Infertility
Definition
Biological inability of a man or a woman to contribute to conception.
Inability to carry a pregnancy to full term.
Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile during the rest of the menstrual cycle.
Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature.
Infertility in a couple can be due to either the woman or the man
A couple is considered infertile if
the couple has not conceived after 12 months of contraceptive-free intercourse if the female is under the age of 34
after 6 months of contraceptive-free intercourse if the female is over the age of 35 (declining egg quality)
the female is incapable of carrying a pregnancy to term.
Primary infertility : Couples with have never been able to conceive
Secondary infertility : is difficulty conceiving after already having conceived and carried a normal pregnancy
Incidence
One in seven couples have problems conceiving
Causes
Adeno-associated virus - male infertility (it's otherwise not harmful)
Improperly timed intercourse
Low sperm count
Endometriosis
Damage to the fallopian tubes - by infections such as chlamydia
Over- or underweight
Age
Genetic Factors
A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility.
General factors
Diabetes mellitus
Thyroid disorders
Adrenal disease
Hypothalamic-pituitary factors
Hyperprolactinemia
Hypopituitarism
Environmental Factors
Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides. [10][11]
In about 15% of cases the infertility investigation will show no abnormalities
Medical treatments
intrauterine insemination (IUI)
ovarian stimulating medication.
in vitro fertilization (IVF). IVF and related techniques (ICSI = Intracytoplasmic sperm injection, ZIFT = Zygote intrafallopian transfer , GIFT = Gamete intrafallopian transfer) are called assisted reproductive technology (ART) techniques.
ART techniques generally start with stimulating the ovaries to increase egg production. After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman’s reproductive tract, in a procedure called embryo transfer.
Other medical techniques are e.g. tuboplasty, assisted hatching and PGD (procedures that are performed on embryos prior to implantation)
Ethics
High-cost
Debate over whether health insurance companies should be forced to cover infertility treatment.
The legal status of embryos fertilized in vitro and not transferred in vivo.
Anti-abortion opposition to the destruction of embryos not transferred in vivo.
IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems.
Religious leaders' opinions on fertility treatments.
Infertility caused by DNA defects on the Y chromosome is passed on from father to son.
Psychological impact
Partners may become more anxious to conceive, ironically increasing sexual dysfunction.
Marital discord often develops in infertile couples,
Women trying to conceive often have clinical depression
Even couples undertaking IVF face considerable stress
Emotional stress and marital difficulties are greater in couples where the infertility lies with the man
Social impact
In many cultures, inability to conceive bears a stigma.
. Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way
