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Infertility is a little discussed but widespread problem that many couples are struggling with. The other disorder interrupting ovulations is premature ovarian insufficiency (POI). This condition is also known as premature menopause and refers to the loss of function of the ovaries before the age of 40. Endometriosis is a disorder when tissue that belongs to the uterus grows in other locations (for example, ovaries, Fallopian tubes, tissues surrounding uterus and pelvic cavity). Pelvic adhesions are strings or bands of scar tissue that develop around the Fallopian tubes, ovaries, uterus and bowel.
Healthy and open Fallopian tubes are necessary for getting pregnant because that is where the sperm fertilizes the egg. Hyperprolactinemia is defined as a condition of abnormally high level of prolactin in the blood. In some cases infertility may be a result of uterine fibroids (also known as myomas) that grows inside the uterus.
Infertility and Subfertility, cont'd A mutation or chromosomal aberration that impairs fertility in the male 20% of the 90% both partners have a medical condition that could contribute- irregular menstruation cycle and low sperm count. Male Infertility, cont'd Mutations in genes that encodes protein fertility hormones that regulate sperm development or motility. Female Infertility, cont'd Common cause- blocked uterine tubes Infection- pelvic inflammatory disease Excess tissues growing n the uterine lining that can include benign tumors like fibroid Endometriosis- thickened lining that hormonally cues to menstruate, tissue bleeds causing cramps Secretions that are hostile to sperm Oocyte fails to release sperm- attracting biochemicals.
Infertility Tests Urologist performs sperm test Checks sperm count, motility and shape Ejaculate containing up to 40% unusual forms is still considered normal Many more than this can impair fertility Genetic counselor may help in identifying the cause of male infertility- interpret the results of a PCR analysis of Y chromosome. Assisted Reproductive Technologies In 2001, 1% of approximately 4 million births in the United States were from ARTs (Assisted Reproductive Technologies). Donated Sperm- Intrauterine Insemination Intrauterine Insemination is the oldest assisted reproductive technology. In Vitro Fertilization Sperm and oocyte joined in a laboratory dish, then placed in the oocyte donor's uterus (or another woman's uterus.) First 'test tube baby' born in 1978.
In Vitro Fertilization, cont'd Intracytoplasmic Sperm Injection: A single cell is injected into the cytoplasm of an oocyte. In Vitro Fertilization, cont'd Children born following IVF have twice the rate of birth defects (About 9%). Gamete and Zygote Intrafallopian Transfer IVF may fail because of the artificial environment for fertilization. Oocyte Bank and Donation Oocytes can be stored, as sperm are, but the procedure may introduce problems. PreImplantation Genetic Diagnosis A test called preimplantation genetic diagnosis (PGD) detects genetic and chromosomal abnormalities before pregnancy starts.
Before the embryo is implanted into the woman, the single cell is karyotyped, or its DNA amplified and probed for particular genes that the parents carry. Michael Cummings David Reisman University of South Carolina Reproductive Technology, Genetic Testing, and Gene Therapy Chapter 16. Reproduction and Fetal Technology Annabel Barajas Tamari Zeigler Thomas Ji Jared Salisbury Nathan Vasquez.
Copyright 2008 Allyn & Bacon Conception, Pregnancy, and Childbirth Chapter 11 This multimedia product and its contents are protected under copyright law. By: Amrusha Bhatt, Vandan Jhaveri, Ananya Jhamb, Teja Mourya Bayyarapu, Divyansh Sharma and Kevin Pathinather. 2014 Conference Melbourne, Australia Embryology 101 Basics of embryo development in an IVF laboratory. If you and your partner have been trying long to conceive but have failed, then you are not alone. There are certain factors that increase the risk of infertility in both men and women and couples trying to conceive must be aware of these factors.
Being Overweight or Obese: One of the worst outcomes of the modern sedentary lifestyle is increased cases of obesity and being overweight.
Sexually Transmitted Infections: Sexually transmitted infections such as chlamydia and gonorrhea can affect both male and female fertility.
One of the most common causes of infertility in women is dysfunction of the two important hormones- follicle-stimulating hormone (FSH) and luteinizing hormone (LH). PCOS or Polycystic ovary syndrome is yet another major cause of anovulation caused by changes in the hypothalamus and pituitary gland which results in hormonal imbalance. Chronic abdominal diseases and bacterial and viral infections can also lead to female infertility. Male infertility refers to a condition in which a male fails to cause pregnancy to a fertile female. One of the most common causes of male infertility is low sperm count in which the testes produce fewer number of sperm than normal and the sperm that are produced are of low quality and weak that don’t work effectively. Testicular infections, mainly sexually transmitted infections such as chlamydia and gonorrhea also affect sperm production and sperm quality.
Prolonged treatment and medication for certain diseases, radiotherapy or surgery for hernia or correcting testicular deformities such as undescended testes or twisted testicles may cause infertility in men. Stay aware about causes of infertility but don’t worry about them because there are several high-end infertility tests for both men and women through which the problem can be diagnosed in no time and treated effectively. Infertility is a very difficult issue, as anyone who has been through it themselves, or who has had family members or close friends who have.
On one hand this is even tougher for those involved, as our human logic wishes to know a reason. I am not proposing it as a cure, only as a way to de-stress a little, and to feel better in yourself.
These factors cause infections, inflammations, sperm deterioration, and hormonal imbalance.
Data worldwide shows that infertility affects from 10 % to 15% of couples all over the globe causing stigma with high social, emotional and financial burden. The name endometriosis refers to the inner layer of the uterus which is called endometrium.
When the tubes are blocked or damaged, the sperm cannot reach the egg and conception is not possible.
Prolactin is a hormone released by a gland which is located in the brains and is called the pituitary gland.
Uterine fibroids are benign tumors that vary in size and usually do not cause any symptoms. Quality over quantity Apoptosis (programmed cell death) selectively kills abnormally shaped sperm. Females: Gynecologists that check to see if the structures of the reproductive system are present and functioning.

Doctor places donated sperm into a woman's reproductive tract, typically the cervix or uterus.
A woman might undergo IVF if her ovaries and uterus work but her uterine tubes are blocked. Measures that improve the chance that IVF will culminate in birth include: Transferring the embryos at a slightly later stage, culturing fertilized ova with other cells that normally surround the oocyte, and screening early embryos for abnormalities.
PGD is possible because one cell, or blastomere, can be removed for testing from an 8-celled embryo, and the remaining 7 cells can complete development normally in the uterus. Today, PGD is increasingly being used to screen fertilization ova and early embryos derived from IVF for chromosome abnormalities before implanted them into the women. T RYING TO G ET P REGNANT Preconception Health Video (6:08minutes) Click on image for video. One in every six couples have a  form of infertility during their reproductive lifetime and infertility problems may be in either partner. It deteriorates the quality and count of sperm in men and affects the egg in women increases the risk of miscarriage. It lowers sperm count and quality of sperm in men and reduces the chances of a healthy pregnancy in women. While excessive body weight reduces the chances of a woman getting pregnant, it increases the risk of developing abnormal sperm in men.
But chronic mental stress for a prolonged period has been shown to affect female ovulation and sperm production thereby reducing the chances of conception. It may also be caused by failure of the ovary to produces eggs, hormonal imbalance and damaged ovary. These two hormones are produced by the pituitary gland during a specific period during each menstrual cycle which induces ovulation. In Polycystic ovary syndrome, the production of FSH reduces while levels of LH either remain normal or increases. The blockage may be caused due to pelvic inflammatory disease or sexually transmitted infections of the uterus that blocks the sperms from reaching the egg. Multiple, extensive and invasive surgeries of the ovary for removing ovarian cysts damages and scars the ovarian capsules to such an extent that it hinders the proper maturation of the follicles that prevents ovulation and leads to infertility. This abnormal growth affects the ovaries, uterus, eggs and fallopian tubes and also blocks the passage of the sperm to the eggs.
Most of the infections are caused by sexually transmitted bacteria and viruses that lead to inflammation, scarring and damage of the fallopian tube. The most common reason for male fertility is low sperm production and low quality of the semen. The most common reasons for low sperm count are infection, stress and dysfunction of the hypothalamus and pituitary glands that produce the male sex hormones. The tubes that carry the sperms from the testes to the penis might be damages due to injury or illness, or it might be blocked which cuts out the flow of the sperms.
At times, the pituitary gland fails to send the right signal to the testicles that cause lower production of testosterone (male hypogonadism) and lack of sperm production by the testes. It is a condition of scrotal abnormality in which the veins of the testicle that drain it is dilated and swell up thereby preventing the natural cooling of the testicle. Severe injury to the testicles during sport or a blow to it during a fight can cause permanent damage the testicles by cutting out blood supply thus disrupting the mechanism of sperm production.
She has done her masters in English and has done her graduation from Banaras Hindu University. Long periods of sitting irritate genital organs because of elevated tissue pressure and elevated temperature and humidity. Factors that may cause POI include autoimmune disorders, genetic abnormalities, radiation and chemotherapy, smoking and hormonal therapy. PID refers to an infection of reproductive organs (uterus, tubes, etc.) that is accompanied by lower abdominal pain. Causes of tubal blockage vary from anatomical abnormalities, previous surgeries in uterus or tubes and infection due to sexually transmitted diseases, especially chlamydia or gonorrhea. This hormone is important for reproduction, control of behavior and maintenance of the internal environment stability.
However, they can block Fallopian tubes and interfere with implantation of a fertilized egg. High percentage of abnormal shaped sperm often have cell surface molecules that indicate impaired apoptosis.
Fertilization is assisted in GIFT, but it occurs in the womens body rather than in glassware.
To avoid the difficulties of freezing oocytes, strips of ovarian tissue can be frozen, stored, thawed, and re implanted at various sites, such as under the skin of the forearm, abdomen, or in the pelvic cavity. Fertility clinics can either discard or store them indefinitely In the US, nearly 500,000 embryos sit in freezers, some for years. AIMAKHU (MBBS,FWACS,FMCOG) CONSULTANT OBSTETRICIAN AND GYNAECOLOGIST, CATHOLIC HOSPITAL, OLUYORO, IBADAN. Around 20-30% cases of infertility are caused due to physiological issues in men and 20-35% due to physiological issues in women.
The complex balance of these hormones can be disrupted due to excessive physical or emotional stress and sudden weight loss or weight gain that in turn disrupts the periodic process of ovulation.
All these conditions lead to premature development of ovarian follicles where an egg cannot mature properly. The fallopian tube may also be damaged due to certain previous surgeries of the abdomen such as surgery for ectopic pregnancy.
Laparoscopy for infertility can be used to identify the growth, and it can be removed surgically.
Abdominal diseases such as chronic colitis or appendicitis damage the abdominal cavity which also leads to scarring and blockage of the fallopian tubes. About two-thirds of male infertility cases are due to low sperm production and low quality of sperms. It also leads to inflammation of the prostate (prostatitis) and inflammation of testicles that cause heavy testicular damage. Abnormalities in other hormonal systems such as the pituitary, hypothalamus and adrenal glands also affect fertility in men. Increased temperature of the scrotum is directly related to reduced sperm count and immobility of sperms.
In order for you to see this page as it is meant to appear, we ask that you please re-enable your Javascript! PCOS is one of the most common hormonal disorders among female affecting approximately 6 % – 12 % of women all over the world.

It is a complication of sexually transmitted diseases (chlamydia and gonorrhea) that can lead to infertility, ectopic pregnancy and chronic pelvic pain.
However, excessive amount of prolactin causes infertility by interfering with ovulation process. Cost: Between 125 and 3000 dollars Parents can choose sperm based on personal characteristics of donor. Problem: A woman may not be able to predict her responses to pregnancy and childbirth before hand, and may change her mind once the child is born. Sometimes they can be donated to couples that can't conceive They can also be donated for scientific research. But surgical removal has its risks because it might scar the tube and affect the lining of the uterus.
However I truly believe that some people can definitely deal with stress better, when they feel more fit. In addition to other symptoms (abnormal menstrual periods, central obesity, hair loss, acne, hirsutism, etc.), PCOS results in anovulation (absence of ovulation). Additionally, adhesions may also be caused by endometriosis, ruptured appendicitis and previous surgeries, particularly on the ovaries, tubes and uterus.
Other symptoms of hyperprolactinemia in women include loss of periods, breast milk secretion (galactorrhea), loss of libido and breast pain. Aging affects the health and count of the eggs, function of the ovaries and the overall health of the woman. About a third of infertile men have deletions of the Y chromosome that remove the only copies of key genes whose products control spermatogenesis. IVF is major source of fertilized ova, however, a new technique called Polar body biopsy allows oocytes to be tested for undesirable traits before they are fertilized.
Infertility is described as the inability to conceive even after 12 months of regular unprotected intercourse without contraception. As a personal trainer, I would recommend to anyone, just for their health generally, to consider some form of regular exercise. Pelvic adhesions may result in tubal blockage and interfere with the ovulation process causing infertility.
Also, some behavioral factors such as smoking, excessive alcohol and caffeine intake, stress, intense exercising, extreme weight levels (either high or low) and exposure to environmental chemicals can cause infertility. But most often, if you are under 35 years of age and have not conceived after a regular and contraceptive free intercourse for a year, you are generally considered eligible for treatment by an Infertility Specialist. Also, endometriosis can result in formation of scars and adhesions that block Fallopian tubes or disrupt implantation of fertilized egg.
Unfortunately, in some cases it is impossible to discover the cause of infertility using currently available methods, thus it remains unexplained.
In addition to infertility, endometriosis is accompanied by other symptoms including painful and heavy periods, pain at the ovulation and pain during sexual intercourse. We do not to wish overwhelm you with medical terminologies and concepts, sometimes ignorance is a bliss.Following chart shows the gender bifurcation of the infertility causes.
Hormone tests rarely required.TreatmentLifestyle changes (Exercise and Weight Loss)Induction of Ovulation, Follicular Monitoring, IUIIf ovulation does not occur with oral medicines, injections (Gonadotropins) may be required. In severe cases which do not respond to medicines, Laparoscopic Surgery is recommended.If Ovarian Hyperstimulation occurs,  IUI can be converted into IVFLikelihood of Pregnancy Post TreatmentVery Good. Pregnancy itself is a good cure for the disease and therefore most of the symptoms like painful periods, pelvic pain etc are relieved after pregnancy.Diminishing Ovarian ReserveDefinitionWhen the number of eggs in the ovary are reduced.
Low AMH and EstradiolTreatmentAttain pregnancy as soon as possible, may require ovarian stimulation with IUI to increase chances of conception per cycle. Supplementation  with DHEA therapy is recommended for expected poor respondersLikelihood of Pregnancy Post TreatmentVery good till treatment is carried out in a timely manner.
When done, absence of secretory changes in endometrium indicate anovulationUltrasonography: Best indicator nowadays. In some cases, laparoscopic correction may not be possible due to extent of damage to the tubes. In all such cases, IVF is the treatment of choice. Likelihood of Pregnancy Post If minor adhesions are corrected surgically, chances of spontaneous conception are very good. If significant loss of tubal function exists, Good Pregnancy rates with IVF.Male InfertilityIn approximately 40 percent of infertile couples, the male partner is the sole cause and in 20 percent a contributing cause, of infertility.
Despite the male factor being at least partly responsible in about 60 percent of infertile couples, infertility evaluations have traditionally focused on women, because women tend to seek Gynaecological care and because men often are reluctant to seek advice.A variety of disorders ranging from hormonal disturbances to physical problems, to psychological problems can cause male infertility. Although many treatment options are now available, in many cases treatment will not work.In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm. Besides testicular damage, the main causes of male infertility are low sperm production and poor sperm quality.Causes of Male InfertilityMale factor infertility refers to the failure of a couple to achieve conception due to problems specifically related to the man’s sperm, seminal fluid, or reproductive organs. A number of things can affect sperm count, ability to move (motility) or ability to fertilize the egg.
For a man to be fertile, the testicles must produce enough healthy sperm, and the sperm must be ejaculated effectively into the woman’s vagina. Tests for male infertility attempt to determine whether any of these processes are impaired.General physical examination. This includes examination of your genitals and questions concerning your medical history, illnesses and disabilities, medications, and sexual habits.Semen analysis.
Semen is generally obtained by masturbating or by interrupting intercourse and ejaculating your semen into a clean container.
A laboratory analyzes your semen specimen for quantity, colour, and presence of infections or blood.
A blood test to determine the level of testosterone and other male hormones is common.Doppler evaluation of the testis and Transrectal Ultrasound.
However, a woman can still become pregnant with assisted reproductive technology or other procedures to restore fertility.Simple lifestyle changes, like abstaining from alcohol, tobacco, and illicit drugs can improve male fertility. A healthy diet, sufficient (not excessive) exercise, and proper amounts of vitamin B12, vitamin C, and zinc also improve fertility.General sexual problemsAddressing impotence or premature ejaculation can improve fertility. Treatment for these problems often is primarily with medication or behavioural approaches, though mechanical and surgical treatment is sometimes effective.

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