The document discusses infertility, its causes and treatments. It defines infertility as failure to conceive after 12 months of unprotected sex. Infertility can be primary (never conceived) or secondary (unable to conceive again). Some key causes of male infertility include abnormal sperm production, problems with sperm delivery, environmental factors like smoking, and cancer treatments. Causes of female infertility include ovulation disorders, uterine abnormalities, fallopian tube damage, endometriosis, and early menopause. Treatments include medicines to induce ovulation, surgery to correct issues, and assisted conception methods like IUI and IVF. Social consequences of infertility include violence, marital instability, social isolation, feelings of exclusion and lack of social support.

1. Infertility
By Rashmi Luintel
National Open College
Pokhara University

2. Infertility
• Infertility means failure to achieve a
pregnancy after 12 months or more of
regular unprotected sexual intercourse.
• Infertility may be primary or secondary.
• If the conception has never occurred, it is
called primary.
• If the patient fails to conceive after having
produced a child or miscarriage, is called
secondary.

3. Infertility
• An estimated 1 in 10 women between the ages
of 15 and 44 have trouble conceiving.
• 25% of women with fertility issues have
irregular ovulation, while 12% do not have a
“normal” BMI.

4. Causes of male infertility
These may include:
Abnormal sperm production or function due to
• Genetic defects
• Health problems such as diabetes or infections such
as chlamydia, gonorrhea, mumps or HIV.
• Enlarged veins in the testes (varicocele) also can
affect the quality of sperm
• Undescended testicles

5. Causes of male infertility
Problems with the delivery of sperm due to
• Sexual problems, such as premature
ejaculation.
• Certain autoimmune diseases, such as cystic
fibrosis.
• Structural problems, such as a blockage in the
testicle.
• Damage or injury to the reproductive organs

6. Causes of male infertility
Overexposure to certain environmental factors:
can lead low or weak sperm count.
• Pesticides and other chemicals, and radiation.
• Cigarette smoking, alcohol, marijuana and taking
medications to treat bacterial infections,
• High blood pressure and depression also can affect
fertility.
• Frequent exposure to heat, such as in saunas or hot
tubs, can raise body temperature and may affect
sperm production.

7. Causes of male infertility
Low sperm count or low testosterone
(hypogonadism).
Damage related to cancer and its
treatment, including radiation or
chemotherapy. Treatment for cancer can impair
sperm production, sometimes severely.

8. Causes of female infertility
Causes of female infertility
may include:
Ovulation
disorders, which affect
the release of eggs from
the ovaries.
• These include hormonal
disorders such as
polycystic ovary
syndrome.

9. • Hyperprolactinemia; A condition in which
you have too much prolactin. The hormone
that stimulates breast milk production also may
interfere with ovulation.
• Either too much thyroid hormone
(hyperthyroidism) or too little
(hypothyroidism) can affect the menstrual
cycle or cause infertility.

10. Causes of female infertility
Uterine or cervical abnormalities, including
• Abnormalities with the cervix e,g: cysts, and
cervical polyps.
• Polyps in the uterus or the shape of the uterus.
• Tumors in the uterine wall (uterine fibroids)
may cause infertility by blocking the fallopian
tubes or stopping a fertilized egg from
implanting in the uterus.

11. Causes of female infertility
Fallopian tube damage or blockage, often
caused by
• Inflammation of the fallopian tube
(salpingitis).
• Past ectopic (tubal) pregnancy.

12. Causes of female
infertility
Endometriosis, which
occurs when
endometrial tissue
grows outside of the
uterus, may affect the
function of the ovaries,
uterus and fallopian
tubes.

13. Causes of female infertility
Primary ovarian insufficiency (early
menopause), when the ovaries stop working
and menstruation ends before age 40.
Cancer and its treatment. Certain cancers
particularly reproductive cancers often impair
female fertility. Both radiation and
chemotherapy may affect fertility.

14. Treatment of infertility
• There are 3 main types of fertility treatment:
• Medicines
• Surgical procedures
• Assisted conception – including Intra- Uterine
Insemination (IUI) and In Vitro Fertilization
(IVF).

15. Medicines
• Clomifene/Tamoxifen: Encourages the monthly
release of an egg (ovulation) in women who do
not ovulate regularly or cannot ovulate at all.
• Metformin: Is particularly beneficial for women
who have polycystic ovary syndrome (PCOS)
• Gonadotrophins: Can help stimulate ovulation
in women, and may also improve fertility in men
• Gonadotrophin releasing hormone and dopamine
agonists, or other types of medicine prescribed to
encourage ovulation in women

16. Surgical procedures
• Fallopian tube surgery
• Surgery of Endometriosis, fibroids
• Correcting an epididymal blockage by
surgery.

17. Assisted conception
• Intrauterine insemination (IUI)
• Intrauterine insemination (IUI), also known as
artificial insemination, involves inserting sperm
into the womb via a thin plastic tube passed
through the cervix.
• Sperm is first collected and washed in a fluid.
The best quality specimens (the fastest moving)
are selected.

19. In vitro fertilisation (IVF)
• In vitro fertilization (IVF), is when an egg is
fertilized outside the body. Fertility medicine is
taken to encourage the ovaries to produce more
eggs than usual.
• Eggs are removed from the ovaries and fertilized
with sperm in a laboratory. A fertilized egg
(embryo) is then returned to the womb to grow
and develop in 3 to 5 days.

21. Egg and sperm donation
• If you or your partner has an infertility
problem, you may be able to receive eggs or
sperm from a donor to help you conceive.
Treatment with donor eggs is usually done
using IVF.

22. Social consequences of infertility

23. Social consequences of infertility
1. Violence
• Psychological violence and domestic physical
violence
• The psychological violence, is usually experienced
as the form of stigma.
• Most infertile people who had experienced stigma
felt loss of dignity and social status by the spouse,
family members and community.
• Domestic physical violence include beating,
slapping etc.

24. Social consequences of infertility
2. Marital instability or uncertainty
• Possibility of divorce among the infertile couples
• High social pressure for remarriage of husband by the
relatives
3. Social isolation
• Avoiding social interactions with family, friends,
relatives and attending certain social events such as
children birthday parties etc.
• Most of the infertile women chose social isolation to
avoid dealing with socio-psychological stress of
infertility as a coping mechanism.

25. Social consequences of infertility
4. Feeling of social exclusion and relative deprivation
• Infertile woman are ignored by family and relatives
specially at the time of arrival of new baby to family
or presence of a newly pregnant woman at family
gathering.
• Reducing social interactions by the family members
and the friends creates a feeling of relative
deprivation and social exclusion for the infertile
women.

26. Social consequences of infertility
5. Lack of social support
• People with no children receive less social support.
• Childless women face discrimination, ostracism and
stigma if they fail to become pregnant or carry a baby
to term. social isolation including avoiding certain
people or certain social events

27. 6.Social exclusion and partial deprivation
including being disregarded by family members
and relatives and reducing social interactions
with the infertile woman and