Infertility Flashcards
What is the definition of infertility?
Failure to achieve pregnancy after 12 months or more of regular unprotected intercourse.
Primary infertility: Never been pregnant.
Secondary infertility: Inability to conceive or carry a pregnancy after the birth of one or more biological children. For women older than 35, evaluation begins after 6 months.
What are the steps involved in fertilization and implantation?
- Sperm is produced, deposited in the vagina, and travels through the cervix and fallopian tubes.
- Capacitation: Sperm gains the ability to fertilize an egg.
- Ovaries release a mature ovum (egg).
- Fertilization occurs in the fallopian tube, and the zygote travels to the uterus.
- Implantation: The fertilized ovum attaches to the uterine wall.
What percentage of infertility cases are due to female vs. male factors?
Female factors: 55%. Male factors: 35%. In 8%-28% of couples (depending on age), no specific cause is identified.
What are the common causes of female infertility?
Ovulatory dysfunction: Total lack or irregular ovulation due to hypothalamic-pituitary-ovarian axis issues.
Tubal problems: Blockages in fallopian tubes due to infections (e.g., STIs), pelvic inflammatory disease, or endometriosis.
Uterine issues: Asherman syndrome, fibroids, chronic endometritis.
What are common causes of male infertility?
Idiopathic causes: Unknown reasons.
Primary gonadal disorders: Chromosomal abnormalities, undescended testes, varicoceles, or infections.
Sperm transport disorders: Blockages or functional issues. Environmental exposures, chronic illnesses, medications, or radiation.
What is unexplained infertility?
Cases where no specific cause for infertility can be found. Psychological stress and simultaneous subclinical male and female factors may contribute.
How is infertility assessed in women?
History and physical examination: Includes menstruation, contraceptive, and medical history.
Ovulation detection: Basal body temperature charting or OTC LH tests.
Tests: Transvaginal ultrasound, hysterosalpingogram, hysteroscopy, laparoscopy.
How is infertility assessed in men?
History and physical examination: Includes reproductive history and overall health.
Semen analysis: Examines sperm count, motility, and morphology.
Tests: Blood tests for hormonal levels, and possibly scrotal ultrasound.
What are treatment options for female infertility?
Ovulation induction: Clomiphene citrate or letrozole.
Correcting luteal phase defects: Normalize prolactin levels.
Assisted Reproductive Technologies (ART) like IVF, GIFT, ZIFT.
What are treatment options for male infertility?
Address underlying causes like infections or hormonal imbalances. ART options such as intracytoplasmic sperm injection (ICSI).
What are Assisted Reproductive Technologies (ART)?
IVF (In vitro fertilization): Fertilization occurs outside the body.
GIFT (Gamete intrafallopian transfer): Sperm and eggs placed in fallopian tube.
ZIFT (Zygote intrafallopian transfer): Fertilized zygote placed in fallopian tube.
ICSI (Intracytoplasmic sperm injection): Single sperm injected into an egg.
What are ethical considerations related to infertility treatments?
High expense of treatments. Questions about “real parenthood.” Management of multiple embryos. Access to care and societal disparities.
What psychological and social factors impact infertility?
Infertility can cause stress and emotional distress. Family and societal expectations vary by culture and socioeconomic status. Counseling can help address psychological and relational impacts.
What are options for couples who cannot conceive?
Collaborative reproduction (e.g., egg or sperm donation, surrogacy). Adoption. Choosing to live child-free.
