1. Reproductive Infertility 2: A bit more about male fertility, then a bunch about puberty, pregnancy, and female infertility.

2. Varicocele

3. Effects of exogenous estrogens on male reproductive system Accidental over-exposure to pesticides with estrogen-like activity in an occupational setting has been associated with male infertility. Pesticide exposure has been shown to change the concentration, motility and morphology of sperm, but these changes have not been shown to affect fertility. Sons whose mothers took DES during pregnancy had only modest changes in semen quality, and no qualitative change in fertility.

4. Puberty Distribution of age of puberty within normal and abnormal populations Among Caucasian Americans, the median age of menarche for girls is about 12.4 years, and about 12.1 years for African American girls. Puberty occurs about 1 year later for boys. http://jcem.endojournals.org/cgi/content/full/86/6/2364

5. Chumlea WC,, et al. Age at menarche and racial comparisons in US girls. PEDIATRICS Vol. 111 No. 1 January 2003, pp. 110-113 Chumlea WC Fig 1. Probit plots for age at menarche for non-Hispanic white, non-Hispanic black, and Mexican American girls in the NHANES III

6. http://www.well-net.com/womenshealth/contraception/bbt-1.gif Fertility

8. Widmaier, E.P. Raff, H. and K.T. Strang. Vander, Sherman and Luciano’s Human Physiology 9/e. McGraw-Hill. 2004

9. http://biology.unm.edu/ccouncil/Biology_124/Images/fertilization.jpeg

11. http://www.sgul.ac.uk/depts/immunology/~dash/troph/blastocyst.jpg

13. Ectopic Pregnancy

14. A Molar Pregnancy Hydatidiform mole. http://www.waybuilder.net/sweethaven/MedTech/FraPkr02.asp?iCode=010305_010306

15. http://www.hopkinsmedicine.org/craniofacial/LynmProject/BSC/BSC2.HTM#FIGURE1

16. Neural Tube Defects http://www.cfsan.fda.gov/~dms/sbifidap.gif

19. Fig. 20.48

20. Widmaier, E.P. Raff, H. and K.T. Strang. Vander, Sherman and Luciano’s Human Physiology 9/e. McGraw-Hill. 2004

21. Cephalic vs. Breech Presentation http://www.breechbaby.info/images/fgwh2606.GIF

22. Breech Presentation http://www.breechbaby.info/images/fgwh2606.GIF

23. C-Sections Optimal rate: 10 – 15% Rate in US: 25.2% Both are safe in a normal pregnancy Overall safety difficult to compare (since C-sections are most often done when there are complications

24. Some Lingering Consequences of C-sections More post-delivery pain than a vaginal birth Delayed nursing and bonding Risk of respiratory problems, even if baby is not premature Increased risk of adverse outcomes in subsequent pregnancies: placental problems, uterine rupture.

27. Common causes of Infertility in Women Tubal Obstruction Ovulatory disorders Polycystic Ovary Disease Endometriosis

29. Obstruction of the Fallopian Tube Normal Obstructed http://www.healthsquare.com/fgwh/wh1c0603.jpg

30. Polycystic Ovary http://medicineworld.org/images/blogs/2-2007/polycystic-ovary-281680.jpg

31. Endometriosis http://www.whathealth.com/endometriosis/images/endometriosis.jpg

32. http://www.aquinohotline.com/images/seps029.jpg

33. Source: Management of the Infertile Woman by Helen A. Carcio and The Fertility Sourcebook by M. Sara Rosenthal

34. http://www.advancedfertility.com/age.htm

35. Number of ART cycles reported for 2003: 112,872* Number of live-birth deliveries resulting from ART cycles started in 2003: 35,785 Number of live babies born as a result of ART cycles carried out in 2003: 48,756 http://www.cdc.gov/ART/ART2003/section1.htm