Infertility & Assisted Reproductive

Technologies

Anatomy & PhysiologyMrs. Halkuff

Infertility The inability to

conceive after 1 year of properly timed, unprotected intercourse.

Fecundity Rate: The monthly probability of conception with a healthy couple is 20%.

After 12 months, 93% of couples will conceive.

Month Monthly Probability

Cumulative Probability

1 0.2 0.202 0.2 0.363 0.2 0.494 0.2 0.595 0.2 0.676 0.2 0.747 0.2 0.798 0.2 0.839 0.2 0.8610 0.2 0.8911 0.2 0.9112 0.2 0.93

Female Causes of Infertility Fallopian Tube Blockage/Damage› Can keep sperm from reaching egg.› Can cause a fertilized egg to implant in the

fallopian tube resulting in an ectopic pregnancy.

› Can be caused by STI’s such as chlamydia.

Female Causes of Infertility Endometriosis› Uterine tissue implants

& grows outside the uterus

› Affects ovary, fallopian tube, & uterine function.

› The implants respond to hormones, shedding & bleeding in sync with the uterus.

› Causes inflammation, pain, scarring, & infertility.

Female Causes of Infertility

Ovulation Disorders› Anovulation: No egg is released from the

ovaries.› Caused by

Abnormal/low levels of hormones (LH/FSH) Tumors Excessive exercise Malnutrition

Female Causes of Infertility

Polycystic Ovarian Syndrome (PCOS)› Many small cysts in the ovaries› Eggs do not mature in the follicles.› Follicles turn into cysts.› Higher than normal levels of androgens

(male hormones)

Male Causes of Infertility Impaired Shape & Movement of

Sperm› Keeps sperm from reaching & penetrating

the egg.

Male Causes of Infertility Low Sperm Concentration

› 20 million sperm/ml is normal› Below 10 million sperm/ml is low sperm

count.› 40 million sperm/ml is high fertility.

Male Causes of Infertility Undescended

Testicle› One or both testicles

fail to descend from the abdominal cavity during fetal development.

› Testes are exposed to high temperatures.

› Affects sperm production.

Male Causes of Infertility Infections

› Cause scarring & block sperm passages.› Inflammation of the testicles, prostate,

urethra, & epididymis› Caused by:

STI’s (Gonorrhea & Chlamydia)

Artificial Insemination Seminal fluid is inserted into the

female body for the purpose of pregnancy by means other than sexual intercourse.› Intravaginal› Intracervical› Intrauterine› Intratubal

Used when the infertility is male related.

In Vitro Fertilization Eggs & sperm are harvested from the

male & female and manually combined in a petri dish.

Usually several eggs are fertilized. A decision must be made regarding the

number of embryos to implant into the uterus.

Remaining embryos can be frozen.

Intracytoplasmic Sperm Injection

Egg is injected with a single sperm.

A special needle is used to insert the sperm into the cytoplasm of the egg.

Embryo is transferred into the female uterus.

Miscarriage Spontaneous loss of fetus before 20

weeks. Most are due to chromosomal

abnormalities in the fetus. Most occur before 7 weeks. 50% of all fertilized eggs are

miscarried, usually before the female knows she is pregnant.

15-20% of miscarriages are known miscarriages.