Infertitlity

Nina Wallace

Definition

Infertility is defined by Medicine Net as "Diminished or absent ability to conceive and bear offspring."

Male Infertility


  • Abnormal sperm production or function
  • Overexposure to certain chemicals and toxins
  • Damage related to cancer and its treatment,


Problems with the delivery of sperm


  • sexual problems, such as premature ejaculation
  • semen entering the bladder instead of emerging through the penis(retrograde ejaculation)
  • blockage of the part of the testicle that contains sperm (epididymis)
  • damage or injury to the reproductive organs.
  • men who have previously undergone a vasectomy and desire a return of fertility will also need to either have the vasectomy reversed
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Female Infertility

  • Ovulation disorders
  • Uterine or cervical abnormalities
  • Fallopian tube damage or blockage
  • Endometriosis
  • Primary ovarian insufficiency
  • Pelvic adhesions
  • Thyroid problems
  • Cancer and its treatment.
  • Certain medications



Other conditions


Medical conditions associated with delayed puberty or the absence of menstruation (amenorrhea), such as celiac disease, Cushing's disease, sickle cell disease, kidney disease or diabetes, can affect a woman's fertility. Also genetic abnormalities can make conception and pregnancy less likely.

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Prevalance

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Population Affected

  • 7.4 million women, or 11.9% of women, have ever received any infertility services in their lifetime.
  • 1 in 6 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy.
  • Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained.
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Symptom/ Signs

The main sign of infertility is the inability for a couple to get pregnant. There may be no other obvious symptoms.

In some cases, an infertile woman may have:

  • Irregular or absent menstrual periods.
  • An infertile man may have signs of hormonal problems
  • Changes in hair growth, sexual function,
  • Reduced sexual desire,
  • Problems with ejaculation.
  • He may also have small testicles or a swelling in the scrotum.

Treatment

Men

Approaches that involve the male include treatment for general sexual problems or lack of healthy sperm. Treatment may include:

  • Treating infections.
  • Treatments for sexual intercourse problems.
  • Hormone treatments and medications.
  • Surgery: An obstructed vas deferens repaired (vasectomy reversal). In cases where no sperm are present in the ejaculate, sperm may often be retrieved directly from the testicles.


Assisted reproductive technology (ART).


  • ART treatments involve obtaining sperm through:
  • Normal ejaculation, surgical extraction or from donor individuals,
  • The sperm is then inserted into the female genital tract, or used to perform in vitro fertilization(IVF).




Women

Although a woman may need just one or two therapies to restore fertility, it's possible that several different types of treatment may be needed before she's able to conceive.

  • Stimulating ovulation with fertility drugs. These medications regulate or induce ovulation.
  • Intrauterine insemination (IUI). Healthy sperm are collected and concentrated are placed directly in the uterus around the time the woman time of ovulation
  • Surgery to restore fertility. Uterine septum or intrauterine scar tissue can be treated with hysteroscopic surgery.

Assisted Reproductive Technology


Assisted reproductive technology (ART): any fertility treatment in which the egg and sperm are handled. An ART health team includes health professionals who work together to help infertile couples achieve pregnancy.


In vitro fertilization (IVF)

The most common ART technique.

IVF involves retrieving multiple mature eggs, fertilizing them with sperm in a lab petri, and implanting the embryos in the uterus three to five days after fertilization.

Each year thousands of babies are born in the United States as a result of ART. The success rate of ART is lower after age 35.

Other techniques are sometimes used in an IVF cycle, such as:

  • Intracytoplasmic sperm injection (ICSI):a single healthy sperm is injected directly into a mature egg.
  • Assisted hatching: This technique attempts to assist the implantation of the embryo into the lining of the uterus
  • Donor eggs or sperm: may choose to use eggs, sperm or embryos from a known or anonymous donor.
  • Gestational carrier: (Surrogate) the couple's embryo is placed in the uterus of the carrier for pregnancy.
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Fertility Prognosis

Prognosis

For most couples (about 90%), the cause for the infertility is found.

Pregnancy occurs with the use of fertility drugs or corrective surgery in up to 60% of infertile couples, once they are treated.

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