1. INFERTILITYINFERTILITY

2. Requirements for conception
• Production of healthy egg and
sperm
• Unblocked tubes that allow
sperm to reach the egg
• The sperms ability to
penetrate and fertilize the egg
• Implantation of the embryo
into the uterus
• Finally a healthy pregnancy

3. Infertility is the inability to conceive a child. A couple may be
considered infertile if, after two years of regular sexual
intercourse, without contraception, the woman has not become
pregnant (and there is no other reason, such as breastfeeding or
postpartum amenorrhea).
- WHO

4. Types of infertility
• Primary Infertility: Woman has never
been pregnant despite frequent,
unprotected sexual intercourse
• Secondary infertility: Woman has had at
least one pregnancy but has failed to
conceive subsequently despite frequent,
unprotected sexual intercourse

5. Incidence of Infertility
• Affects both men and women
• Affects approximately 15% of all couples
• WHO study found:
– Female causes 25-37%
– Male causes 8-22%
– Both male & female 21-38%
– No identified cause 5-15%

6. Risk factors
Male
• ETOH
• Drugs
• Tobacco
• Health problems
• Radiation/Chemotherapy
• Age
• Enviromental factors
– Pesticides
– Lead
Female
• Age
• Stress
• Poor diet
• Athletic training
• Over/underweight
• Tobacco
• ETOH
• STD’s
• Health problems

8. Major Female Factors
• Tube problems
• Ovulation disorders
– Anovulation (PCOD)
• Problems in second half of
Cycle
• Pituitary Gland Problems
• Pelvic problems and
endometriosis
• Problems of the cervix

10. Major Male Factors
• Varicocele
• Ejaculatory problems
• Pituitary problems
• Genito-urinary tract infections
• Hormonal problems

11. Investigations - Female
• History
• Physical examination
• Post-coital test
• X-rays of the tubes
• Looking into the uterus
• Biopsy of the lining of the uterus
• Measuring progesterone levels

12. Investigations - Males
• Semen analysis
• Urological examination to look for:
– anatomical abnormalities
– Infections
– endocrine disorders
– varicocele

13. Impact of Infertility
Psychological reaction:
• Frustration
• feeling less of a man/woman
• feeling of loss
• decreased self-esteem, self-
confidence
• guilt or apportioning blame
disappointment

14. Emotional Responses
• Guilt
• Depression
• Anger
• Isolation

15. Impact on Relationships
• Questioning of the meaning of the relationship
• Fear that the relationship will not survive
– Approximately 68% of women threatened with divorce
• Conflict - study found:
– Approximately 10% of women abused by husband
– Approximately 16% abused by in laws
• Onset of sexual dysfunctions

16. Treatment
• Hormonal therapy for stimulation
• Abstinence or condom use if hostile cervical
mucus
• Surgery to correct abnormalities
• Assisted Reproductive Technologies
(ARTs)

17. Assisted Reproductive Technologies
• Drugs ( clomiphene citrate)
•In vitro fertilization (IVF)
•Intrauterine
insemination (IUI)

18. •Gamete intrafallopian
transfer (GIFT)
•Zygote intrafallopian transfer
(ZIFT)
•Intracytoplasmic sperm injection
(ICSI)

19. THANK YOUTHANK YOU