Index

A

Abnormal initial semen analysis, 91 Abnormal prolactin, 36

Abnormal uterine bleeding (AUB), 54 evaluation of, 54

hormonal pro le, 54 laboratory testing, 55 medical history, 53 pathophysiology of, 54 pelvic exam, 53 transvaginal ultrasound, 53

Acupuncture, 50 Adhesion formation, 8 Ambiguous genitalia

differential diagnosis, 1, 2 evaluation, 3, 4 treatment, 5–7

American College of Obstetricians and Gynecologists (ACOG), 54, 80 American Thyroid Association (ATA)

guidelines for pregnancy, 78 Anastrozole, 182

Androgen receptor (AR) gene, 4 Androgens, 2

Aneuploidy, 232, 234 Antiandrogens, 66

Anti-Mullerian hormone (AMH), 99, 117, 121, 231, 237, 249

Anti-sperm antibody (ASA), 151, 170 Antithyroid drugs (ATD), 82

Antral follicular count (AFC), 127 Aromatase inhibitors, 66

Arti cial oocyte activation (AOA), 188 Aspiration, 101

Assisted reproductive technology (ART), 152, 220, 225

accelerated utilization, 217, 218 epidemiology, 214

evaluation, 214, 215 indications, 217 recent trends, 219 safety, 220

success rates, 219 treatment, 216, 217 Asymptomatic myomas, 104

Azoospermia, 175–177, 180–182

genetic work-up and implications, 180 history and physical examination, 178, 179 laboratory investigations, 179, 180 obstructive, 181

post-testicular, 176, 177 pre-testicular, 176 testicular, 176, 180

B

Bardet-Biedl syndrome, 21

Bilateral tubal patency, 100

Biochemical testing, 94

Bone marrow-related illnesses, 21

C

Central nervous system (CNS) lesion, 28 Central precocious puberty (CPP), 12 Centrosome assessment, 191, 192

Child intelligence quotient (IQ), 79 Chromotubation, 100, 110

254

Chronic endometritis, 136

Chronic iron de ciency anemia, 103 Chronic orchialgia, 165 Clomiphene citrate, 68

Clomiphene Citrate Challenge Test (CCCT), 117

Cognitive behavioral therapy (CBT), 203 Cognitive development, 80

Cognitive restructuring, 204

Combined oral contraceptives (OCs), 66 Complete androgen insensitivity syndrome

(CAIS), 4, 30

Complete blood count (CBC), 54 Congenital renal anomalies, 39–40 Constitutional delay of growth and puberty

(CDGP), 20, 28

Controlled ovarian hyperstimulation (COH), 118, 225

Cryopreservation of embryos, 237 Cumulative pregnancy, 234, 235

D

Decreased ovarian reserve, 115, 117, 118 anti-Mullerian hormone, 117

controlled ovarian hyperstimulation, 118 diagnosis, 118

growth hormone, 118 treatment, 119

Delayed puberty background, 19 de ned, 20

differential diagnosis of, 20, 21

history and physical examination, 21, 22 laboratory investigation and

imaging, 22, 23 treatment, 23

Dermoid cysts, 110, 111 Diagnostic laparoscopy, 50

Disorders of sexual development (DSD), 1 DNA fragmentation, 170

Doppler imaging, 110, 111 Dual-energy X-ray absorptiometry scan

(DEXA), 121 Dysmenorrhea

anaerobic metabolites, 48 diagnostic laparoscopy, 49 lower abdominal pain, 48 NSAIDs and acetaminophen, 49

patient education and reassurance, 49 physical exam, 47

Index

E

Embryo cryopreservation, 243 Endometrial cancer, 66 Endometrial factor, 133, 134, 136

chronic endometritis, 136, 137 endometrial receptivity analysis, 136 intrauterine pathology, 134

thin lining, 135 Endometrial hyperplasia, 66

Endometrial receptivity analysis (ERA), 133, 135, 136

Endometriosis

clinical pregnancy rates, 101 diagnostic laparoscopy, 100 mechanisms for, 100 medical management of, 112

ovulation induction and intrauterine insemination, 101

prevalence of, 111

randomized controlled trials, 100 Epididymitis, 164

Erectile dysfunction (ED), 155–157 endocrine dysfunction, 156 evaluation, 157

iatrogenic, 156 lifestyle changes, 158 medications, 156, 159

neurologic conditions, 156 pathophysiology, 157 psychologic issues, 156 vacuum erection device, 159 vascular disorders, 156

European Medicines Agency, 105

F

Ferriman-Gallwey (F-G) score, 59 Fertility counseling, 199–202

cognitive behavioral, 202 intrauterine insemination, 199 in vitro fertilization, 199

Fertility preservation, 237, 243 egg freezing, 239

embryo cryopreservation, 238 oocyte cryopreservation, 237 ovarian tissue, 237

sperm, 237

Fetal thyroid gland, 78

Fluorescent in situ hybridization (FISH), 190 Follicle-stimulating hormone (FSH), 148, 169,

208, 249

Index

Follicular atresia, 90

Fragile X Mental Retardation 1 (FMR1), 123 Frozen-thawed embryo transfer (FET), 219 Functional hypothalamic amenorrhea, 27, 34 Functional hypothalamic hypogonadism, 95 Functional ovarian cyst, 110

G

Gamete intrafallopian transfer (GIFT), 216 Genetic and epigenetic pro ling, 194 Genome wide ampli cation studies

(GWAS), 64 Globozoospermia, 188, 194, 196 Gonadal dysgenesis, 28 Gonadal germ cells, 7 Gonadectomy, 6, 9

Gonadotropin releasing hormone (GnRH), 67, 101, 118

Gonadotropin releasing hormone agonists (GnRH-a), 101, 105

Graves’ disease, 82

H

Herlyn-Werner-Wunderlich syndrome (HWW), 45

Hirsutism causes of, 59 de ned, 58

external genital exam, 58 growth phase, 58 involution phase, 58

ovarian stromal hyperthecosis, 61 physical exam, 57, 59 reproductive-aged or postmenopausal

woman, 61 resting phase, 58 treatment options, 58 ultrasound, 60

urine and serum pregnancy tests, 58 Hormonal replacement therapy (HRT), 7, 123 Hot fash, 248

Human chorionic gonadotropin (hCG), 78, 94, 182

Human menopausal gonadotropin (HMG), 237, 242

Hydrocele, 164 21-Hydroxylase de ciency, 2

17-Hydroxyprogesterone (17-OHP), 2 Hyperandrogenism, 60 Hyperprolactinemia

causes of, 72

255

drug-induced hyperprolactinemia, 73 management of, 74

physical exam, 72 secondary causes of, 73 transvaginal ultrasound, 72 treatment of, 74

Hypothalamic dysfunction diagnosis of, 94 dynamic testing, 95

functional hypothalamic hypogonadism, 95 nonfunctional causes of, 94

Hysterosalpingography (HSG), 90, 122, 127, 134

Hysteroscopic myomectomy, 104

I

Infertility evaluation de ned, 88

medications/supplements, 87 ovulatory function, 89 physical examination, 88, 89 semen analysis report, 88

Inguinal hernia, 165 Injectable gonadotropins, 96

Injectable ovulation induction (IUI), 96 Insulin resistance, 64

Intermittent testicular torsion, 164 International Federation of Gynecology and

Obstetrics (FIGO), 54, 104 Intrabdominal testes, 26 Intracavernosal injections, 160 Intracervical insemination (ICI), 209

Intracytoplasmic sperm injection (ICSI), 81, 148, 188, 194

Intramural myoma, 103

Intrauterine insemination (IUI), 199, 208, 209, 231–232

cervical factor, 209 male factor, 210 mild male factor, 209

ovulation induction, 208 treatment, 208

Iodine supplementation, 79 Isolated GnRH de ciency, 28

In vitro fertilization (IVF), 67, 88, 99, 112, 188

K

Kallmann syndrome, 21, 176

256

L

Laparoscopic ovarian drilling, 68

Laparoscopic surgery, 100, 102

Letrozole, 68, 182

Live birth rate, 234

Luteinizing hormone, 209

M

Macroadenomas, 74

Macro/microscopic broid fragments, 106 Magnetic resonance imaging (MRI), 6, 14, 41 Male genitalia, 1

Male infertility, 148 adjunctive tests, 152 genetic testing, 151 history, 148, 149 imaging, 152 laboratory testing, 150 physical exam, 149 semen analysis, 150

Malnutrition, 21

Mature cystic teratomas, 111 Mayer-Rokitansky-Kuster-Hauser (MRKH)

syndrome, 30 McCune-Albright syndrome (MAS), 17 Medical therapy, 101

Menopause, 246 diagnosis, 247

differential diagnosis, 246 hot fash, 245, 248 imaging evaluation, 246 laboratory evaluation, 246 management, 247–249 patient history, 246 physical exam, 246

Menstrual cycles, 12 Metformin (Glucophage®), 66 Methimazole (MMI), 83 Microadenomas, 74 Microsurgical epididymal sperm

aspiration, 182

Microtubule organizing center (MTOC), 191 Mild dysmenorrhea, 87

Miscarriage rate, 232, 234, 235 Mixed Gonadal Dysgenesis (MGD), 3 Mullerian anomalies

delay in diagnosis, 43 evaluation, 40

MRI, 42 physical exam, 42 treatment, 43, 45

ultrasound imaging, 40

Index

Myelodysplastic syndrome, 241

Myomas, 105

Myomectomy, 105

N

Next generation sequencing (NGS), 194 Non-obstructive azoospermia, 181 Normal testicular function, 4

O

Obesity, 64 Obstetric history, 35

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), 42, 45

Oocyte cryopreservation, 243

Oral contraception pill (OCP), 74, 105, 109, 122

Oral progestins, 36 Orchitis, 164 Ovarian cysts, 110

Ovarian hyperstimulation syndrome (OHSS), 67, 224

classi cation, 226–227 evaluation, 224

incidence and severity, 228 management, 226, 228, 229 pathophysiology, 225 prevention, 227

treatment, 227 Ovarian reserve, 90

Ovarian tissue cryopreservation (OTC), 241–244

Ovarian transposition, 243 Overt hypothyroidism, 80 Ovulatory dysfunction, 89

P

Packed red cells (PRBCs), 242 Para-testicular mass, 165 Partial AIS (PAIS), 4

Pelvic exam, 93

Pelvic ultrasound, 14, 36, 95, 111 Penile doppler ultrasound (PDUS), 158 Penile implant surgery, 160, 161 Peripheral precocious puberty (PPP), 12 Permanent hypogonadotropic

hypogonadism, 21 Phosphodiesterase-5 inhibitor (PDE5i), 156 Physical examination, 19

Physiologic hypersecretion, 72

Index

Planned oocyte cryopreservation, 238 Polycystic ovarian syndrome (PCOS),

29, 94, 207

clinical presentation of, 64 differential diagnosis of, 65 laboratory testing, 65 pathophysiology of, 64 physical examination, 63, 65 prevalence of, 64 ultrasound examination, 65

Postpartum thyroiditis, 83 Prader-Willi syndrome, 21 Precocious puberty

background, 11 differential diagnosis of, 12 evaluation of, 14, 16 normal pubertal stages, 12 treatment

CPP, 16

non-exhaustive differential diagnoses of, 14

PPP, 17

Preimplantation genetic testing (PGT), 7, 118, 124, 219, 232

Pre-implantation genetic testing for aneuploidy (PGT-A), 128, 233

Pre-menstrual bloating, 87 Primary amenorrhea

causes of, 26 de nition, 26

differential diagnosis, 27–31 etiologies of, 26

evaluation of, 26, 27 gonadal dysgenesis, 28

hypothalamic and pituitary disease, 27 outfow tract abnormalities, 29–31 polycystic ovarian syndrome, 29

Primary ovarian insuf ciency (POI), 36, 121, 122, 243

diagnosis, 123

fragile X syndrome, 123

hormone replacement therapy, 124 management, 123

Progestins, 50, 66 Prolactin, 72 Prolactinomas, 73 Propylthiouracil (PTU), 83 Prostatitis, 164

Protamine assay, 189 Pseudoephedrine, 181

Psychoeducational counseling, 202, 203 Putative approach, 15

257

R

Radiation therapy, 74–75 Reconstructive surgery, 8 Recurrent pregnancy loss, 143

anatomic evaluation, 143 anti-phospholipid antibodies, 143 etiologies, 144

maternal age, 143, 145

maternal endocrinological diseases, 143 treatment, 144, 145

uterine anatomic issues, 143

Recurrent spontaneous abortions (rSAB), 141, 142, 144

Repeated surgeries, 102 Reproductive endocrinologist, 199 Rotterdam criteria, 64

S

Saline infusion sonohysterography (SIS), 134 Salpingectomy, 130

Scrotal testes, 6 Secondary amenorrhea, 97

breast and pelvic exam, 35 causes of, 35

physical examination, 35 Secondary dysmenorrhea, 49

Selective norepinephrine reuptake inhibitors (SNRI), 248

Selective progesterone receptor modulators (SPRMs), 105

Selective serotonin reuptake inhibitors (SSRI), 248

Semen analysis, 188 Sexual development, 1

Sexually transmitted infections (STIs), 87 Sexual transmitted disease, 164

Single embryo transfer (SET), 219 Sperm activating factor assessment, 191 Sperm aneuploidy assessment, 190 Sperm chromatin fragmentation (SCF),

189, 190

Sperm function assays, 195 Spontaneous conception, 90 Spontaneous POI (sPOI), 123

Stem cell transplantation (SCT), 243 Sterile abscesses, 16

Stress, 199, 200, 202 Subclinical hypothyroidism, 77 Submucosal myomas, 106

Submucous resection (SMR), 106 Superovulation protocol, 194

258

Supportive counseling, 203

Surgical ablation/excision, 100

Swyer syndrome, 29

T

Tanner stages, 13 Testicular malignancy, 164 Thyroid and reproduction

diagnosis, 82

iodine supplementation, 79 maternal hypothyroidism, 80 postpartum thyroiditis, 83 subclinical hypothyroidism, 77 thyroid autoimmunity, 81 thyroid function tests, 78 treatment, 83

Thyroid antibodies, 81 Thyroid autoimmunity, 81

Thyroid binding globulin (TBG), 78 Thyroid function tests (TFTs), 78 Thyroid stimulating hormone (TSH), 123 Tissue containment system, 106

Transcutaneous electrical nerve stimulation (TENS), 50

Transdermal estrogen, 96

Transmission electron microscopy (TEM), 192 Transvaginal ultrasound, 93, 96, 103

Trauma, 164

TruClear morcellator, 104 Tubal factor, 128

hydrosalpinx, 128 hysterosalpingogram, 127, 128 intrauterine insemination, 129 in vitro fertilization, 128 management, 128 salpingectomy, 130

Index

Tubal patency, 91

Turner’s syndrome, 20, 29

U

Urethrovaginal stulae, 8

Urine and serum hCG, 54

Urine pregnancy test, 71, 72, 109

Uterus didelphys, 42

V

Vacuum erection device, 159 Vaginal dilation, 8

Vaginal stenosis, 8 Vaginoplasty, 8 Varicoceles, 163, 164

hypogonadism, 166 infertility history, 166 laboratory investigations, 169 pain history, 165

physical examination, 167

proper varicocele examination, 168 scrotal ultrasound, 169

semen analysis, 167 sexual history, 166 treatment, 170–172

Vascular endothelial growth factor (VEGF), 225

Virilization, 60

Visual eld defects, 74 Vitals signs, 109

W

World Health Organization (WHO), 79