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REDLARA associated centers
 
CLINICAL COURSE
 
Basic and clinical fundamentals of the ovulatory process

For Obstetrician Gynecologist
Duration: Theoretical: 4 months
Practical: 15 days
Start: January 2004

Further information: : info@redlara.com

                                                                     
Physiology
Propedeutic and Diagnosis
Stimulador agents of the ovulation process
GnRH Analoques Use: agonists and antagonists
Luteal Function
Complivations of the ovarian stimulation process
Conduct in the patients with poor ovarian response


  Physiology
Neuro-Endocronology of natural and stimulated cycles
Development and natural follicular maturation
Theory of the two cells and the ovarian steroidogenesis
Hyperprolactinaemia and the ovarian function
Hyperandrogenism and the ovarian functionHypo and
Hyperthyroidism and the ovarian function

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  Propedeutic and Diagnosis
Man: clinical exam and spermogram
Woman: clinical exam and factors (vaginal, uterine, tube-peritonial, immunologic, psychosomatic)
Classification of the ovulatory disturbs by the Healthy World Organization
Hormonal diagnosis of the ovulatory process
Ultrasonografic diagnosis of the ovulatory process
Ovarian Reserve Tests:
• Basal FSH, E2, Inhibine B determination
• FSH/LH Relation
• Dynamic tests: clomiphene citrate, GnRH-a, FSH exogenous
• Image Techniques: measure of the ovarian volume, count of the antral follicles, measure of the ovarian stroma blood flow with color Doppler. Endometrium echographic evaluation and Hysterosonography.

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Stimulator agents of the ovulation process
Weight loss
Aromatases inhibitors
Metformine
Dopaminergic
Clomiphene Citrate.
• Structure and action mechanisms
• Indications
• Therapeutic schemas for ovulation induction
• Association with others medicines
• Hormonal and ultrasonografic control of the ovulatory process
• Contra-indications and adverse reactions
• Success Rates
Gonadotrophins: urinary and recombinants
• Structure and mechanisms of action
• Therapeutic schemas for mono-follicular and multi-follicular ovulation induction
• Hormonal and ultrasonografic control of the ovulatory process
a. Step-up and step-down protocols
b. Polycystic Ovary Syndrome
c. LH Recombinant
Laparoscopy with ovarian drilling

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  GnRH Analogues Use: agonists and antagonists
Structures and action mechanisms
Extra-pituitary actions
Agonists
• Induction of the ovulation for Assisted Reproduction
• Protocols: ultra-short / short / long duration
• Association with pills or progestagens
• Endometriosis
• Polycystic Ovary Syndrome
• Uterine Myoma
• Precocious puberty
Antagonists
• Protocols with unique and multiple dose

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  Luteal function
Physiology of the luteal body
Pharmacodynamic and mechanisms of action of the progesterone
Progesterone types
Ways of administration of progesterone: oral, intramuscular, vaginal
Luteal phase support with hCG
Maintenance of the luteal phase in cycles without ovarian function
Results with the clinical support of the luteal phase

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  Complications of the ovarian stimulation process
Ovarian Hyperstimulation Syndrome
• Physiopatology
• Clinical Laboratorial
• Prevention
Albumine
Coasting
Cryopreservation of all embryo
• Treatment
Multiple Gestations
Risk of the use of gonadotrophins
Neoplasy: Ovary Cancer, Breast Cancer

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  Conduct in the patients with poor ovarian response
Response to the tests of ovarian reserve
Protocols
• Regimen with micro-dose of GnRH-a
• Co-treatment with growth hormone
• Co-treatment with pills and estrogens
Natural cycle for Assisted Reproduction

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In this section youดll find information about the accredited and affiliated centres that belong to the Latin American Network of Assisted Reproduction.