3. introduction
• Infertility:- is the inability to produce
offspring .
To carry pregnancy .
To conceive child by natural process.
Immature reproductive system (R .S)
Defective R.S.
Endocrine disorder .
4. Infertility type
• Primary infertility
–a couple that has never conceived.
• Secondary infertility
–infertility that occurs after previous
pregnancy regardless of outcome.
–now is unable to conceive.
5. Common causes for infertility
• male
– Drugs
– Tobacco
– Health problems
– Radiation/Chemother
apy
– Age
– Over exersise
– Enviromental factors
• Pesticides
• Lead
• Female
– Age
– Stress
– Poor diet
– Athletic training
– Over/underweight
– Tobacco
– Health problems
– Enviromental factors
• Pesticides
• Lead
alcoholic drink
Genetic disorders.
7. Other disorders.
1. Pelvic inflammatory disease
(PID)
2. Ovarian dysfunction
3. Hypothalamic disorder
4. Disorder of pituitary gland
8. 5.Local factors in the uterus and cervix
may interfere with implantation and
woman’s ability to carry pregnancy to term
6.Luteal phase defect
results in low production of progesterone
may lead to early miscarriage
7.Production of anti-sperm antibodies
can interfere with fertilization
Shows spermicidal activity
9. Causes male infertility
1. Abnormal sperm:-
2. Decreased sperm count
3. Obstruction of reproductive system
Other causes :-
1. Cryptorchidism
2. Trauma
3. Mumps
4. Alcoholism and drugs consumption
5. Hypothalamic and pituitary disorder .
11. Inadequate Spermatogenesis
• Eliminate alterations of thermoregulation
• Clomiphene citrate is occasionally used
for induction of spermatogenesis
–20% success
• In vitro fertilization may facilitate
fertilization
• Artificial insemination with donor sperm
is often successful
12. Anovulation
• Restore ovulation
– Administer ovulation inducing agents
• Clomiphene citrate
– Antiestrogen
– Combines and blocks estrogen receptors at the
hypothalamus and pituitary causing a negative
feedback
– Increases FSH production
• stimulates the ovary to make follicles
14. Treatment of Female Infertility:
Ovulation Induction Agents
induces release of gonadotropins
Gonadotropins
Clomiphene citrate
Gonadotropin
releasing
hormone analogs
similar in structure to natural GnRH,
provoke a massive release of GnRH
into the circulation
human menopausal gonadotropin
(HMG), which contains equal
quantities of FSH and LH
Bromocriptine suppresses production of prolactin
15. Treatment of Female Infertility:
Intrauterine Insemination
A fertility procedure in which sperm are washed,
concentrated and injected directly into a woman’s
uterus.
Increases the number of sperm in the fallopian
tubes
It fail when tubal blockage, poor egg quality,
ovarian failure and severe male factor infertility
16. Treatment of Female Infertility:
Assisted Reproductive Technology (ART)
Noncoital methods of conception
Includes all fertility treatments in which both eggs
and sperm are manipulated
Types of ART include:
In Vitro Fertilization (IVF)
Zygote Intrafallopian Transfer (ZIFT)
Gamete Intrafallopian Transfer (GIFT)
17. ART: In Vitro Fertilization
Involves retrieving eggs and sperm from female
and male partners and placing them in a lab dish
to enhance fertilization
Fertilized eggs are transferred several days later
into the uterus
Ovarian stimulation drugs are used prior to
procedure in order to retrieve several eggs and
maximize chances for successful fertilization
Success rates are about 20% per egg retrieval
18. Basic Steps in IVF
•Ovary stimulation
•Egg retrieval
•Sperm retrieval-wash
sperm
•Fertilization
•Embryo transfer
•Progesterone
19. ART: Gamete Intrafallopian
Transfer (GIFT)
GIFT is a procedure that involves:
ovarian stimulation
retrieval of eggs
placing a mixture of sperm and eggs directly into the
woman’s fallopian tube
GIFT does not allow visual confirmation of
fertilization
Success rates per egg retrieval are about 28%
(higher than for IVF)
20. ART: Zygote Intrafallopian
Transfer (ZIFT)
ZIFT, also called tubal embryo transfer, is another
variation of IVF
As with IVF, the actual fertilization takes place in a
lab dish
Fertilized eggs are placed directly into a fallopian
tube
Success rate is about 29% per egg retrieval
21.
22. Risks of ART?
• To woman
–Overstimulation of ovary syndrome
–Multiple pregnancies
–Risk of ovarian cancer (clomid,
pergonal)
• To baby
-ICSI associated with problems (XYY)
23. Treatment Possibilities: Male Infertility
Surgical treatment in some cases (varicocele)
Intrauterine insemination can be performed either
with patient’s or donor’s sperm
ART procedures:
GIFT
IVF
ICSI
Donor semen should be free from STDs/HIV
24. ART: Intracytoplasmic Sperm Injection (ICSI)
Involves injection of single sperm into the egg
The woman is administered fertility drugs prior to
the procedure to aid in the production of multiple
eggs
Only active undamaged sperm are selected for
injections
25. ART: Intracytoplasmic Sperm Injection (ICSI)
(Continued)
Eggs are observed to see if fertilization takes place
average fertilization rate is 65%
Implantation into the uterus takes place within 72
hours after ICSI
Success rates range from 15% to 35% per egg
retrieval
27. Refrencess
• Medical physiology dr. N V Mishra
https://avirupguha.files.wordpress.com/2009/0
5/infertility1.html
http://www.hfea.gov.uk/infertility.html