nigeria, held in Enugu Nigeria, from the 22nd – 25th November 2006.

7] The Fetal Medicine Foundation Theoretical Course in Ultrasound Examination at 11 – 14 weeks gestation, held in Cairo Egypt, on 5th May 2007.

8]Intensive Course in Abdominal and Prostate Ultrasound , organised by Jefferson Ultrasound Research and Educational Institute/Centre for Ultrasound Research and Education, Lagos University Teaching Hospital, held in Lagos Nigeria, from 25th – 30th June 2007.

9]7th Middle East Imaging and Diagnostic Conference, organised by Arab Health/The American Academy of Continuing Medical Education, held in Dubai UAE, from the 28th –31 January 2007.

10]CPR PRO for The Professional Rescuer Course, organised by The Department of Health and Safety Division --- IBC, held in Dubai UAE, on the 2nd November 2007

11] Four weeks full time course in Medical Diagnostic Ultrasound , held at The Afro-Asian Institute of Medical Sciences, Lahore Pakistan , from the 3rd – 30th November 2007.

12] Advanced Course in Ultrasound in Obstetrics and Gynaecology , held in KASR EL AINI Hospital, Cairo University, Cairo Egypt, from 2nd – 3rd May 2007.

13] Transthoracic Echocardiography Ultrasound Course , organised by LUDWIG-MAXIMILIAN UNIVERSITY MUNCHEN[LMU MUNICH MEDICAL INTERNATIONAL] ULTRASOUND TRAINING ACADEMY DUBAI/HAVARD MEDICAL SCHOOL DUBAI CENTRE, Dubai UAE, from October 29th – November 1 2007.

14] The Fetal Medicine, Cairo 2007 International Congress, held in Cairo Egypt, from 4th – 7th May 2007

15] Second Trimester Fetal Medicine Foundation/ISUOG Course, held in Cairo Egypt, from the 4th – 7th May 2007.

16] Fetal Echocardiography ISUOG Course, held in Cairo Egypt, on 7th May 2007.









LOCAL AND INTERNATIONAL MEMBERSHIP



Association of Radiographers of Nigeria

The Medical Ultrasound Practitioners Of Nigeria

American Institute of Ultrasound In Medicine

British Medical Ultrasound Society

World Federation Of Ultrasound in Medicine and Biology

International Society of Radiographers and Radiologic Technologist

Afro-Asian Association of Ultrasound





REFEREES



1] MR. SUNDAY IDOWU

GENERAL MANAGER

JOAS MEDICAL DIAGNOSTIX

JOAS HOUSE, 2 Okesuna Street,

Off Ikotun-Isolo Road,

Opposite The Synagogue Church Busstop,

Bolorunpelu, Ikotun, Lagos, Nigeria, WestAfrica

TEL: 23418112054



2] PROF. DR. SYED AMIR GILANI

Afro-Asian Institute of Medical Sciences

626-Shadman -1 - Lahore, Pakistan

Phone: 0092-42-7521116-7 Ext:786Fax: 0092-427521118 Mob: 0300-8460876

Email: director@aaimsonline.com , dgilani@brain.net.pk

Web sites: www.aaimsonline.com



3] Dr. Johnny Walker

CEO

GLOBAL DIAGNOSTICS IRELAND LTD

Rockfield Medical Campus,Balally, Dundrum,

Dublin 16

Republic of Ireland

TEL: +353 85 272 7577

EMAIL: j.walker@globaldiagnostics.ie





3] DR. BOLAJI  OLADUNNI

MEDICAL DIRECTOR

CAREWAY HOSPITAL AND MATERNITY

14, Orelope Street, Egbeda, Lagos Nigeria

Tel: 23418167197





4] MR. M .S. OKPALEKE

Director of Institute

Radiographers Registration Board Of Nigeria

Medical Library Compound

Medical Compound

Yaba, Lagos, Nigeria

TEL: +2348035825535

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BREAST SELF EXAMINATION, PREVENT CANCER, SAVE LIFE
Breast cancer early diagnosis campaign.

BREAST SELF EXAMINATION(BSE)
BSE is regularly performed by a woman will make her familiar with the specific texture of her breast and know what is considered as normal for herself. She will discover a lump including cancer at an earlier stage than the one who does not practice BSE or the one who practice it occasionally. Cancer of the Breast is the most common cancer in women!

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Why BSE?
Approximately 90% of breast lumps are discovered by women themselves.
NB: Not all breast lumps are cancerous
Large numbers of women with breast cancer are cured if discovered and treated early

Positive family history of breast cancer is recognized as a risk factor
When and what stage do you perform BSE
All women older than 20 years should examine their breast monthly .Before menopause should examine 5-7 days after the completion of menstrual cycle. After menopause, or after removal of the womb or during pregnancy, choose a particular date each month and stick to that.How do you perform BSE?

Part 1: VISUAL EXAMINATION: -
-Performed standing before a mirror.
-Arm by side-Arms overhead and palms pressed together
-Arms on hips and press firmly
What to observe
[1] Change in size, shape or color (redness) of the breast.
[2] Change in position and shape of the nipple e.g. retraction, cracking etc
[3] Scaling or sores around the nipples
[4] Swellings, dimples or enlargement of the pores of the skin.

Part 2: PALPATION:
Performed standing or lying down with pillow under the shoulder of the side (i.e. Right or left) where the breast is to be examined, using the opposite hand. Then follow the pattern as described below;
-Starting from the outer part of the breast, palpate by making small circular movements. You must examine the entire surface including the nipples.
-Continue this way up to the nipples, you palpate with straightened fingers.
-Squeeze each nipple between the thumb and the index finger to eventually observe any nipple discharge.
-Hooked fingers will allow you examine the underarm with the wrist bent.


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What to observe
1. Any change in the texture of your breast e.g. thickening or hardening.
2. Appearance of a new lump.
3. Abnormal nipple discharge

What to do if you notice any unusual lump in your breasts?Contact your health care provider. ‘The earlier the better.’
NB: Early detection makes all the DIFFERENCE.




BREAST CANCER RISK ASSESSMENT [BRCAS]
YOU SHOULD KNOW YOUR…….
.-BREAST CANCER FACTOR(S)!
-BREAST CANCER 5 YEAR RISK!!
-BREAST CANCER LIFE TIME RISK!!!
DO YOUR BREAST CANCER RISK ASSESSMENT REGULARLY FOR EARLY DIAGNOSIS AND CURE”BREAST CANCER RISK FACTORS
Breast Cancer (BRCA) is one of the leading causes of cancer death for women.
1. A positive family history of BRCA in first-degree relative due to inherited genetic mutation BRCA1 and BRCA2 genes
2. Early menarche and late natural menopause
3. Woman’s age at the time of her first live birth of a child
4. A woman with medical history of non-invasive BRCA, cancer of uterine body and has undergone biopsy with atypical hyperplasia or fibrocystic change of the breast.
5. Radiation exposure
6. Age of a woman, and hormonal supplementation.
7. Lifestyle factors such as diet, exercise, alcohol consumption, smoking etc
8. Race/Ethnicity

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SCREENING TESTS

X-RAY MAMMOGRAPHYTo find breast cancer early, NCI recommends that:Women in their 40s and older should have mammograms every 1 to 2 years. A mammogram is a picture of the breast made with x-rays.

SONOMAMMOGRAPHY [BREAST ULTRASOUND]
Sonomammography is ultrasound of the breasts. It is used as a complimentary test to mammography in patients with dense breasts [ young patients less than 40 years] or even in patients with breast lumps. It is done quite regularly with X-ray mammography
1. Breast Ultrasound can detect whether a lump is a malignant mass or a benign cyst. While there are a few exceptions, ultrasound can do it while mammography cannot.
2. Ultrasound It is relatively inexpensive and most mammograms must be complemented with ultrasound. As ultrasound is already used for diagnosis, we could skip one step and use it for screening and diagnosis.
3. Sonomammography is painless. Many patients say mammography hurts
4. Sonomammography scans the whole breast. Mammography scans almost all the breast
5. Ultrasound is safer: mechanical waves with very low power and very short exposition time. Mammography uses X-rays whose adverse effects are cumulative
6. Ultrasound works for dense breast. Mammography does not.
7. Modern Ultrasound devices are digital and can use computer-aided detection systems very easily.

DIAGNOSTIC TESTS
Further testing is necessary to confirm whether a lump detected on screening is cancer, as opposed to a benign alternative such as a simple cyst.In a clinical setting, breast cancer is commonly diagnosed using a "triple test" of clinical breast examination (breast examination by a trained medical practitioner), mammography/sonomammography, and fine needle aspiration cytology.Both mammography/sonomammography and clinical breast exam, also used for screening, can indicate an approximate likelihood that a lump is cancer, and may also identify any other lesions.Fine Needle Aspiration and Cytology (FNAC), which may be done in a GP's office using local anaesthetic if required, involves attempting to extract a small portion of fluid from the lump. Clear fluid makes the lump highly unlikely to be cancerous, but bloody fluid may be sent off for inspection under a microscope for cancerous cells. Together, these three tools can be used to diagnose breast cancer with a good degree of accuracy.
Other options for biopsy include core biopsy, where a section of the breast lump is removed, and an excisional biopsy, where the entire lump is removed.

PREVENTION
Regular exercise, weight loss, avoidance of alcohol, stressors, toxic chemicals and environmental pollutants are all helpful measures in the prevention of breast cancer. Dietary inclusion of dried beans, cruciferous vegetables , and whole grains have also proven beneficial. Brazil nuts, rich in the mineral selenium , when combined with natural vitamin E as found in almonds and walnuts are also highly effective in reducing cancer risk.

TREATMENT
The mainstay of breast cancer treatment is surgery when the tumor is localized, with possible adjuvant hormonal therapy (with tamoxifen or an aromatase inhibitor], chemotherapy, and/or radiotherapy.

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JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria , offers breast ultrasound screening with colour doppler for accuracy in diagnosis.We also offer mammography studies. For accurate assessment of your breast contact JOAS MEDICAL DIAGNOSTIX, Ikotun lagos Nigeria.

JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI].
For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.


For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact
JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.

We are located at

JOAS HOUSE, 2, Okesuna Street,
Opposite The Synagogue Church Busstop,
Bolorunpelu, Ikotun, Lagos
Postcode: 100265
Nigeria.  

TEL:
08032509975,
08184590752,
08058166504,
08064981455


EMAIL:
joasmedicaldiagnostix@yahoo.com
joasmedicaldiagnostix@gmail.com



DISCLAIMER
The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us.
The informations provided in this site is subject to change without notice.
This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

FOLLICULAR TRACKING IN INFERTILITY INVESTIGATIONS

FOLLICULAR TRACKING IN INFERTILITY INVESTIGATIONS



FEMALE FACTOR INFERTILITYInfertility is the inability of a couple to become pregnant (regardless of cause) after 1 year of unprotected sexual intercourse (using no birth control methods).
Female factor infertility means infertility of a couple because of a problem in the female's reproductive system. The main causes of female factor infertility are ovulation disorders, tubal disease and endometriosis.

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INDICATIONS FOR FOLLICULOMETRY[1] Monitoring ovulation for infertility checks
[2] To rule out ovarian failure
[3] To rule out anovulatory cycle
[4] To rule out Luteinised follicular syndrome
[5] Gender selection
[6] IUI and IVF [assisted reproduction]

OVARIAN FAILURE FACTORThe diseases of the ovary which most frequently cause infertility are: anovulation from follicular atresia, the empty follicle syndrome, the luteinized unruptured follicle syndrome; chronic anovulation syndromes, within which polycystic ovarian syndrome plays a major role; ovarian endometriosis.
Sonography and Color Doppler US are the first choice procedures in the monitoring of ovarian cycles, which combined with serum hormone values, are able to identify possible changes in the physiologic sequence of the cycle. In follicular atresia, ovaries with minute follicles (3mm or less) and early disappearance of primary follicle are observed on sonography. The empty follicle syndrome characterized by the lack of oocytes within the primary follicle, is of difficult sonographic diagnosis, a possible sign being the missed visualization of cumulus oophorus. The luteinized unruptured follicle syndrome consists in the absence of oocyte expulsion from primary follicle persisting more than 48 hours after LH blood peak.

THE OVARY
The ovary is an ovum-producing reproductive organ, often found in pairs as part of the vertebrate female reproductive system. Ovaries in females are homologous to testes in males, in that they are both gonads and endocrine glands.
Ovaries are oval shaped and, in the human, measure approximately 3 cm x 1.5 cm x 1.5 cm (about the size of a Greek olive). The ovary (for a given side) is located in the lateral wall of the pelvis in a region called the ovarian fossa. The fossa usually lies beneath the external iliac artery and in front of the ureter and the internal iliac artery.
Each ovary is then attached to the fimbria of the fallopian tube. Usually each ovary takes turns releasing eggs every month; however, if there was a case where one ovary was absent or dysfunctional then the other ovary would continue providing eggs to be released.

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1. OOGENESISThe female germ cells, called oogonia, lodge in the outer layer, or cortex, of the ovary. They divide rapidly and at the fifth month of a female fetus's life number up to 6-7 million cells. At that time, they begin maturation and are now called primary oocytes, eventually maturing to become primordial follicles. At birth, a female baby will have 2-4 million primordial follicles. In terms of numbers, birth is the high point, as many of the follicles will degenerate so that, by puberty, a woman will have, on average, about 400,000 of these follicles in her ovaries. It has been generally accepted that these are all the germ cells a woman has for her lifetime because these cells have not been known to multiply during life the way the spermatogonia do. Although there is one recent article that suggests that germ cells in the ovary may be able to regenerate later in life, in humans, for all practical purposes "what you have at birth is what you get for life" is still the case.

2. FOLLICLE DEVELOPMENT
Throughout female life from the onset of menstruation (menarche) to menopause, a small number of these primordial follicles are constantly beginning development. At puberty, hormones from the hypothalamus and pituitary glands in the brain will start to influence ovarian function. Without these hormones, the follices will not survive. The names of the hormones: gonadotropin releasing hormone (GnRH), follicle stimulating hormone (FSH) and luteinizing hormone (LH).

3. OVULATIONWith respect to the ovary, the menstrual cycle is divided into two phases: the follicular phase and the luteal phase. The follicular phase is dominated by the development of the follicle under the influence of FSH, while the luteal phase is dominated by another pituitary hormone, luteinizing hormone (LH). LH and FSH cause the production of prostaglandins and enzymes that disrupt the follicle and release the ovum, or egg, from the ovary. This release into the peritoneal space at the open fringed end of the fallopian duct is called ovulation.


OVARIAN FOLLICLESOvarian follicle is the basic unit of female reproductive biology and is composed of roughly spherical aggregations of cells found in the ovary. They contain a single oocyte (aka ovum or egg). These structures are periodically initiated to grow and develop, culminating in ovulation of usually a single competent oocyte. These eggs/ova are only developed once every menstrual cycle (i.e, once a month).

GRAFFIAN FOLLICLEA mature ovarian follicle in which the oocyte attains its full size and the surrounding follicular cells are permeated by one or more fluid-filled cavities. Also called secondary follicle, vesicular ovarian follicle.The Graafian follicle is characterized by a large, fluid-filled antrum, and an eccentric oocyte. The granulosa cells can be divided into two groups; the zona granulosa is a thin layer along the periphery of the follicle and the corona radiata surrounds the oocyte. The oocyte has undergone the first meiotic division, giving rise to a secondary oocyte and the first polar body. The secondary oocyte is now arrested in metaphase of the second meiotic division and will so remain until fertilization. The first meiotic division appears to be initiated by LH acting on granulosa cells, however the exact mechanism of action is unknown. The Graafian follicle represents the final stage of follicular development before ovulation.
The Graafian follicle is identified by the large antrum , and the corona radiata that surrounds the actual oocyte and projects into the antrum
CUMULUS OOPHORUS: a mass of follicular cells surrounding the oocyte in the vesicular ovarian follicle.


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FOLLICULAR TRACKING BY ULTRASOUNDUltrasound Folliculometry is a serial Transvaginal ultrasound scan test carried out to monitor follicular growth . Follicular growth can be best monitored by ultrasound , providing 40–70% effectiveness. Folliculometry is one of the most accurate method for determining ovulation. Ovulation scans allow us to determine accurately when the follicle matures; and when it ruptures. Daily scans are done to visualize the growing follicle, which looks like a black bubble on the screen. Other useful information which can be determined by these scans is the thickness of the uterine lining - the endometrium. The ripening follicle produces increasing quantities of estrogen, which cause the endometrium to thicken. We can get a good idea of how much estrogen the patient is producing (and thus the quality of the egg) based on the thickness and brightness of the endometrium on the ultrasound scan.

In a normal ovarian cycle, a single follicle begin to mature under the influence of the gonadotrophic hormone FSH and LH. The follicle appears sonographically as a vesicular echo free structure on the ovary. While some small follicles from 0.4 to 0.6cm in diameter can usually be seen in both ovaries during the initial days of the cycle, a follicle on one of the ovaries become dorminant starting about day 10, enlarging to a diameter of approximately 1 cm. That follicle grows at an almost linear rate of 2 to 3mm per day over the next 4 to 5 days reaching a size of 18 to 24mm just before ovulation. The follicle may have a somewhat elliptical shape initially , but the preovulatory follicle is generally round.
Research found a good correlation between follicular size by ultrasound and the serum estradiol level .
In folliculometry the follicle diameter is determined by measuring the internal diameter of the follicle in three planes [ long, transverse, anterior-posterior] and taking the average of these diameters.
Sonographic follicular monitoring is started on about 6 to 8 days of the menstrual cycle, on day 10 when the dormant follicle presumably has reached a minimum size of 1cm. The scans are repeated at intervals of 1 to 2 days until ovulation is detected.
Occassionally the Cumulus Oophorus can be identified with a high resolution scanner shortly before ovulation. It appears as a peripheral circular feature within the follicular wall.
During folliculometry [transvaginally] we should make an effort to see the Cumulus mass. When a cumulus mass is seen, it can be taken as evidence of a sign of maturity of that particular follicle and oocyte. Cumulus visualization by ultrasound appears to be an indicator for mature oocytes and successful fertilization. Follicles in which the cumulus cannot be visualized are unlikely to contain mature oocytes or oocytes in which fertilization is achieved.
Normally ovulation is not expected to occur until the follicle has reached a size of 1.7cm.

Once ovulation has occurred , various sonographic changes maybe observed
[1] Complete disappearance of the cystic structure in the ovary.
[2] Collapse of the cystic structure with a decrease in its diameter.
[3] A cystic mass with internal echoes [the corpus hemorrhagicum]
[4] The presence of follicular fluid in the cul de sac.

Serial ultrasound examinations cannot only demonstrate normal follicular development. These include failure of the follicle to mature.
Defficient growth of the follicle and Luteinized unruptured follicle syndrome.


COMPLICATIONS
OVARIAN HYPERSTIMULATION SYNDROME

Ovarian hyperstimulation syndrome (OHSS) is a common
complication in assisted reproductive technologies. It is seen
to occur in ,10% of the treatments, and the severe form is
observed in 0.5–2% of IVF cycles . OHSS
is usually described by enlarged multicystic ovaries, ascites
and haemoconcentration. Acute renal failure due to a hypovolaemic
state following production of protein-rich ascites in
patients with OHSS .
Even though the complication risk related to IVF is low,
one should be aware of a possible compression or damage to the ureters with subsequent development of acute renal failure.


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JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI].

For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.

For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact

JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.

We are located at

JOAS HOUSE, 2, Okesuna Street,

Opposite The Synagogue Church Busstop,

Bolorunpelu, Ikotun, Lagos

Postcode: 100265

Nigeria.  

TEL:

08032509975,

08184590752,

08058166504,

08064981455

EMAIL:

joasmedicaldiagnostix@yahoo.com

joasmedicaldiagnostix@gmail.com

DISCLAIMER

The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us.

The informations provided in this site is subject to change without notice.

This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

FEMALE FACTOR INFERTILITY

FEMALE FACTOR INFERTILITY

She looked at me in desperation, as if to say ‘’Give me a child now or I die here, because I cannot go home without one. I cannot afford to fail the second time’’.
Her case is like the plight of so many infertile African women.
She had been married to her first husband for over 10 years without giving him a child. When the man got tired of waiting , he decided to test his manhood by playing an away game with his secretary, and scored, she became pregnant for him.
As if that was not enough problem for the poor lady, her mother in-law and sisters in-law came over , beat her thoroughly then threw her out of her matrimonial home to make way for the new pregnant secretary/wife to take over.
Luckily she was such a pretty and desirable lady, so not long she had remarried to another man.
She is now married to her new husband for 4 years without giving him any child.
Now she is desperate.

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INFERTILITY: is usually defined as no pregnancy after one year of unprotected intercourse. This is a relative measurement. Over time, many couples may achieve pregnancy. In five years, nearly one half of "infertile" couples will conceive.

SUBFERTILITY: is used to describe gradations between normal fertility and sterility, often used interchangeably with infertility.

FECUNDABILITY: is the pregnancy rate from one menstrual cycle. The normal rate in humans is 20%. Seventy-five percent of normally fertile couples are expected to have conceived in six months and almost 100% by one year.

STERILITY: is the absolute inability to procreate: an absent uterus in women, absent testes in men. In years past, a woman with blocked fallopian tubes or man with an obstructed vas deferens would be sterile. But with assisted reproductive technology (ART), this is no longer the case.Normal fertility can be considered from several different points of view: the couple, the female and the male. In this article, we are going to look at female fertility: the biological steps and mechanisms, the defects, the causes of the defects and what to do.

THREE BASIC QUESTIONSThere are really three basic questions that have to be answered when doctors try to determine why a woman is having problems getting pregnant.
[1]Is she ovulating?
[2]Is there a clear passage from the ovary to the uterus?
[3]How old is she?
A similar set of questions has to be answered in men. Is there sperm? Can it be delivered to the female? Is the sperm normal? In the male these questions are answered in a preliminary and rather thorough way by semen analysis. With women the process is more complicated.

FEMALE INFERTILITYFemale factor infertility is the inability to conceive or carry a pregnancy to term due to one or more problems specific to females. For example, if a couple is struggling to achieve pregnancy and the male has adequate sperm count, motility, and shape, but the woman has polycystic ovarian syndrome, then their inability to conceive is likely due to female factor infertility.

FEMALE FERTILITY PROBLEMS
There are several conditions that contribute to female factor infertility, including uterine and pelvic abnormalities, secondary infertility, polycystic ovarian syndrome, and hostile cervical mucus. It is important to understand, however, that infertility, whether male infertility or female infertility, is not the same thing as sterility - conception and successful pregnancy are possible in many cases. Likewise, secondary infertility (the inability of a couple to conceive after having already achieved a successful pregnancy or pregnancies) can often be treated.
[1] Abnormal Uterine/Pelvic Area
[2] Blocked Fallopian Tubes
[3] Endometriosis
[4] Hostile cervical mucus. This is a condition in which the cervical mucus creates a thick barrier that sperm cannot penetrate.
[5] Irregular Ovulation
[6] Medications/Contraceptives and Infertility
[7] Polycystic Ovarian Syndrome
[8] Premature Ovarian Failure
[9] Uterine Fibroids
[10] High levels of the hormone prolactin
[11] Galactorhoea (milk leaking from the breasts).
[12] Amennorhoea [absence of periods]
[13] The production of sperm antibodies (when a woman develops antibodies to her partner’s sperm).

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INFERTILITY AFTER MISCARRIAGEThe termination of a pregnancy is devastating to couples who wish to have a baby; worse yet is the prospect of female infertility after miscarriage. Unfortunately, such a fate is possible. This form of female factor infertility can be caused by hormonal, environmental, immunological, and even physiological problems. There is hope, however, with treatment from a female fertility specialist.

SECONDARY INFERTILITY
Sometimes female infertility occurs after a woman has already given birth to one or more children. If a couple has already successfully conceived and delivered before, but is having difficulty becoming pregnant again, they may be experiencing secondary infertility.Secondary infertility can be caused by a wide range of issues, including age, irregular ovulation, endometriosis, hostile cervical mucus, and an abnormal uterus or pelvis. Scar tissue from the previous pregnancy may be causing blockage to the fallopian tubes or cervix, resulting in female factor infertility.

INFERTILITY CAUSED BY ABORTION
There is a risk of becoming infertile after an abortion, arising from various complications. If you have had a first trimester abortion (in the first 13 weeks) this is done by vacuum suction which can cause perforation of the womb. This is when the womb ruptures and causes internal bleeding. It is life threatening and the surgeon would be required to do additional surgery to repair the damage. Sometimes after this has occurred, the damage to the womb prevents another embryo from attaching. Rupture happens in about 1% of cases, so if 100 women had an abortion, one of them would have this problem.The main abortion complications that could cause infertility:90% of abortions are done in the first trimester. However, a late abortion frequently requires a material called laminaria to dilate the cervix. This makes the passage large enough to allow a suction tube to be inserted. The laminaria could weaken the cervix and conceivably cause infertility.If the physician scrapes too hard, the lower lining of the uterus can be removed. This is extremely rare.An untreated infection can scar the uterus and cause later fertility problems. The infection rate for first trimester abortions is less than 1%. Most women monitor their body temperature after an abortion to detect if an infection has occurred. Early detection should prevent any problems.
A woman who already have gonorrhea or chlamydia are very likely to suffer pelvic inflammatory disease which causes infertility. They are particularly susceptible to damage from PID after an abortion. This can be avoided by obtaining a STD test before the abortion.The suction tube can perforate both the uterus and a large blood vessel or intestine. If the latter happens, then surgery may be required. The surgery can cause infertility. Perforation of the uterus is also quite rare.
It would seem that if the physician is competent, and the woman monitors her body temperature after the procedure, that the chances of an abortion causing later infertility is quite remote.

CAUSES AND MECHANISMS OF FEMALE INFERTILITYThe main causes of female factor infertility are ovulation disorders, tubal disease and endometriosis. In a population of infertile couples, if you consider unexplained and male factor infertility at about 25% each, ovulatory disorders and tubal factors would be about 20% each and endometriosis 5-10%, with small percentages for uterine/cervical problems.3

The history and physical exam offer us many hints about the cause of infertility :


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FEMALE INFERTILITY WORK-UP: HISTORY AND PHYSICAL EXAMINATION.

HISTORY[1]Systemic illnesses: weight gain, weight loss
[2]Cancer, chemotherapy, radiation treatment, surgery
[3]Urogenital system: surgery: D & C, laparoscopy
[4]Pregnancy: outcome
[5]Menstruation: regular, irregular, absent
[6]Pelvic pain, dysmenorrhea, dyspareunia
[7]Sexual history: function, sexually transmitted disease, pelvic inflammatory disease
[8]Endocrine history: diabetes, thyroid disease

FAMILY HISTORYInfertility, cystic fibrosis, endometriosis

MEDICATIONS AND DRUGS
Prescription: endocrine, psychoactive, anti-hypertensive

PHYSICAL EXAMINATION
[1]Height & weight, neck, arms (carrying angle)
[2]Skin: hirsuitism
[3]Breasts: galactorrhea
[4]Abdomen: girth, adiposity
[5]Mass Pelvic exam: uterus, ovaries, pelvic mass, tenderness Genital ulcers, warts

QUESTIONS AND ANSWERS
[1]IS SHE OVULATING?Defects in ovulation comprise about 25% of female fertility problems. The biggest clue that ovulation is occurring is the presence of regular menstrual periods. Regular periods are almost always associated with ovulation. Irregular or scanty menstruation (oligomenorrhea) or absent periods (amenorrhea) have to be investigated by your doctor.It is impossible to describe all the conditions that affect ovulation, but let me hit the highlights and give you some examples of the mechanisms involved. Causes for ovulatory defects can be genetic, as in Turner's syndrome, or hormonal, as in prolactinoma or the polycystic ovary syndrome (PCOS). Deficient or excessive body fat can also lead to hormonal changes that stop ovulation.


[2]IS THERE A CLEAR PASSAGE FROM THE OVARY TO THE UTERUS?The two main conditions that can affect the fallopian tubes are endometriosis and tubal infection.

[A] ENDOMETRIOSISIn this condition, implants of endometrial tissue are found outside the uterine cavity, primarily in the pelvis, on the ovaries, tubes, body linings and adjacent organs of the GI and GU tracts. This extra endometrial tissue responds to cyclical estrogen and progesterone in the same way the uterine endometrium does -- proliferating, swelling and bleeding. The implants can invade the surrounding tissues, affect nerve endings, and cause scarring and adhesions on adjacent peritoneal surfaces. The most common symptoms of endometriosis are pelvic pain, painful periods (dysmenorrhea) and painful sexual intercourse (dyspareunia). These symptoms generally coincide with menstruation but can become chronic. That said, there are women who have had no complaints at all and are found to have endometriosis at laparoscopy or surgery.

[B] PELVIC INFLAMMATORY DISEASE [PID] / SALPINGITIS
PID is the most common cause of tubal factor infertility. The infection involves the upper genital tract (the uterus, the fallopian tubes and the ovaries) and structures around these organs. The infection of the fallopian tube (salpingitis) is the most crucial element causing infertility. The fallopian tube is lined with special, ciliated cells that direct the egg toward the sperm and the fertilized egg into the uterine cavity. Infection can destroy these cells and distort and/or block the tube.
The main bacterial culprits are Neisseria gonococcus (NG) and Chlamydia trachomatis (CT). NG is directly kills the special cells; CT probably destroys cells through immunological mechanisms. With the infection, the tubes can become thickened, distorted and blocked. Abscesses can form between the tube and the ovary or in the adjacent pelvis, and can be life threatening. This condition requires prompt, broad-spectrum antibiotic treatment. Interestingly, in about half of cases of tubal infertility secondary to PID, there is no history of acute infection. Chlamydia in particular can linger in the genital tract, causing ongoing subclinical damage. Chronic pelvic pain, infertility and ectopic pregnancy (where the pregnancy develops in the tube instead of the uterus) are the serious consequences of PID.


[3]HOW OLD IS SHE?
Fertility decreases with age. Nationally, in assisted reproductive technology facilities, live birth rates are 37% for women <35>42. As mentioned earlier, there are only so many primordial follicles present in the ovary at birth and they decrease steadily until the time of menarche, from 2-4 million to 400,000. With every cycle, primordial follicles are lost. As women age, more chromosomal abnormalities occur during cell division of the ova. The decreasing numbers of follicles, cycles without ovulation (anovulatory) and poor quality of the ova all combine to diminish the chances of older women, especially after age forty, becoming pregnant.While age is the strongest predictor of a women's ovarian function, there are some tests that are also helpful. They are the follicle count, which is determined by ultrasound, and blood tests for follicle stimulating hormone (FSH) and estradiol. All these tests are performed on or about the third day of the menstrual cycle. Follicle count is used because the number of small follicles seen on Day 3 gives a good idea about ovarian reserve.The hormone levels give indirect evidence about ovarian reserve because inhibin, secreted by cells of the follicles, effects the hormone FSH. As the follicle number diminishes, there are fewer cells producing inhibin and FSH increases. As the specialized cells, called granulosa cells, continue to diminish, ovarian estrogen decreases despite elevated FSH. A high FSH and a low estrogen indicate severe loss of follicles.
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INFERTILITY DIAGNOSTIC TESTS
The Female Work-up (Diagnostic Tests)

[1] ULTRASOUND : Ultrasound scan is a simple and easy outpatient procedure to examine the internal reproductive organs. It can clearly show the position and size of uterus, endometrial lining and the ovaries. Certain abnormal conditions such as fibroid, double uterus and ovarian cyst can be diagnosed through ultrasound scan alone. In addition, ultrasound scan can be used for the diagnosis of ovulation.
Ultrasound scan appears as a routine practice in the management of infertility, from the initial stages of diagnosis of the cause of infertility, to the eventual confirmation of pregnancy, including routine monitoring of early pregnancy. Ultrasound scan is probably the most important test in investigation of infertility. A well-preformed and detailed ultrasound scan of the female pelvis will give more information than any other single test.
Ultrasound is the only definitive way to tell you have ovulated. Especially TRANSVAGINAL ULTRASOUND SCAN. This can tell if you have LUFS (Lutenized Unruptured Follicle Syndrome), which looks exactly like you are ovulating in every way except the egg is not released.

[2] HORMONAL BLOOD TESTS: perform some basic hormone blood tests. Here is a list of the common blood tests performed. FSH (Follicle Stimulating Hormone)LH (Lutenizing Hormone)EstrogenProgesterone
including estradiol, inhibin B, Pooled progesterone, prolactin,thyroid stimulating hormone, testosterone.

[3] POSTCOITAL TEST: This test will tell if you and your partner's cervical mucus and sperm are compatible. During the fertile time of your cycle, the doctor will take a sample of the female's cervical fluid withintwo hours of intercourse. If the sperm survive and move forward in the cervical fluid, you will know the sperm andcervical mucus are compatible.

[4] HSG (Hysterosalpingogram) : This is a Special X-Ray examination. This will tell if your fallopian tubes are open by injecting dyethrough the cervix. Blocked tubes and lesions or polyps on the uterine cavity can be foundwith this method.

TRANSVAGINAL ULTRASOUND SCAN
Definition
Transvaginal ultrasound is a imaging technique used to create a picture of the genital tract in women. The hand-held device that produces the ultrasound waves is inserted directly into the vagina, close to the pelvic structures, thus often producing a clearer and less distorted image than obtained through transabdominal ultrasound technology, where the probe is located externally on the skin of the abdomen.
Purpose
Transvaginal ultrasound can used to evaluate problems or abnormalities of the female genital tract. It may provide more accurate information than transabdominal ultrasound for women who are obese, for women who are being evaluated or treated for infertility , or for women who have difficulty keeping a full bladder. However, it does provide a view of a smaller area than the transabdominal ultrasound.

Types of conditions or abnormalities that can be examined include:
[a]the endometrium of women with infertility problems or who are experiencing abnormal bleeding
[b]sources of unexplained pain
[c]congenital malformations of the ovaries and uterus
[d]ovarian cysts and tumors
[e]pelvic infections, such as pelvic inflammatory disease
[f]bladder abnormalities
[g]a misplaced IUCD (intrauterine contraceptive device)·
[h]other causes of infertility
Transvaginal ultrasound can also be used during pregnancy. Its capability of producing more complete images means that it is especially useful for identifying ectopic pregnancy, fetal heartbeat, and abnormalities of the uterus, placenta, and associated pelvic structures.


FOLLICULOMETRY [ULTRASOUND]
Ultrasound Folliculometry is a serial Transvaginal ultrasound scan test carried out to monitor follicular growth . Ovulation/Follicular growth can be best monitored by ultrasound folliculometry, providing 40–60% effectiveness.
Folliculometry is one of the most accurate method for determining ovulation. Ovulation scans allow the doctor to determine accurately when the egg matures; and when you ovulate. This is often the basic procedure for most infertility treatment since the treatment revolves around the wife's ovulation. Daily scans are done to visualize the growing follicle, which looks like a black bubble on the screen. Most women can see the follicle clearly for themselves - and know by the scans when the egg has ruptured.
Other useful information which can be determined by these scans is the thickness of the uterine lining - the endometrium. The ripening follicle produces increasing quantities of estrogen, which cause the endometrium to thicken.
The doctor can get a good idea of how much estrogen you are producing (and thus the quality of the egg) based on the thickness and brightness of the endometrium on the ultrasound scan. Ultrasound Folliculometry is started from day 6 – 8 counting from the first day of menstruation. Folliculometry is performed every 2 or 3 days in the initial stages and can be done daily from the day 12, till after the follicle ruptures [post ovulation]. So in a routine ultrasound folliculometry the lady could be scanned transvaginally for between 3 to 6 sessions.
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JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI]. For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria. For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact JOAS MEDICAL DIAGNOSTIX JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES. We are located at JOAS HOUSE, 2, Okesuna Street, Opposite The Synagogue Church Busstop, Bolorunpelu, Ikotun, Lagos Postcode: 100265 Nigeria. TEL: 08032509975, 08184590752, 08058166504, 08064981455 EMAIL: joasmedicaldiagnostix@yahoo.com joasmedicaldiagnostix@gmail.com DISCLAIMER The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us. The informations provided in this site is subject to change without notice. This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships