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INFERTILITYINFERTILITY
Requirements for conception
• Production of healthy egg and
sperm
• Unblocked tubes that allow
sperm to reach the egg
• The sperms ability to
penetrate and fertilize the egg
• Implantation of the embryo
into the uterus
• Finally a healthy pregnancy
Infertility is the inability to conceive a child. A couple may be
considered infertile if, after two years of regular sexual
intercourse, without contraception, the woman has not become
pregnant (and there is no other reason, such as breastfeeding or
postpartum amenorrhea).
- WHO
Types of infertility
• Primary Infertility: Woman has never
been pregnant despite frequent,
unprotected sexual intercourse
• Secondary infertility: Woman has had at
least one pregnancy but has failed to
conceive subsequently despite frequent,
unprotected sexual intercourse
Incidence of Infertility
• Affects both men and women
• Affects approximately 15% of all couples
• WHO study found:
– Female causes 25-37%
– Male causes 8-22%
– Both male & female 21-38%
– No identified cause 5-15%
Risk factors
Male
• ETOH
• Drugs
• Tobacco
• Health problems
• Radiation/Chemotherapy
• Age
• Enviromental factors
– Pesticides
– Lead
Female
• Age
• Stress
• Poor diet
• Athletic training
• Over/underweight
• Tobacco
• ETOH
• STD’s
• Health problems
Major Female Factors
• Tube problems
• Ovulation disorders
– Anovulation (PCOD)
• Problems in second half of
Cycle
• Pituitary Gland Problems
• Pelvic problems and
endometriosis
• Problems of the cervix
Major Male Factors
• Varicocele
• Ejaculatory problems
• Pituitary problems
• Genito-urinary tract infections
• Hormonal problems
Investigations - Female
• History
• Physical examination
• Post-coital test
• X-rays of the tubes
• Looking into the uterus
• Biopsy of the lining of the uterus
• Measuring progesterone levels
Investigations - Males
• Semen analysis
• Urological examination to look for:
– anatomical abnormalities
– Infections
– endocrine disorders
– varicocele
Impact of Infertility
Psychological reaction:
• Frustration
• feeling less of a man/woman
• feeling of loss
• decreased self-esteem, self-
confidence
• guilt or apportioning blame
disappointment
Emotional Responses
• Guilt
• Depression
• Anger
• Isolation
Impact on Relationships
• Questioning of the meaning of the relationship
• Fear that the relationship will not survive
– Approximately 68% of women threatened with divorce
• Conflict - study found:
– Approximately 10% of women abused by husband
– Approximately 16% abused by in laws
• Onset of sexual dysfunctions
Treatment
• Hormonal therapy for stimulation
• Abstinence or condom use if hostile cervical
mucus
• Surgery to correct abnormalities
• Assisted Reproductive Technologies
(ARTs)
Assisted Reproductive Technologies
• Drugs ( clomiphene citrate)
•In vitro fertilization (IVF)
•Intrauterine
insemination (IUI)
•Gamete intrafallopian
transfer (GIFT)
•Zygote intrafallopian transfer
(ZIFT)
•Intracytoplasmic sperm injection
(ICSI)
THANK YOUTHANK YOU

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Infertility

  • 2. Requirements for conception • Production of healthy egg and sperm • Unblocked tubes that allow sperm to reach the egg • The sperms ability to penetrate and fertilize the egg • Implantation of the embryo into the uterus • Finally a healthy pregnancy
  • 3. Infertility is the inability to conceive a child. A couple may be considered infertile if, after two years of regular sexual intercourse, without contraception, the woman has not become pregnant (and there is no other reason, such as breastfeeding or postpartum amenorrhea). - WHO
  • 4. Types of infertility • Primary Infertility: Woman has never been pregnant despite frequent, unprotected sexual intercourse • Secondary infertility: Woman has had at least one pregnancy but has failed to conceive subsequently despite frequent, unprotected sexual intercourse
  • 5. Incidence of Infertility • Affects both men and women • Affects approximately 15% of all couples • WHO study found: – Female causes 25-37% – Male causes 8-22% – Both male & female 21-38% – No identified cause 5-15%
  • 6. Risk factors Male • ETOH • Drugs • Tobacco • Health problems • Radiation/Chemotherapy • Age • Enviromental factors – Pesticides – Lead Female • Age • Stress • Poor diet • Athletic training • Over/underweight • Tobacco • ETOH • STD’s • Health problems
  • 7.
  • 8. Major Female Factors • Tube problems • Ovulation disorders – Anovulation (PCOD) • Problems in second half of Cycle • Pituitary Gland Problems • Pelvic problems and endometriosis • Problems of the cervix
  • 9.
  • 10. Major Male Factors • Varicocele • Ejaculatory problems • Pituitary problems • Genito-urinary tract infections • Hormonal problems
  • 11. Investigations - Female • History • Physical examination • Post-coital test • X-rays of the tubes • Looking into the uterus • Biopsy of the lining of the uterus • Measuring progesterone levels
  • 12. Investigations - Males • Semen analysis • Urological examination to look for: – anatomical abnormalities – Infections – endocrine disorders – varicocele
  • 13. Impact of Infertility Psychological reaction: • Frustration • feeling less of a man/woman • feeling of loss • decreased self-esteem, self- confidence • guilt or apportioning blame disappointment
  • 14. Emotional Responses • Guilt • Depression • Anger • Isolation
  • 15. Impact on Relationships • Questioning of the meaning of the relationship • Fear that the relationship will not survive – Approximately 68% of women threatened with divorce • Conflict - study found: – Approximately 10% of women abused by husband – Approximately 16% abused by in laws • Onset of sexual dysfunctions
  • 16. Treatment • Hormonal therapy for stimulation • Abstinence or condom use if hostile cervical mucus • Surgery to correct abnormalities • Assisted Reproductive Technologies (ARTs)
  • 17. Assisted Reproductive Technologies • Drugs ( clomiphene citrate) •In vitro fertilization (IVF) •Intrauterine insemination (IUI)
  • 18. •Gamete intrafallopian transfer (GIFT) •Zygote intrafallopian transfer (ZIFT) •Intracytoplasmic sperm injection (ICSI)

Editor's Notes

  1. Endometriosis is a gynecological medical condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the ovaries
  2. Varicocele is an abnormal enlargement of the vein that is in the scrotum draining the testicles.
  3. Drugs to stimulate ovulation Intrauterine insemination (IUI) where prepared sperm placed inside uterus In vitro fertilization (IVF) where eggs are extracted, fertilized in a laboratory and the embryo transferred to the uterus Gamete intrafallopian transfer (GIFT) where unfertilized eggs and sperm are placed in the fallopian tubes Zygote intrafallopian transfer (ZIFT) where eggs are fertilized in the laboratory and the fertilized eggs (zygote) placed in the fallopian tubes Intracytoplasmic sperm injection (ICSI) used for male infertility where a sperm is injected directly into an egg and then the embryo is transferred to the uterus
  4. Sorting sperm to select only those that will produce girls and do not carry x-linked chromosomal diseases Pre-implantation diagnosis allows DNA testing of embryonic cells to confirm that only healthy embryos are transferred to avoid genetic diseases