INFERTILITY

(Chap 8 pp.163)
 The inability to conceive a child or sustain
a pregnancy to birth
 A couple is said to be infertile if they have
not become pregnant after at least 1 year
of unprotected sex (Subfertility)
 Sexual Dysfunction
• Sexual dysfunction (or sexual malfunction
or sexual disorder) is difficulty experienced by
an individual or a couple during any stage of a
normal sexual activity, including physical
pleasure, desire, preference, arousal or
orgasm.
 STERILITY
• The inability to conceive because of a
known condition, such as the absence of
uterus
• Primary Subfertility- no previous
conceptions
• Secondary Subfertility-with previous viable
pregnancy but unable to conceived at the
present
 General Factors could affect
• Sexual activity
• Age
• Use of oral contraception
• Position
• Body weight
 FACTORS: MALE SUBFERTILITY
(Pilliteri)
• Limited Sperm Count
• Obstruction or Impaired Sperm Motility
• Ejaculation Problems
 LIMITED SPERM COUNT
• Sperm Count – the number of sperm in a single
ejaculation or in a milliliter of semen.
• Normal minimum sperm count contains:
-36 or 46 M sperm/milliliter or 50M/ejaculation
-50% should be motile
-30% normal in shape and form
• Temperature of scrotal sac should be
maintained slightly lower than the body
temperature
 Causes
• Congenital Abnormalities such as:
CRYPTORCHIDISM and VARICOCELE
• Past Trauma to the testes
• Surgery
• Endocrine imbalance
• Drug and alcohol use
• Exposure to radiation
• Avoid activities than can lower sperm count
• Maintain ideal body weight

• Testing for Sperm Number and Availability

 OBSTRUCTION OR IMPAIRED
SPERM MOTILITY
• Obstruction in the pathway such as
sominiferous tubules, epidydymis,vas
deferens, ejaculatory duct, or urethra
 Causes
• Mumps/orchitis-testicular inflammation and
scarring
• Epididymitis
• Infections
• Congenital stricture of spermatic duct
• BPH
• Infection of the Prostate
• Congenital Anomalies of the Penis
EJACULATION PROBLEMS
• Inability to achieve an
erection (impotence)
• PRIMARY- a man has never
been able to achieve
erection and ejaculation
• SECONDARY- a man was
able to achieve ejaculation
in the past but now has
difficulty
 Causes
• Psychological
problems
• CV accidents
• Parkinson’s diseases
• Use of
antihypertensive
agents
• Use of drug for male
baldness
 FACTORS THAT CAUSE FEMALE
SUBFERTILITY
• Limited production of FHS or LH
• Anovulation
• Problems of ova transport FT
• Uterine factors
• Cervical and vaginal factors
• Poor nutrition
 UNEXPLAINED SUBFERTILITY
• No known cause
• One partner’s problem is significant
 USE OF REPRODUCTIVE
TECHNIQUES
• ALTERNATIVE OR ALTERNATIVE
INSEMINATION- the instillation of sperm from
a mansturbatory sample into the female
reproductive tract by means of a cannula
• Male partner’s sperm
• Donor insemination
 In Vitro Fertilization
• Most often used for couples who have not
been able to conceive
• Used for couple whose husband has
oligospermia
• Absence of cervical mucus