Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples. Infertility may result from an issue with either you or your partner, or a combination of factors that prevent pregnancy.
Infertility is typically defined as the inability to achieve pregnancy after
one year of unprotected intercourse. If you have been trying to conceive
for a year or more, you should consider an infertility evaluation.
UNEXPLAINED INFERTILITY &INTRAUTERINE INSEMINATION Dr. Sharda jain Lifecare...Lifecare Centre
UNEXPLAINED INFERTILITY &INTRAUTERINE INSEMINATION DR. SHARDA JAIN , DR. JYOTI AGARWAL
DR. JYOTI BHASKAR
DEFINITION
Unexplained infertility means that couple does not conceive after 1year of unprotected vaginal sexual intercourse, with basic infertility evaluation showing no obvious abnormality.
INCIDENCE
15%to 20% of infertile couples
UNEXPLAINED IS PRIMARILY A
DIAGNOSIS OF EXCLUSION
Infertility is typically defined as the inability to achieve pregnancy after
one year of unprotected intercourse. If you have been trying to conceive
for a year or more, you should consider an infertility evaluation.
UNEXPLAINED INFERTILITY &INTRAUTERINE INSEMINATION Dr. Sharda jain Lifecare...Lifecare Centre
UNEXPLAINED INFERTILITY &INTRAUTERINE INSEMINATION DR. SHARDA JAIN , DR. JYOTI AGARWAL
DR. JYOTI BHASKAR
DEFINITION
Unexplained infertility means that couple does not conceive after 1year of unprotected vaginal sexual intercourse, with basic infertility evaluation showing no obvious abnormality.
INCIDENCE
15%to 20% of infertile couples
UNEXPLAINED IS PRIMARILY A
DIAGNOSIS OF EXCLUSION
medical management of infertility,think before surgery!!!!ShitalSavaliya1
Nowdays infertility is major issues world wide,It covers both male and female infertility causes,investigation and related treatments.it also includes recent options available at infertility centres.
Infertility affects both the female and male spouses equally. Inability to conceive isn't usually due to a medical condition. Stress, obesity, excessive alcohol and coffee usage, and smoking can all have a detrimental influence on fertility. Check out the Infertility Causes.
medical management of infertility,think before surgery!!!!ShitalSavaliya1
Nowdays infertility is major issues world wide,It covers both male and female infertility causes,investigation and related treatments.it also includes recent options available at infertility centres.
Infertility affects both the female and male spouses equally. Inability to conceive isn't usually due to a medical condition. Stress, obesity, excessive alcohol and coffee usage, and smoking can all have a detrimental influence on fertility. Check out the Infertility Causes.
Infertility and Pregnancy
Here you will discover the foloowing:
Signs of Infertility
The Real Cause of Infertility
Infertility Treatments
How to get Pregnant Naturally
As an intern doctor in Gyne department , this presentation outlines the steps of assessment of an infertile couple including history taking , examinations and relevant investigations and imagings .
Men and women can both be infertile, and the cause of infertility varies in women and men. For women, the cause of infertility ranges from diseases of the thyroid to fibroids in the uterus and even endometriosis.
Female and male infertility Causes & Management by Asar KhanAsar Khan
In this Presentation we have included the male and female infertility their causes and Management. we hope that it will provide you some basic information regarding this issues.
Dr. Shilpa Bhandari is a highly experienced IVF specialist in Indore Madhya Pradesh and provides affordable ivf cost in Indore at Mohak infertility center. Book an appointment today Call now us 78980-47572 / 80852-77666 and online visit - https://mohakivf.com/
Hypogonadotropic hypogonadism is brought on by a hypothalamic GnRH deficiency or absence or by a malfunctioning pituitary, which leads to inadequate gonadal stimulation (LH) and (FSH). hypogonadism is more common in females The increased synthesis of prolactin, which is caused by hypothyroidism, may lead to morphological alterations in the follicles . Hyperprolactinemia in men causes low testosterone, infertility, and sexual dysfunction. In men, chronic hyperprolactinemia could affect fertility (with or without hypogonadism)
Cystic fibrosis is a disease in which the mucus secretion is aberrant due to a direct effect on the reproductive tract epithelial cells. Cystic fibrosis severely affects male reproductive health like obstructive azoospermia and causes testosterone deficiency (Yoon et al., 2019).In addition CF is associated with female infertility in which sperm penetration is hampered by the thick cervical mucous (Ahmad et al., 2013).
Fallopian tube ciliary action transports sperm and embryos. Fallopian tube cilia could be destroyed by infections or inflammation; however, Primary Ciliary Dyskinesia(PCD), a primary disorder of ciliary structure and function, will also decrease tubal transport and lead to ectopic implantation and subfertility. Most males with PCD suffer infertility due to immobile sperm as results of defective sperm-flagella motion
Sepsis or renal failure can inhibit implantation. Diabetes reduces sperm motility, untreated celiac disease, vitamin D deficiency, autoimmune disease, hypothyroidism lowers fertility, dyslipidemia, atherosclerosis, hypertension or medicines induce erectile dysfunctio
Pathogens affect fertility in diverse ways. In men, they can damage organs, cells via inflammatory mediators, and block or bind to spermatozoa . Genital infections cause genital injuries, semen infections, prostatitis, urethritis, epididymitis, and orchitis (Gimenes et al., 2014). Viruses impact spermatogenesis, genital inflammation, and anti-sperm antibodies, causing male infertility. Hepatitis B/C, Herpes simplex virus, Human papillomavirus, Toxoplasma gundi (Liu et al., 2018). Chlamydia spp., E. coli, and Neisseria gonorrhoea infections increase seminal leukocytes
Unexplained infertility (UI) Undiagnosed infertility, known as idiopathic infertility, is a disorder when couples are unable to conceive for unknown reasons. Unexplained infertility is a kind of infertility in which the findings of routine testing, such as ovulation tests (midluteal serum progesterone level), tubal patency and uterine cavity (hysterosalpingogram), and sperm analysis (spermiogram), are all normal. (Kumari P et al,2017). Following their diagnostic procedures, 15 – 25% of infertile couples suffer from UI. Female infertility creates pregnancy problems, up to 70% of infertility instances are attributed to the complexity of the female reproductive system. The main causes of infertility are polycystic ovary syndrome, hormonal problems, endometriosis
Male and female infertility, being a common problem needs one to better understand it! Know how infertility is causes and how it is cured with fertility treatments and solutions! IVF (test tube baby) and assisted reproductive techniques!
Infertility problem and Fertility managementRotunda TCHR
Infertility India, Infertility Clinic India, Infertility Surgery India, Infertility, Infertility treatment India, Infertility abroad, conceive a baby, IVF, ICSI, PGD, GIFT, ZIFT, egg donation, sperm, embryo transfer, Pregnancy, egg donor, low cost IVF treatment, diagnosis, female fertility, male infertility, infertility specialist, infertility specialist in India, infertility treatment hospitals in India, infertility treatment clinic India, infertility treatment centre India, test tube baby, gender selection, sex selection, assisted reproductive technique, causes of infertility, procedure of fertility, IVF clinic, IVF clinics in India, pregnancy, sperm analysis, low sperm count, infertility treatment, infertility causes, infertility,IVF India, IVF Clinic India, IVF India, IVF Centre, IVF Treatment India, IVF, IVF Clinic, IVF Center, IVF India, IVF Specialist Doctor, IVF Treatment, IVF Treatment In India, IVF Treatment In Abroad, Women Infertility, Men Fertility, Test Tube Baby, IVF Procedure, ICSI, Embryo Transfer, Variations On Embryo Transfer, GIFT, ART, Egg Donation, Egg Donor, Low Cost Of Treatment, IVF Treatment Available In India, IVF,IVF India, IVF Clinic, Egg Donation, Surrogacy India, Fertility, Infertility, Surrogacy, Genetic Treatment, Human Reproduction, IVF Specialists, Success Rate, Fertility In India, Fertility Abroad, Fertility Treatment In India, Fertility Treatment In Abroad, Infertility In India, Infertility Treatment Abroad, Infertility Treatment In India, Infertility Treatment Abroad, IVF Treatment, IVF Treatment In India, IVF Treatment Abroad, Surrogacy, Surrogacy Treatment, Surrogacy Treatment In India, Surrogacy Treatment In Abroad, Gynecologist, Surrogate Mother, Surrogate Motherhood, Surrogate Mother India, Ovulation Induction, Laser Assisted Hatching, Oocyte Retrieval
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
6. When a couple experiences problems with fertility, the cause(s) can be
multiple and overlapping. Problems in the male are just as likely as
problems in the female, and it is equally likely that the cause is a
combination from both partners.
In many cases, the exact cause of the infertility remains unknown or
unexplained—a situation called idiopathic infertility.
In some cases, these causes or factors overlap and occur at the same time,
compounding their effects on fertility.
7. Infertility Definitions and Terminology
• Infertility is “a disease of the reproductive system defined by the failure
to achieve a clinical pregnancy after 12 months or more of regular
unprotected sexual intercourse.”… (WHO-ICMART glossary1).
• Infertility is the inability of a sexually active, non-contracepting couple
to achieve pregnancy in one year. The male partner can be evaluated for
infertility or subfertility using a variety of clinical interventions, and also
from a laboratory evaluation of semen.” (Semen manual, 5th Edition).
Demographic Definitions of Infertility
• Infertility: An inability of those of reproductive age (15-49 years) to
become or remain pregnant within five years of exposure to pregnancy.
(DHS2)
• Infertility: An inability to become pregnant with a live birth, within five
years of exposure based upon a consistent union status, lack of
contraceptive use, non-lactating and maintaining a desire for a child.
(Trends in prevalence).
Clinical Definitions
8. Epidemiological Definition of Infertility
(for monitoring and surveillance) Women of reproductive age (15–
49 years) at risk of becoming pregnant (not pregnant, sexually
active, not using contraception and not lactating) who report trying
unsuccessfully for a pregnancy for two years or more.
(Reproductive Health Indicators)
Infertility as a Disability
Disability: Infertility generates disability (an impairment of
function), and thus access to health care falls under the Convention
on the Rights of Persons with Disability. An estimated 34 million
women, predominantly from developing countries, have infertility
which resulted from maternal sepsis and unsafe abortion (long term
maternal morbidity resulting in a disability). Infertility in women
was ranked the 5th highest serious global disability (among
populations under the age of 60).
9. Primary Infertility
When a woman is unable to ever bear a child, either due to the
inability to become pregnant or the inability to carry a pregnancy to
a live birth she would be classified as having primary infertility.
Thus women whose pregnancy spontaneously miscarries, or whose
pregnancy results in a still born child, without ever having had a
live birth would present with primarily infertility. (Trends in prevalence).
Secondary Infertility
When a woman is unable to bear a child, either due to the inability
to become pregnant or the inability to carry a pregnancy to a live
birth following either a previous pregnancy or a previous ability to
carry a pregnancy to a live birth, she would be classified as having
secondary infertility. Thus those who repeatedly spontaneously
miscarry or whose pregnancy results in a stillbirth, or following a
previous pregnancy or a previous ability to do so, are then not
unable to carry a pregnancy to a live birth would present with
secondarily infertile. (Trends in prevalence)
10. Global infertility prevalence rates are
difficult to determine, due to the
presence of both male and female
factors which complicate any estimate
which may only address the woman
and an outcome of a pregnancy
diagnosis or live birth.
Global prevalence of infertility, infecundity and childlessness
11. New infertility prevalence calculation
One in every four couples in
developing countries had been found
to be affected by infertility,When an
evaluation of responses from women in
Demographic and Health Surveys from
1990 was completed in collaboration
with WHO in 2004.
The burden remains high. A WHO
study, published at the end of 2012, has
shown that the overall burden of
infertility in women from 190 countries
has remained similar in estimated
levels and trends from 1990 to 2010.
13. INFERTILITY IN MALES
Men also contribute to infertility in a couple. In fact, men are
found to be the only cause or a contributing cause of infertility
problems in couples in about 40% of cases.
• To conceive a child, a male's sperm must combine with a
female's egg. The testicles make and store sperm, which are
ejaculated by the penis to deliver sperm to the female
reproductive tract during sexual intercourse.
• The most common issues are problems that affect how the
testicles work. Other problems are hormone imbalances or
blockages or absence of some of the ducts in the male
reproductive organs.
Lifestyle factors and age-related factors also play a role in
male infertility.
14. 1) Conditions That affects Sperm Formation
Many different issues can affect the formation of sperm in the
testicles. These conditions can lead to sperm that is abnormally
shaped or malformed or to low amounts of sperm.
Common issues includes;
• Chromosome defects
• Diabetes
• Hyperprolactinemia (pronounced hi-purr-proh-lak-tih-NEE-
mee-ah), which is overproduction of a hormone called
prolactin made by the pituitary gland
• Injury to the testicle
• Insensitivity to hormones called androgens, which include
testosterone
• Swelling of the testicles from infections such as mumps,
gonorrhea, or chlamydia
• Chromosome disorder called Klinefelter syndrome
• Thyroid problems
15. Conditions That affects Sperm Formation
Cont.
Common issues includes;
• Cryptorchidism (pronounced krip-TAWR-ki-diz-uhm), which occurs when one or both
testicles are not descended
• Varicocele, which is the enlargement of veins in the scrotum; enlarged veins disrupt the blood
flow in the testicle and cause an increase in temperature, which negatively affects sperm
production. This condition is present in about 40% of men with fertility problems.5
• Remember that lifestyle, environmental, and age-related factors can also play a role in male
infertility.
16. 2) Conditions That affects Sperm Transport
Even if the male's body produces enough viable sperm, sometimes
factors and conditions that affect how or whether the sperm moves can
also contribute to infertility.
• Sperm may move too slowly or not at all and thus die before they can
reach the egg. Sometimes the seminal fluid, which contains the
sperm, is too thick for the sperm to move around properly.
• An inability to transport sperm from the testicles to the penis causes
about 10% to 20% of the cases of male infertility. The inability can
be caused by natural blockages in the tubes that transport sperm from
the testicles to the penis or from vasectomy, a surgical procedure that
cuts and seals the ends of the tubes.
17. In males, age is known to reduce the quality of sperm, which affects the sperm's
ability to reach or fertilize an egg. Men also produce fewer sperm as they age.
Other age-related causes of reduced fertility in males include:
Genetic abnormalities of the sperm; which can reduce the chances of their
partner becoming pregnant or increase the likelihood of miscarriage or of an
infant having a condition such as Down syndrome
Erectile dysfunction; which can be affected by decreasing testosterone levels as
a man ages or by medications for age-related conditions such as hypertension
Changes to the reproductive tissues or organs; For example, testicle volume
decreases with age. Also, men may have an enlarged prostate, which can cause
problems with ejaculations.
Lifestyle and Environmental Factors In Males
18. Major lifestyle factors that are associated with male infertility are
• Smoking
• Cigarettes,
• Alcohol intake,
• Use of illicit drugs,
• Obesity,
• Psychological stress
• Advanced paternal age
• Dietary practices, and coffee consumption.
• Other factors such as testicular heat stress, intense cycling training, lack of sleep and
exposure to electromagnetic radiation from mobile phone use are briefly discussed.
19. When health care providers cannot find a specific or even likely
cause for infertility in males, they will diagnose the infertility as
"idiopathic" or unexplained.
This diagnosis applies to about 50% of male infertility cases.
In some cases, however, knowing the exact cause may not be
necessary. The health care provider may begin treatment to
improve the chances of conception, including fertility
treatments, even if no cause can be identified.
Idiopathic or Unexplained Infertility Males
21. Getting pregnant and carrying a pregnancy to term are actually very
complicated processes.
Many things can go wrong during these processes to lead to infertility.
For this reason, the following list includes only some of the common
causes of infertility in females; it is not meant to be all-inclusive.
A woman who is having difficulty getting pregnant or carrying a
pregnancy to term should talk with her health care provider about
possible treatments.
INFERTILITY IN FEMALES
22. The most common overall cause of female infertility is the failure to ovulate,
which occurs in 40% of women with infertility issues.
Not ovulating can result from several causes, such as:
Ovarian or gynecological conditions; such as primary ovarian insufficiency
(POI) or polycystic ovary syndrome (PCOS)
Aging; including "diminished ovarian reserve," which refers to a low number of
eggs in a woman's ovaries due to normal aging
Endocrine disorders; such as thyroid disease or problems with the
hypothalamus, which affect the hormones produced by the body so that there
might be too much or too little of a hormone or group of hormones
Lifestyle and environmental factors
1) FAILURE TO OVULATE
23. Problems with the menstrual cycle, the process that prepares the female body for
pregnancy, can lead to infertility.
The menstrual cycle includes several phases, and problems at any one of the
stages can lead to difficulty getting pregnant or to infertility.
For most women, a normal menstrual cycle ranges from 21 to 35 days. However,
14% to 25% of women have irregular menstrual cycles, meaning the cycles are
shorter or longer than normal; are heavier or lighter than normal; or are
experienced with other problems, like abdominal cramps.
Irregular cycles can be ovulatory, meaning that ovulation occurs, or anovulatory,
meaning ovulation does not occur.
2) PROBLEMS WITH MENSTRUAL CYCLE
24. The most common menstrual irregularities include:
Amenorrhea (pronounced ey-men-uh-REE-uh) or absent menstrual periods:
When a woman does not get her period by age 16, or when she stops getting her
period for at least 3 months and is not pregnant.
Oligomenorrhea (pronounced ol-i-goh-men-uh-REE-uh) or infrequent
menstrual periods:
Periods that occur more than 35 days apart.
Menorrhagia (pronounced men-uh-REY-jee-uh) or heavy menstrual periods:
Also called excessive bleeding. Although anovulatory bleeding and menorrhagia
are sometimes grouped together, they do not have the same cause and require
different diagnostic testing.
PROBLEMS WITH MENSTRUAL CYCLE cont. 1
25. Prolonged menstrual bleeding: Bleeding that exceeds 8 days in duration on a
regular basis.
Dysmenorrhea (pronounced dis-men-uh-REE-uh): Painful periods that may
include severe menstrual cramps.
Additional menstrual irregularities include:
Polymenorrhea (pronounced pol-ee-men-uh-REE-uh): Frequent menstrual
periods occurring less than 21 days apart
• Irregular menstrual periods with a cycle-to-cycle variation of more than 20
days
• Shortened menstrual bleeding of less than 2 days in duration.
Intermenstrual bleeding: Episodes of bleeding that occur between periods, also
known as spotting
PROBLEMS WITH MENSTRUAL CYCLE cont. 2
26. Structural problems usually involve the presence of abnormal tissue in the fallopian tubes or
uterus.
If the fallopian tubes are blocked, eggs are not able to move from the ovaries to the uterus
and sperm is not able to reach the egg for fertilization.
3) STRUCTURAL PROBLEMS WITH REPRODUCTIVE SYSTEM.
Structural problems with the uterus, such as
those that may interfere with implantation, can
also cause infertility.
Some specific structural problems that can
cause infertility include:
Endometriosis; when tissue that normally
lines the inside of the uterus is found in other
places, such as blocking the fallopian tubes
27. Uterine fibroids;
growths that appear within and around the wall of the
uterus, although most women with fibroids do not
have problems with fertility and can get pregnant.
However, some women with fibroids may not be able
to get pregnant naturally or may have multiple
miscarriages or preterm labor.
Polyps, which are noncancerous growths on the
inside surface of the uterus. Polyps can interfere with
the function of the uterus and make it difficult for a
woman to remain pregnant after conception. Surgical
removal of the polyps can increase the chances for a
woman to get pregnant.
STRUCTURAL PROBLEMS WITH REPRODUCTIVE SYSTEM cont. 1
28. Scarring in the uterus from previous injuries,
infections, or surgery. Scarring may increase the risk
of miscarriage and may interfere with implantation,
thus leading to infertility.
An unusually shaped uterus, which can affect
implantation and the ability to carry a pregnancy to
term
STRUCTURAL PROBLEMS WITH REPRODUCTIVE SYSTEM cont. 2
29. Infections can also cause infertility in men and women.
Untreated gonorrhea and chlamydia in women can lead to pelvic inflammatory
disease, which might cause scarring that blocks the fallopian tubes.
Untreated syphilis increases the risk for a pregnant woman to have a stillbirth.
Chronic infections in the cervix and surgical treatment of cervical lesions
associated with human papillomavirus (HPV) infection can also reduce the
amount or quality of cervical mucus.
Problems with this sticky or slippery substance that collects on the cervix and in
the vagina can make it difficult for women to get pregnant.
4) INFECTIONS
30. Eggs may not mature properly for a variety of reasons, ranging from conditions
such as PCOS, to obesity, to a lack of specific proteins needed for the egg to
mature.
An immature egg may not be released at the correct time, may not make it down
the fallopian tubes, or may not be able to be fertilized.
5) FAILUTRE OF AN EGG TO MATURE
6) IMPLANTATION FAILURE
Refers to the failure of a fertilized egg to implant in the uterine wall to begin
pregnancy. While the specific cause of implantation failure are often unknown,
possibilities include:
• Genetic defects in the embryo
• Thin endometrium (pronounced en-doh-MEE-tree-uhm)
• Embryonic defects
• Endometriosis
• Progesterone resistance
• Scar tissue in the endometrial cavity
31. 7) POLYCYSTIC OVARIAN SYNDROME
PCOS is one of the most common causes of female
infertility.
It is a condition in which a woman's ovaries and, in
some cases, adrenal glands produce more androgens
(a type of hormone) than normal.
High levels of these hormones interfere with the
development of ovarian follicles and release of eggs
during ovulation. As a result, fluid-filled sacs, or
cysts, can develop within the ovaries.
Researchers estimate that 5% to 10% of women in
the United States have PCOS. The exact cause of
PCOS is unknown, but current research suggests
that a combination of genetic and environmental
factors leads to the disease.
32. 8) PRIMARY OVARIAN INSUFFICIENCY
POI is a condition in which a woman's ovaries stop producing hormones and eggs
at a young age.
Women with POI ovulate irregularly, if at all, and may have abnormal levels of
ovarian and pituitary hormones due to problems with their ovaries.
Women with POI often have trouble getting pregnant. However, pregnancy is still
possible, though rare. About 5% to 10% of women with POI get pregnant without
medical treatment
33. Uterine fibroids are noncancerous growths that form inside the uterus. Uterine fibroids can
cause symptoms in some cases, depending on their size and location. Scientists do not know
what causes fibroids to form, but it is believed that there may be a genetic basis.
Fibroids can contribute to infertility and are found in 5% to 10% of infertile women. Fibroids
located in the uterine cavity (as opposed to those that grow within the uterine wall) or those that
are larger than 6 centimeters in diameter are more likely to have a negative effect on fertility.
9) UTERINE FIBROID
34. Fibroids are more likely to affect a woman's fertility if they:
• Change the position of the cervix, which can reduce the number of sperm that enter the
uterus.
• Change the shape of the uterus, which can interfere with the movement of sperm or
implantation.
• Block the fallopian tubes, which prevents sperm from reaching the egg and keeps a fertilized
egg from moving to the uterus.
• Interfere with blood flow to the uterus, which can prevent the embryo from implanting
UTERINE FIBROID cont.
35. Autoimmune disorders cause the body's
immune system to attack normal body tissues it
would normally ignore.
Autoimmune disorders, such as
• lupus
• Hashimoto's and other types of thyroiditis,
or rheumatoid arthritis, may affect fertility.
The reasons for this are not fully understood
and differ between diseases, but they are
thought to involve inflammation in the uterus
and placenta or medications used to treat the
diseases. Both men and women can make
antibodies that attack sperm or the
reproductive organs
10) Autoimmune Disorders
37. Treatments for infertility can range from medications to
embryo implantation through assisted reproductive
technology (ART).
There are treatments that are specifically for men or for women
and some that involve both partners.
In 85% to 90% of cases, infertility is treated with
conventional medical therapies, such as medication or
surgery.
If fertility treatments are unsuccessful, it is possible to use eggs
or sperm donated by a third party or to have another woman
carry a fetus. Select a category of treatment to learn more.
INFERTILITY TREATMENT
38. Treatment with Medication
Medication can treat some issues that affect male fertility, including hormone imbalances and
erectile dysfunction.
• Clomiphene or Clomid
• Anastrazole or arimidex
• hCG (human chorionic gonadotropin) or hMG (human menopausal gonadotropin)
Most of these fertility drugs are taken by mouth except hCG and hMG, which are injections. As
with any medication, these drugs do have side effects
Treatment with Surgery
Surgery can be effective for repairing blockages in the tubes that transport sperm from the
testicles to the penis. Surgery also can be used for repair of varicocele, or varicose veins, in the
testicles. Current research suggests that surgical repair of varicocele can improve health of
sperm, but it has not affected the chances for conception.1
If surgery does not restore fertility, ART can be effective.
Fertility Treatments for Males
39. Once a woman is diagnosed with infertility, the overall likelihood for successful
treatment is 50%.
Whether a treatment is successful depends on:
• The underlying cause of the problem
• The woman's age
• Her history of previous pregnancies
• How long she has had infertility issues
• The presence or absence of male factor infertility
Fertility treatments are most likely to benefit women whose infertility is due to
problems with ovulation.
Treatment with medications is least likely to benefit infertility caused by damage
to the fallopian tubes or severe endometriosis, although in vitro fertilization can
help women with these conditions to conceive.
FERTILITY TREATMENTS FOR FEMALES
40. The most common medications used to treat infertility help
stimulate ovulation. Examples of these types of medications
include:
• Clomiphene or Clomiphene Citrate
• Letrozole
• Gonadotropins or Human Chorionic Gonadotropin (hCG)
• Bromocriptine or Cabergoline
MEDICATION TRTEATMENT FOR FEMALE INFERTILITY
41. • Clomiphene or Clomiphene Citrate
Clomiphene is a medication patients take by mouth (orally).
It causes the body to make more of the hormones that cause the
eggs to mature in the ovaries.
If a woman does not become pregnant after taking clomiphene
for six menstrual cycles, a health care provider may prescribe
other fertility treatments.
Patients take clomiphene in the beginning of the menstrual cycle.
Clomiphene causes ovulation to occur in 80% of women treated.
About half of those who ovulate are able to achieve a pregnancy
or live birth.
• Use of clomiphene increases the risk of having a multiple
pregnancy.
• There is a 10% chance of twins, but having triplets or more is
rare—less than 1% of cases.
42. • Letrozole
Letrozole is an oral pill that decreases the amount of estrogen a woman makes, stimulating
her ovaries to release eggs.
Patients take letrozole toward the end of their menstrual cycle for around 5 days.
A 2015 study by researchers in the NICHD Reproductive Medicine Network found that
about 19% of couples with unexplained infertility went on to have a live birth after using
letrozole for 4 months. This rate was slightly lower than the live birth rate for couples
using clomiphene (23%).
Other studies have found that letrozole may work better than clomiphene in women with
polycystic ovary syndrome.
43. Gonadotropins and Human Chorionic Gonadotropin (hCG)
Gonadotropins such as follicle-stimulating hormone (FSH) are hormones that are injected in a
woman to directly stimulate eggs to grow in the ovaries, leading to ovulation.
Health care providers normally prescribe gonadotropins when a woman does not respond to
clomiphene or to stimulate follicle growth for assisted reproductive technology (ART).
Gonadotropins are injected in the early part of the menstrual cycle for 7 to 12 days.
While a woman is treated with gonadotropins, a health care provider uses transvaginal
ultrasound to monitor the size of the developing eggs, which grow inside tiny sacs called
follicles. The health care providers also draw blood frequently to check the ovarian production
of estrogen.
The chance of a multiple birth is higher with gonadotropins than with clomiphene, and 30% of
women who conceive a pregnancy with this medication have multiple births.
About two-thirds of multiple births are twins. Triplets or larger multiple births account for the
remaining third.
hCG is a hormone similar to luteinizing hormone that can be used to trigger release of the
egg after the follicles have developed.
44. Bromocriptine or Cabergoline
Bromocriptine and cabergoline are pills taken orally to treat abnormally high levels of the
hormone prolactin, which can interfere with ovulation.
Pituitary growths; certain medications, including antidepressants; kidney disease; and thyroid
disease can cause high levels of prolactin.
Bromocriptine or cabergoline allow 90% of women to have normal prolactin levels.
Once prolactin levels become normal, 85% of women using bromocriptine or cabergoline
ovulate.
45. If disease of the fallopian tubes is the cause of infertility, surgery can be used to repair the
tubes or remove blockages in the tubes. Success rates of these types of surgery, however, are
low (approximately 20%, depending on the skill of the surgeon).
These surgeries involving the fallopian tubes also increase the risk of ectopic (pronounced
ek-TAH-pik) pregnancy, which is a pregnancy that occurs outside of the uterus.
Ectopic pregnancies are also called "tubal pregnancies," because they most often occur in a
fallopian tube”.
Surgery to remove patches of endometriosis has been found to double the chances for
pregnancy. Surgery can also be used to remove uterine fibroids, polyps, or scarring, which
can affect fertility.
SURGICAL TREATMENT FOR FEMALE INFERTILITY