Infertility

"Infertility is defined as the failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse. Approximately 85% of infertile couples have an identifiable cause. The most common causes of infertility are , , and . The remaining 15% of infertile couples have “unexplained infertility.” Lifestyle and environmental factors, such as and , can adversely affect fertility. Ovulatory disorders account for approximately 25% of infertility diagnoses; 70% of women with anovulation have . Infertility can also be a marker of an underlying chronic disease associated with infertility. , s such as , and s are used to induce ovulation or for ovarian stimulation during (IVF) cycles. Adverse effects of gonadotropins include multiple pregnancy (up to 36% of cycles, depending on specific therapy) and ovarian hyperstimulation syndrome (1%-5% of cycles), consisting of ascites, electrolyte imbalance, and hypercoagulability. For individuals presenting with anovulation, ovulation induction with timed intercourse is often the appropriate initial treatment choice. For couples with unexplained infertility, , or mild male factor infertility, an initial 3 to 4 cycles of ovarian stimulation may be pursued; IVF should be considered if these approaches do not result in pregnancy. Because female fecundity declines with age, this factor should guide decision-making. Immediate IVF may be considered as a first-line treatment strategy in women older than 38 to 40 years. IVF is also indicated in cases of severe male factor infertility or untreated bilateral tubal factor."

"I had a good family doctor. But I don’t think we ever discussed fertility until I told her that I was ready to start a family. Eighteen months after that conversation, I was standing in a fertility clinic listening to a fertility specialist tell me that my hormone levels were borderline menopausal and my ovaries didn’t have many eggs left. I was shocked. I was only thirty-four. The doctor explained that twenty percent of women my age were infertile, making it hard or impossible to get pregnant. As I learned the facts about infertility, I was baffled that every girl and woman would not be equipped early in life with information on how to reduce the risks of this happening to them. I began to see infertility as an epidemic that no one was talking about."

"There are certain conditions that warrant seeing a doctor sooner: • Periods at three week (or less) intervals. • No periods for more than three months. * Irregular periods • A history of pelvic infection. • Two or more miscarriages. * Women over the age of 35 — time is now at a premium! * Men who have had prostate infections. • Men whose testes are not felt in the scrotum"

"The (WHO) performed a large multinational study to determine gender distribution and infertility etiologies. In 37% of infertile couples, female infertility was the cause; in 35% of couples, both male and female causes were identified; in 8%, there was male factor infertility. ... In the same study, the most common identifiable factors of female infertility are as follows: • : 25% • : 15% • : 12% • Tubal blockage: 11% • Other tubal/uterine abnormalities: 11% • : 7%"