Infertility

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] or if they are incapable of carrying a pregnancy to term.

Table of contents

1 Causes 1.1 Female infertility 1.2 Male infertility 2 Treatment 3 Ethics 4 External Links

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". [1] ''

Female infertility

Factors relating to female infertility include:

• Problems with ovulation
• Blocked fallopian tubes; this can happen as the result of pelvic inflammatory disease, endometriosis, or an ectopic pregnancy
• Hormonal problems such as Polycystic ovarian syndrome (PCOS)
• Inability of the fertilized egg to implant in the uterus
• Inability to carry a pregnancy to term
• Genetic abnormalities, such as Turner syndrome
• Age. A woman's fertility declines after the age of 30, both in her ability to conceive and her ability to carry a pregnancy to term.

Male infertility

The chief factor in male infertility is sperm quality; the man may be producing few or no sperm (conditions known as oligospermia and azoospermia respectively), or the sperm that he produces may have poor motility (affecting its ability to reach the egg). Alcohol and drug abuse can affect sperm quality. Other possible factors include erectile dysfunction and retrograde ejaculation. Age is also believed to affect male fertility.

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 Clomiphene Citrate (Clomid, Serophene), which stimulates ovulation.
• Surgery to fix problems such as blocked fallopian tubes.
• 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.
• 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.
• 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.

External Links

• American Society for Reproductive Medicine
• International Council on Infertility Information Dissemination (INCIID)
• [http://www.drmalpani.com/book How to Have a Baby - A Guide for the Infertile Couple. Free online book to help couples conceive