The pathologies of the reproductive system
Infertility means you cannot make a baby (conceive).
Infertility is grouped into two categories:
• Primary infertility refers to couples who have not become pregnant after at least 1 year of unprotected sex (intercourse).
• Secondary infertility refers to couples who have been pregnant at least once, but never again.
Causes, incidence, and risk factors
A wide range of physical and emotional factors can cause infertility. Infertility may be due to problems in the woman, man, or both.
Female infertility may occur when:
• A fertilized egg or embryo does not survive once it sticks to the lining of the womb (uterus)
• The fertilized egg does not attach to the lining of the uterus
• The eggs cannot move from the ovaries to the womb
• The ovaries have problems producing eggs
Female infertility may be caused by:
• Autoimmune disorders, such as antiphospholipid syndrome (APS)
• Cancer or tumor
• Clotting disorders
• Growths (such as fibroids or polyps) in the uterus and cervix
• Birth defects that affect the reproductive tract
• Excessive exercising
• Eating disorders or poor nutrition
• Use of certain medications, including chemotherapy drugs
• Drinking too much alcohol
• Older age
• Ovarian cysts and polycystic ovary syndrome (PCOS)
• Pelvic infection or pelvic inflammatory disease (PID)
• Scarring from sexually transmitted infection or endometriosis
• Surgery to prevent pregnancy (tubal ligation) or failure of tubal ligation reversal
• Thyroid disease
• Too little or too much of certain hormones
Male infertility may be due to:
• A decrease in sperm count
• Sperm being blocked from being released
• Sperm that do not work properly
Male infertility can be caused by:
• Environmental pollutants
• Being in high heat for prolonged periods
• Birth defects
• Heavy use of alcohol, marijuana, or cocaine
• Too little or too much hormones
• Older age
• Cancer treatments, including chemotherapy and radiation
• Scarring from sexually transmitted diseases, injury, or surgery
• Surgery to prevent pregnancy (vasectomy), or failure of vasectomy reversal
• Retrograde ejaculation
In healthy couples under age 30 who have sex regularly, the chance of getting pregnant is about 25 - 30% per month.A woman's peak fertility occurs in her early 20s. After age 35 (and especially 40), the chances that a woman can get pregnant drops considerably.
The main symptom of infertility is the inability to become pregnant. Specific symptoms depend on what is causing the infertility.Infertility can cause many painful emotions in one or both partners.
Signs and tests
When you should seek treatment for infertility depends on your age. It is recommended that women under 30 should generally try to get pregnant on their own for 1 year before seeking testing.
Infertility testing involves a complete medical history and physical examination of both partners.
Blood and imaging tests will be done. In women, this may include:
• Blood tests to check hormone levels, including progesterone and follicle stimulating hormone
• Checking body temperature first thing in the morning to check if the ovaries are releasing eggs
• FSH and clomid challenge test
• Hysterosalpingography (HSG)
• Pelvic ultrasound
• Luteinizing hormone urine test (ovulation prediction)
• Thyroid function tests
Tests in men may include: sperm testing, testicular biopsy (rarely done).
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