Infertility: Basically, there are two types of Infertility. One is Male Infertility and Second is Female Infertility. In this Blog, we will Discuss briefly Infertility.

Definition-
Failure to achieve conception by couples who have not used contraception for at least one year.

Etiology-
The following causes of infertility main exert their influence or one or more of the five categories listed earlier.

In Men

  • Environmental toxins( common) _Effect of drugs such as Alcohol or illicit drugs (common)
  • Undescended Testis
  • Varicocele
  • Traumatic or infection related Testicular Atrophy
  • Prolonged fever
  • Any Endocrine disorder that affects the hypothalamic pituitary gonadal axis
  • Anti-Sperm antibodies
  • Obstruction of seminal tract due to cystic fibrosis, congenital abnormalities, orchitis, epididymitis, prostatitis, seminal vesiculitis, urethritis, urethral stricture, vasectomy
  • Premature Ejaculation
  • Functional for organic impotency
  • Prostatectomy
  • Surgery of the bladder neck.

In women–

  • Failure to ovulate (common cause) e.g. polycystic ovarian syndrome, stress, hormonal imbalance (clinical features of ovulation include cervical mucus changes, an increase in basal body temperature and possibly mid-cycle pain)
  • Disorders of reproductive organs like ovaries: endometriosis, infection, dysgenesis, radiation damage, tumors
  • Uterine Tubes:- Salpingitis, absence, obstruction, endometriosis
  • Uterus:- Fibroids, adenomyosis, absence, congenital abnormalities, tumors, infections
  • Cervix:- displacement, cervicitis, stenosis
  • Vaginitis
  • Sexually transmitted diseases
  • Peritoneal adhesions following abdominal surgery
  • Endocrine disorders e.g. hyperprolactinemia hypopituitarism, premature ovarian failure, Congenital adrenal hyperplasia, thyroid disorders, polycystic ovarian syndrome
  • Systemic disease such as diabetes mellitus
  • Genetic disorders e.g.turner’s syndrome *immunological causes
  • Spasm of Uterine tubes due to stress.

Pathophysiology–

Fertility- requires:–

  1. Ovulation and spermatogenesis (normal structure and function of hypothalamus pituitary gonadal Axis)
  2. The Effective transport of sperm from the testis, through the male reproductive tract, and into the female (need patent pathways, the appropriate composition of semen, erection, and ejaculation in the mail; plus normal vagina and appropriate composition of vaginal and cervical secretion in the female)

  3. The effective transport of ovum to the uterine tube where fertilization takes place.

  4. The effective transport of fertilized ovum for zygote from the uterine tube to the uterus

  5. A healthy uterus so implantation can occur.

Any disturbance in one of these categories main result infertility.

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