Infertility Flashcards
Whose health issue is Male infertility?
Women’s.
What is needed associated with male infertility?
Research.
Clinical evaluation.
How many people does infertility affect?
15% of couples globally.
48.5 million couples.
Where does the weight of treatment always dall?
On women.
Why is the weight of treatment of male infertility always fall on women?
Because of the loss of diagnostic options for men.
How much of infertility lies on male?
50% of cases.
What do we have to understand in order to achieve new diagnostics and treatment options in male infertility?
Physiology of males and females.
Why is infertility a greater problem in women?
Because, of the need to understand the process of egg production.
How sperm behaves in tract.
How successful pregnancy happens.
When did the first observation of human sperm occur?
In the 17th century.
When was artificial insemination conducted?
In the 18th century.
To who did artificial insemination occur first?
In dogs.
To who did artificial insemination conducted after dogs?
In humans.
In what did artificial insemination result in humans?
In a live birth in 1793.
When did succefful fertilisation occur in vitro?
Late 20th century.
Why was successful fertilisation late?
Because it wasn’t appreciated that the sperm must undergo biochemical changes in order to be fertilised competent.
When was the term capacitation used?
In 1951.
As what did the term capacitation used to describe?
Changes for over 8 million babies to be born thanks to IVF.
What does Intracytoplasmic sperm injection bypass?
All natural selection steps.
Why does intracytoplasmic sperm injection bypass all natural selection steps?
Because of the sperm head which contains nucleus –> injected directly in the egg.
What is the definition of infertility?
Inability of a couple to conceive after 1 year of unprotected sexual intercourse.
What does Primary infertility mean?
Inability to conceive.
What does Secondary infertility mean?
Inability to conceive but has previous pregnancy.
When is the lowest prevalence of infertility and help request in women?
In the lowest age.
When does infertility and help ask peak in women?
At age 35-44.
What is the age 35-44 in women?
The top end of a woman natural fertility.
Until what age women still seek for treatment?
Until advanced age.
Do male have a longer fertile lifespan than women?
YES.
When is the beginning of subfertility in women?
At age of 21.
When is the beginning of sterility in women?
At age of 31.
When is the beginning of irregular menstrual cycle in women?
At age of 41.
When is the beginning of menopause in women?
At age of 51.
What are the factors that impact the ability to reproduce?
Physiological = menstrual cycle stage. Patho = infections, genetic mutation, PCOS. Economic = can't afford children, poor living impacts health. Psychological = stress. Abortion = choosing no child. Contraception = Use prevents. ART access = economic and geographical. Social.
What are the social factors that impact infertility?
Cigarette smoking. Marijuana smoking. Anabolic steroids. Alcohol. Emotional stress. Excessive heat exposure. Tight underwear/clothing. Prolonged sitting. Prolonged cycling. Environmental exposure. Exposure to Pesticides and toxins. Exposure to radiation/cytotoxic drugs.
What are some pathophysiological factors that impact male?
Cystic fibrosis. High frequency of CFTR mutations. Cryptochordism. Obesity. Varicocele. Azoospermia. Globozoospermia. Asthenozoospermia. Infections. Pollutants. Impotence = inability. Idiopathic = unexplained. KS syndrome.
What is Cystic fibrosis?
The primary cause of infertility in 95% of affected men.
Congenital bilateral absence of vas deferens.
Where is high frequency of CFTR mutations found?
In non-CBAVD males.
With what is the high frequency of CFTR mutations associated?
With spermatogenesis defects.
What is Crypochordism?
The name given to undescended testes.
Where does Crypochordism result?
In impaired spermatogenesis.
Why does Crypochordism result in impaired spermatogenesis?
Because internal body temperature prevents spermatogenesis.
How can obesity effect sperm production?
If it is associated with elevated estrogen production.
What happens in obesity that affects fertility?
Testosterone –> converted to –> estrogen by fat cells.
What is Varicocele?
A varicose vein in scrotum.
What is the function of Varicocele in infertility?
Helps keep heat exchange and testis cooler than body temperature , but it doesn’t work efficiently.
Which factors suffer from stress and affect fertility?
Nutrient and waste exchange.
What happens to nutrient and waste exchange and testis duffer stress and affect spermatogenesis?
They are impaired.
What is Azoospermia?
The failure to produce viable sperm.
What is Globozoospermia?
The production of sperm with abnormal heads and no acrosome.
Sperms –> cannot fertile.
What is Asthenozoospermia?
Sperm with poor motility.
What do infections cause and affect fertility?
Inflammation.
Immune response –> damages –> sperm and spermatogenesis.
What can pollutants affect?
Testosterone production.
Spermatogenesis.
Sperm function.
What is Impotence?
A cause o infertility.
Why is impotence a cause of infertility?
Because the man cannot naturally inseminate the women.
What happens in KS syndrome condition in men that affects fertility?
Man has an extra X chromosome.
Affects puberty.
Men –> infertile.
How does Idiopathic/unexplained infertility affect men?
75& of infertility.
Huge demand of progress.
In what does Cystic fibrosis result?
In blocked fallopian tubes.
When does Primary ovarian insufficiency occur?
When a woman’s ovaries stop working normally.
When does Primary ovarian insufficiency occur?
Before woman is 40.
What can PCOS syndrome affect?
Ovulation.
Which factors can result in woman getting pregnant?
Treatment.
Surgery.
IVF.
What can Endometriosis cause?
Infertility.
When does Endometriosis cause infertility?
If there is damage to uterus or fallopian tubes.
What is chlamydia?
An infections that can cause damage and scarring to reproductive tissues.
What are the unexplained causes of female infertility?
Prevalent.
How much was the global population growth since 1950?
From 2.6 billion - 7.6 billion.
What is the estimation of future world population growth?
World’s population will expand before declining back to todays level.
What should be made for fertility?
Mindful research of projected population changes.
Research against demands of medical disciplines.
Example = cancer research.
What is important to emphasise in terms of infertility research?
Is not about increasing the number of people per se.
It is about bringing new life into the world.
What can an economic argument show us in terms of infertility?
The interests of every country to ensure youthful population remains at light levels.
What do researchers say about human fertility?
It could be getting worse.
What do some NHS trusts do?
They are cutting back on free IVF services.
What does research and development require in terms of infertility?
Huge sums of money.
What do we have to understand in terms of infertility research?
The molecular regulation of fertility.
Why should we understand molecular regulation of fertility?
To help in development of contraceptive.
What is ‘planned parenting’?
Part of WHO 17 sustainable development goals.
What does ‘WHO 17 sustainable development goals’ say?
By 2030 countries should aim to ensure universal access to sexual and reproductive health-care services.
What ‘WHO goals’ includes?
Family planning.
Information.
Education.
Reproductive health into strategies and programmes.
What is the current contraceptive strategy doing?
Failing.
What do unplanned pregnancies present?
Significant health.
Social problems.
How many pregnancies were unintended and aborted in 2008, out of 208 million pregnancies, respectively?
86 million = unintended (42%).
41 million = aborted (19.7%).
How many were born over the past 20 years, out of 10M cycles?
2M babies.
What do the figures of born babies in the past 20 years show?
There is a lot of progress to be made –> increase effectiveness of treatment.
How much is the mean pregnancy rate for IVF and ICSI treatments?
Around 25% only.
How much is the cost for people using private clinics?
A huge financial cost.
How much is one 3 cycle IVF package from UK?
10K.
How much is one 1 cycle IVF package in USA.
$12K, without including medication.
What do some people still consider for the current treatment methods?
They are sufficient.
When was the huge breakthrough with the first live birth from IVF?
In 1978.
What is IVF along with ICSI?
Still the only treatment options.
What does the fact that IVF and ICSI are still the only treatment options for infertility since 1978?
There has been no progress for 40 years.
About what are some scientists concerned?
About the increasing and routine use of ICSI.
Why are some scientists concerned abut the increasing and routine use of ICSI?
Because it removes all the barriers of natural selection.
What option solves everything?
ART.
When was Louise Brown born?
In 1978.
How does ART solve everything?
It contributes to 1-4% live births.
What happened in 2017?
Nearly 55K people undertook > 75K treatment cycles.
Which country had the largest majority of infertility treatment in 2017?
England.
What does the NHS provide in Scotland?
Three free cycles.
What do recent updated guidelines fail to find?
The benefit of ICSI in non-male factor treatment.
What do recent guidelines advise?
Against ICSI routine use.
What happened in pregnancy rates since 1997 until 2011?
Little progress in improving rates.
What does an increasing number of studies suggest?
That children born using reproductive technologies –> increased risk of certain conditions.
Is the fact that ‘children born using reproductive technologies have increased risk of certain conditions’ proved?
No.
It remains unproved.
What is certain about IVF and ICSI?
They both are far removed from natural selection.
What do scientists think is better about restoring natural fertility?
A significant treatment milestone would be routinely restore natural fertility.
What is infertility?
A disease of the reproductive system.
Who does infertility impact?
Individuals.
How does infertility impact individuals?
Physically through treatment.
Mentally.
Financially.
What is a fact about ART using in infertility?
It is increasingly used.
Increasingly invasive.
What does understanding of molecular causes of infertility serve?
A medical and a contraceptive discovery agenda.
