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Infertility
Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal state of a human child or other young offspring, because they have not undergone puberty, which is the body's start of reproductive capacity. In humans, infertility is the inability to become pregnant after one year of unprotected and regular sexual intercourse involving a male and female partner.Chowdhury SH, Cozma AI, Chowdhury JH. Infertility. Essentials for the Canadian Medical Licensing Exam: Review and Prep for MCCQE Part I. 2nd edition. Wolters Kluwer. Hong Kong. 2017. There are many causes of infertility, including some that medical intervention can treat. Estimates from 1997 suggest that worldwide about five percent of all heterosexual couples have an unresolved problem with infertility. Many more couples, however, experience ...
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Female Infertility
Female infertility refers to infertility in women. It affects an estimated 48 million women, with the highest prevalence of infertility affecting women in South Asia, Sub-Saharan Africa, North Africa/Middle East, and Central/Eastern Europe and Central Asia. Infertility is caused by many sources, including nutrition, diseases, and other malformations of the uterus. Infertility affects women from around the world, and the cultural and social stigma surrounding it varies. Cause Causes or factors of female infertility can basically be classified regarding whether they are Acquired disorder, acquired or genetic, or strictly by location. Although factors of female infertility can be classified as either acquired or genetic, female infertility is usually more or less a combination of nature and nurture. Also, the presence of any single risk factor of female infertility (such as smoking, mentioned further below) does not necessarily cause infertility, and even if a woman is definitely in ...
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Male Infertility
Male infertility refers to a sexually mature male's inability to impregnate a fertile female. In humans it accounts for 40–50% of infertility. It affects approximately 7% of all men. Male infertility is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity. More recently, advance sperm analyses that examine intracellular sperm components are being developed. Age considerations There is a decrease in sperm concentration as men age: 90% of seminiferous tubules in men in their 20s and 30s contain spermatids, whereas men in their 40s and 50s have spermatids in 50% of their seminiferous tubules, and only 10% of seminiferous tubules from men aged > 80 years contain spermatids. In a random international sample of 11,548 men confirmed to be biological fathers by DNA paternity testing, the oldest father was found to be 66 years old at the birth of his child; the ratio of DNA-confirmed versus DNA-rejected paternity tests around that ...
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In Vitro Fertilisation
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating an individual's ovulatory process, removing an ovum or ova (egg or eggs) from their ovaries and letting sperm fertilise them in a culture medium in a laboratory. After the fertilised egg ( zygote) undergoes embryo culture for 2–6 days, it is transferred by catheter into the uterus, with the intention of establishing a successful pregnancy. IVF is a type of assisted reproductive technology used for infertility treatment, gestational surrogacy, and, in combination with pre-implantation genetic testing, avoiding transmission of genetic conditions. A fertilised egg from a donor may implant into a surrogate's uterus, and the resulting child is genetically unrelated to the surrogate. Some countries have banned or otherwise regulate the availability of IVF treatment, giving rise to fertility tourism. Restric ...
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Fertility
Fertility is the capability to produce offspring through reproduction following the onset of sexual maturity. The fertility rate is the average number of children born by a female during her lifetime and is quantified demographically. Fertility is addressed when there is a difficulty or an inability to reproduce naturally, which is referred to as infertility. Infertility is widespread, with fertility specialists available all over the world to assist mothers and couples who experience difficulties having a baby. Human fertility depends on factors of nutrition, sexual behaviour, consanguinity, culture, instinct, endocrinology, timing, economics, personality, way of life, and emotions. Fertility differs from fecundity, which is defined as the ''potential'' for reproduction (influenced by gamete production, fertilization and carrying a pregnancy to term). Where a woman or the lack of fertility is infertility while a lack of fecundity would be called sterility. Demograph ...
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Fertility
Fertility is the capability to produce offspring through reproduction following the onset of sexual maturity. The fertility rate is the average number of children born by a female during her lifetime and is quantified demographically. Fertility is addressed when there is a difficulty or an inability to reproduce naturally, which is referred to as infertility. Infertility is widespread, with fertility specialists available all over the world to assist mothers and couples who experience difficulties having a baby. Human fertility depends on factors of nutrition, sexual behaviour, consanguinity, culture, instinct, endocrinology, timing, economics, personality, way of life, and emotions. Fertility differs from fecundity, which is defined as the ''potential'' for reproduction (influenced by gamete production, fertilization and carrying a pregnancy to term). Where a woman or the lack of fertility is infertility while a lack of fecundity would be called sterility. Demograph ...
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Reproductive Endocrinologist
Reproductive endocrinology and infertility (REI) is a surgical subspecialty of obstetrics and gynecology that trains physicians in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of infertility. While most REI specialists primarily focus on the treatment of infertility, reproductive endocrinologists are trained to also test and treat hormonal dysfunctions in females and males outside infertility. Reproductive endocrinologists have specialty training (residency) in obstetrics and gynecology (ob-gyn) before they undergo sub-specialty training (fellowship) in REI. Reproductive surgery is a related specialty, where a physician in ob-gyn or urology further specializes to operate on anatomical disorders that affect fertility. Certification In a number of countries, the pathway to become a subspecialist in REI is regulated. Thus, in the United States, for instance, the American Board of Obstetrics and Gynecology (ABOG) and Americ ...
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Semen Quality
Semen quality is a measure of male fertility, a measure of the ability of sperm in semen to accomplish fertilization. Semen quality involves both sperm quantity and quality Cryptorchidism, hypospadias, testicular cancer and poor semen quality make up the syndrome known as testicular dysgenesis syndrome. Factors There are many factors that influence the sperm quality. Exposure to any of the temporary factors can cause up to a three-month delay before sperm quality returns to normal, due to spermiogenesis. General decline A 2017 review and meta-analysis found sperm counts among Western men (i.e. men in Australia, Europe, New Zealand, and North America) declined 50–60% between 1973 and 2011, with an average decline of 1.4% per year. The meta-analysis found no indication the decline is leveling off. The amount of decline among men in North America and men in Australia/Europe is similar. The decline in sperm count among men in South America, Asia, and Africa is less than men in ...
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Fertility Awareness
Fertility awareness (FA) refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gynecological health. Methods of identifying infertile days have been known since antiquity, but scientific knowledge gained during the past century has increased the number, variety, and especially accuracy of methods. Systems of fertility awareness rely on observation of changes in one or more of the primary fertility signs ( basal body temperature, cervical mucus, and cervical position), tracking menstrual cycle length and identifying the fertile window based on this information, or both. Other signs may also be observed: these include breast tenderness and mittelschmerz (ovulation pains), urine analysis strips known as ovulation predictor kits (OPKs), and microscopic examination of saliva or cervical fluid. Also available are computerized ...
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Assisted Reproductive Technology
Assisted reproductive technology (ART) includes medical procedures used primarily to address infertility. This subject involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), cryopreservation of gametes or embryos, and/or the use of fertility medication. When used to address infertility, ART may also be referred to as fertility treatment. ART mainly belongs to the field of reproductive endocrinology and infertility. Some forms of ART may be used with regard to fertile couples for genetic purpose (see preimplantation genetic diagnosis). ART may also be used in surrogacy arrangements, although not all surrogacy arrangements involve ART. The existence of sterility will not always require ART to be the first option to consider, as there are occasions when its cause is a mild disorder that can be solved with more conventional treatments or with behaviors based on promoting health and reproductive habits. Procedures General With ART, the p ...
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Gynecology
Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area of obstetrics and gynecology (OB-GYN). The term comes from Greek and means "the science of women". Its counterpart is andrology, which deals with medical issues specific to the male reproductive system. Etymology The word "gynaecology" comes from the oblique stem (γυναικ-) of the Greek word γυνή (''gyne)'' semantically attached to "woman", and ''-logia'', with the semantic attachment "study". The word gynaecology in Kurdish means "jinekolojî", separated word as "jin-ekolojî", so the Kurdish "jin" called like "gyn" and means in Kurdish "woman". History Antiquity The Kahun Gynaecological Papyrus, dated to about 1800 BC, deals with gynaecological diseases, fertility, pregnancy, contraception, etc. The text is divided into ...
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Amenorrhoea
Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation (breastfeeding). Outside the reproductive years, there is absence of menses during childhood and after menopause. Amenorrhoea is a symptom with many potential causes. Primary amenorrhea is defined as an absence of secondary sexual characteristics by age 13 with no menarche or normal secondary sexual characteristics but no menarche by 15 years of age. It may be caused by developmental problems, such as the congenital absence of the uterus, failure of the ovary to receive or maintain egg cells, or delay in pubertal development. Secondary amenorrhoea, ceasing of menstrual cycles after menarche, is defined as the absence of menses for three months in a woman with previously normal menstruation, or six months for women with a history of oligomenorrhoea. It is often caused by hormonal disturbances from the hypothalam ...
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Basal Body Temperature
Basal body temperature (BBT or BTP) is the lowest body temperature attained during rest (usually during sleep). It is usually estimated by a temperature measurement immediately after awakening and before any physical activity has been undertaken. This will lead to a somewhat higher value than the true BBT. In women, ovulation causes a sustained increase of at least in BBT. Monitoring BBTs is one way of estimating the day of ovulation. The tendency of a woman to have lower temperatures before ovulation, and higher temperatures afterwards, is known as a biphasic temperature pattern. Charting this pattern may be used as a component of fertility awareness. The BBT of men is comparable to the BBT of women in their follicular phase. Hormonal causes of biphasic patterns The higher levels of estrogen present during the pre-ovulatory (follicular) phase of the menstrual cycle lower BBTs. The higher levels of progesterone released by the corpus luteum after ovulation raise BBTs. ...
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