17/03/2018
Definition
Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”
Primary infertility refers to couples who have never become pregnant.
Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.
Epidemiology
There are about 10 to 15 percent of couples in the United States and around 7 to 10 % of couples in Vietnam undergo infertility. As for the etiology of infertility in humans, the cause of infertility lies in both the male and female partners. The male partner is responsible for 30% of cases, the female another 30 to 40 %, and in another, the combination of male and female reasons for infertility 15-30% and around 10% of these cases remains unexplained.
Causes
Many physical and emotional factors can cause infertility. It may be due to problems in the woman, man, or both.
Male infertility
Decreased quality and quantity of sperm.
Hormone imbalance.
Sexual dysfunction such as: erectile dysfunction, ejaculate disorder (retrograde ejaculation).
Infections: Mumps, sexual transmitted infection (chlamydia… gonorrhea).
Birth defects, injury, or surgery.
Smoking & toxins in the environment.
Vasectomy.
Female infertility
Uterine causes: Polyps and fibroids.
Endometriosis: A condition where the uterine tissue implants and grows outside the uterus,
Polycystic ovary syndrome (PCOS): A hormonal condition in which the body produces too much androgen, which can affect ovulation.
Fallopian tube damage: Scarring from pelvic infections, endometriosis or pelvic surgeries.
Ovulation disorders: The inability of the ovaries to release eggs (anovulation).
Hormonal causes.
Early menopause: Although the cause is often unknown, certain conditions are associated with early menopause.
Pelvic adhesions: Pelvic infection, appendicitis or abdominal/pelvic surgery can cause scar tissue, which may impair fertility.
Healthy couples under age 30 who have sex regularly will have a 25% to 30% per month chance of getting pregnant each month. Most of couple can get pregnant within the first year of marriage. A woman is most fertile in her early 20s. The chance a woman can get pregnant drops greatly after age 35 (and especially after age 40). The age when fertility starts to decline varies from woman to woman.
Treatment
Infertility treatment depends on each gender and cause for example
Causes of the infertility.
Duration of the infertility.
Age and your partner’s age.
Personal preferences.
Treatment for men
Internal therapy may improve a man’s sperm count & sperm quality and likelihood for achieving a successful pregnancy..
Surgery to reverse a sperm blockage and repaire testicular vein dilated.
Sperm retrieval.For men who undergone no spermatozoa.
Treatment for women
Stimulating ovulation with fertility drugs.
Intrauterine insemination (IUI).
Surgery to restore fertility.
Assisted reproductive technology In vitro fertilization
Intracytoplasmic sperm injection (ICSI).
Assisted hatching.
Donor eggs or sperm.
Gestational carrier.
By Nguyen Ba Hung
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Andrology and Fertility Hospital of Hanoi
? (+84) 1900 56 56 01
➡ https://www.facebook.com/afhanoi/
➡ 431 Tam Trinh Street, Hoang Mai District, Hanoi, Vietnam.
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