Baby gender conceive date mean,3 months pregnant woman pictures,how my life changed after having a baby - PDF 2016

Gender-Baby is a division of HRC Fertility, offering the latest information about gender selection technologies. HRC Fertility is a world-class fertility clinic serving patients throughout California, the United States and the rest of the world with cutting edge reproductive technology. Our fertility doctors are specialists in reproductive endocrinology, with expertise that is unsurpassed by any other advanced fertility and gender selection clinic.  . One-on-one discussions with the doctors or nurse practitioner following the seminars will be available. At present laparoscopy is the most frequently performed gynaecologic procedure in the world. Most important, therefore, has been progress, in particular the ability to perform haemostasis through the use of electrocoagulation and ultrasound.
Attempts at the visualization of the uterine cavity preceded the development of peritoneoscopy. The development of effective distending media and clear visualization of the uterine cavity were the next steps forward. In 1901, Kelling performed the first endoscopic procedure in the stomach of a dog.4 In 1925, Rubin combined the cystoscope with CO2 insufflation of the uterine cavity. Since the lens systems were in the beginning rather inferior, inadequate light and image transmission occurred frequently. The clinical utility of hysteroscopy was increased by the development of high molecular weight dextran as a distension medium.
In 1807, Bozzini visualized the urethral orifice with candlelight and a simple tube.3 This led to the development of the first urethroscope and cystoscope in 1843 by Desormeaux who used mirrors to reflect the light from a kerosene lamp. The first reported observation of the human peritoneal cavity with an optical instrument was by Jacobaeus in 1910 using a trocar and cannula to induce a pneumoperitoneum in women.10 He introduced a Nitze cysoscope through the same cannula to achieve a pelviscopy, laparoscopy or peritoneoscopy.
In 1929, a 45° lens system and the use of a second puncture were introduced by Kalk.11 Later, biopsy instrumentation and cauterization of intraabdominal adhesions as well as a single puncture operating laparoscope were introduced. The first gynaecologist to use laparoscopy clinically on a wide basis was Palmer in 1946.13 He was responsible for the development of chromopertubation. The introduction of fiber optics in 1953 by Hopkins made another huge step forward in the performance of surgical procedures with laparoscopy.14 In the early 1960’s, Hopkins also started to design the rod lens system that is used in most endoscopes today.
In 1964, Semm introduced several advancements in pelviscopic techniques and instrumentation.16 He introduced the use of an automatic insufflator to maintain pneumoperitoneum. The knowledge of abdominal and pelvic anatomy is the most important factor to avoid and handle complications during laparoscopy.
The base of the umbilicus is the thinnest part of the anterior abdominal wall in all patients. Complications occur during surgical procedures and should be recognized and dealt with immediately. Prolonged procedures under general anaesthesia can lead to nerve injuries especially to the brachial plexus, ulnar, femoral and common peroneal nerves. If the shoulder rest is improperly placed, it causes the compression of the brachial plexus.
The legs should be placed in stirrups with attention to the common peroneal and femoral nerve. The femoral nerve can be stretched when the legs are placed at an extreme external rotation and abduction. The bladder should be emptied before starting the settlement as the dome of the bladder lies a few centimeters below the symphysis. The three major areas of intraoperative complications are: bowel, vascular and urological injuries. In an average patient, the distance between anterior abdominal wall and retroperitoneal vessels is normally 3-4 cm. Usually, the pneumoperitoneum is created by using a Veress needle through a subumbilical incision. Avoid the Trendelenburg position during primary trocar insertion as it can make the angle of insertion more perpendicular. Patients with a previous caesarean section and those with endometriosis have an increased likelihood of these complications.
If laparoscopy has to be performed, the patient will have to undergo a further operative procedure in general anaesthesia.
Uterine fibroids are benign muscle tumors that are found in at least 20% of women over 30 years of age. For the fertility procedure, laparoscopic adhesiolysis includes salpingo-ovariolysis, often necessary prior to fimbrioplasty or salpingostomy. In a hemodynamically unstable and symptomatic patient with a positive urine pregnancy test, a free uterine cavity and intraabdominal fluid the laparoscopy should be immediately performed. Frequencies of implantation sites are: 78% ampulla, 12% isthmus, 5% fimbriae, 2% corneal, interstitial or intramural, 3% abdominal, cervical or ovarian.
The classic triad of abdominal pain, vaginal bleeding and adnexal mass is present in less than half of these patients and represents today mostly the advanced cases. The marker ?-hCG is very sensitive and can detect the presence of pregnancy as early as a week after implantation.
Salpingectomy can be performed if the family planning has been completed, in cases of a ruptured ectopic pregnancy and tube, in badly damaged tubes and when the contra lateral tube is healthy. Before proceeding to laparoscopic microsurgery the inside of the tube must be evaluated to confirm that the anastomosis is going to be fruitful.
Excision of the pathological segment, the incision should not extend beyond the mesosalpinx.
Treating phimosis and agglutination is the principle to restore the original anatomy of the tubal opening. Small oozers are controlled by submersing the infundibular portion of the tube in warm (37°C) normal Ringer’s lactate for a few minutes.
Opening the tube by incision after injection of methylene blue via cervix and uterus to see the end of the tube.
Cystectomy is the choice of surgery for women of reproductive age with the purpose of preserving fertility. Complete removal with minimal trauma to the residual ovarian tissue provides a specimen for histology and minimizes the chances of recurrence.
Aspiration and ablation do not destroy the entire cyst wall but increase the chance of recurrence and damage the underlying cortex by heat. For ovarian tumors that lie within the body of the ovary, an incision should be made directly over the cyst.
In cases of endometrioma, an adhesiolysis is usually performed prior to the cystectomy because endometriomas are generally involved in dense adhesions to the pelvic sidewall or sigmoid. Hysteroscopy is considered the gold standard for the evaluation of endometrial cavity in infertile patients. Hysteroscopy allows the evaluation of the cervical mucosal lining and also the channel for embryo transfer. Fibroids of the uterus are the most common solid pelvic tumours in females and occur among 20-40% of women in the reproductive age group. This classification is part of the preoperative assessment and plays an important role in determining the operative possibility by hysteroscopic myomectomy.
Uterine anomalies listed by the AFS (American Fertility Society) are: aplasia, unicornuate uterus, bicornuate uterus, septate uterus, arcuate uterus and DES related anomalies.
Leiomyoma of the uterus are the most common solid pelvic tumors found in women and are estimated to occur in 20-40% of women with increased frequency during the late reproductive years. The intramural portion is devascularized by laser fiber into the myoma to a depth of 5-10 mm depending on the depth of remaining intramural portion.
Multiple submucous myomas: Each myoma is either separated from the surrounding myometrium or totally coagulated. Uterine malformations can be present in patients with normal fertility, with infertility, or with recurrent pregnancy loss. The uterine septum is due to a lack of reabsorption of an original septum that results from fusion of the two Mullerian ducts in the mid portion to form the uterus. The uterine septum may be of different widths and lengths involving only the corporal portion or extending also into the cervix.
To avoid complications, it is necessary to have knowledge of the anatomical uterine landmarks. If fiberoptic lasers are used, the same precautions should be taken as with electrosurgery to avoid invading the fundal myometrial wall. Hydroflotation with liters of icodextrin solution (4%) for rinsing and instillation at the end of surgery resulted in a significant adhesion reduction on the surgical site.
A combination of a site-specific spray or gel together with hydroflotation, possibly assisted by an anti-inflammatory medication, seems promising. As in any kind of surgery, robotic, laparoscopic or conventional, the best prevention consists of a careful analysis of the medical history of the patient, the planning of the surgery, the evaluation of available imaging reports and careful, gentle and precise surgery.


In laparoscopic and hysteroscopic surgery of the female, access complications as well as intra- and postsurgical complications are well differentiated and have been discussed in this chapter and by other authors.34-36 Any complication arising during the surgery has to be treated immediately.
Infertility surgery performed by laparoscopy and hysteroscopy is subject to surgical risks, such as access lacerations, intraoperative traumas and infections, but it is usually performed without complications. In this chapter we deal with the development of laparoscopic and hysteroscopic complications with the following subtitles: patient’s position, trocar related injuries, surgical lacerations as bowel and vascular lesions as well as gastrointestinal and bladder-ureter injuries.
Maggino T, Gadducci A, D’ Addario V, Pecorelli S, Lissoni A, Stella M, Romagnolo C, Federghini M, Zucca S, Trio D, Trovo’ S.
Jansen, Frank Willem, Vredevoogd, Corla B, Van Ulzen, Karin, Hermans, Jo, Trimbos, J, Trimbos-Kemper, Trudy C.M. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
Clipping is a handy way to collect and organize the most important slides from a presentation. The process by which your baby becomes a boy or a girl, according to what's written in his or her genetic code, is awe-inspiring. Many couples want to keep the sex of the baby a surprise while many others want to find out the sex of the baby so that they prepare the baby’s nursery accordingly.
You can take aid of the ultrasound technician to reveal the sex of your baby in a unique way. HRC Fertility has nine locations throughout California with clinics in Encino, Fullerton, Laguna Hills, Newport Beach, Oceanside, Pasadena, Rancho Cucamonga, Westlake Village, and West Los Angeles.  For more than 20 years, HRC Fertility has helped thousands of couples achieve their dreams of having a family with the help of fertility treatments and assisted reproduction technology. The development of laparoscopy has decreased the number of laparotomies constantly and has also reduced the costs. These were the most important achievements for the performance of surgical procedures through the laparoscope, besides the development of the rod lens system, CO2 insufflation, light sources and HDV (high definition television cameras). In 1971 Lindemann used CO2 for uterine distension.6 In 1963, an optical trocar was used and was perfected in France in 1973 for clinical use. The first pneumoperitoneum was created by using air, only later was the use of CO2 introduced. This method was used until the introduction of the transvaginal retrieval of the oocyte in 1980’s. Understanding the abdominal wall and the location of the retroperitoneal vessels is extremely important for the blind placement of the primary umbilical trocar. The placement of the Veress needle and the trocar should be at a 45° angle in thin patients. The common peroneal nerve passes very close to the head of the fibula and should not be in contact with the stirrups. In patients with a previous laparotomy, the dome of the bladder might be extended cephalad even when the bladder is catherized. The injection of a few cc of water to distant the bowel and afterwards aspiration with a syringe before connecting to the CO2 source is useful to avoid gas embolism.23,24 The intraabdominal pressure should be at 12 mmHg. Preset the intraabdominal pressure to 20 mmHg for the primary entry; then continue with an intraabdominal pressure of 15 – 16 mmHg. If adhesions are expected, an enema and decompression of the stomach can help to recognise the injuries more easily.
A normal delivery should be carefully discussed with the obstetrician who may opt for a caesarean section.
One of the advantages of laparoscopic adhesiolysis is the closed internal environment which avoids the drying of the peritoneum and therefore the recurrence of adhesions. A serial measurement over a 48-hour interval with a rise of less than 66% is highly suggestive of either an abnormal intrauterine pregnancy or ectopic pregnancy. Ruptured tubal pregnancies can be treated if the bleeding has stopped or can be arrested adequately. The identification and mobilization of the tube should be followed by making an anitmesenteric linear incision on the surface just above the pregnancy. The risk of subsequent ectopic pregnancy is slightly higher than in the methotrexate group. It should be made parallel to the long axis of the ovary and as far as possible posterior taking care not to incise the cyst wall but only the cortex.
It is the most reliable method for determining the nature of intracavitary abnormalities and is also a very effective treatment modality.
The incidence of myomas in infertile women without any obvious cause of infertility is estimated to be between 1-2.4%.
The distance between the deepest portion of myoma and the uterine serosa is evaluated by sonography.
Postoperative estrogen therapy is indicated after resection of multiple myomas, especially if the myomas are on the opposing wall as there is a risk of formation of adhesion between the two raw surfaces. Systematic, delicate and shallow cuts should be performed in order to observe at all times the symmetry of the uterine cavity. Infertility surgery deals with the male and female reproductive tract, testicles, ovaries, tubes and uterus, the organs and pathways of gametes. Postoperative complications, such as unrecognized bleeding, infections, and dehiscence of wound round up the picture and also have to be considered. We look into laparoscopic procedures, such as fertiloscopy, myomectomy, adhesiolysis, management of ectopic pregnancies, tubal recanalization, fimbrioplasty, salpingostomy and ovarian cystectomies as well as hysteroscopic procedures, such as myomectomy, septum resection and adhesiolysis. De I’Endoscope et de ses Applications au Diagnostic et au Traitement de Affections de Furetre et de la Vessie. Der Lichtleiter oder die Beschreibung einer einfachen Vorrichtung und ihrer Anwendung zur Erleuchtung innerer Hohlen und Zwischenraume des lebenden animalischen Korpers.
Office hysteroscopic metroplasty: three “diagnostic criteria” to differentiate between septate and bicornuate uteri. Transvaginal access heralds the end of Standard diagnostic laparoscopy in infertility. The biological process occurring before you can say it's a girl or it's a boy is a complicated one. During your nineteenth or twentieth week of pregnancy, the doctor will conduct an ultrasound to check if the baby is growing and developing well. If not, order a few cupcakes and ask the baker to either frost them blue or pink according to the sex of your unborn child.
Clinically proven to dramatically increase your chances of conception and help you get pregnant fast from the very first use.
Babies born through fertility treatments at HRC Fertility are represented on almost every continent. Daniel Potter to help her get pregnant a second time, she had every reason to be confident. Postoperative morbidity has been reduced and patient recovery is faster due to laparoscopy. In 1853, Desormeaux inspected the uterine cavity with an early endoscope and reported the first hysteroscopy.1 He also identified polyps in the uterus as the cause of postmenopausal bleedings. After the invention of the light bulb, Newman developed a cystoscope using a small bulb at the distal end. The knowledge of the abdominal wall vasculature is important for the placement of secondary trocars.
In overweight patients, the angle of insertion should be increased to 60° to decrease the preperitoneal placement. The prevention of ulnar and brachial plexus injuries is achieved by placing the right arm extended and abducted at an angle less than 90°. The combined Dutch and ISGE survey reported 14 cases of delayed diagnosis with a mortality of 21%. The first step is hydropelviscopy with the dye test and the second step hysteroscopy with the endometrial biopsy. Submucous myomas or large intramural myomas may be associated with recurrent pregnancy loss and infertility.
Transvaginal ultrasound and the measurement of ?-hCG values give us a high diagnostic capability.
It is often possible to detect the pregnancies unruptured and thereby mostly preserve the tube and increase the chance of subsequent intrauterine pregnancy. Once the bleeding has been controlled, blood clots and the products of conception can be removed. The excision of cysts larger than 10 cm in diameter may sometimes be difficult because the cyst wall is thinned out.
The posterior placement minimizes the possibility of adhesions to the bowel, uterus or tube. The side where the cyst is attached to the pelvic side is usually thinned out in comparison to the other ovarian cortex covering the endometrioma.
A diagnostic hysteroscopy determines the status of the endometrium in terms of presence or absence of intrauterine pathology, endometrial hyperplasia, vascularity and endometritis.


Uterine anomalies are also associated with recurrent pregnancy losses and failure of IVF treatment. For diagnosis of the remaining anomalies a combined procedure of hysteroscopy and laparoscopy is used.
Myomas may cause dysfunctional uterine contraction that may interfere with sperm migration, ovum transport and nidation. In some centres there is no pretreatment with GnRHa because cervical dilatation is more difficult. The end point of laser coagulation is identifiable by the observation of distinct craters with brown borders on all fibroid areas. If implantation occurs on this site, the blastocyst does not have sufficient nutrition and is eventually aborted.
The use of a resectoscope is useful in cases with broad septa where the scissors may be more difficult to use.
In the forefront, however, stand the meticulous surgical technique and the aim to traumatize as little as necessary.
In recent years sprayable liquids, such as polyethylene glycols = PEGs (SprayShield and Coseal) which polymerize to hydrogels with addition of colorants and without colour, revealed 65–70% reduced adhesion formation compared to the use of saline solution and Ringer’s lactate.
We all know that complications should not arise and feel very unhappy if they do; however, early recognition is still the best key for a good outcome.
Now you can deliver these cupcakes to your family members and close friends, whom you want to share the details with. The best thing to do would be to reveal the sex of the baby when everyone you want to reveal it to is present in one place. And now for a limited time, Try a FREE starter pack today & receive 20 FREE pregnancy tests and a FREE Digital BBT Thermometer! He described several models of hysteroscopic instrumentation and published material on the technique of hysteroscopy. It has been demonstrated that the injection of 200cc CO2 per minute into the veins is not lethal, while injection of the same amount of air causes immediate death. Even the simplest cases of endometriosis and adhesiolysis require an understanding of the retroperitoneal structures.
If severe adhesions are expected, it is recommended to insert the trocar after opening the abdominal layers of the incision. Within the procedure, an assessment is made of the ovaries, endometriotic disease of the ovaries and the pelvis, tubal infertility and uterine fibroids. The usage of ultrasonic devices produces less carbonisation and bleeding which leads to less macrophage activation and adhesion formation.
If an ectopic pregnancy is diagnosed early, it can be treated before tubal destruction or haemorrhage occurs. Spreading the tips of the scissors will create a plane while the edge of the cortex can be gasped using a biopsy forceps. To enucleate the cyst, the border between the ovarian cortex and cyst wall has to be visualized.
Diagnostic accuracy compared with histological diagnosis showed a sensitivity of 98%, specificity of 95%, positive predictive value of 96% and negative predictive value of 98%. Myomas may also be associated with implantation failure or gestation discontinuation due to focal endometrial vascular disturbance, endometrial inflammation, secretion of vasoactive substances or an enhanced endometrial androgen environment.
Furthermore, the compromised distending ability of a hemiuterus can cause irritability and premature labour. The use of a resectoscope provides continuous washing of the uterine cavity and keeps bleeding to a minimum.
Any peritoneal damage leads to an acute inflammatory response and to fibrous adhesions which may provoke bowel obstruction, chronic pelvic pain, dyspareunia, infertility and a higher complication rate for subsequent surgeries. It’d be ideal to do this when all your loved ones are present so that everyone gets to know at the same time.
They will not just be delighted by the sweet surprise, they will be very happy to discover the gender of your child! If it is difficult to decipher, you can ask him to type the sex on the ultrasound and then print it. The left arm should be in a sling close to the body; it should also be extended and pronated. The secondary trocars are placed under vision lateral to the inferior epigastric and suprapubic vessels. Patients of childbearing age who present with pelvic pain and abnormal vaginal bleeding should be screened with a urine ?-hCG test. The cyst can be aspirated and opened or enucleated once an adequate dissection plane is created circumferentially.
Myomas are known to be associated with infertility and the causal relationship in this regard appears to be more evident for submucous myomas. In laparoscopy and hysteroscopy the use of heated and moist gas definitely causes fewer adhesions.
This particular time is a huge milestone for you and surely, you would want to celebrate it with your loved ones.
They all might get confused and quizzical at first but they will soon understand what you are trying to tell them! For the placement of secondary trocars, it is advisable to use the smallest trocars available to avoid vessel injuries. If the surgery does not require a steep Trendelenburg position, it is better to avoid shoulder rests. In cases of slight to moderate adhesions, pregnancy rates are around 60%, in severe cases 20%. Injection of normal saline between the cortex and cyst capsule creates a tissue plane and reduces bleeding. At second look hysteroscopy the hysteroscopic view shows a white avascular fibroid remnant protruding in the lumen, as if the shrinkage of uterus induced by GnRHa therapy had virtually expelled the residual necrotic fibroid. With microsalpingoscopy the staining of the nuclei of the tubal cells by methylene blue dye determines the functional capacity of the tube: the greater the degree of staining the lesser the functional state of the mucosa. It can be reduced by infiltration of a suprarenine solution (1:100 diluted vasopressin or octapressin, a derivative of vasopressin) into the myometrium surrounding the myoma. If the test is positive and the uterine cavity has no fetus, proceed rapidly to laparoscopic salpingotomy or salpingectomy, depending on the situation of the individual patient.
This will be even more exciting for those couples that haven’t yet revealed that they are pregnant. Another treatment proposed by the Belgian School is to open the cyst, coagulate the borders and let the endometrioma dry out. So, each of their sperm carries one of the 2 sex chromosomes, which sex chromosome is in the sperm that fertilizes the egg dictates the baby's sex. Generally, the bleeding is self-limiting and the ovary heals without the need for suturing. This practice is based on the theory of how an endometrioma is formed; however, enucleation is the preferred method.
This means that dad, although he can't control wether an X or a Y gets to the egg first, chooses you baby's sex. Humans have roughly 25,000 genes, yet only 1 gene located on the Y chromosome, the SRY gene is required for male development.
Suturing in two layers gives more anatomical closure and added strength to the myoma bed which can endure the stress of pregnancy. How does a single gene out of so many hold the key to whether your baby will be a boy a plain an simple explanation is that this gene activates other boy genes. The internal and external sexual organs of boys and girls developed from the same basic body plan, but you know, at birth, you can clearly distinguish the 2 sexes just by looking. Male and female hormones caused the embryonic gonad and 2 sets of ducts to form male or female structures. If a Y chromosome is present, SRY is activated signaling production of the male hormone testosterone and the development of the embryonic gonads into testes. The phallus stops growing forming a clitoris and the skin around it becomes the outside of the vagina.
This all starts by the end of the first trimester although you won't know if you're having a boy or a girl until your ultrasound around week 16.



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