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Infertility

Infertility. Ana Dimitrović Mentor: A. Žmegač Horvat. Definition. Not being able to get pregnant despite having frequent unprotected sex for at least a year. Symptoms. Inability for a couple to get pregnant Woman: abnormal menstrual periods

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Infertility

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  1. Infertility Ana Dimitrović Mentor: A. Žmegač Horvat

  2. Definition • Not being able to get pregnant despite having frequent unprotected sex for at least a year

  3. Symptoms • Inability for a couple to get pregnant • Woman: abnormal menstrual periods • Man: hormonal problems (changes in hair growth or sexual function)

  4. When to see a doctor • You plan to conceive and you are a woman older than 30 or haven‘t menstruated in six months • You are a woman who has a history of irregular or painful menstrual cycles, pelvic pain, endometriosis… • You are a man with a low sperm count or a history of testicular, prostate or sexual problems

  5. Causes of male infertility Impaired production or function of sperm • Impaired shape or movement of sperm • Low sperm concentration • Varicocele • Undescended testicle • Testosterone deficiency (male hypogonadism) • Genetic defects • Infections

  6. Causes of male infertility Impaired delivery of sperm • Sexual issues • Retrograde ejaculation • Blockage of epididymis or ejaculatory ducts • No semen (ejaculate) • Hypospadia • Anti – sperm antibodies • Cystic fibrosis

  7. Causes of male infertility General health and lifestyle • Emotional stress • Malnutrition • Obesity • Cancer and its treatment • Alcohol and drugs • Age • Other medical conditions

  8. Causes of male infertility Environmental exposure • Pesticides and other chemicals • Overheating the testicles • Substance abuse • Tobacco smoking

  9. Causes of female infertility • Fallopian tube damage or blockage • Endometriosis • Ovulation disorders • Hyperprolactinemia • Polycystic ovary syndrome (PCOS) • Early menopause • Uterine fibroids • Pelvic adhesions

  10. Causes of female infertility • Medications • Thyroid problems • Cancer and its treatment • Caffeine intake • Other medical conditions

  11. Risk factors • Age • Tobacco smoking • Alcohol use • Being overweight • Too much exercise • Caffeine intake

  12. Tests for men General physical examination Semen analysis Hormone testing Transrectal and scrotal ultrasound Tests for women Ovulation testing Hysterosalpingography Laparoscopy Hormone testing Ovarian reserve testing Genetic testing Pelvic ultrasound Tests and diagnosis

  13. Medical treatments Drugs • Clomiphene • Human menopausal gonadotropin, hMG • FSH • Human chorionic gonadotropin, hCG • Gonadotropin – releasing hormone (Gn-RH) analogs • Aromatase inhibitors • Metformin • Bromocriptine

  14. Medical treatments Fertility drugs and the risk of multiple pregnancies • Injectable fertility drugs increase the chance of multiple births • Careful monitoring: blood tests, hormone tests, ultrasound measurement of ovarian follicle size • Multifetal pregnancy reduction

  15. Medical treatments Surgery • Laparoscopic techniques • Blockages, varicocele

  16. Medical treatments Assisted reproductive technology (ART) • In vitro fertilization (IVF)

  17. Medical treatments • Electric or vibratory stimulation to achieve ejaculation • Surgical sperm ejaculation • Intracytoplasmic sperm injection (ICSI) • Assisted hatching

  18. Complications of treatment • Multiple pregnancy • Ovarian hyperstimulation syndrome (OHSS) • Bleeding or infection • Low birth weight • Birth defects

  19. Complementary and alternative treatments • Group psychological intervention • Acupuncture • Manual physical therapy • Fertility tourism (legal regulation, lower prices, sought procedure)

  20. Male: Avoid alcohol, tobacco and street drugs Avoid hot tubs and steam baths Female: Avoid alcohol, tobacco and street drugs Exercise moderately Avoid weight extremes Limit caffeine Limit medications Prevention

  21. The end

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