Infertility

INFERTILITY AND STERILITY
Submitted By:
Abdulgani, Omar James
Ahamadul, Elham
Escio, Sitti Allyza
Hiya-Hiya, Afnan Aira
Jawali, Waliya
Jimenez, Jasmin Paula
Lakibul, Airhiza
Madjid, Parhana
Wahid, Arwyzza
Submitted To:
Marites A. Yusop, RN, MN
Infertility is defined as not being able to get pregnant (conceive) after one year (or
longer) of unprotected sex. (CDC, 2020)
There are 2 types of infertility:
 Primary infertility refers to couples who have not become pregnant after at least
1 year having sex without using birth control methods.
 Secondary infertility refers to couples who have been able to get pregnant at
least once, but now are unable
Sterility refers to the inability to have children due to problems in fertilization, i.e.,

caused by the inability of the egg and sperm to fuse to form the embryo.
Infertility, on the other hand, indicates the inability to carry out gestation, that is, the
absence of birth in spite of the fact that conception has taken place.
Sterility can occur from different causes in both men and women:
 Defects in the structure or quality of the eggs
•Ovulation issues
•Alterations in Fallopian tubes
•Functional or anatomical alterations of the cervical canal that may prevent sperm from
entering.
•Uterine factor: structural alterations such as the presence of fibroids or abnormalities, as
well as endometrial alterations.
Risk Factors of Infertility

Men and women are equally at risk for fertility problems.
 Age
 Smoking
 Drinking alcohol
 Weight
 Environmental factors
Her Risks
There are certain things that apply only to women.
 Endometriosis
 Fallopian tube disease
 Chronic disease like diabetes, lupus, arthritis, hypertension, or asthma
 Two or more miscarriages
 History of irregular periods
 Early menopause (before age 40)
 An abnormally shaped uterus
 Leftover scar tissue from a pelvic infection or surgery
 Uterine fibroids or cysts
 Polycystic ovary syndrome (PCOS)
His Risks
Some factors are male-only, and could affect sperm count, sperm health, or sperm
delivery, including:
A repaired hernia
Testicles that haven’t descended
An inflamed or infected prostate
Prescription medications for ulcers or psoriasis
Cystic fibrosis
Premature ejaculation or a blockage in your testicles
Diagnostic exam
Tests for male

This include:
 general physical exam, esp. on genitals
 detailed history (sexual, medical and reproductive)
 Endrocrinolgic studies may assess FHS, LH,
 Prolactin and serum testoterone level.
 Specific fertility tests include:

 Semen analysis
 Hormone testing.
 Genetic testing.
 Testicular biopsy.
 Imaging.- (transrectal or scrotal ultrasound, or vasography.
Other more specific tests
includes:
 fructose concentration and the Sims-Huhner test - to assess the penetration of
cervical mucus by sperm.
Test for female

 Ovulation testing.
 Hysterosalpingography
 Hysteroscopy
 Laparoscopy
Possible Treatments
For Infertile men:

1. Premature ejaculation or Erectile dysfunction:Behavioral approaches or
medications.
2. Variocele:surgical removal of varicose vein in scrotum.
3. Blockage of the ejaculatory duct: Sperms can be extracted directly from the
testicles and injected into an egg in laboratory.
4. Retrograde ejaculation: Sperms can be taken directly from the bladder and
injected into an egg in laboratory.
5. Vaso-epididymostomy: A bypass of epididymal blockage .
For infertile women:

1. Ovulation disorder:Fertility drugs are prescribed
a) Clomifine: To encourage ovulation (in case of PCOS, etc).
b) Metformin: For patient with PCOS linked to insulin resistance.
c) FSH: A hormone produced by pituitary which controls estrogen production by
ovaries.
d)Human Menopausal Gonadotrophin: Contains both FSH and LH for patients
with absent ovulation due to pituitary dysfunction.
EX: Bravelle, Repronex, and Menopur (given I/M or S/C).
e) Human Chorionic Gonadotrophin: It stimulates follicles to ovulate.
f) Gn- RH :For women who ovulate premature follicle during HMG treatment.
g) Bromocriptane:- - Stimulate ovulation by inhibiting production of prolactin.
Ex: Parlodel, Cycloset, (given oral or iv)
Assisted reproductive technologies used to treat infertility include the following:

 In vitro fertilization (IVF)
 Gamete intrafallopian transfer (GIFT)
 Zygote intrafallopian transfer ZIFT)
 Intracytoplasmic sperm injection (ICSI)
 Intrauterine insemination (IUI)
 Sperm, oocyte, or embryo cryopreservation
Statistics
 In the Philippines, one in 10 Filipino couples are facing the challenge of

conceiving a child.
About 9% of men and about 11% of women of reproductive age in the United
States have experienced fertility problems.
1 in 8 couples (or 12% of married women) have trouble getting pregnant or
sustaining a pregnancy. (2006-2010 National Survey of Family Growth, CDC)
 7.4 million women, or 11.9% of women, have ever received any infertility
services in their lifetime. (2006-2010 National Survey of Family Growth,
CDC)
 A couple ages 29-33 with a normal functioning reproductive system has only a
20-25% chance of conceiving in any given month (National Women’s Health
Resource Center). After six months of trying, 60% of couples will conceive
without medical assistance. (Infertility As A Covered Benefit, William M.
Mercer, 1997)
 According to the World Health Organization, failure in pregnancy has involved
around 80 million people worldwide.

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INFERTILITY AND STERILITY

Sterility refers to the inability to have children due to problems in fertilization, i.e.,

Risk Factors of Infertility

Tests for male

 Specific fertility tests include:

Test for female

For Infertile men:

For infertile women:

Assisted reproductive technologies used to treat infertility include the following:

 In the Philippines, one in 10 Filipino couples are facing the challenge of

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