INFERTILITY
DESCRIPTION
Failure to conceive after one year of unprotected intercourse
SYSTEMS AFFECTED
Reproductive, Endocrine/Metabolic
INCIDENCE/PREVALENCE IN THE USA
10 - 15% of all couples
PREDOMINANT AGE
Increases with age,
ages 30 - 34: 14% infertile
ages 35 - 39: 20% infertile
ages 40 - 45: 25% infertile
SIGNS AND SYMPTOMS
Thorough history and physical should be performed on each partner
Genital/pelvic infection (i.e., pelvic inflammatory disease)
often associated with an obstruction of reproductive tract
Endocrine dysfunction (i.e., hypothyroidism, hypogonadism, abnormal puberty)
often associated with abnormalities of ovulation or sperm production
Sexual dysfunction (i.e., premature ejaculation) may contribute to the problem
Menstruation without egg production can occur without premenstrual symptoms.
Some patients may have facial/chest hair, obesity, acne which may be
suggestive of polycystic ovarian syndrome
Endometriosis is often associated with dysfunctions of menstruation.
CAUSES
Most couples have more then one factor
Male factors 30 - 40%
Ovulation factors 15%
Cervical/ uterine factors 10%
Tubal/peritoneal factors 25 - 30 %
Immunologic factors 5 %
Psychogenic/nutritional/ metabolic factors 5%
Unexplained infertility 10 - 20 %
TREATMENT
Appropriate Health Care
Treat underlying cause
Discontinue bad habits such as smoking and poor eating
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