Infertility
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Infertility is defined when a couple not being able to get pregnant after at least 1 year of unprotected sex (using no birth control methods) .Infertility affects about 10% of people in the reproductive age. Men and women both affects equally.
What causes the Infertility ?
There are different causes of infertility in men and female.
Infertility in female is due to following reasons:
1. Unable to survive fertilized egg or embryo in the uterus
2. Unable to move eggs from the ovary.
3. Unable to produced eggs
Infertility in men is due to following reasons : .
- Low sperm count
- Decreased movement of sperm
Causes of infertility in female includes :
- Polycystic ovary syndrome(POCS)
- Ovarian cysts
- Myomas or fibroid
- Polyps
- Antiphospholipid syndrome
- Anorexia nervosa( an eating disorder consisting of loss of appetite due to and emotional states such as anxiety,irritation , anger or fear. In anorexia nervosa there is no real loss of appetite, but rather a refusal to eat or an aberration in eating patterns, so that the term anorexia may be misnomer)
- Obesity
- Stress, depression
- Excessive exercise
- Dyspareunia
- Turners syndrome
- Defects of the uterus and cervix
- Endometriosis
- Pelvic inflammatory disease
- Adrenal hormone deficiency
- Thyroid hormone deficiency
- Prolactinoma
- Autoimmune disease
- Scar tissue after surgery
- Diabetes
- Hypertension
- Urinary tract infection
- Smoking, heroin, cocaine and heavy alcohol consumption
- Antibiotics , Antidepressants , acetaminophen , estrogen supplement
- Chemotherapy
- Radiation
- Premature menopause
Causes of infertility in male includes :
- Genetic abnormalities
- Erectile dysfunction
- Dyspareunia
- Impotence
- Retrograde ejaculation
- No sperm
- Anti-sperm antibodies
- Cystic fibrosis
- Varicocele
- Undescended testis
- Deficiency of testosterone
- Klinefelter,s syndrome
- Sexually transmitted disease includes chlamydia and gonorrhea.
- Exposure to radiation and chemical
- Smoking, heroin, cocaine and heavy alcohol consumption
- Chemotherapy
- Post operation scar
- Hypothyroidism
- Diabetes
- Hypertension
- Urinary tract infection
- Spinal cord injuries
- Drugs such as cimetidine, nitrofurantion, spironolactone
What are the signs and symptoms of infertility ?
Main signs and symptoms of infertility is the inability for a couple to get pregnant after at least 1 year of unprotected sex (using no birth control methods).
How is a infertility diagnosed ?
Diagnosis relies on clinical findings ,laboratory tests and radiological imaging.
Laboratory tests includes :
- Serum progesterone analysis
- Thyroid function tests
- Luteinizing hormone test
- Testosterone level
- FSH and LH level
- Estrogen level
- Genetic testing
- Blood glucose analysis
- Complete blood test
Radiological imaging includes:
- Hysterosalpingography
- Pelvic ultrasound
- Scrotal ultrasound
- Pelvic CT scan
- Laparoscopy
How is a infertility managed?
Management of infertility depends upon causes , duration of infertility and age of the women.
Treatment of infertility in women :
- Drugs used for those who have ovulation disorders includes clomiphene, hMG( human menopausal gonadotropin , FSH( follicle-stimulation hormone), HCG(Human chorionic gonadotropin hormone), Gn-RH ( Gonadotropin-releasing hormone), metformin, Bromocriptine.
- Treatment of STD s
- Treatment of diabetes, hypertension, hypothyroidism.
- Surgical management of tumors, Myomas , fibroid and Polyps
- Assisted reproductive technology (ART is the procedure that involves manipulation of eggs or sperm to establish pregnancy) is indicated when women has a healthy uterus but medical treatment fails to achieve a pregnancy. ART includes IVF( in vitro fertilization, surgical sperm aspiration , ICSI( intracytoplasmic sperm injection), ZIFT( zygote intrafallopian transfer).
Treamtment of infertility in men :
- Treatment of impotence
- Treatment of STD s
- Treatment of diabetes, hypertension and hypothyroidism
- Surgical management of undescended testis, Varicocele .
- ART
What is the prognosis of infertility?
About 60 % of couple become pregnant after appropriate treatments( exclude ART techniques) . Couple who are candidate of ART success rate is up to 27%.
References:
- http://www.emedicinehealth.com
- http://en.wikipedia.org
- http://www.mayoclinic.com
- http://www.medicinenet.com
- http://www.ncbi.nlm.nih.gov
- http://www.ehealthmd.com
- http://www.umm.edu
- http://www.fertilitycommunity.com
- http://www.cdc.gov
Filed Under: Female Health
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