Lecture 8 – Infertility Flashcards
What are the five main requirements for fertility?
Normal sperm Normal eggs Sperm must be able to traverse the female tract Sperm must be able to penetrate the egg Embryo must be able to implant
What is the definition of fertility?
The measure of the actual outcome of process e.g. number of children to an individual couple
What is the definition of fecundability?
The probability of concieving each month
What is the definition of fecundity?
The measure of the ability to concieve and produce a live birth.
What is the definition of infertility?
The inability to concieve or bring a pregnancy to term
What is subfertility?
A state of reduced fertility
What is the nice definition of infertility?
The inability to concieve after 2 years of regular unprotected intercourse.
What are the first and second most common reasons for women 20-40 to see their GP?
Most common is pregnancy, second most common is infertility.
What are the main female factors that cause infertility?
Ovulatory disorders Tubal damage Endometriosus Uterine abnormalities Problems with implantation, growth and development
What are the main ways that female factors are diagnosed?
Can be diagnosed on blood tests, by surgery (laproscopy) or by radiography (hysterosalpingogram)
Ovulation disorders form 40% of female factors, what can cause these?
Stress, anorexia nervosa, strenuous excercise and drug use. Can have failure of development of neuroendocrine system at puberty. Treating with placebo works alot for stress etc.
Idiopathic ovarian failure
Polycycstic ovary syndrome
Anovulatory cycles - unruptured follicles
What is idiopathic ovarian failure?
-Gonadotrophin secretion is normal but doesn’t produce normal cycle - oestrogen doesnt rise.
What are anovulatory cycles?
Lutenised unruptured follicle syndrome - normal endocrine - follicles form but do not rupture.
What can increase the chances of tubal obstruction?
Previous infections - scarring adhesions
STIs
Post-abortal sepsis
What is endometriosus?
Tissue growth that results in scarring and adhesions