Female Infertility:

Treatment Possibilities
Ovulation Ovulation inducing drugs
disorders

Hyperprolactinemi Prolactin-suppressing drugs

a

Uterine and tubal Surgical procedures

abnormalities

Cervical mucus Intrauterine insemination

problems

Suppressing hormones or surgical

Endometriosis procedure
 Treatment of Female Infertility:
Induction of Ovulation
Medications: stimulate
development of one or more
mature follicles
Success rates depends on:
Age of the woman

Type of medication used

Presence of other

infertility factors
 Ovulation Induction Agents

Medications Mode of action

Clomiphene citrate Induce release of gonadotropins
Gonadotropin Similar structure to natural GnRH,
releasing hormone provoke massive release of GnRH into
analogues blood circulation
Human menopausal gonadotropin (HMG),
Gonadotropins which contains equal FSH and LH
quantity
Bromocriptine Suppress production of prolactin
 Treatment of Female Infertility:
Intrauterine Insemination
Sperm are washed, concentrated and injected directly into a womans
uterus
Increases the number of sperm in the fallopian tubes
Not recommended:
tubal blockage, poor egg quality, ovarian failure and severe male
factor infertility
Most successful when coupled with drugs inducing ovulation (success
rates of 5% to 20% per cycle)
 Treatment of Female Infertility:
Assisted Reproductive Technology
(ART)
Noncoital method of conception: surgically removing eggs from a
womans ovaries, combining them with sperm in the laboratory, and
returning them to the womans body
Includes all fertility treatments in which both eggs and sperm are
manipulated
Types of ART include:
In Vitro Fertilization (IVF)
Zygote Intrafallopian Transfer (ZIFT)
Gamete Intrafallopian Transfer (GIFT)

Another ART procedure Intracytoplasmic Sperm Injection (ICSI) is

used mainly in cases of male infertility to treat couples who cannot
achieve fertilization due to the male partners extremely low number
of normal, viable sperm.
 AVF
Gamete Intra- Zygote Intra-
In-vitro
fallopian Transfer fallopian Transfer
Fertilization (IVF)
(GIFT) (ZIFT)
Retrieve eggs and Ovarian stimulation Also called tubal
sperm from Retrieval of eggs embryo transfer
partners Place mixture of
Place them in a lab
dish to enhance sperm and eggs
Description directly into the
fertilization
Fertilized eggs are womans fallopian
transferred several tube
days later into the
uterus
Ovarian stimulation Does not allow Actual fertilization
drugs are used prior visual confirmation takes place in a
to procedure in to of fertilization lab dish
Explanatio retrieve several Woman should have Fertilized eggs are
n eggs and maximize at least 1 placed directly
chances for undamaged into a fallopian
successful fallopian tube tube
fertilization
Success 20% per egg retrieval 28% per egg retrieval 29% per egg
rate retrieval
 Treatment Possibilities: Male
Infertility
Varicocele Surgical treatment

Low sperm Intrauterine insemination (donors

count/ or patients sperm; if culturally
Azoospermia acceptable)

Poor sperm Intrauterine insemination

quality

ART procedures GIFT, IVF, ICSI

*Donor sperm should be free from HIV and STDs.

ART: Intracytoplasmic Sperm Injection
(ICSI)
Injection of single sperm into the
egg (active, undamaged)
Woman: fertility drugs prior to the
procedure to aid in the production
of multiple eggs
Eggs are observed to see if
fertilization takes place
average fertilization rate is 65%
Implantation into the uterus takes
place within 72 hours after ICSI
Success rates range from 15% to
35% per egg retrieval
 Infertility: Summary
Infertility is a significant social and medical problem affecting couples
worldwide
Female and male factors are equally responsible
Evaluation of both partners is essential
Treatment depends on the cause of infertility and varies from ovulation-
inducing drugs to surgery and ART