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Infertility is the inability of a couple to naturally conceive, carry or deliver a healthy child. The International Council on Infertility Information Dissemination (INCIID) considers a couple to be infertile if they have not conceived "after a year of unprotected intercourse in women under 35, or after six months in women over 35" [1] http://www.inciid.org/faq/general1.html or if they are incapable of carrying a pregnancy to term.
Causes
According to the American Society for Reproductive Medicine, infertility affects about 6.1 million people in the U.S., equivalent to ten percent of the reproductive age population. Female infertility accounts for one third of infertility cases, male infertility for another third, combined male and female infertility for another 15%, and the remainder of cases are "unexplained". [2] http://www.asrm.org/Patients/faqs.html
Female infertility
Factors relating to female infertility include:
Male infertility
Factors relating to male infertility include:
- Producing few or no sperm, or oligospermia and azoospermia respectively.
- Sperm that has poor motility, or asthenozoospermia.
- Other factors affecting sperm quality, such as influences from alcohol or other drug abuse. For instance, some sperm banks do not accept donations from men who are marijuana users.
- Inability to maintain an erection, or erectile dysfunction.
- Inability to ejaculate, or delayed ejaculation.
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retrograde ejaculation.
- Age. Fertility may decline in older men.
Treatment
There are various treatments for infertility, depending what the problem is. These treatments include:
- Fertility drugs to assist with problems ovulating. One example would be clomifene citrate (Clomid®, Serophene®), which stimulates ovulation.
- Surgery to fix problems such as blocked fallopian tubes.
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In vitro fertilization (IVF) in which eggs are removed from the woman, fertilized and then placed in the woman's uterus, bypassing the fallopian tubes. Children produced this way are popularly known as test-tube babies.
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Gamete intrafallopian transfer (GIFT) in which eggs are removed from the woman, and placed in one of the fallopian tubes, along with the man's sperm. This allows fertilization to take place inside the woman's body.
- Zygote intrafallopian transfer (ZIFT) in which eggs are removed from the woman, fertilized and then placed in the woman's fallopian tubes rather than the uterus.
- Egg donation by another woman (in combination with IVF, GIFT or ZIFT). This happens when a woman's eggs are unusable, or she has a genetic disease that she does not want to run the risk of passing on.
- Donor insemination which involves the woman being artificially inseminated with donor sperm.
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Intracytoplasmic sperm injection (ICSI) in which a single sperm is injected directly into an egg; the fertilized egg is then placed in the woman's uterus using IVF.
- Using a surrogate mother to carry the child.
Ethics
There are many ethical issues associated with infertility and its treatment, particular with regard to any treatment involving embryos.
Recent increases over the last few years in the number of multiple births (the best known being the McCaughey Septuplets) have also provoked concern; the greater the number of babies in a single pregnancy, the more likely they are to have a low birth weight , to be born prematurely and to consequently suffer medical problems.
Some religions (e.g. Catholicism) frown on some or all fertility treatments. Other issues include whether infertility treatment should be funded through health care.
See also
Reference
External links
- American Society for Reproductive Medicine http://www.asrm.org/
- International Council on Infertility Information Dissemination http://www.inciid.org (INCIID)
Last updated: 05-03-2005 17:50:55
