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In order to maximize success rates with in vitro fertilization we want a good number of high quality eggs from the woman. There are several ovarian stimulation medication protocols that are used to "pump up" the ovaries to make enough follicles and eggs. The commonly used stimulation regimens include injections of follicle stimulating hormone - FSH. The ovaries are stimulated with the injectable FSH medications for about 7-12 days until multiple mature size follicles have developed. With ovarian stimulation for in vitro fertilization, the goal is to get approximately 8 to 15 quality eggs at the egg retrieval procedure. We do not want to have overstimulation of the ovaries which can lead to significant discomfort for the woman and in rare cases can result in ovarian hyperstimulation syndrome, OHSS. We also do not want the ovarian stimulation to be insufficient and only give us a few eggs if we might have been able to obtain more by using higher medication doses, etc.
In vitro fertilization can be successful with a very low number of eggs retrieved, but success rates are substantially higher when more eggs are recovered. Quality control throughout the entire process is very important with in vitro fertilization.
We use a GE Voluson E8 ultrasound machine with a computer built-in that can outline and accurately measure the developing follicles.
We have found that this method is more precise and reliable as compared to the traditional method - which is usually manual measurements in two dimensions. The HCG injection is given when the estrogen level and the follicle measurements look best for successful outcome. The egg retrieval is planned for 34-35 hours after HCG injection - shortly before the woman's body might start to release the eggs (ovulate). The minimum number of follicles needed to proceed with in vitro fertilization treatment depends on several factors, including their sizes, age of the woman, results of previous stimulations and the willingness of the couple (and the doctor) to proceed with egg retrieval when there will be a low number of eggs obtained. Some doctors will say that you should have at least 5 that measure 14mm or greater while others might do the egg retrieval with only one follicle. Women that are more likely to be low responders to ovarian stimulation would be those that have low antral counts, those women who are older than about 37, women with elevated FSH levels, and women with other signs of reduced ovarian reserve. In an average 28 day menstrual cycle, ovulation usually occurs on day 14, with day 1 being the first day of menstrual bleeding. The length of time it takes a follicle to mature and ovulate is somewhat variable in different women (and in different cycles in the same woman), but the number of days from ovulation to the next period is much less variable and should be close to 14 days in everyone. Some women do not properly develop and release a mature egg every month - they do not ovulate regularly. Some women never develop and release an egg without medication - we say they are anovulatory. Usually the doctor can tell from discussing the details regarding previous menstrual cycles whether there is likely to be an ovulation disorder. Polycystic ovarian syndrome is a very common cause of anovulation, or oligoovulation and infertility.
In general, cumulative pregnancy success rates are high with treatment from a fertility specialist when the fertility issue is an ovulation problem. If the female age is under about 37, it is usually more a matter of which fertility medications and treatments will end up being successful - rather than whether anything will ever work. The following article on pattern baldness helps you to understand the balding cure with hair transplantations.
Androgenetic alopecia, androgenic alopecia, or pattern baldness, has been a part of the human race for as long as we have historical records. Medicine has long recognized androgenetic alopecia as an inherited systemic disease associated with sexual development. Androgenetic alopecia develops as a gradual reduction of scalp hair follicle size, and reduced time in the anagen active growth phase, leading to more hair follicles in the telogen resting stage of the hair cycle. The gradual changes that occur in the androgenetic alopecia affected scalp skin is the same whether describing male of female baldness.


Over time the terminal scalp hair follicles undergo progressively shorter and shorter cycles involving reduced anagen growth periods.
In androgenetic alopecia the terminal hair follicles reduce size both in length and diameter.
Andrea Dixon has been writing since 2005 and has been published in "Injury" and "J Spinal Dis." Dixon holds a Bachelor of Science from Youngstown State University, completed two years of medical school at the Northeastern Ohio Universities Colleges of Medicine and Pharmacy and holds a Master of Public Health from the University of Akron. A boil, also known as a furuncle, is a skin infection that involves a hair follicle and the surrounding skin tissue. Boils begin as a red swollen area of the skin and develop into a larger, pus-filled pustule.
Considering boils are caused by bacteria on the skin, one of the key prevention methods is practicing good hygiene. Without stimulating medications, the ovaries make and release only 1 mature egg per menstrual cycle (month). Triggering to early or too late reduces success and can sometimes increase the risk for ovarian hyperstimulation (if triggered late).
One of the ways that we have improved quality control in our program is by using highly specialized ultrasound equipment. However, sometimes the response of the ovaries is poor - and a low number of growing follicles are seen.
Most IVF programs in the US want a minimum of about 3-4 mature (or close to mature) follicles. If a woman has cycle lengths that are shorter or longer than 28 days, then the day of ovulation will usually be 14 days before her next period.
We call this anovulation (lack of ovulation) - or oligoovulation (infrequent or irregular ovulation). They will often need medication to stimulate more regular egg development and ovulation to increase the chances for pregnancy. In addition, blood testing and ultrasound studies of the ovaries at various times of the menstrual cycle can clarify whether ovulation is occurring.
Evolutionary evidence suggests androgenetic alopecia has been around longer than the modern human race. Ancient Greek doctors realized that male pattern baldness can develop in men of any age after puberty.
Hair loss is first observed in women in their late twenties to early forties, somewhat later in age than first onset in men. This applies regardless of whether the hair follicles are terminal, intermediate, or vellus hairs. Boils are quite common and are usually caused by the bacteria Staphylococcus aureus, the most common bacteria found on the skin. If you experience redness or red streaks spreading from the infected area, have an accompanying fever, if you are diabetic or are currently taking an antibiotic or cortisone medication you should see your health-care provider at the onset of symptoms. Thorough hand washing and using antibacterial soaps may help to prevent bacteria from infecting hair follicles. From the volume it calculates an average diameter for each follicle (as if it was a sphere).
So if she has a 26 day cycle length, then her ovulation should be on about day 12 and if she has a 32 day cycle, the ovulation is about day 18. Our nearest non-human primate relatives, orangutans and gorillas can also develop androgenetic alopecia. They recorded that young boys castrated before puberty did not develop androgenetic alopecia regardless of their genetic family history.
Unlike men, the frequency of women affected does not continue to increase with increasing age.
In women the presentation is usually different with just diffuse thinning over the top of the head and sometimes thinning over the entire scalp. With a lack of dermal papilla cell stimulation, the hair fiber and root sheaths stop growing.


When the hair follicle is damaged by a scratch or other break in the skin, the bacteria is able to move deeper into the follicular tissues, causing an infection and resulting in a boil. Using a hot compress on the boil or sitting in a hot bath may help to alleviate the pain until the boil ruptures and drains on its own. Avoid sharing items such as towels, razors and athletic equipment to cut down on the spread of infection. Androgenetic alopecia is a very common form of hair loss and could be described as part of our general genetic phenotype. For men in their forties, 40% have alopecia and so on until about 80% of men are affected when 80 or more years old. After the fifth decade of life the numbers of women with androgenetic alopecia does not increase. Where there is a limit to the hair loss, such that there are still sizable areas of normal hair growth on the scalp, the individual is usually suitable for a hair transplant. When looking at a punch biopsy under the microscope neighboring hair follicles can be seen to be variably affected. The net effect is that androgenetic alopecia is characterized by a gradual increase in the number of resting telogen hair follicles present at any one time.
Beneath the miniaturized vellus hair follicle a fibrous tract, known as a streamer or follicular stela, can be observed marking the terminal hair follicle bulb’s original position to the base of the current vellus hair dermal papilla. When a new hair growth cycle starts the hair follicle regrows but it does not grow as big as it was previously.
Boils may appear after taking antibiotics and are more common in diabetic and immune compromised individuals.
Boils are usually pea-sized but can be as large as a golf ball, usually growing at a rapid pace.
By keeping cuts and scrapes clean and covered during the healing process the spread of infection will also be minimized.
When an area is damaged, whether from plucking or a scar, that tissue has to be replaced with a transplant.Innocenti had her first transplant last year.
In some cases, they may even require medical attention because of the degree of blood loss.
We now know that the reason for their observations is that castration prepuberty stops hair follicles from being exposed to androgens made by the gonads during adolescence. African and Asian men have a lower frequency of andorgenetic alopecia, perhaps about half the rate of Caucasian men.
Androgenetic alopecia has been suggested to be present in the general female population at a rate anywhere between 20 to 40%.
If however, the hair loss affects the scalp extensively, there may not be enough normal hair follicles left to transplant and get a good result. The face, neck, buttocks, armpit and thigh are the most common locations for boils, although they can occur in any of the body's hair follicles. In some cases, your health-care provider may need to provide an antibiotic to clear up the underlying infection in hopes of preventing boils in the future. So, one parameter of androgenetic alopecia is a decrease in the density of terminal hairs and an increase in the vellus hair count. In the early stages of androgenetic alopecia affected scalp the number of telogen stage hair follicles can be up to 20% of the total. This is not unusual in men although a complete loss of hair follicle in women is relatively rare.
Once hair follicles have been exposed to androgens they are fated to become androgen sensitive and androgenetic alopecia can develop. As androgenetic alopecia progresses the total number of hair follicles can be reduced as the hair follicles are irreversibly destroyed.



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