Infertility and Treatments

According to research, about one-fourth of couples conceives after a month of regular and unprotected sexual intercourse while 80 percent are likely to conceive within 12 months. Couples are considered as infertile when they are unable to conceive a baby after a year of unprotected sex. Couples who have never conceived are considered as primary infertile, while couple who cannot conceive despite prior successful conception are referred to as secondary infertility. Infertility prevalence differs across different countries, in the US, about 10 to 14 percent of couple experiences infertility. In developing nations, the rate is higher as a result of the greater prevalence of contributing infectious diseases, where the rate is as high as 30 percent (O’Brien, Varghese& Agarwal, 2010).

The World Health Organization estimate that less than half of infertility is attributed to inherent genetic and biological factors such as anatomical and endocrinological abnormalities. In most cases, infertility result from preventable factors such as sexually transmitted and infectious disease, harmful environmental substances, and unsafe health care. Maternal age is a determinant of fertility and western countries tendency among women to bear children later in life has contributed to the misperception that infertility is on an increasing trend. Women fertility starts to decline in late 20s and earlier 30s with a steeper decline after 35 years. At the age of 40 years, research reveals that 1 out of every three women is likely to be infertile and at the age of 45 years 1 in every ten women is likely to conceive. The decline is explained by gradual diminishing supply and weakening quality of oocytes. Apparently, infertility was perceived as women problem. However, malefactors specifically cause at least 20 percent of infertility and contributing factor in another 30 percent. Infertility in men results from sperm abnormality including the oligospermia, irregular sperm shape and problems with sperm movement. The exact reason for deficiencies in sperm production and role is unclear, but diseases, genetic disorders, environmental factors, infection, and nutrition play a role. The most common physiological female factor contribute to infertility is absent and infrequent ovulation, implicated in up to one-third of sterility cases. A main root of ovulatory abnormality is polycystic ovarian syndrome which is an endocrine disorder affecting at least 5 percent of female in the US. Damaged and blocked fallopian tubes dues to pelvic inflammatory disease and endometriosis are other cause of female infertility.

Infertility is treated by reproductive endocrinologists, who are physicians specialized in gynecology and obstetrics and complete training and research in infertility. The treatment starts by testing both partners in the effort of determining the most likely cause of infertility. Women with ovulation problems are typically treated with the ovulation-inducing medication, also referred to as fertility drugs. Two different classes of drugs are used clomiphene citrate is taken orally and gonadotropins which are administered by injection. Clomiphene successfully induces ovulation in majority of women who is prescribed range between 60 and 90 percent. In most cases, less than half of women conceive within six months which are the recommended maximum treatment period (Bulletti, Coccia, Battistoni&Borini, 2010). When clomiphene is ineffective, gonadotropins are used. Gonadotropins injections are likely to result in pregnancy, have significant side effects including greater increase the likelihood of multiple births.

Surgery is another approach used in infertility treatment. Women with blocked fallopian tubes benefit from surgical attempts to repair and repair tubes. In addition, malefactors causes of infertility can also be corrected by surgery. Microsurgical procedures can be performed to reverse prior tubal ligation surgery in women as vasectomies in men. Thirdly, intrauterine insemination is an intervention of infertility caused by sperm abnormalities or infertility that is unexplained. The approach involves the collection of the semen sample from a male partner, removing and preparing the sperm and through a thin catheter the sperm is placed in the woman’s uterus. Intrauterine insemination should be timed perfectly with ovulation to maximize the effectiveness. Success case of intrauterine insemination on pregnancy range between 4 to 15 percent. There are factors that influence the effectiveness of intrauterine insemination including number of ovarian follicles, maternal age, and sperm motility (Poongothai, Gopenath, &Manonayaki, 2009).

Fourthly, assisted reproductive technologies are defined therapies that involve the handling sperms and eggs. Assisted reproductive technologies has gained attention from the media, there are few people seeking to undergo the procedure, which is after all other available options are exhausted. Assisted reproductive technologies involve stimulation of woman’s ovaries, surgically removing the egg and combining with sperm, transferring fertilized eggs to the back of woman’s body. The most common practice is Vitro fertilization where eggs and sperm are combined to facilitate fertilization, and then the embryos are placed directly into woman’s uterus. Gamete intrafallopian transfer (GIFT) uses the same concept with Vitro fertilization, but the eggs are transferred to the fallopian tubes and fertilized there rather than outside the body. The other type of assisted reproductive technologies which combines laboratory fertilization of the embryo which is transferred to the fallopian tubes (Guerin, Prins& Robertson, 2009).

The Centers for Disease Control collect data from fertility clinics in the US on an annual basis for the purpose of tracking down the effectiveness of assisted reproductive technologies. Results reveal that assisted reproductive technologies approaches that used fresh non-donor eggs resulted in pregnancy. Success rate declines as maternal age increase and the likelihood of pregnancy in women over the age of 40 years. Assisted reproductive technologies has been realized over time in the part by the introduction of intracytoplasmic sperm injection, which is a technique that allow single sperm to be directly injected into an egg increasing the chances that fertilization to occur. Third party reproductive technique refer to the donation of eggs, embryo, and sperm to infertile couples. The donor may be selected by the couple or is anonymous. Surrogacy, which is carrying of an embryo throughout pregnancy by another woman considered as a third party reproductive technique. There are legal. Ethical and psychological issues considered in third party techniques, with the exception of sperm donation which are still new approaches to the treatment of infertility (Bentov, Esfandiari, Burstein & Casper, 2010).

Conclusion

Infertility is attributed to inherent genetic and biological factors such as anatomical and endocrinological abnormalities. Infertility result from preventable factors such as sexually transmitted and infectious disease, harmful environmental substances, and unsafe health care.The most common physiological female factor contribute to infertility is absent and infrequent ovulation, implicated in up to one-third of sterility cases. A main root of ovulatory abnormality is polycystic ovarian syndrome which is an endocrine disorder affecting at least 5 percent of female in the US.Assisted reproductive technologies involve stimulation of woman’s ovaries, surgically removing the egg and combining with sperm, transferring fertilized eggs to the back of woman’s body. The most common practice is Vitro fertilization where eggs and sperm are combined to facilitate fertilization, and then the embryos are placed directly into woman’s uterus.

 

 

 

Reference

Bentov, Y., Esfandiari, N., Burstein, E., & Casper, R. F. (2010). The use of mitochondrial            nutrients to improve the outcome of infertility treatment in older patients. Fertility and             sterility, 93(1), 272-275.

Bulletti, C., Coccia, M. E., Battistoni, S., &Borini, A. (2010). Endometriosis and infertility.          Journal of assisted reproduction and genetics, 27(8), 441-447.

Guerin, L. R., Prins, J. R., & Robertson, S. A. (2009). Regulatory T-cells and immune tolerance    in pregnancy: a new target for infertility treatment?.Human reproduction update, 15(5),      517-535.

O’Brien, K. L. F., Varghese, A. C., & Agarwal, A. (2010). The genetic causes of male factor         infertility: a review. Fertility and sterility, 93(1), 1-12.

Poongothai, J. E. N. S., Gopenath, T. S., &Manonayaki, S. W. A. M. I. N. A. T. H. A. N. (2009).             Genetics of human male infertility. Singapore medical journal, 50(4), 336-347.