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Related Concept Videos

Oogenesis02:07

Oogenesis

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In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
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Oogenesis,  the process of developing egg cells (female gametes), occurs within the ovaries and is fundamental to female fertility. This sequence begins during fetal development when diploid oogonia in the developing ovaries undergo mitotic divisions to produce primary oocytes. By birth, these primary oocytes enter prophase I of meiosis but become arrested in this stage, remaining suspended until puberty.
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Hormonal Control of the Ovarian Cycle01:30

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The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
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The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
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Infertility in Females01:28

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Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
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Menopause01:28

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Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
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Z-Scores for Assessing Ovarian Reserve in Young Patients Undergoing Fertility Preservation
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Ovarian reserve screening before contraception?

Vitaly A Kushnir1, David H Barad2, Norbert Gleicher2

  • 1Center for Human Reproduction (CHR), New York, NY, USA.

Reproductive Biomedicine Online
|September 22, 2014
PubMed
Summary

Women using hormonal contraceptives may miss early signs of ovarian aging. Screening for premature ovarian senescence before long-term use is proposed to aid early diagnosis and intervention.

Keywords:
family planningfertility counsellinghormonal contraceptionovarian reserve testing

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Area of Science:

  • Reproductive Endocrinology
  • Gynecology
  • Women's Health

Background:

  • Increasing trend of delayed conception in women.
  • Hormonal contraceptives induce artificial cyclicity, masking natural ovarian behavior and potential pathologies.
  • Suppression of anti-Müllerian hormone by contraceptives hinders accurate assessment of ovarian reserve.

Purpose of the Study:

  • To highlight the diagnostic challenges posed by hormonal contraceptives for early detection of ovarian issues.
  • To propose a risk-screening strategy for premature ovarian senescence in young women.
  • To facilitate timely diagnosis and management of ovarian pathology before or during long-term contraceptive use.

Main Methods:

  • Review of the impact of hormonal contraceptives on menstrual cyclicity and ovarian hormone markers.
  • Analysis of diagnostic delays in women using long-term hormonal contraception.
  • Proposal of a pre-contraception risk-screening protocol for premature ovarian senescence.

Main Results:

  • Long-term hormonal contraceptive users often present with undiagnosed premature ovarian senescence upon cessation.
  • Menstrual abnormalities and infertility are common presentations of undiagnosed ovarian senescence post-contraception.
  • Current screening methods can identify young women at risk for premature ovarian senescence.

Conclusions:

  • Hormonal contraception use can mask the early signs of premature ovarian senescence, leading to delayed diagnosis.
  • Implementing risk screening before initiating long-term hormonal contraception is crucial for early detection.
  • A proactive screening approach can improve the management of ovarian health in women delaying conception.