190 likes | 301 Views
Fertility. NormallyCouple has approximately 25% chance of conception per monthIn 1 year 85-90% of couple will have conceivedIn prolonged infertility there is approximately 2% chance of spontaneous pregnancy. Definitions. Infertility: Failure to conceive after one year of frequent, unprotected sex
E N D
1. INFERTILITYBy Joan MeadeNovember 2006
2. Fertility Normally
Couple has approximately 25% chance of conception per month
In 1 year 85-90% of couple will have conceived
In prolonged infertility there is approximately 2% chance of spontaneous pregnancy
3. Definitions Infertility: Failure to conceive after one year of frequent, unprotected sexual intercourse
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
4. Issues in Treatment
Investigation and treatment costly
Financially
Emotionally
No guarantee of success
5. Incidence of Infertility Affects both men and women
Affects approximately 15% of all couples
Varies from country to country
Worldwide ranges from 12 – 20%
WHO study found:
Female causes 25-37%
Male causes 8-22%
Both male & female 21-38%
No identified cause 5-15%
6. Study found that most infertile couples suffer from primary infertility
Latin America has fairly high incidence of secondary infertility – 40%
About 5% of couples suffer from anatomical, genetic, hormonal, and immunological causes
Remainder relate to preventable causes: STIs, infectious and parasitic diseases, poor health care practices, exposure to toxic substances.
7. Major Female Factors Tube problems
Ovulation disorders
Problems in second half of Cycle
Pituitary Gland Problems
Pelvic problems and endometriosis
Problems of the cervix
8. Major Male Factors Varicocele
Ejaculatory problems
Pituitary problems
Genito-urinary tract infections
Hormonal problems
9. 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
10. Investigations - Males Semen analysis
Urological examination to look for:
anatomical abnormalities
infections
endocrine disorders
varicocele
11. 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
12. Emotional Responses Guilt
Depression
Anger
Isolation
13. 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
14. Treatment
Hormonal therapy for stimulation
Abstinence or condom use if hostile cervical mucus
Surgery to correct abnormalities
Use of Assisted Reproductive Technologies (ARTs)
15. Assisted Reproductive Technologies Drugs to stimulate ovulation
Intrauterine insemination (IUI) where prepared sperm placed inside uterus
In vitro fertilization (IVF) where eggs are extracted, fertilized in a laboratory and the embryo transferred to the uterus
16. Assisted Reproductive Technologies (contd.) Gamete intrafallopian transfer (GIFT) where unfertilized eggs and sperm are placed in the fallopian tubes
Zygote intrafallopian transfer (ZIFT) where eggs are fertilized in the laboratory and the fertilized eggs (zygote) placed in the fallopian tubes
17. Assisted Reproductive Technologies (contd.) Intracytoplasmic sperm injection (ICSI) used for male infertility where a sperm is injected directly into an egg and then the embryo is transferred to the uterus
18. Assisted Reproductive Technologies (contd.) Sorting sperm allows doctors to select only those that will produce girls and do not carry x-linked chromosomal diseases
Preimplantation diagnosis allows DNA testing of embryonic cells to confirm that only healthy embryos are transferred to avoid genetic diseases
19. Issues
Can ARTs be justified in third world countries like Jamaica?
What are the legal and ethical considerations?