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INFERTILITY DUE TO TUBAL FACTOR Tubal factor can be acquired through pelvic inflammatory disease as a result of  gonorrhea / Chlamydia  infection or septic abortion, abdominal diseases like  appendicitis , prior tubal or ovarian surgery, severe  endometriosis . Furhermore some women may have history of surgical sterilization procedure through bilateral tubal interruption. Tubal factor evaluation may need  transvaginal ultrasound , which may show distended tubal segments due to their obstruction at their distal ends (Hydrosalpinx),  hysterosalpingography (HSG)  an X-ray method involving radi-opaque contrast injection of uterus, and tubes may show tubal occlusion at any segment of the tubes. If one or all of these tests were positive the patients may need evaluation by an outpatient surgical techniques called as laparoscopy.  Laparoscopy  may be combined with hysteroscopy especially if proximal tubal cannulation for proximal tubal occlusion is indicated. Through laparoscopy micro-su
Anovulatory disorders Disorders of timely oocyte (egg) production are the most common causes of female infertility. These disorders range from  anovulation , oligo-ovulation, ovarian aging.  Anovulation  and oligo-ovulation are typically associated with cessation of regular menstrual cycles or increased length between tow menstrual periods greater than 35 days. Many diseases are associated with  anovulation  and infertility. Anovulatory disorders are approached as classified by World Health Organization. WHO Group 1: Hypogonadotropic hypogonadism or hypothalamic amenorrhea: Causes related with central nervous system, stress, eating disorders, exercised induced ovulatory dysfunction are included in this category. About 35% of adult-onset  anovulation  may be related with dysfunction of hypothalamus, the region of brain controlling reproductive events, 15% of them may be related to pituitary diseases such as small adenomas of the pituitary gland located just below hypothalamus sec

Kanker Leher Rahim

         Tentu anda sudah tak asing lagi dengan istilah kanker servik (Cervical Cancer), atau kanker pada leher rahim. Benar, sesuai dengan namanya, kanker leher rahim adalah kanker yang terjadi pada servik uterus, suatu daerah pada organ reproduksi wanita yang merupakan pintu masuk ke arah rahim yang terletak antara rahim (uterus) dengan liang senggama (vagina). Kanker ini biasanya terjadi pada wanita yang telah berumur, tetapi bukti statistik menunjukan bahwa kanker leher rahim dapat juga menyerang wanita yang berumur antara 20 sampai 30 tahun.          Memang istilah "kanker" sendiri sudah pasti memberi kesan menakutkan dan menyeramkan. Laksana seorang terpidana menerima hukuman mati. Bagaimana pula dengan kanker leher rahim? Apakah juga sama menakutkannya dengan beberapa kanker lainnya? Menurut para ahli kanker, kanker leher rahim adalah salah satu jenis kanker yang paling dapat dicegah dan paling dapat disembuhkan dari semua kasus kanker. Tetapi, biarpun demikian, d

Ectopic Pregnancy

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An ectopic pregnancy is a complication of pregnancy in which the fertilized ovum is implanted in any tissue other than the uterine wall. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies ), but implantation can also occur in the cervix , ovaries , and abdomen . The fetus produces enzymes that allow it to implant in varied types of tissues, and thus an embryo implanted elsewhere than the uterus can cause great tissue damage in its efforts to reach a sufficient supply of blood. An ectopic pregnancy is a medical emergency and if not treated properly can lead to the death of the mother. In a normal pregnancy , the fertilized egg enters the uterus and settles into the uterine lining where it has plenty of room to divide and grow. About 1% of pregnancies are in an ectopic location with implantation not occurring inside of the womb, and of these 98% occur in the Fallopian ट्यूब. In a typical ectopic pregnancy, the embryo does not reach the uterus, but

Comparison of the effects of Letrozole and Clomiphene Citrate towards endometrial thickness, amount and size of follicles for couples wishing to get

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I Ketut Agus Sunatha Dr.I.P.G.Wardhiana,SpOG(K) Background: Data shows that 20-25% of infertile women have ovulation disturbances which needs medical intervention by means of ovulation induction with clomiphene citrate as the most widely used medicine. Since the year 2001 many research had been done which supports the use of letrozole as an individual induction medicine or used in combination with exogenic FSH, and because of is advantages many researchers predict that it will be the drug of choice for the treatment of anovulation infertility. Objective: The purpose of this study is to find the differences in effects and advantages between letrozole and clomiphene citrate for couples wishing to get pregnant. Method: Double blind randomized design. All woman attending the fertility policlinics at Sanglah General Hospital who are eligible fo the study since December 2006 were admitted. Sampling were done consecutively by simple randomization. Observation of endometri

A doctor goes to work in a remote community in Flores

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Remote communities in Indonesia suffer from a lack of doctors, nurses and midwives. The Temporary Contract Employee (PTT) program requires doctors to spend two years working in a remote area before they can open a practice. Besides helping the local community, it also allows the doctor to experience some of Indonesia’s diversity. Dr I Ketut Agus Sunatha graduated from medical school in his home province of Bali in 2002. He was then posted to Ritaebang, West Solor, off the island of Flores, for two years. He departed, leaving his wife and young son in Bali. This is his own account of his experience. The journey to Ritaebang, West Solor, was exhausting. I waited for two weeks in Kupang to receive my placement but finally I was able to go. I took a ferry from Kupang to Larantuka, Flores, and then a smaller boat to Pamakayo, on the island of Solor. I wasn’t used to ocean travel. From there, I got onto a

MENCINTAI TANPA SYARAT???

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BISAKAH KITA MENCINTAI TANPA SYARAT Ini cerita nyata. Beliau adalah Bapak Eko Pratomo, Direktur Fortis Asset Management yang sangat terkenal di kalangan Pasar Modal dan Investment, beliau juga sangat sukses dalam memajukan industri reksadana di Indonesia. Apa yang diutarakan beliau adalah sangat benar sekali : MAMPUKAH KITA MENCINTAI TANPA SYARAT. SEBUAH PERENUNGAN Dilihat dari usianya beliau sudah tidak muda lagi, usia yang sudah senja bahkan sudah mendekati malam. Pak Suyatno, 58 tahun, kesehariannya diisi dengan merawat istrinya yang sakit. Istrinya juga sudah tua. Mereka menikah sudah lebih 32 tahun dan dikarunia 4 orang anak. Di sinilah awal cobaan menerpa. Setelah istrinya melahirkan anak ke empat tiba-tiba kakinya lumpuh dan tidak bisa digerakkan. Itu terjadi selama 2 tahun. Menginjak tahun ke tiga seluruh tubuhnya menjadi lemah bahkan terasa tidak bertulang, lidahnya pun sudah tidak bisa digerakkan lagi. Setiap hari Pak Suyatno memandikan, membersihkan kotoran, menyua