Infertility

Beth McNeillTexas A&M University

What is infertility?

A condition which impairs the reproductive system from successfully producing offspring.

Couples are considered infertile if unable to get pregnant after one year of unprotected intercourse.

Facts about Infertility• Infertility is NOT an incontinence; it is a

disease that inhibits the reproductive system from performing its most basic function—reproduction.

• Affects about 6.1 million people in U.S (10%)• Infertility equally affects men and women• 80% to 90% of infertility cases are treatable.• In vitro fertilization treatments account for

less than 5% of infertility services

Conditions for Conception

1. Ovulation-release of the egg from the woman's ovaries

2. Fertilization-the uniting of the woman’s egg and the man’s sperm

3. Implantation-The attaching of the fertilized egg to the lining of the uterus

32%

16%9%

20%

14%

9%Tubal Factor

Endometriosis

Ovarian Factor

Male Factor

UnexplainedfactorOther causes

Factors That Causes InfertilityPrimary Diagnoses for ART Procedures, 1995

THE MALE FACTORStructural Abnormalities

• Physical damage to reproductive organs

• Abnormal Functioning• Medical conditions

THE MALE FACTORQUALITY & QUANTITY of Sperm

• QUALITY Recreational Drug use Stress Age

• QUANTITY Nutrition Recreational drug use Temperature

You just never know doc… Any day could be the day. And then,

competing with 50 million other guys for just one egg! The stress is

killing me!

THE MALE FACTOR MYTH OR REALITY?

BOXERS VS. BRIEFS

ABSTAIN TO GAIN

THE FEMALE FACTOR

• Weight and fertility

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THE FEMALE FACTOR• Improper hormone level

PCOS-Polycystic Ovarian Syndrome• Antibody production• Medical / Genetic Conditions• Recreational drug use

THE FEMALE FACTOR • Presence of infection

-Sexually Transmitted Infections (STI’s)

-Pelvic Inflammatory Disease (PID)

THE FEMALE FACTOR• Structural Abnormalities

A. Scarring or tumors of the uterusB. EndometriosisC. Poor quality or lack of cervical mucusD. Adhesions & Fibroids

Testing for Infertility

• Basic work up includes:A semen analysisProof of ovulationPostcoital test to observe

movement of sperm through cervical mucus

Evaluation of fallopian tubes

Testing for Infertility--MALES

• Semen Analysis

• Urologist Evaluation

Testing for Infertility--FEMALES

• Tests for Ovulation

• Urine Test- evaluates for luteinizing hormone

• Basal Body Temperature –looks at body temperatures

• Progesterone test- measures levels• Endometrial Biopsy–looks at uterine lining

Testing for Infertility--FEMALES• Structural Abnormalities

Postcoital Test (PCT)- evaluates sperm movement

Hysterosalpingography (HSG)-X-rays organs Ultrasound- provides pictures of organs

using sound Hysteroscope – telescopic examination Laparoscopy- light telescopic examination

Individual Treatments

• MALES Microsurgery when

treating blocked parts of the reproductive tract.

Hormone injections to stimulate production of sperm

• FEMALES Fertility drugs to

bring on ovulation Surgery to correct

structural abnormalities

Treatments to Insure FertilizationIntracytoplasmic sperm injection (ICSI)

• Procedure injects a single sperm directly into an egg.

Treatments for Mobility Problems Intrauterine insemination

Treatments for PartnersASSISTED REPRODUCTIVE TECHNOLOGY

Treatments or procedures that involve surgically removing eggs from a woman’s ovaries and combining them with sperm to help a woman become pregnant. • In Vitro Fertilization (IVF)• Gamete Intrafallopian Transfer (GIFT)• Zygote Intrafallopian Transfer (ZIFT)

Treatments for Partners In Vitro Fertilization (IVF)

• An ART procedure that uses fertility drugs to mature multiple eggs.

• Laparoscopy used to remove mature eggs prior to ovulation.

• Mature egg is fertilized in a dish then placed back in the woman's uterus.

Treatments for PartnersGamete Intrafallopian Transfer (GIFT)• ART procedure

involving removal of eggs from the ovary, combining them with sperm, using laparoscope to place the unfertilized eggs and sperm into the woman's fallopian tube.

Treatments for PartnersZygote Intrafallopian Transfer (ZIFT)

• An ART procedure that is a variation of the IVF and GIFT.

• A zygote (fertilized egg) is used in the IVF procedure

• Fertilization occurs outside the body in a dish.

Decisions about InfertilityFactors to Consider

• Expense• Time-consuming• Big commitment• Professional counseling may be needed to

help sort out issues alternatives

For more information

• www.cdc.gov/reproductive health

• www.fertility-docs.com

• www.asrm.org

• http://cis.nci.nih.gov/fact