Definition
Infertility is the inability to become pregnant after 12 months of unprotected intercourse.
Symptoms
- Inability to become pregnant.
- A range of emotional reactions by either or both members of the couple. In general, such reactions are greater among childless couples. Having at least one child tends to soften these painful emotions.
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Definition
Infertility is the inability to become pregnant after 12 months of unprotected intercourse.
Symptoms
- Inability to become pregnant.
- A range of emotional reactions by either or both members of the couple. In general, such reactions are greater among childless couples. Having at least one child tends to soften these painful emotions.
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Causes
Primary infertility is the term used to describe a couple that has never been able to conceive a pregnancy, after at least 1 year of unprotected intercourse.
Secondary infertility describes couples who have previously been pregnant at least once, but have not been able to achieve another pregnancy.
Causes of infertility include a wide range of physical as well as emotional factors. Approximately 30 - 40% of all infertility is due to a "male" factor such as retrograde ejaculation , impotence , hormone deficiency, environmental pollutants, scarring from sexually transmitted disease, or decreased sperm count . Some factors affecting sperm count are heavy marijuana use or use of prescription drugs such as cimetidine, spironolactone, and nitrofurantoin.
A "female" factor -- scarring from sexually transmitted disease or endometriosis, ovulation dysfunction, poor nutrition, hormone imbalance, ovarian cysts, pelvic infection, tumor, or transport system abnormality ...
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Treatment
Treatment depends on the cause of infertility. It may involve:
- Simple education and counseling
- Medicines to treat infections or promote ovulation
- Highly sophisticated medical procedures such as in vitro fertilization
It is important for the couple to recognize and discuss the emotional impact that infertility has on them as individuals and together and to seek medical advice from their health care provider.
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Other Names
Barren; Inability to conceive; Unable to get pregnant
Possible Complications
Although infertility itself does not cause physical illness, the psychological impact of infertility upon individuals or couples affected by it may be severe. Couples may encounter marital problems, as well as individual depression and anxiety.
Outlook (Prognosis)
A cause can be determined for about 85- 90% of infertile couples.
Appropriate therapy (not including advanced techniques such as in vitro fertilization) allows pregnancy to occur in 50 - 60% of previously infertile couples.
Without any treatment intervention, 15 - 20% of couples previously diagnosed as infertile will eventually become pregnant.
Prevention
Because infertility is frequently caused by sexually transmitted diseases, practicing safer sex behaviors may minimize the risk of future infertility. Gonorrhea and chlamydia are the two most frequent causes of STD-related infertility.
STDs are often asymptomatic at first, until PID or salpingitis develops. These inflammatory processes cause scarring of the fallopian tubes and decreased fertility, absolute infertility, or an increased incidence of ectopic pregnancy .
Mumps immunization has been well demonstrated to prevent mumps and its male complication, orchitis. Immunization prevents mumps-related sterility.
Some forms of birth control , such as the intrauterine device (IUD), carry a higher risk for future infertility. However, IUDs are not recommended for women who have not previously had a child.
Women selecting the IUD must be willing to accept the very slight risk of infertility associated with its use. Careful consideration of this risk, weighed with ...
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Exams and Tests
A complete history and physical examination of both partners is essential.
Tests may include:
- Semen analysis -- the specimen is collected after 2 to 3 days of complete abstinence to determine volume and viscosity of semen and sperm count, motility, swimming speed, and shape.
- Measuring basal body temperature -- taking the woman's temperature each morning before arising in an effort to note the 0.4 to 1.0 degree Fahrenheit temperature increase associated with ovulation.
- Monitoring cervical mucus changes throughout the menstrual cycle to note the wet, stretchy, and slippery mucus associated with the ovulatory phase.
- Postcoital testing (PCT) to evaluate sperm-cervical mucus interaction ...
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Support Groups
Many organizations provide informal support and referrals for professional counseling. See infertility - support group .
References
Speroff L, Fitz M. Clinical Gynecologic Endocrinology and Infertility. 7th ed. Lippincott Williams & Wilkins; 2004.
Stenchever A. Comprehensive Gynecology. 4th ed. St. Louis, Mo: Mosby; 2001:1204-1206.
