infertility in human and treatment by sachin londhe

2. Representation by –
Mr.Sachin londhe
Roll no:- 13953

3. introduction
• Infertility:- is the inability to produce
offspring .
To carry pregnancy .
To conceive child by natural process.
Immature reproductive system (R .S)
Defective R.S.
Endocrine disorder .

4. Infertility type
• Primary infertility
–a couple that has never conceived.
• Secondary infertility
–infertility that occurs after previous
pregnancy regardless of outcome.
–now is unable to conceive.

5. Common causes for infertility
• male
– Drugs
– Tobacco
– Health problems
– Radiation/Chemother
apy
– Age
– Over exersise
– Enviromental factors
• Pesticides
• Lead
• Female
– Age
– Stress
– Poor diet
– Athletic training
– Over/underweight
– Tobacco
– Health problems
– Enviromental factors
• Pesticides
• Lead
 alcoholic drink
Genetic disorders.

6. In female
1.Abnormalities of ovary
2.Abnormalities of uterus
3.Absence of ovulation

7. Other disorders.
1. Pelvic inflammatory disease
(PID)
2. Ovarian dysfunction
3. Hypothalamic disorder
4. Disorder of pituitary gland

8. 5.Local factors in the uterus and cervix
 may interfere with implantation and
woman’s ability to carry pregnancy to term
6.Luteal phase defect
 results in low production of progesterone
 may lead to early miscarriage
7.Production of anti-sperm antibodies
 can interfere with fertilization
 Shows spermicidal activity

9. Causes male infertility
1. Abnormal sperm:-
2. Decreased sperm count
3. Obstruction of reproductive system
Other causes :-
1. Cryptorchidism
2. Trauma
3. Mumps
4. Alcoholism and drugs consumption
5. Hypothalamic and pituitary disorder .

10. Treatment of the
Infertile Couple

11. Inadequate Spermatogenesis
• Eliminate alterations of thermoregulation
• Clomiphene citrate is occasionally used
for induction of spermatogenesis
–20% success
• In vitro fertilization may facilitate
fertilization
• Artificial insemination with donor sperm
is often successful

12. Anovulation
• Restore ovulation
– Administer ovulation inducing agents
• Clomiphene citrate
– Antiestrogen
– Combines and blocks estrogen receptors at the
hypothalamus and pituitary causing a negative
feedback
– Increases FSH production
• stimulates the ovary to make follicles

13. Treatment Possibilities:
Female Infertility
Ovulation disorders Ovulation-inducing drugs
Hyperprolactinemia
Prolactin-suppressing
drugs
Uterine and tubal
abnormalities
Surgical procedures
Cervical mucus problems Intrauterine insemination
Endometriosis
Suppressing hormones
or surgical procedure

14. Treatment of Female Infertility:
Ovulation Induction Agents
induces release of gonadotropins
Gonadotropins
Clomiphene citrate
Gonadotropin
releasing
hormone analogs
similar in structure to natural GnRH,
provoke a massive release of GnRH
into the circulation
human menopausal gonadotropin
(HMG), which contains equal
quantities of FSH and LH
Bromocriptine suppresses production of prolactin

15. Treatment of Female Infertility:
Intrauterine Insemination
 A fertility procedure in which sperm are washed,
concentrated and injected directly into a woman’s
uterus.
 Increases the number of sperm in the fallopian
tubes
 It fail when tubal blockage, poor egg quality,
ovarian failure and severe male factor infertility

16. Treatment of Female Infertility:
Assisted Reproductive Technology (ART)
 Noncoital methods of conception
 Includes all fertility treatments in which both eggs
and sperm are manipulated
 Types of ART include:
 In Vitro Fertilization (IVF)
 Zygote Intrafallopian Transfer (ZIFT)
 Gamete Intrafallopian Transfer (GIFT)

17. ART: In Vitro Fertilization
 Involves retrieving eggs and sperm from female
and male partners and placing them in a lab dish
to enhance fertilization
 Fertilized eggs are transferred several days later
into the uterus
 Ovarian stimulation drugs are used prior to
procedure in order to retrieve several eggs and
maximize chances for successful fertilization
 Success rates are about 20% per egg retrieval

18. Basic Steps in IVF
•Ovary stimulation
•Egg retrieval
•Sperm retrieval-wash
sperm
•Fertilization
•Embryo transfer
•Progesterone

19. ART: Gamete Intrafallopian
Transfer (GIFT)
 GIFT is a procedure that involves:
 ovarian stimulation
 retrieval of eggs
 placing a mixture of sperm and eggs directly into the
woman’s fallopian tube
 GIFT does not allow visual confirmation of
fertilization
 Success rates per egg retrieval are about 28%
(higher than for IVF)

20. ART: Zygote Intrafallopian
Transfer (ZIFT)
 ZIFT, also called tubal embryo transfer, is another
variation of IVF
 As with IVF, the actual fertilization takes place in a
lab dish
 Fertilized eggs are placed directly into a fallopian
tube
 Success rate is about 29% per egg retrieval

22. Risks of ART?
• To woman
–Overstimulation of ovary syndrome
–Multiple pregnancies
–Risk of ovarian cancer (clomid,
pergonal)
• To baby
-ICSI associated with problems (XYY)

23. Treatment Possibilities: Male Infertility
 Surgical treatment in some cases (varicocele)
 Intrauterine insemination can be performed either
with patient’s or donor’s sperm
 ART procedures:
 GIFT
 IVF
 ICSI
Donor semen should be free from STDs/HIV

24. ART: Intracytoplasmic Sperm Injection (ICSI)
 Involves injection of single sperm into the egg
 The woman is administered fertility drugs prior to
the procedure to aid in the production of multiple
eggs
 Only active undamaged sperm are selected for
injections

25. ART: Intracytoplasmic Sperm Injection (ICSI)
(Continued)
 Eggs are observed to see if fertilization takes place
 average fertilization rate is 65%
 Implantation into the uterus takes place within 72
hours after ICSI
 Success rates range from 15% to 35% per egg
retrieval

26. ICSI

27. Refrencess
• Medical physiology dr. N V Mishra
https://avirupguha.files.wordpress.com/2009/0
5/infertility1.html
http://www.hfea.gov.uk/infertility.html

28. Questions?

29. THANK
YOU SO
MUCH.