Female infertility
From Wikipedia, the free encyclopedia
| Female infertility Classification and external resources |
|
| ICD-10 | N97.0 |
|---|---|
| ICD-9 | 628 |
| DiseasesDB | 4786 |
| MedlinePlus | 001191 |
| eMedicine | med/3535 |
| MeSH | D007247 |
Female infertility is a term that refers to infertility in female humans.
Contents |
[edit] Causes
Factors relating only to female infertility are:
[edit] General factors
- Significant liver or kidney disease
- Thrombophilia[1][2]
[edit] Hypothalamic-pituitary factors
[edit] Ovarian factors
- Diminished ovarian reserve, also see Poor Ovarian Reserve
- Luteal dysfunction[3]
- Gonadal dysgenesis (Turner syndrome)
[edit] Tubal (ectopic)/peritoneal factors
- Pelvic adhesions
- Pelvic inflammatory disease (PID, usually due to chlamydia)[5]
- Tubal occlusion[6]
- Tubal dysfunction
[edit] Uterine factors
- Uterine fibroids (leiomyoma)
[edit] Cervical factors
- Antisperm antibodies[10]
[edit] Vaginal factors
- Vaginismus
- Vaginal obstruction
[edit] Genetic factors
- Various intersexed conditions, such as androgen insensitivity syndrome
[edit] Diagnosis
Diagnosis of infertility begins with a medical history and physical exam. The healthcare provider may order tests, including the following:
- an endometrial biopsy, to verify ovulation and inspect the lining of the uterus
- hormone testing, to measure levels of female hormones at certain times during a menstrual cycle
- day 2 or 3 measure of FSH and estrogen, to assess ovarian reserve
- measurements of thyroid function[12] (a thyroid stimulating hormone (TSH) level of between 1 and 2 is considered optimal for conception)
- laparoscopy, which allows the provider to inspect the pelvic organs
- fertiloscopy, a relatively new surgical technique used for early diagnosis (and immediate treatment)
- measurement of progesterone in the second half of the cycle to help confirm ovulation
- Pap smear, to check for signs of infection
- pelvic exam, to look for abnormalities or infection
- a postcoital test, which is done soon after intercourse to check for problems with sperm surviving in cervical mucous (not commonly used now because of test unreliability)
- special X-ray tests
Diagnosis and treatment of infertility should be made by physicians who are fellowship trained as reproductive endocrinologists. Reproductive Endocrinologists are usually Obstetrician-Gynecologists with advanced training in Reproductive Endocrinology & Infertility (in North America). These highly educated professionals and qualified physicians treat Reproductive Disorders affecting not only women but also men, children, and teens.
Prospective patients should note that reproductive endocrinology & infertility medical practices do not see women for general maternity care. The practice is primarily focused on helping their patients to conceive and to correct any issues related to recurring pregnancy loss.
[edit] Prevention
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Some cases of female infertility may be prevented by taking the following steps:
- Avoid excessive exercise.
- Avoid smoking.
- Control diseases such as diabetes and hypothyroidism
- Eat a well balanced nutritious diet with plenty of fresh fruits and vegetables (plenty of folates).
- Follow good weight management guidelines.
- Practice safer sex to avoid sexually transmitted diseases.
- Get early treatment for sexually transmitted diseases.
- Have regular physical examinations (including pap smears) to detect early signs of infections or abnormalities.
- Limit caffeine and alcohol intake.
- Ask your mother (biological) to share any unusual or abnormal issues she had related to conceiving. For example, premature menopause in your mother can be genetic and passed on to you, which limits the years in which you will have optimal egg quality.
- Fertility starts declining after age 27 and drops at a somewhat greater rate after age 35.[13] It should be noted, however, that fertility does not ultimately cease before menopause.
[edit] References
- ^ Middeldorp S (2007). "Pregnancy failure and heritable thrombophilia". Semin. Hematol. 44 (2): 93–7. doi:. PMID 17433901.
- ^ Qublan HS, Eid SS, Ababneh HA, et al (2006). "Acquired and inherited thrombophilia: implication in recurrent IVF and embryo transfer failure". Hum. Reprod. 21 (10): 2694–8. doi:. PMID 16835215.
- ^ eMedicine - Luteal Phase Dysfunction : Article by Thomas L Alderson, DO. Retrieved on 2007-11-21.
- ^ Tomassetti C, Meuleman C, Pexsters A, et al (2006). "Endometriosis, recurrent miscarriage and implantation failure: is there an immunological link?". Reprod. Biomed. Online 13 (1): 58–64. PMID 16820110.
- ^ Guven MA, Dilek U, Pata O, Dilek S, Ciragil P (2007). "Prevalance of Chlamydia trochomatis, Ureaplasma urealyticum and Mycoplasma hominis infections in the unexplained infertile women". Arch. Gynecol. Obstet. 276 (3): 219–23. doi:. PMID 17160569.
- ^ García-Ulloa AC, Arrieta O (2005). "Tubal occlusion causing infertility due to an excessive inflammatory response in patients with predisposition for keloid formation". Med. Hypotheses 65 (5): 908–14. doi:. PMID 16005574.
- ^ Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simón C, Pellicer A (1997). "Reproductive impact of congenital Müllerian anomalies". Hum. Reprod. 12 (10): 2277–81. PMID 9402295.
- ^ Magos A (2002). "Hysteroscopic treatment of Asherman's syndrome". Reprod. Biomed. Online 4 Suppl 3: 46–51. PMID 12470565.
- ^ Tan Y, Bennett MJ (2007). "Urinary catheter stent placement for treatment of cervical stenosis". The Australian & New Zealand journal of obstetrics & gynaecology 47 (5): 406–9. doi:. PMID 17877600.
- ^ Francavilla F, Santucci R, Barbonetti A, Francavilla S (2007). "Naturally-occurring antisperm antibodies in men: interference with fertility and clinical implications. An update". Front. Biosci. 12: 2890–911. PMID 17485267.
- ^ Farhi J, Valentine A, Bahadur G, Shenfield F, Steele SJ, Jacobs HS (1995). "In-vitro cervical mucus-sperm penetration tests and outcome of infertility treatments in couples with repeatedly negative post-coital tests". Hum. Reprod. 10 (1): 85–90. PMID 7745077.
- ^ Wartofsky L, Van Nostrand D, Burman KD (2006). "Overt and 'subclinical' hypothyroidism in women". Obstetrical & gynecological survey 61 (8): 535–42. doi:. PMID 16842634.
- ^ Study speeds up biological clocks / Fertility rates dip after women hit 27. Retrieved on 2007-11-21.
