Infertility is defined as the inability to conceive after one year of regular unprotected sex. It can be primary infertility, where a woman has never conceived, or secondary infertility where conception was previously possible but no longer is. Causes of infertility in men include low sperm count or mobility, while causes in women include ovulation disorders, infections, or structural issues. In vitro fertilization (IVF) is a process where eggs are fertilized by sperm outside the body in a laboratory and then implanted in the uterus, if fertilization is successful. IVF was first used successfully in 1978 and has since helped many couples conceive who were otherwise unable to do so naturally.

1. INFERILITY
&
INVETRO FERTILIATION
PRESENTER
LEKHNATH YADAV
MANISHA SAPKOTA
BPH 3RD SEMESER
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2. INRODUCTION
Infertility:-
• Infertility happens when a couple cannot conceive after having
regular unprotected sex.
• 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).
• An inability of those of reproductive age (15-49 years) to become
or remain pregnant within five years of exposure to pregnancy.
(DHS2) 2

3. Types
•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.
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4. •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.
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5. CAUSES IN MALE:
1. Low sperm count, Abnormal sperm,
2. Low sperm mobility (motility)
3. Excess alcohol consumption
4. Ejaculation disorders
5. Genetic factors
6. Chemotherapy
7. Exposure to chemicals: Pesticides,
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8. CAUSES IN WOMEN
Ovulation disorders :-Premature ovarian failure, Polycystic ovary syndrome
Thyroid problems
Age: The ability to conceive starts to fall around the age of 32 year
Problems in the Menstrual Cycle.
Structural Problems of the Reproductive System.
Infections.
Implantation Failure.
Endometriosis.
Chronic conditions: These include AIDS or cancer
Mental stress
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12. SUBFERTILITY
• Subfertility is a defined as a situation where a couple is less fertile
compared to a normal couple. It does not mean that there is no
chance of getting pregnant. It tells that there is a difficulty in
becoming pregnant compared to others. Pregnancy may take a
longer time when a couple is sub fertile.
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13. RISK FACTORS OF SUBFERTILITY
FOR MALE AND FEMALE :
Being a female over the age of 35
Being a male over the age of 40
Being overweight or underweight
Smoking tobacco
Excessive alcohol use
Excessive physical or emotional stress
Exposure to radiation
Certain medications
Exposure to environmental toxins, such as lead and pesticides
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15. IN-VITRO FERTILISATION(IVF)
In-vitro Fertilisation, a process in which egg cells are fertilized
by sperm outside the womb. This process involves hormonally
controlling the ovulatory process, removing ova (eggs) from the
woman’s ovaries and allowing sperms to fertilize them in a
fluid medium. The resulting fertilized egg is placed in the
woman’s uterus for further development of the fetus.
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16. BACKGROUND OF IVF
The world’s first IVF pregnancy was reported in 1973 by a team
of doctors researching at Monash University in Melbourne.
the world’s first live IVF birth, of baby Louise Brown, in
England, 1978.
Om Mani Tamang, Nepal’s first test-tube baby, March 3, 2005.
Dr. Sushil Koirala, director of National Dental Hospital, was the
first father to have twin test-tube babies on April 3, 2005, in the
country’s history.
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18. • Fertility Centre Nepal have done more
than 7500 art cycles with a success
rate of over 80%.
• Exceptional results in egg donor IVF
having a success rate of over 85 %.
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20. INDICATION FOR IVF
1. Anovulatory infertility
2. Female tubal damage or obstruction
3. Male infertility
4. Endometriosis
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21. EFFECT OF IVF
I. Multiple pregnancy.
II. Low birth weight.
III.High risk of perinatal and neonatal death.
IV.Congenital abnormality.
V. Growth retardation.
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22.  IMPACT OF IVF IN FAMILY
Emotional effects
Mental stress
Money problem
Psychological effect
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23. Any Q
Any Suggestions
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25. REFERENCE
• https://www.who.int/reproductivehealth/topics/infertility
• Determinants of Infertility in Couples J Nepal Health Research Council 2019.
• Medically reviewed by Valinda Riggins Nwadike, MD, MPH on May 13,
2019 — Written by Adrienne Santos-Longhurst
• https://healthengine.com.au/info/in-vitro-fertilisation-ivf.
• www.medicalnewstoday.com/
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