Fertility: Difference between revisions

No edit summary
No edit summary
Line 6: Line 6:


== Definition ==
== Definition ==
Infertility and subfertility affect a significant proportion of humanity. WHO has calculated that over 10% of women are inflicted<ref>World Health Organization. Sexual and reproductive health. Available from https://www.who.int/reproductivehealth/topics/infertility/perspective/en/</ref>
The World Health Organization calculated that over 10% of women are affected by infertility and subfertility.<ref>World Health Organization. Sexual and reproductive health. Available from https://www.who.int/reproductivehealth/topics/infertility/perspective/en/</ref>


Fertility: refers to the capacity to conceive and produce offspring
Fertility: refers to the capacity to conceive and produce offspring

Revision as of 20:59, 27 April 2019

This article is currently under review and may not be up to date. Please come back soon to see the finished work! (27/04/2019)

Definition[edit | edit source]

The World Health Organization calculated that over 10% of women are affected by infertility and subfertility.[1]

Fertility: refers to the capacity to conceive and produce offspring

Infertility: is the inability to conceive despite frequent coitus. Infertility refers to a state in which the capacity for fertility is diminished, but not necessarily absent

Etiology[edit | edit source]

Pathology affecting fertility[2]

  • Ovulatory dysfunction – 21 percent
  • Tubal damage – 14 percent
  • Endometriosis – 6 percent
  • Coital problems – 6 percent
  • Cervical factor – 3 percent
  • Unexplained – 28 percent
  • Male factor (hypogonadism, post-testicular defects, seminiferous tubule dysfunction) – 26 percent

Modifiable factors affecting fertility

Factors affecting fertility Information
Tobacco use
Weight
Exercise
Alcohol intake
Diet
Caffiene
Stress
Environmental factors
Recreational drug use
Sexual behaviour

Management[edit | edit source]

Physiotherapy

Medical Interventions

The following tests are useful in most couples with infertility:[3]

  • Semen analysis to assess male factors.
  • Menstrual history, assessment of luteinizing hormone surge in urine prior to ovulation, and/or luteal phase progesterone level to assess ovulatory function.
  • Hysterosalpingogram or sonohysterogram with a test of tubal patency such as hysterosalpingo-contrast-sonography to assess tubal patency and the uterine cavity.
  • Assessment of ovarian reserve with day 3 serum follicle-stimulating hormone and estradiol levels, anti-Müllerian hormone, and/or antral follicle count.
  • Thyroid-stimulating hormone.

In select couples, the following additional tests may be warranted:

  • Pelvic ultrasound to assess for uterine myomas and ovarian cysts
  • Laparoscopy to identify endometriosis or other pelvic pathology

Resources[edit | edit source]

References[edit | edit source]

  1. World Health Organization. Sexual and reproductive health. Available from https://www.who.int/reproductivehealth/topics/infertility/perspective/en/
  2. Hull MG, Glazener CM, Kelly NJ, Conway DI, Foster PA, Hinton RA, Coulson C, Lambert PA, Watt EM, Desai KM. Population study of causes, treatment, and outcome of infertility. Br Med J (Clin Res Ed). 1985 Dec 14;291(6510):1693-7.
  3. Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertility and sterility. 2012 Aug 1;98(2):302-7.