Chapter 9: Infertility

Question 1

How common is infertility?

Answer 1

affects 18% of reproductive-age couples; increases with age, especially with women 35+

Question 2

What is the difference between infertility and sterility?

Answer 2

• infertility: prolonged time to conceive
• sterility: inability to conceive

Question 3

What are some female infertility causes?

5 causes

Answer 3

• hormonal and ovulatory factors: ovarian developmental anomalies, primary anovulation (not ovulating), or secondary anovulation (secondary causes for not ovulating)
• tubal and peritoneal factors: tubal anomalies, inflammation within tube, tubal pregnancy causing damage/rupture, endometriosis
• uterine factors: myometrial fibroid tumors, Asherman’s syndrome (scar tissue build up in uterus)
• vaginal-cervical factors: STIs, cervical mucous inadequacy, isoimmunization (sperm antibodies)
• other factors: nutrition, obesity (overproduction of androgen from fat), thyroid dysfunction, idiopathic causes

Question 4

What are some male infertility causes?

2 causes

Answer 4

• structural and hormonal disorders: undescended testes, hypospadias (urethral opening is not at tip of penis), varicocele (varicose vein of scrotum), low testosterone, azoospermia (no sperm cells produced), or oligospermia (few sperm cells produced)
• other factors: nutritional, genetic, endocrine, STIs, obesity, environmental hazards, substance abuse

Question 5

What are some ways that female infertility can be diagnosed?

4 ways

Answer 5

• ovulation detection
• hormone analysis
• imaging – ultrasound, MRI, sonohysterography, hysterosalpingography (HSG – X-ray determines patency of fallopian tubes), laparoscopy
• endometrial biopsy – determines thickness of endometrial lining; determines if something in endometrium is causing infertility

Question 6

What are some ways that male infertility can be diagnosed?

6 ways

Answer 6

• evaluation of general health
• semen analysis – sperm number, morphology, motility, pH
• hormone analysis
• ultrasonography – scrotal and transrectal – for abnormalities
• tests for chronic diseases
• tests for environmental hazards

Question 7

What are 2 types of medication that can help women with infertility?

Answer 7

1. clomiphene citrate – an estrogen modulator; helps stimulate ovulation; 1st therapy
2. metformin – decreases androgen production and insulin resistance; helps with weight loss

Question 8

What is ART?

Answer 8

• assisted reproductive therapy
• manipulation of eggs, sperm, and/or embryo to produce pregnancy

Question 9

What are the 8 types of ART?

Answer 9

1. intrauterine insemination (IUI) – placement of washed and concentrated sperm into uterus around ovulation
2. in vitro fertilization-embryo transfer (IVF-ET) – most common ART; placement of fertilized egg into uterus
3. gamete intrafallopian transfer (GIFT) – placement of non-fertilized gametes (sperm and egg) into fallopian tubes
4. zygote intrafallopian transfer (ZIFT) – placement of fertilized egg into fallopian tubes
5. oocyte donation
6. sperm donation
7. embryo donation
8. surrogate mothers and embryo hosts