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See also: Female infertility and Male infertility
Infertility
Classification and external resources
ICD-10 N46., N97.0
ICD-9 606, 628
DiseasesDB 21627
MedlinePlus 001191
eMedicine med/3535  med/1167
MeSH D007246

Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. Female infertility is a term that refers to Infertility in female humans Male infertility is a term that refers to Infertility in male humans The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings N00-N39 - Diseases of the Genitourinary system: urinary system (N00-N08 Glomerular diseases Prefixes. N00-N39 - Diseases of the Genitourinary system: urinary system (N00-N08 Glomerular diseases Prefixes. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books A man is a Male Human. The term man (irregular plural For soil improvement see Fertilization (soil. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. Pregnancy ( Latin graviditas) is the carrying of one or more offspring known as a Fetus or Embryo, inside the Uterus of a Female Pregnancy ( Latin graviditas) is the carrying of one or more offspring known as a Fetus or Embryo, inside the Uterus of a Female There are many biological causes of infertility, some which may be bypassed with medical intervention. [1]

Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile during the rest of the menstrual cycle. Fertility is the natural capability of giving life As a measure "Fertility Rate" is the number of children born per couple person or population Note This article deals primarily with Human ovulation nonhuman Animal ovulation is touched on briefly at the conclusion The menstrual cycle is a recurring cycle of physiologic changes that occurs in reproductive-age Females Overt menstruation (where there is blood flow from the Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature. Fertility awareness (FA refers to a set of practices used to determine the fertile and infertile phases of a woman's Menstrual cycle. Basal body temperature is the body temperature measured immediately after awakening and before any physical activity has been undertaken

Contents

Definition

There are strict definitions of infertility used by many doctors. However, there are also similar terms, e. g. subfertility for a more benign condition and fecundity for the natural improbability to conceive.

Infertility

Reproductive endocrinologists, the doctors specializing in infertility, consider a couple to be infertile if:

Subfertility

A couple that has tried unsuccessfully to have a child for a year or more is said to be subfertile. CHILD syndrome (or congenital hemidysplasia with ichthyosiform erythroderma and limb defects) is a genetic disorder A year (from Old English gēr) is the time between two recurrences of an event related to the Orbit of the Earth around the Sun The couple's fecundability rate is approximately 3-5%. Many of its causes are the same as those of infertility. Such causes could be endometriosis, or polycystic ovarian syndrome.

Primary vs. secondary infertility

Couples with primary infertility have never been able to conceive,[2] while, on the other hand, secondary infertility is difficulty conceiving after already having conceived and carried a normal pregnancy. Technically, secondary infertility is not present if there has been a change of partners.

Some women are infertile because their ovaries do not mature and release eggs. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries.

Prevalence


Causes

This section deals with unintentional causes of sterility. For more information about surgical techniques for preventing procreation, see sterilization. Sterilization (also spelled sterilisation) is a surgical technique leaving a male or female unable to reproduce.

Causes in either sex

For a woman to conceive, certain things have to happen: intercourse must take place around the time when an egg is released from your ovary; the systems that produce eggs and sperm have to be working at optimum levels; and your hormones must be balanced. [8]

There are several possible reasons why it may not be happening naturally. In a third of cases, it can be because of male problems such as low sperm count.

Problems affecting women include endometriosis or damage to the fallopian tubes (which may have been ccaused by infections such as chlamydia).

Other factors that can affect your chances of conceiving including being over- or underweight or your age - female fertility declines sharply after the age of 35. Sometimes it can be a combination of factors, and sometimes a clear cause is never established.


Factors that can cause male as well as female infertility are:

Combined infertility

In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these conditions. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc The thyroid is one of the largest Endocrine glands in the body In Mammals the adrenal glands (also known as suprarenal glands) are the triangle-shaped Endocrine glands that sit on top of the Kidneys their Kallmann syndrome is an example of Hypogonadism (decreased functioning of the sex hormone-producing glands caused by a deficiency of Gonadotropin-releasing hormone Hyperprolactinaemia ( BrE) or hyperprolactinemia ( AmE) is the presence of abnormally-high levels of Prolactin in the blood Hypopituitarism is the decreased ( hypo) secretion of one or more of the eight Hormones normally produced by the Pituitary gland at the base of the Brain In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.

Unexplained infertility

In about 15% of cases the infertility investigation will show no abnormalities. In these cases abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization.

Assessment

If both partners are both young and healthy, and have been trying for a baby for 18 months to two years without success, a visit to the family doctor could help to highlight potential medical problems earlier rather than later. He or she may also be able to suggest lifestyle changes you can make to increase your chances of conceiving. [9]

Women over the age of 35 should see their family doctor after six months as fertility tests can take some time to complete, and your age may affect the treatment options that are open in that case.

A family doctor will take amedical history and give you a physical examination. They can also carry out some basic tests on on both partners to see if there is an identifiable reason for having achieved a pregnancy yet. If necessary, they can refer you to a fertility clinic or your local hospital for more specialist tests. The results of these tests will help determine which is the best fertility treatment for you and your partner.


Treatment

Main article: Assisted reproductive technology

Treatment of infertility usually starts with medication. Assisted reproductive technology ( ART) is a general term referring to methods used to achieve Pregnancy by artificial or partially artificial means In vitro fertilization (IVF) in addition to various forms and developments of it (ICSI, ZIFT, GIFT) is another solution. In vitro fertilisation ( IVF) is a process by which They all include that the fertilization takes place outside the body. On the other hand, an insemination can make a fertilization inside the body. Other techniques are e. g. tuboplasty, assisted hatching and PGD.

Ethics

There are several ethical issues associated with infertility and its treatment.


Many countries have special frameworks for dealing with the ethical and social issues around fertility treatment.

Psychological impact

Infertility may have profound psychological effects. Partners may become more anxious to conceive, ironically increasing sexual dysfunction. Sexual dysfunction or sexual malfunction (see also Sexual function) is difficulty during any stage of the Sexual act (which includes desire, Marital discord often develops in infertile couples, especially when they are under pressure to make medical decisions. Women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer[13]. Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Even couples undertaking IVF face considerable stress. [14]

Social impact

In many cultures, inability to conceive bears a stigma. In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way [15].

There are legal ramifications as well. Infertility has begun to gain more exposure to legal domains. An estimated 4 million workers in the U. S. used the Family and Medical Leave Act (FMLA) in 2004 to care for a child, parent or spouse, or because of their own personal illness. Parental leaveThe Family and Medical Leave Act of 1993 ( enacted February 5, 1993) is a United States Labor law allowing an employee to take "MMIV" redirects here For the Modest Mouse album see " Baron von Bullshit Rides Again " Many treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for FMLA leave.

See also

References

  1. ^ Makar RS, Toth TL (2002). Reproduction and pregnancy are common themes in Science fiction, as well as Utopian and Dystopian works Advanced maternal age is defined as an increase in the age at which women give birth to their first child is now a widespread and indeed near universal phenomenon across the "The evaluation of infertility". Am. J. Clin. Pathol. 117 Suppl: S95–103. PMID 14569805.  
  2. ^ MedlinePlus Medical Encyclopedia: Infertility. Retrieved on 2007-11-21. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 164 BC - Judas Maccabaeus, son of Mattathias of the Hasmonean family restores the Temple in Jerusalem.
  3. ^ http://www.nice.org.uk/guidance/index.jsp?action=download&o=29271 NICE fertility guidance
  4. ^ http://www.nice.org.uk/guidance/index.jsp?action=download&o=29271 NICE fertility guidance
  5. ^ http://www.hfea.gov.uk/en/1215.html#Reasons_for_infertility HFEA Chart on reasons for infertility
  6. ^ Core clinical cases in Obs and Gynae, 2nd edition, Page 152, published by Hodder Arnold 2006
  7. ^ [http://sahlgrenska.se/upload/SU/omrade_oss/reproduktionsmedicin/Spermadonatorinformation.pdf Sahlgrenska University Hospital. (translated from the Swedish sentence: "Cirka 10% av alla par har problem med ofrivillig barnlöshet. "
  8. ^ http://www.hfea.gov.uk/en/802.html
  9. ^ http://www.hfea.gov.uk/en/804.html
  10. ^ http://europa.eu/scadplus/leg/en/cha/c11573.htm EU Tissues and Cells directive
  11. ^ http://www.hc-sc.gc.ca/hl-vs/reprod/agenc/index_e.html
  12. ^ http://www.ita.org.au/
  13. ^ Domar AD, Zuttermeister PC, Friedman R. The psychological impact of infertility: a comparison with patients with other medical conditions. J Psychosom Obstet Gynaecol. 1993;14 Suppl:45-52. PMID 8142988.
  14. ^ Beutel M, Kupfer J, Kirchmeyer P, Kehde S, Kohn FM, Schroeder-Printzen I, Gips H, Herrero HJG, Weidner W. Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI. Andrologia. 31 (1999): 27-35.
  15. ^ Schmidt et al. "The Social Epidemiology of Coping with Infertility. " Human Reproduction. 20 (2005): 1044-1052.

External links

Dictionary

infertility

-noun

  1. the condition of being infertile; of having poor fertility
  2. the inability to conceive children
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