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Encyclopedia > Infertility
Infertility
Classification & external resources
ICD-10 N46., N97.0
ICD-9 606, 628
DiseasesDB 21627
MedlinePlus 001191
eMedicine med/3535  med/1167
MeSH D007246

Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. 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] The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // N00-N39 - Diseases of the genitourinary system: urinary system (N00-N08) Glomerular diseases Prefixes: .2 Diffuse membranous glomerulonephritis (N00) Acute nephritic syndrome (N01) Rapidly progressive nephritic syndrome (N02) Recurrent and persistent haematuria (N03) Chronic nephritic syndrome (N04) Nephrotic syndrome Lipoid nephrosis (N05) Unspecified nephritic syndrome (N06) Isolated proteinuria with specified... // N00-N39 - Diseases of the genitourinary system: urinary system (N00-N08) Glomerular diseases Prefixes: .2 Diffuse membranous glomerulonephritis (N00) Acute nephritic syndrome (N01) Rapidly progressive nephritic syndrome (N02) Recurrent and persistent haematuria (N03) Chronic nephritic syndrome (N04) Nephrotic syndrome Lipoid nephrosis (N05) Unspecified nephritic syndrome (N06) Isolated proteinuria with specified... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Photograph of a nude man by Wilhelm von Gloeden, ca. ... Diverse women. ... Categories: Biology stubs ... This article is about human pregnancy in biological females. ... This page is a candidate to be copied to Wiktionary. ...


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. Fertility is the natural capability of giving life. ... Ovulation is the process in the menstrual cycle by which a mature ovarian follicle ruptures and discharges an ovum (also known as an oocyte, female gamete, or casually, an egg) that participates in reproduction. ... Menstrual cycle In the female reproductive system, the menstrual cycle is a recurring cycle of physiologic changes that occurs in reproductive age females of several mammals, including human beings and other apes. ... Fertility Awareness (FA) is the practice of observing one or more of a woman’s primary fertility signs to determine the fertile and infertile phases of her menstrual cycle. ... Basal body temperature is the body temperature measured immediately after awakening and before any physical activity has been undertaken. ...

Contents

Definition

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 fecundity for the natural improbability to conceive.


Infertility

Reproductive endocrinologists, the doctors specializing in infertility, consider a couple to be infertile if:

  • the couple has not conceived after 12 months of contraceptive-free intercourse if the female is under the age of 34
  • the couple has not conceived after 6 months of contraceptive-free intercourse if the female is over the age of 35 (declining egg quality of females over the age of 35 account for the age-based discrepancy as when to seek medical intervention)
  • the female is incapable of carrying a pregnancy to term.

Subfertility

A couple that has tried unsuccessfully to have a child for a year or more is said to be subfertile. The couple's fecundability rate is approximately 3-5%. Many of its causes are the same as those of infertility. Such causes could be endometriosis, or polycystic ovarian syndrome. Look up couple in Wiktionary, the free dictionary. ... For other uses, see Child (disambiguation). ... A year (from Old English gēr) is the time between two recurrences of an event related to the orbit of the Earth around the Sun. ...


Prevalence

(This section needs proper numbers based on detailed statistics and studies. Please expand.)


Causes

This section deals with unintentional causes of sterility. For more information about surgical techniques for preventing procreation, see sterilization. Sterilization is a surgical technique leaving a male or female unable to procreate. ...


Primary vs. secondary

Couples with primary infertility have never been able to conceive,[2] while, on the other hand, secondary infertility is difficulty conceiving after already having conceived and carried a normal pregnancy. Technically, secondary infertility is not present if there has been a change of partners.


Some women are infertile because their ovaries do not mature and release eggs. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries.


Causes in either sex

Factors that can cause male as well as female infertility are:

Robertsonian translocation is a common form of chromosomal rearrangement that occurs in the five acrocentric human chromosome pairs, namely 13, 14, 15, 21, and 22. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... In mammals, the adrenal gland (also known as suprarenal glands) are the triangle-shaped endocrine glands that sit on top of the kidneys; their name indicates that position (ad, near or at + renes, kidneys). They are chiefly responsible for regulating the stress response through the synthesis of corticosteroids and catecholamines... Kallmann syndrome is an example of hypogonadism (decreased functioning of the sex hormone-producing glands) caused by a deficiency of gonadotropin-releasing hormone (GnRH), which is created by the hypothalamus. ... Prolactin is a hormone secreted by lactotropes in the adenohypophysis (anterior pituitary gland) which is made up of 199 amino acids with a molecular weight of about 23,000 daltons. ... Hypopituitarism is a medical term describing deficiency (hypo) of one or more hormones of the pituitary gland. ...

Combined infertility

In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these conditions. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.


Unexplained infertility

In about 15% of cases the infertility investigation will show no abnormalities. In these cases abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization.


Treatment

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. 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 e.g. tuboplasty, assisted hatching and PGD. Assisted reproductive technology (ART) is a general term referring to methods used to achieve pregnancy by artificial or partially artificial means. ... In vitro fertilization (IVF) is a technique in which egg cells are fertilized outside the mothers body in cases where conception is difficult or impossible through normal intercourse. ...


Ethics

There are several ethical issues associated with infertility and its treatment.

  • High-cost treatments are out of financial reach for some couples.
  • Debate over whether health insurance companies should be forced to cover infertility treatment.
  • Allocation of medical resources that could be used elsewhere
  • The legal status of embryos fertilized in vitro and not transferred in vivo. (See also Beginning of pregnancy controversy).
  • Anti-abortion opposition to the destruction of embryos not transferred in vivo.
  • IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems.
  • Religious leaders' opinions on fertility treatments.
  • Infertility caused by DNA defects on the Y chromosome is passed on from father to son. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation.

Categories: Biology stubs | Developmental biology ... In vitro (Latin: within the glass) refers to the technique of performing a given experiment in a test tube, or, generally, in a controlled environment outside a living organism. ... In vivo (Latin for (with)in the living). ... Controversy over the beginning of pregnancy usually occurs in the context of the abortion debate. ... In vivo (Latin for (with)in the living). ... Quadruplet, quintuplet, etc. ... In most systems of human pregnancy, the condition, premature birth (also known as a preterm birth), occurs when the baby is born within sooner than 36 weeks of completed gestation. ... For other uses, see Natural selection (disambiguation). ... Oocyte is injected during ICSI Intracytoplasmic sperm injection (ICSI) is an in vitro fertilization procedure in which a single sperm is injected directly into an egg; this procedure is most commonly used to overcome male infertility problems. ...

Psychological impact

Infertility may have profound psychological effects. Partners may become more anxious to conceive, ironically increasing sexual dysfunction. Marital discord often develops in infertile couples, especially when they are under pressure to make medical decisions. Women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer[3]. Even couples undertaking IVF face considerable stress, especially the female partner [4] Sexual dysfunction or sexual malfunction (see also sexual function) is difficulty during any stage of the sexual act (which includes desire, arousal, orgasm, and resolution) that prevents the individual or couple from enjoying sexual activity. ... On the Threshold of Eternity. ...


Social impact

In many cultures, inability to conceive bears a stigma. In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way [5].


There are legal ramifications as well. Infertility has begun to gain more exposure to legal domains. An estimated 4 million workers in the U.S. used the Family and Medical Leave Act (FMLA) in 2004 to care for a child, parent or spouse, or because of their own personal illness. Many treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for FMLA leave. The Family and Medical Leave Act of 1993 (Public Law 103-3, enacted February 5, 1993) was one of the first major new laws enacted by United States President Bill Clinton in his first term, fulfilling a campaign promise. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ...


See also

Numerous science fiction, utopian and dystopian novels revolve around sexual reproduction, pregnancy and infertility. ...

References

  1. ^ Makar RS, Toth TL (2002). "The evaluation of infertility". Am. J. Clin. Pathol. 117 Suppl: S95–103. PMID 14569805. 
  2. ^ MedlinePlus Medical Encyclopedia: Infertility. Retrieved on 2007-11-21.
  3. ^ Domar AD, Zuttermeister PC, Friedman R. The psychological impact of infertility: a comparison with patients with other medical conditions. J Psychosom Obstet Gynaecol. 1993;14 Suppl:45-52. PMID 8142988.
  4. ^ Beutel M, Kupfer J, Kirchmeyer P, Kehde S, Kohn FM, Schroeder-Printzen I, Gips H, Herrero HJG, Weidner W. Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI. Andrologia. 31 (1999): 27-35.
  5. ^ Schmidt et al. "The Social Epidemiology of Coping with Infertility." Human Reproduction. 20 (2005): 1044-1052.

Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 325th day of the year (326th in leap years) in the Gregorian calendar. ...

External links

Hematospermia, or the presence of blood in semen, is most often a benign and idiopathic symptom, but can sometimes result from medical problems such as a urethral stricture, infection of the prostate, or a congenital bleeding disorder, and can occur transiently after surgical procedures such as a prostate biopsy. ... In males, retrograde ejaculation occurs when the fluid to be ejaculated, which would normally exit via the urethra, is redirected towards the urinary bladder. ... For other uses, see Breast (disambiguation). ... Chronic cystic mastitis, also called fibrocystic disease, Diffuse cystic mastopathy and Mammary dysplasia is a condition rather than a disease. ... Mastitis is the inflammation of the mammalian breast caused by the blocking of the milk ducts while the mother is lactating (see breastfeeding). ... Gynecomastia, or gynaecomastia, pronounced is the development of abnormally large mammary glands in males resulting in breast enlargement, which can sometimes cause secretion of milk. ... Galactorrhea or galactorrhoea is the spontaneous flow of milk from the breast, unassociated with childbirth or nursing. ... Mastalgia, mastodynia or mammalgia are names for a medical symptom that means - pain in the breast (from the Greek masto-, breast and algos, pain). ... Nipple discharge is the abnormal release of fluid from the nipples of the breasts. ... galactocele ...

  Results from FactBites:
 
ASRM: Frequently Asked Questions About Infertility (1104 words)
Infertility is NOT an inconvenience; it is a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction.
For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained.
In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.
Introduction: Infertility: Merck Manual Home Edition (476 words)
Infertility is the inability of a couple to achieve a pregnancy after repeated intercourse without contraception for 1 year.
The cause of infertility may be due to problems in the man, the woman, or both.
In a small percentage of cases, infertility is caused by problems with mucus in the cervix or by unidentified factors.
  More results at FactBites »

 
 

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