Symptoms and Causes of Infertility

Symptoms

The main symptom of infertility is the inability to get pregnant. A menstrual cycle that's too long (35 days or more), too short (less than 21 days), irregular or absent can mean that the woman is not ovulating. There may be no other outward signs or symptoms.

When to see a doctor

When to seek help sometimes depends on your age:

• Up to age 35, most doctors recommend trying to get pregnant for at least a year before testing or treatment.
• If you're between 35 and 40, discuss your concerns with your doctor after six months of trying.
• If you're older than 40, your doctor may want to begin testing or treatment right away.

Your doctor may also want to begin testing or treatment right away if you or your partner has known fertility problems, or if you have a history of irregular or painful periods, pelvic inflammatory disease, repeated miscarriages, prior cancer treatment, or endometriosis.

Female reproductive system

Fertilization and implantation

Fertilization and implantation

Causes

Each of these factors is essential to become pregnant:

• You need to ovulate. To get pregnant, your ovaries must produce and release an egg, a process known as ovulation. Your doctor can help evaluate your menstrual cycles and confirm ovulation.
• Your partner needs sperm. For most couples, this isn't a problem unless your partner has a history of illness or surgery. Your doctor can run some simple tests to evaluate the health of your partner's sperm.
• You need to have regular intercourse. You need to have regular sexual intercourse during your fertile time. Your doctor can help you better understand when you're most fertile.
• You need to have open fallopian tubes and a normal uterus. The egg and sperm meet in the fallopian tubes, and the embryo needs a healthy uterus in which to grow.

For pregnancy to occur, every step of the human reproduction process has to happen correctly. The steps in this process are:

• One of the two ovaries releases a mature egg.
• The egg is picked up by the fallopian tube.
• Sperm swim up the cervix, through the uterus and into the fallopian tube to reach the egg for fertilization.
• The fertilized egg travels down the fallopian tube to the uterus.
• The fertilized egg implants and grows in the uterus.

In women, a number of factors can disrupt this process at any step. Female infertility is caused by one or more of the factors below:

Ovulation disorders

Ovulation disorders, meaning you ovulate infrequently or not at all, account for infertility in about 1 in 4 infertile couples. Problems with the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or problems in the ovary, can cause ovulation disorders.

• Polycystic ovary syndrome (PCOS). PCOS causes a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It's the most common cause of female infertility.
• Hypothalamic dysfunction. Two hormones produced by the pituitary gland are responsible for stimulating ovulation each month — (FSH) and luteinizing hormone (LH). Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt production of these hormones and affect ovulation. Irregular or absent periods are the most common signs.
• Premature ovarian failure. Also called primary ovarian insufficiency, this disorder is usually caused by an autoimmune response or by premature loss of eggs from your ovary (possibly from genetics or chemotherapy). The ovary no longer produces eggs, and it lowers estrogen production in women under the age of 40.
• Too much prolactin. The pituitary gland may cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility. Usually related to a pituitary gland problem, this can also be caused by medications you're taking for another disease.

Damage to fallopian tubes (tubal infertility)

Damaged or blocked fallopian tubes keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include:

• Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections
• Previous surgery in the abdomen or pelvis, including surgery for ectopic pregnancy, in which a fertilized egg implants and develops in a fallopian tube instead of the uterus
• Pelvic tuberculosis, a major cause of tubal infertility worldwide, although uncommon in the United States

Endometriosis

Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which may block fallopian tubes and keep an egg and sperm from uniting.

Endometriosis can also affect the lining of the uterus, disrupting implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.

Uterine or cervical causes

Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage:

• Benign polyps or tumors (fibroids or myomas) are common in the uterus. Some can block fallopian tubes or interfere with implantation, affecting fertility. However, many women who have fibroids or polyps do become pregnant.
• Endometriosis scarring or inflammation within the uterus can disrupt implantation.
• Uterine abnormalities present from birth, such as an abnormally shaped uterus, can cause problems becoming or remaining pregnant.
• Cervical stenosis, a narrowing of the cervix, can be caused by an inherited malformation or damage to the cervix.
• Sometimes the cervix can't produce the best type of mucus to allow the sperm to travel through the cervix into the uterus.

Unexplained infertility

Sometimes, the cause of infertility is never found. A combination of several minor factors in both partners could cause unexplained fertility problems. Although it's frustrating to get no specific answer, this problem may correct itself with time. But, you shouldn't delay treatment for infertility.

Risk factors

Certain factors may put you at higher risk of infertility, including:

• Age. The quality and quantity of a woman's eggs begin to decline with increasing age. In the mid-30s, the rate of follicle loss speeds, resulting in fewer and poorer quality eggs. This makes conception more difficult, and increases the risk of miscarriage.
• Smoking. Besides damaging your cervix and fallopian tubes, smoking increases your risk of miscarriage and ectopic pregnancy. It's also thought to age your ovaries and deplete your eggs prematurely. Stop smoking before beginning fertility treatment.
• Weight. Being overweight or significantly underweight may affect normal ovulation. Getting to a healthy body mass index (BMI) may increase the frequency of ovulation and likelihood of pregnancy.
• Sexual history. Sexually transmitted infections such as chlamydia and gonorrhea can damage the fallopian tubes. Having unprotected intercourse with multiple partners increases your risk of a sexually transmitted infection that may cause fertility problems later.
• Alcohol. Stick to moderate alcohol consumption of no more than one alcoholic drink per day.

Diagnosis

By Mayo Clinic Staff

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Hysterosalpingography

If you've been unable to conceive within a reasonable period of time, seek help from your doctor for evaluation and treatment of infertility.

Fertility tests may include:

• Ovulation testing. An at-home, over-the-counter ovulation prediction kit detects the surge in luteinizing hormone (LH) that occurs before ovulation. A blood test for progesterone — a hormone produced after ovulation — can also document that you're ovulating. Other hormone levels, such as prolactin, also may be checked.
• Hysterosalpingography. During hysterosalpingography (his-tur-o-sal-ping-GOG-ruh-fee), X-ray contrast is injected into your uterus and an X-ray is taken to detect abnormalities in the uterine cavity. The test also determines whether the fluid passes out of the uterus and spills out of your fallopian tubes. If abnormalities are found, you'll likely need further evaluation. In a few women, the test itself can improve fertility, possibly by flushing out and opening the fallopian tubes.
• Ovarian reserve testing. This testing helps determine the quality and quantity of eggs available for ovulation. Women at risk of a depleted egg supply — including women older than 35 — may have this series of blood and imaging tests.
• Other hormone testing. Other hormone tests check levels of ovulatory hormones as well as thyroid and pituitary hormones that control reproductive processes.
• Imaging tests. A pelvic ultrasound looks for uterine or fallopian tube disease. Sometimes a hysterosonography (his-tur-o-suh-NOG-ruh-fee) is used to see details inside the uterus that can't be seen on a regular ultrasound.

Depending on your situation, rarely your testing may include:

• Other imaging tests. Depending on your symptoms, your doctor may request a hysteroscopy to look for uterine or fallopian tube disease.
• Laparoscopy. This minimally invasive surgery involves making a small incision beneath your navel and inserting a thin viewing device to examine your fallopian tubes, ovaries and uterus. A laparoscopy may identify endometriosis, scarring, blockages or irregularities of the fallopian tubes, and problems with the ovaries and uterus.
• Genetic testing. Genetic testing helps determine whether there's a genetic defect causing infertility.

Treatment

By Mayo Clinic Staff

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Infertility treatment depends on the cause, your age, how long you've been infertile and personal preferences. Because infertility is a complex disorder, treatment involves significant financial, physical, psychological and time commitments.

Although some women need just one or two therapies to restore fertility, it's possible that several different types of treatment may be needed.

Treatments can either attempt to restore fertility through medication or surgery, or help you get pregnant with sophisticated techniques.

Fertility restoration: Stimulating ovulation with fertility drugs

Fertility drugs regulate or stimulate ovulation. Fertility drugs are the main treatment for women who are infertile due to ovulation disorders.

Fertility drugs generally work like the natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. They're also used in women who ovulate to try to stimulate a better egg or an extra egg or eggs. Fertility drugs may include:

• Clomiphene citrate. Clomiphene (Clomid) is taken by mouth and stimulates ovulation by causing the pituitary gland to release more FSH and LH, which stimulate the growth of an ovarian follicle containing an egg.
• Gonadotropins. Instead of stimulating the pituitary gland to release more hormones, these injected treatments stimulate the ovary directly to produce multiple eggs. Gonadotropin medications include human menopausal gonadotropin or hMG (Menopur) and FSH (Gonal-F, Follistim AQ, Bravelle). Another gonadotropin, human chorionic gonadotropin (Ovidrel, Pregnyl), is used to mature the eggs and trigger their release at the time of ovulation. Concerns exist that there's a higher risk of conceiving multiples and having a premature delivery with gonadotropin use.
• Metformin. Metformin (Glucophage, others) is used when insulin resistance is a known or suspected cause of infertility, usually in women with a diagnosis of PCOS. Metformin helps improve insulin resistance, which can improve the likelihood of ovulation.
• Letrozole. Letrozole (Femara) belongs to a class of drugs known as aromatase inhibitors and works in a similar fashion to clomiphene. Letrozole may induce ovulation. However, the effect this medication has on early pregnancy isn't yet known, so it isn't used for ovulation induction as frequently as others.
• Bromocriptine. Bromocriptine (Cycloset), a dopamine agonist, may be used when ovulation problems are caused by excess production of prolactin (hyperprolactinemia) by the pituitary gland.

Risks of fertility drugs

Using fertility drugs carries some risks, such as:

• Pregnancy with multiples. Oral medications carry a fairly low risk of multiples (less than 10 percent) and mostly a risk of twins. Your chances increase up to 30 percent with injectable medications. Injectable fertility medications also carry the major risk of triplets or more (higher order multiple pregnancy).

Generally, the more fetuses you're carrying, the greater the risk of premature labor, low birth weight and later developmental problems. Sometimes adjusting medications can lower the risk of multiples, if too many follicles develop.

• Ovarian hyperstimulation syndrome (OHSS). Injecting fertility drugs to induce ovulation can cause OHSS, which causes swollen and painful ovaries. Signs and symptoms usually go away without treatment, and include mild abdominal pain, bloating, nausea, vomiting and diarrhea.

If you become pregnant, however, your symptoms might last several weeks. Rarely, it's possible to develop a more-severe form of OHSS that can also cause rapid weight gain, enlarged painful ovaries, fluid in the abdomen and shortness of breath.

• Long-term risks of ovarian tumors. Most studies of women using fertility drugs suggest that there are few if any long-term risks. However, a few studies suggest that women taking fertility drugs for 12 or more months without a successful pregnancy may be at increased risk of borderline ovarian tumors later in life.

Women who never have pregnancies have an increased risk of ovarian tumors, so it may be related to the underlying problem rather than the treatment. Since success rates are typically higher in the first few treatment cycles, re-evaluating medication use every few months and concentrating on the treatments that have the most success appear to be appropriate.

Fertility restoration: Surgery

Several surgical procedures can correct problems or otherwise improve female fertility. However, surgical treatments for fertility are rare these days due to the success of other treatments. They include:

• Laparoscopic or hysteroscopic surgery. These surgeries can remove or correct abnormalities to help improve your chances of getting pregnant. Surgery might involve correcting an abnormal uterine shape, removing endometrial polyps and some types of fibroids that misshape the uterine cavity, or removing pelvic or uterine adhesions.
• Tubal surgeries. If your fallopian tubes are blocked or filled with fluid (hydrosalpinx), your doctor may recommend laparoscopic surgery to remove adhesions, dilate a tube or create a new tubal opening. This surgery is rare, as pregnancy rates are usually better with IVF. For hydrosalpinx, removal of your tubes (salpingectomy) or blocking the tubes close to the uterus can improve your chances of pregnancy with IVF.

Reproductive assistance

The most commonly used methods of reproductive assistance include:

• Intrauterine insemination (IUI). During IUI, millions of healthy sperm are placed inside the uterus close to the time of ovulation.
• Assisted reproductive technology. This involves retrieving mature eggs from a woman, fertilizing them with a man's sperm in a dish in a lab, then transferring the embryos into the uterus after fertilization. IVF is the most effective assisted reproductive technology. An IVF cycle takes several weeks and requires frequent blood tests and daily hormone injections.

http://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/treatment/txc-20231648 (3)

Causes of female infertility

Disorders of ovulation

They may occur at the level of pituitary or hypothalamus as well as at the level of the ovary. If there is amenorrhoea it should be investigated as such and oligomenorrhoea along similar lines.

The World Health Organization (WHO) classifies ovulation disorders into three groups:

• Group I: hypothalamic pituitary failure (hypothalamic amenorrhoea or hypogonadotrophic hypogonadism).
• Group II: hypothalamic-pituitary-ovarian dysfunction, predominately a result of polycystic ovary syndrome (PCOS). This is the cause of the vast majority of ovulation disorder.
• Group III: ovarian failure.

As above, PCOS is responsible for the majority of ovulation disorders. Others include:

• Pituitary tumours can displace or destroy normal tissue and the production of follicle-stimulating hormone (FSH) and luteinising hormone (LH) is often the first to be affected. Panhypopituitarism is also called Simmonds' disease.
• Sheehan's disease is pituitary infarction following postpartum haemorrhagic shock.
• Hyperprolactinaemia may present with galactorrhoea or amenorrhoea. The control of prolactin (PRL) is unlike the other releasing factors, in that it is controlled by an inhibiting rather than a releasing factor from the hypothalamus into the hypothalamic-pituitary portal circulation. It is also released in response to thyrotropin-releasing factor, as is thyroid-stimulating hormone (TSH), and so it is elevated if thyroxine is low.
• The pituitary gland may be responsible for other disorders such as Cushing's syndrome.
• A number of chromosomal disorders result in inadequate ovarian function and usually primary amenorrhoea:
• Turner syndrome - there is a loss or abnormality of the second X chromosome in at least one cell line in a phenotypic female. The ovaries are usually just streaks. This condition may be a mosaic.
• In testicular feminisation there is primary amenorrhoea. The karyotype is XY but there is androgen insensitivity.
• XXY, or Klinefelter's syndrome, appears as a male.
• The XXX karyotype - this is the most common female chromosomal abnormality, occurring in approximately 1 in 1,000 female births. While fertility in women with trisomy X is generally considered normal, there is an increased risk for premature ovarian failure.
• Premature ovarian failure or premature menopause (menopause that occurs <40 years, although many gynaecologists use <45 years) causes secondary amenorrhoea. Premature ovarian failure occurs in about 1% of women.

Problems of tubes, uterus or cervix

• The Fallopian tubes are delicate structures whose cilia waft the ovum, or even early embryo, to its destination for implantation - more correctly called nidation:
• Damage to the tubes may occur as a result of infection:
• A history of pelvic inflammatory disease (PID) is highly suggestive of damage to tubes.
• Severe pelvic infection following illegal abortion is rarely seen in this country but still occurs in places where termination of pregnancy is illegal or difficult to secure.
• Even a legal termination or miscarriage can lead to infection of retained products of conception.
• Postpartum infection can also affect fertility.
• Sexually transmitted infections may cause infertility, largely through associated PID. Chlamydia and gonorrhoea are the most important.
• Infection may be less direct, and spread from appendicitis is possible, even without overt peritonitis.
• Female sterilisation operations involve disruption of the tube and results of attempted reversal are poor. Laparoscopic proof of patency of the tubes is not necessarily evidence that they function normally.
• Infection can also damage the uterus. Adhesions in the uterus and cervix are called Asherman's syndrome.[2]
• Deformity of the uterus, such as a septum or bicornuate uterus, may be more likely to cause recurrent abortion than failure to conceive.
• Significant distortion of the uterine cavity by fibroids can prevent implantation and hence fertility, although the impact on fertility remains a subject for debate.
• The cervix may have been shortened and damaged by a cone biopsy.
• There may be problems of cervical mucus, including hostility to sperm.
• Endometriosis may cause such inflammation, adhesion and distortion in the pelvis that it causes tubal infertility. Even when it is much less severe than that, it is commonly associated with subfertility.[3]There is evidence for improvement in conception rates following surgery but not medical treatment of endometriosis.[4]

History[1]

General health

Even in the absence of systemic illness, poor general health will impair fertility. Enquire about general lifestyle, including smoking, alcohol and recreational drug use, in addition to exercise and dietary intake.

• Aim for an ideal BMI:
• Women with a BMI of <19 and who have irregular menstruation or are not menstruating should be advised that increasing body weight is likely to improve their fertility.
• Women with a BMI of ≥30 should be informed that they are likely to take longer to conceive and those who are not ovulating should be informed that losing weight is likely to increase their chance of conception.
• Participating in a group programme involving exercise and dietary advice, rather than receiving weight loss advice alone, leads to more pregnancies.
• Smoking cigarettes impairs fertility and smoking in pregnancy increases the risk of miscarriage, obstetric complications, intrauterine growth restriction and even delayed reading ability (at least to the age of 7).[5]
• Women who are trying to become pregnant should be informed that drinking no more than one or two units of alcohol once or twice per week and avoiding episodes of intoxication reduce the risk of harming a developing fetus. Excessive alcohol consumption impairs sperm quality in men and may affect fertility in women.[6, 7]
• There is currently insufficient evidence for a strong association between excessive caffeine consumption and poor pregnancy outcomes, including infertility.[8]
• Illicit drugs should be avoided. Some have adverse effects on fertility or the fetus or both and, for most, the question of teratogenicity has not been adequately addressed. Cannabis can impair ovulation and cocaine can cause tubal infertility. There is also reason to be concerned about the effect these drugs may have in pregnancy.

Sexual history

• Enquire about frequency of coitus (ideally two to three times a week) and any prolonged or recurrent absences of one of the partners.
• Ask about potential physical problems such as inadequate penetration or dyspareunia.

Past medical history

Previous treatment for malignancy (chemotherapeutic agents, such as those used in childhood leukaemia) may result in subsequent sterility. Surgery and radiotherapy may be relevant if they involved the pelvic region.

Systemic disease may impair fertility, probably by interference with the hypothalamic-pituitary axis:

• This may include autoimmune disease such as rheumatoid disease or systemic lupus erythematosus (SLE), although the latter - eg, antiphospholipid syndrome - may be associated with recurrent miscarriage.[9]
• Chronic kidney disease can impair fertility.
• Poorly controlled diabetes mellitus should be improved.
• Anorexia nervosa can cause anovulation and amenorrhoea.

Medication and drug history

A thorough review of all medication is required with a view to both fertility and possible adverse effects on pregnancy, including teratogenicity. A number of recreational drugs may have an adverse effect on fertility, as above. Some prescribed medication may also cause problems:

• Phenothiazines and the older typical antipsychotics as well as metoclopramide can increase levels of PRL.
• Non-steroidal anti-inflammatory drug (NSAID) use is associated with luteinised unruptured follicles.[10]
• Immunosuppressants, used in autoimmune disease or post-transplant, may also affect fertility.

Examination

• Look for signs of hirsutism:
• Facial hair may be more profuse than normal, although this should be interpreted in the light of racial norms.
• Acne may also indicate high androgen levels.
• There may be a hint of male pattern alopecia with slight bitemporal recession.
• The pubic hairline may extend up towards the umbilicus in a typical male pattern.
• Abdominal examination should be performed and it must precede bimanual pelvic examination or it is very easy to miss a large mass such as a big ovarian cyst.
• Gynaecological examination, especially vaginal examination, may indicate undisclosed sexual difficulties - eg, vaginismus.
• Bimanual examination: may detect an adnexal mass from an ovary of tubo-ovarian mass or tenderness suggesting PID or endometriosis, or the presence of uterine fibroids.

Investigations[1]

The search for the cause of infertility or subfertility should be systematic and led by clinical features, not a blind screening process for everything.

• Mid-luteal progesterone level to assess ovulation:
• If low, it may need repeating, as ovulation does not occur every month.
• The blood test is taken seven days before the anticipated period, ie on day 21 of a 28-day cycle. However, this day will need to be adjusted for different lengths of cycle
• FSH and LH should be measured if there is menstrual irregularity:
• High levels may suggest poor ovarian function.
• A comparatively high LH level relative to FSH level can occur in PCOS.
• Women who are concerned about their fertility should be offered testing for their rubella status. Those women who are susceptible to rubella should be offered vaccination and advised not to become pregnant for at least one month following vaccination.
• Basal body temperature charts are not recommended to predict ovulation, as they are unreliable.
• Other tests are not recommended in primary care.

Secondary care investigations[1]

Each clinic may well have its own protocol for the investigation of couples in whom no problem has been identified, and even after extensive investigation no problem is found in 25%.

An earlier referral for specialist consultation should be offered when:

• The women is aged ≥36 years.
• There is a known cause of infertility.
• There is a history of predisposing factors for infertility.
• Investigations show there is apparently no chance of pregnancy with expectant management.

Tubal patency

Tubal damage is estimated to account for 20% of infertility in women.

• A hysterosalpingogram (HSG) or a hysterosalpingo-contrast ultrasound is recommended by the National Institute for Health and Care Excellence (NICE) for women who are not known to have comorbidities (such as PID, ectopic pregnancy or endometriosis).
• A laparoscopy and dye test is recommended for those women who are thought to have comorbidities
• Prior to undergoing uterine instrumentation, women should be offered screening for Chlamydia trachomatis and be treated appropriately if the result is positive.
• Prophylactic antibiotics should be considered before uterine instrumentation if screening has not been undertaken.

Ovarian reserve testing

The woman's age should be used as an initial predictor of her overall chance of success through natural conception.

One of the following measures should be used (measured around Day 3 of the menstrual cycle) to predict the likely ovarian response  to gonadotrophin stimulation in IVF:

• Total antral follicle count of ≤4 for a low response and >16 for a high response.
• Anti-Müllerian hormone of ≤5.4 pmol/L for a low response and ≥25.0 pmol/L for a high response.
• FSH >8.9 IU/L for a low response and <4 IU/L for a high response.

A high response results in more mature follicles developing, leading to higher-than-average pregnancy rates.

The following tests should not be used individually to predict any outcome of fertility treatment:

• Ovarian volume
• Ovarian blood flow
• Inhibin B
• Estradiol (E2)

People undergoing IVF treatment should be offered testing for HIV, hepatitis B and hepatitis C. Those people found to test positive for one or more of HIV, hepatitis B or hepatitis C should be offered specialist advice and counselling and appropriate clinical management.

Six Senses Hotels Resorts Spas

INTRODUCTION

This report is going to shed some lights on discussion about main topic is environmental organization Business in Sultanate of Oman. This Report discuss specific company in term Hospitality. It is six senses resort in Musandam Governance. In order to discuss such pointes; first point there will be a discussion about profile of Six Senses Resort. Then, the second point there will be a discussion about feature and characteristics of a resort.  After that, the third point there will be a discussion green practices and green marketing. Finally, the last point there will be a discussion is analysing evaluating the green practices in the resort.

SIX SENSES PROFILE

Six Senses Resort is one of the traditional and ecotourism resort in Oman. Six Senses Zighy Bay is located on the northern Musandam Peninsula in the Sultanate of Oman. It is located 120kilometers, or approx. 2hrs'drive from Dubai international airport, which is the gateway city to six Senses Zighy Bay. The setting of these beautiful indigenous village-style accommodations and private marina is spectacular, with the mountains on one side and the sandy beach on the other. It set between the mountains and a1.6 kilometres and it private beach on Zighy Bay. This village – style resort offers luxury villas with private pools and a spa with juice bar a 2 hammams.(booking,2013)

Author argue to choice this resort , because it strategy to  focus on sustainable environment  area and concern to get  a  certificate  of "green ball"  .When the guest visit the resort , there touching this difference. It is remote area ,so there are lots of feature like quite rural area, landscape, trational   Omani building and service , Guest outdoor and indoor activities through green practise . Resort is attracted visitors especially from United Arab of Emeritus, because it is close with their country. On the other hand, there are tourist from German and France, because it is a remote location to enjoy an area of natural beauty. Support services, such as laundry and maintenance, must be provided. Transportation may need to be provided for employees.

LECTURE REVIEW

The theoretical bases for this study are supported by  a discussion of the current study is evidence based on relevant  studies of difference source the same filed of eco-tourism in environmental organization and he importance of green practices and green marketing in resort .

Six senses resort try to be more successful and run the business also called internal environment in long term by decreasing the wastage. It contains the resort itself, its suppliers, marketing intermediaries, customer markets and public. Six Senses Resort is one of the tempt to focuses of letting this resort in term of green hospitality and sustainability to make a resort in good well by sustain the environment, social and using eco – friendly product. Resort using eco-friendly and green friendly product to helps business to be familiar business, because people will fell relax as well the workers going to be much more responsible on cleaning and maintaining. (booking,2013 )

According to Six Senses Hotels Resorts Spas(2013), Sustainable Policy of six senses is to concentration on energy efficiency, protecting natural surroundings, water and waste management, air quality and noise control and social commitment. It is good   to reduce negative impact  that effect on the environment .

 It has many great facilities that provide them to the resort guests. Author opinion, it needs more improvement to be more attractive and popular for most people. They should have more promoting to attract more guests inside and outside the country. Most of local people do not have any idea about the resort itself. In that case, they have to promote the resort too much. They should diverse the prices and put special prices for local people. Six Senses Zighy Bay features extra-large villas in traditional Omani style. There are some Omani staff at six scenes organize several daily activates including staff at six senses organize several daily activities including snorkelling excursion, surest cruises and cooking classes. Guests can train at the gym, or play a game of tennis with friends and Barbeque.

Leisure facilities and life activities- the adventure that starts at zighy bay and allows you to experience the reviving culture of Oman.  Combining creative tours to suit both the active guest and the guest who prefers to sit back and relax take in the scenery and culture  for example provide a large variety of activities are offered on land and on and under the water.

RESORT SEASONALITY

Weather is a major determinant of travel and recreation patterns because most tourist and sport activities require optimal conditions to create guest satisfaction. These have been described as the physical factors of seasonality. They form only a part of the push and pull factors that lead to seasonality within tourism. Their influence is modified by the social and cultural factors that impact on guest choice of vacation. Their impacts on seasonality have been joined by the modifying process of resort management. If visitors come in the shoulder season they will pay a more competitive rate because there is some spare capacity and more choice. If they come in the off season they will receive a heavy discount ,because the resort is looking for business to maintain its core staffing and in recognition that some of the local activities will be closed down

The management of six senses can manage the issue of seasonality by promoting the resort through online .They providing handled advice to their providing the highest level of service and information for the clients. They support the activities with brokers on request, selected images. The six senses always try to have special offers to compliment the season, special event or a cultural. They provide more offers with discounts to attract more guests to come and stay. The high season which has more tourists is from November to April. During these days the tourist can do outdoor and daytime activates such as: hiking, biking and many more adventures and excursions. During the warmer months from May to September most of tourist prepare indoor and evening activates, in addition to whale shark watching from January to March. From March to April it's called tuna season which is about many Omani's make their livelihood from fishing and the villagers of Zighy   bay are traditional fisherman, for a few weeks the Musandam waters are rich with local tuna with some catches even valued up to 3000 OMR.

From January to March it's called where shark season. The ware sharks migrate from the southern bay of Oman to the straits of hormuz during seasonal shifts and on hones in water temperature. This is the best time for enounce of spotting in a transient position around Lima Rock. From October to April, they provide adventure activities for the guest such as: trekking, rock climbing, can yoking, mountain biking and hiking are mixing from the hash adrenaline activities for which Oman is well known. The weather condition is perfect for day which Mother Nature. Pre-booked appointment slots should be with the experiences team. Therefore, the level to which any  resort will be willing to prepare and follow policies regarding the environment  and seasonality It will depend upon its economic development and awareness about how the environment can be used in a profitable way.

 

SWOT analysis of  Six Senses Resort

Strengths Government tries to maximizing positive impact of eco- tourism through training and employment of local people, tourism education, Investment and so on. Increase the economics of destination. Positive trends of sustainability’s  is related increasing the average life of human being, reduce the costs, increasing the quality of work, Increasing the work environment, creating the eco-friendly environment and so on.

Opportunities Developing marketing tool such as internet. Increase private sector in developing eco-tourism and environment activities

Weaknesses Lack of marketing experience. Communities do not have enough idea about eco-tourism

Threats Taxation introduced on product and services. Increase the diseases and so on compared to past years while you are working with sustainability. Increasing in pollutions There are illegal activities with protected area such as poaching for animals lead to the extinction of animals.

CONCLUSION

Broadly speaking, eco-tourism is one of the most important factors. In Oman, majority of hotels and resorts are not having proper implementation of eco- tourism and sustainability. If Government can take proper measures towards eco- tourism and sustainability development would be very useful for our country. Whereas, majority of western countries are already implements the eco-tourism and sustainability development models in their countries. So that, in Musandam also we have to take proper measures to be create eco-friendly nature in future otherwise it would be very difficult to control in future. It is very important to focus positive trend sustainability to get succeed. Governments educate resident communities in term of ecotourism diversity and how minimize the conflict of environment function derived from tourism activities.

Most of resort business   to be more successful and run the business in long term by decreasing the wastage.  Many  resorts are tempt to focuses of letting  their business in term of  Green Hospitality and Sustainability to make a resort in good well by sustain the environment, social and using eco- friendly product. Resort using eco- friendly and green friendly product  to helps  business to be familiar business,  because people will feel relax as well the workers going to be much more responsible on cleaning and maintaining.

Tourism is one of the world's largest industries and one of the fastest growing economic sectors. It has a multitude of impacts, both positive and negative, on people's lives and on the environment.

To explain this further, the main reason for visiting a particular place for tourism is because of the environment that lies there. The environment is reflected in the beautiful landscapes and the exotic cultures different places have to offer. Looking at the other side, the changes in the social and economic conditions have created opportunities for the environment to be promoted and people encouraged for travel. Hence, tourism is predominantly based on the consumption of experiences through an interaction with environments composed of wildlife, nature and indigenous cultures.

Sustainable tourism development meets the needs of the present tourists and host regions while protecting and enhancing the opportunity for the future.

RECOMMENDATION

• Six senses resort is one of the biggest resorts in Musandam peninsula. It has many great facilities that provide them to the resort guests. In  my opinion it needs more improvement to be more attractive and popular for most people.
• They should have more promoting as eco-resort  to attract more guests inside and outside the country. Most of local people don’t have any idea about the resort itself. In that case they have to promote the resort too much.
• They should diverse the prices and put special prices for local people.
• The environment is a range of external conditions in which we live including physical, social, cultural, economic and political dimensions.
•  Tourism depends upon the existence of environments in other locations which are viewed as desirable and attractive.
• This view keeps changing with changes in fashion.
•  The relationship between tourism and environment is seen in the interaction between tourists and the destination environments.

The difficulties course of Aggregate that through Angles abrasion loss test.

1. TITLE: Loss angles abrasion and aggregate impact value.
2. AIM OF THE EXPERIMENTS: To knowledge the difficulties course of Aggregate that through Angles abrasion loss test.

In experiment 7, The test is to determine the total impact value of coarse aggregates as IS: 2386

( Part IV ) – 1963

3. THEORY: In experiment 6, The Testing for Loss Angles Abrasion in Machine composes a hollow through steel cylinder and closed in both ends, an inside  having diameter of 28" and an inside length 20". Cylinder is placed in the shafts stub  that will be attached to both ends of the steel cylinder, which do not enter and mounted in such a way that it can be rotated around its center in a horizontal position. Slot is provided in the cylinder for the introduction of the test sample and that it can be closed dust-tight with the removable cover closed in place. The cover is designed to preserve the Contour of the cylindrical inner surface. They are placed on the shelf so the charges do not fall into the cover or come in contact with them during the probationary period. Steel rack removable radial projection 3- ½" into the cylinder and extending its full length is mounted along one thing of the interior surface of the cylinder. Also, The shelf is such thickness and so mounted by bolts or other approved means to be strong & firm. The position of the shelf, which is like the distance from the shelf to the opening of the measure along the perimeter of the cylinder, which should be in the direction of rotation of at least 50 ".If It stops the lid on the bottom, so it can be difficult to access the site, and move the barrel through the panel and then the weight of the external push forward and then reverse with the withdrawal of move the barrel to the wanted position.

In experiment 7, the road aggregate it was  has been manufactured to a specified grading stockpiled,  transported, spread loaded into trucks, tipped, and set up when was manufactured. Some degradation may take place and result in a change in grading and the production of excessive and undesirable fines if the aggregate is weak. However, when an aggregate complying with a specification at the quarry in the pavement, it may fail to do so. It can be quite high for  the Granular base layers and surfacing to be prone to repeated loadings from big truck tyres and stress at the contact points of aggregate particles. These crushing tests can manifest aggregate properties vulnerable to mechanical degradation of this form. The table below shows requirements. A . KAIKADE, J . (2005).

4. APPARATUS: 

Experiment 6:

Standard Sieves , Los Angeles Machine ,  Drying Oven , Steel balls Charge , Scales and 1.70 mm(No.12) sieve.

Figure 6.1: Equipment’s of experiment

Experiment 7:

• Weighing Tools: Impact testing machine conforming to IS: 2386 Sieves and sizes  10 mm 2.36 mm and 12.5 mm).
• A cylindrical metal measure of ( 75 mm dia.)+( 50 mm depth ).

Figure 7.1 : Equipment’s of experiment

5. MATERIALS:

Experiment 6

Aggregate Coarse

6. EXPERIMENT METHOD:

Experiment 6:

1.Wash and so oven‐dry 5000 grams  sample  of the aggregate - dry to a constant mass at 230 ºF ( + / - 9)( 110  ° C  ( + / -  5 )) nest sieves in order of decreasing size of the opening, and place sample  of aggregate on the top sieve.

2. sample of separate  to the individual size fractions with sieving material retained weight in each sieve.

3. Reassemble material  sieved to the required grades - the total mass of the nearest record 1 gram.

4. Rotate the drum for five-hundred revolutions at a constant speed of 30 to thirty -three rpm - approximately a quarter-hour - shelf recommendations up charge + sample at bottom of drum  -  charge  +  sample dropped as drum goes around  crushing - charge  & sample roll at lower side grinding.

5. It should remove sample from machine.

6. Dry Sieve over a No. 12 sieve

7. Passing Material=degraded

8. Retained Material=intact

9. Wash and oven retained dry material ( if required  )

10. Near of weigh 1 gram

11. Calculate percent loss because abrasion with calculating the difference between the original sample of weight and larger particles  for retained material. The difference  weight is reported as a percent from the original weight and called " loss  of percent  ".

figure 6.2: weight of aggregate

Experiment 7

1) The sample test should adjust to following grading:

Passing on IS : (12.5 mm )Sieve 100 %

Retention through IS: ( 10 mm ) Sieve 100 %

2) The sample which will be oven-dried for four hours from 100 to 110 oC temperature and cooled.

3) The measure is about one - third full prepared aggregates and compacted with (25 ) strokes of the compacting rod.

A more similar quantity of aggregates will be added and a further tamping of ( 25 ) given strokes. The measure will finally be filled to surplus, tamped (25)times and the overflow aggregates struck off, using a tamping rod for straight edge. The net weight aggregates in the measure will be determined to the nearest g ( Weight A ).

A) The effect testing machine cup will be fixed securely properly on the foundation of the machine. The total of the sample test  placed in it and tamped by(25) strokes for tamping rod.

B) The hammer will be elevated to ( 380 mm ) over an upper surface of the aggregates in the cup and allowed to fall freely onto the aggregates. sample test will be prone to an overall total of ( 15 )such blows, and each one will be delivered at an interval which not less than one second.

figure 7.2: weight the fine aggregate

7. DATA AND RESULTS OF THE EXPERIMENTS:

Loss angles abrasion

2500 grams of 9.5 mm

2500 grams of 12.5 mm

Retained from 1.7mm =    4285 grams

LAN= ( 5000    -   4285  / 5000   ) *   100% = 14.3%

Aggregate impact value

1- The sample will removed by IS sieve (2. 36mm). The fraction moving will be through ( Weight B ) and the fraction salvaged on the sieve will be ( Weight C). So, if the overall weight B+C is less than first ( weight A ) by more the 1 gram, the end result will be rejected and a new test will be achieve.

2- The weight of rate fines formed to the overall sample weight should be as a percentage.

Weight 1=   38.2 grams

Weight 2=   33.6 grams

W.  of  Coarse Aggregate =Weight 2 – Weight 1 =38.2-33.6= 4.6grams

  passing A = 33.6 + 4.6 = 38.2grams

  retuning B  = 33.6grams

Aggregate impact value= (   B  /  A  ) x 100  %

Aggregate impact value= ( 33.6   /    38.2) x 100% =    87.95 %

8. Discussion

Experiment 6:

The Loss angles test to scrape test pilot. Therefore it is not directly linked to the performance in the field of aggregates. Observations generally do not reveal A good relationship between the values of Loss angles abrasion  and field performance. Loss Angles friction loss is able to field performance expected. Specially, the test may not be satisfying for some types of aggregates. Some aggregates, such as some limestone and slag, tend to perform adequately in the field but have high Loss angles abrasion. Loss angles abrasion loss seems to be well related with dust be during handling and production of HMA in those aggregates with higher Loss Angles. values of abrasion loss  and usually generate more of dust. Through the result gained in the experiment, it is clear that rubble fit in the use of construction such as the foundation because it was given less than 17% and this resists external affecting factors. We all used, 11 balls for 500 cycles and which gave required  result of specifications

Experiment 7:

This experiment discussed the geological description of the aggregate, particle size and the source quarry. Also, it showed  the applied force,  dry is different in the weight and the masses of material after sieving  while calculations for result  was 5.3% . Moreover, it will discussed the results using in the range and collect results using from other group, then compare the  obtained values. Millard, R.S. (1993).

9. Conclusion

The experiment investigated  the possibility of assuming the loss angles abrasion from the crushability index and the results of  loss angles abrasion, density, crushability and porosity tests . These tests were analyzed using multiple regression analyses and simple. Important relations  were generally gained from both multiple regression analyses and simple. The Simple equation is practical and reliable enough for the estimation of the loss angles abrasion from crushability index. However, who wants to make more precise assumption which can alternatively using two multiple regression equations.

Chocolate Meltways

Chocolate meltaways, also called velvets, meltaway candies, and by a variety of other smooth-sounding names, are unique confections with melt-in-the-mouth properties. The chocolate meltaways recipe uses the science of eutectics to create a candy which has a melting point slightly below that of pure chocolate (30 to 32 C). This makes the meltaway so soft that it begins to dissolve immediately as you put it in your mouth. This eutectic effect is achieved by creating a mix of chocolate with another kind of fat which differs in molecular structure, but not greatly in melting temperature, from cocoa butter already present in the chocolate. The result is a melting point that is lower than the melting point of either of the constituent fats.

Some fats are more appropriate than others for particular application in chocolate meltaways. Since the flavour components are mostly held within the fat phase, the rate of release is often dependent on the melting profile of the fat used. Meltaways are often used in cakes and cookies with additional flavour elements, such as coconut and mint, added to the mix to create a more complex taste profile. Meltaways can even be designed to give a cooling sensation on your tongue by increasing the amount of latent heat removed from the mouth during melting. This is done by incorporating fats that melt very quickly from a solid state at 20 C to an almost liquid state at 30 C. The coolness can be magnified by increasing the fat content and/or by using other ingredients that have a similar effect, such as peppermint. Chocolate meltaways taste interesting because of the speed at which they begin to melt on your tongue, releasing a burst of  flavours at a very fast pace. These flavours then bind to your taste receptors giving them their characteristic mouthfeel.