infertility

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anaplJ

Computer Science

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I need a word document on infertility

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Attached.

INFERTILITY
Specific learning Outcomes
• List causes of infertility
• Document the psychosocial effects of infertility
• State the necessary investigations
1

• Describe the various modes of treatment
• Enumerate options to the couple

Definitions
Infertility – Inability of a couple to conceive in 1year (sub-fertility)
Sterility – Intrinsic inability to achieve pregnancy
Fecundity – Probability of achieving a life birth in one menstrual cycle
Fecundability – likely- hood of conception per month of exposure

Epidemiology
• Prevalence 13% (range between 7- 28%)
• Normal fertile couples with frequent intercourse, fecundability (20 – 25%)
• Approx. 90% of couples with unprotected sex will have a pregnancy within a year
• Sterility affects 1 – 2% of couples

2

Aetiology
▪ In 80% of cases found
▪ In 15 – 20% cause not found
▪ Male factor alone causes about 25%.

Causes of Infertility
Male
Endocrine disorders
Hypothalamic dysfunction
Hyperprolactinaemia (drug, tumour)
Pituitary failure (tumour, radiation, surgery)
Exogenous androgens
Thyroid disorders
Adrenal hyperplasia

3

Anatomic disorders
Congenital absence of vas deferens
Congenital abnormalities of ejaculatory system
Obstruction of vas deferens

Abnormal spermatogenesis
Chromosomal abnormalities e.g., Klinefelter’s syndrome
Mumps orchitis
Cryptorchidism
Chemical or radiation exposure

Abnormal motility
Absent cilia
Antibody formation
Varicocoele

4

Sexual dysfunction
Retrograde ejaculation (removal of prostate)
Decreased libido
Impotence
Premature ejaculation
Penile abnormalities e.g. hypospadias or phimosis

Female
A. Ovulatory Factor
Central defects
Chronic hyperandrogeneamic anovulation
Hyperprolactinemia (drug, tumor, empty sella turcica)
Hypothalamic insufficiency
Pituitary insufficiency (trauma, tumor, congenital)

5

Peripheral defects
Gonadal dysgenesis e.g Turner syndrome
Premature Ovarian failure
Ovarian tumor
Ovarian resistance
Thyroid disease
Androgen excess, (adrenal or neoplastic)

B. Pelvic Factor
Infection
Appendicitis
Uterine adhesions (Asherman’s syndrome)
Endometriosis
Pelvic inflammatory disease

Structural abnormalities
Diethylstilbestrol (DES) exposure
6

Myoma
Failure of normal fusion of the reproductive tract

C.Cervical Factor
Congenital
Mullerian duct abnormality
Acquired
Surgical treatment
Infection

Psychological Aspects of infertility
• Diagnosis affect self-image, sexuality and relationships
• Includes high hopes, denial, anger grief and resolutions.
• Appropriate support crucial

Diagnosis
• Since causes are many the tests should be case spec...


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