Infertility overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[3]
Overview
Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. It is defined as the failure to conceive after 1 or more years of unprotected sex. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. 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 awareness methods are used to discern when these changes occur; by tracking changes in cervical mucus or basal body temperature.
Causes
- A wide range of physical and emotional factors can cause infertility. Infertility may be due to problems in the woman, man, or both.
- The most common cause of male infertility is sperm abnormalities such as oligospermia, azoospermia etc.
- Causes of infertility in females are divided into endocrine, ovarian, tubal, uterine, cervical and other anatomical defects.[2]
Differentiating Infertility from Other Diseases
- 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 fecundityfor the natural improbability to conceive. [3]
Treatment
Medical Therapy
- Treatment of infertility usually starts with medication.
- In vitro fertilization (IVF) in addition to various forms and developments of it (ICSI, ZIFT, GIFT) is another solution. All these come under the gamut of assisted reproductive technology. [4]
- 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 assisted hatching and PGD.
Surgical therapy
- Surgical therapy mainly aims at resolving any anatomical defects in the genital tract.
- Tuboplasty is done for any defects in the fallopian tubes such as scarring due to pelvic inflammatory disease or tuberculosis.[5]
- When fibroids are the cause of infertility, myomectomy can be done.
- Other surgical methods include metroplasty, polypectomy, adhesiolysis.
References
- ↑ Makar RS, Toth TL (2002). "The evaluation of infertility". Am. J. Clin. Pathol. 117 Suppl: S95–103. PMID 14569805.
- ↑ Luciano AA, Lanzone A, Goverde AJ (2013). "Management of female infertility from hormonal causes". Int J Gynaecol Obstet. 123 Suppl 2: S9–17. doi:10.1016/j.ijgo.2013.09.007. PMID https://www.ncbi.nlm.nih.gov/pubmed/24139473 Check
|pmid=value (help). - ↑ Wood JW (1989). "Fecundity and natural fertility in humans". Oxf Rev Reprod Biol. 11: 61–109. PMID 2697833.
- ↑ Szamatowicz M (2016). "Assisted reproductive technology in reproductive medicine - possibilities and limitations". Ginekol Pol. 87 (12): 820–823. doi:10.5603/GP.2016.0095. PMID 28098933.
- ↑ Tanaka Y, Tajima H, Sakuraba S, Shimokawa R, Kamei K (2011). "Renaissance of surgical recanalization for proximal fallopian tubal occlusion: falloposcopic tuboplasty as a promising therapeutic option in tubal infertility". J Minim Invasive Gynecol. 18 (5): 651–9. doi:10.1016/j.jmig.2011.06.014. PMID 21872171.