In this Presentation we have included the male and female infertility their causes and Management. we hope that it will provide you some basic information regarding this issues.

2. Presenting By
AsAr KhAn & sAimA
(M.Sc Zoology)
AWKUM Buner

3. What is infertility?

Couples that have been unable to conceive a
child after 12 months of regular
sexual intercourse without birth
control.

Women who have repeated
miscarriages are also said to
be infertile.

4. 
In order for a woman to become pregnant:
Egg must be released from one of her ovaries
Egg must go through the fallopian tube toward the
uterus

5. Sperm must join with the egg in the fallopian tube
(fertilization)
Fertilized egg must attach to the uterine wall
(implantation)

6. You’re not alone

About 12% of women (7.3 million) in the United
States aged 15-44 had difficulty getting pregnant
or carrying a baby to term in 2002.

10 to 15% of couples in the U.S. are infertile.

8. When should you go see a doctor?

Women in their 30s who've been trying to
become pregnant for six months should speak to
their doctors as soon as possible.

9. 
Women with the following issues should speak to
their doctors:
irregular periods or
no menstrual periods
very painful periods
Endometriosis
pelvic inflammatory disease
more than one miscarriage

10. What Increases the Risks?
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Age
Stress
Poor diet
Smoking
Alcohol
Overweight
Underweight
Caffeine intake
Too much exercise

11. The Age Factor

A woman's fertility naturally
starts to decline in her late
20's.

After age 35 a woman's
fertility decreases rapidly.

A woman is born with all the
eggs she'll have, and with
time, the supply diminishes.

The remaining eggs also
age along with the rest of the
body.

12. 
20% of women in the United States have their
first child after age 35.

About one third of couples over age 35 have
fertility problems.

Age decreases the woman’s ability to conceive
by:
Ability of a woman’s ovaries to release eggs
Increased miscarriages

13. Common Causes of Infertility
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Severe endometriosis
Pelvic Inflammatory Disease (PID)
Ovulation disorders
Elevated prolactin
Polycystic ovary syndrome (PCOS)
Early menopause
Benign uterine fibroids
Pelvic adhesions

14. Physical Obstructions

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Endometriosis
Pelvic Inflammatory Disease
Uterine Fibroids
Pelvic Adhesions
Ovarian Failure

15. Endometriosis

Occurs when the uterine tissue
implants and grows outside of
the uterus, affecting the
function of the ovaries, uterus
and fallopian tubes.

Scar tissue can block the
fallopian tubes and prevent the
egg from entering the uterus.

There is a 25-35% rate of
infertility in moderate to severe
cases of Endometriosis

16. PID (Pelvic inflammatory disease )

(PID) is a spectrum of infections of the female
genital tract that includes endometritis, salpingitis,
tuboovarian abscess, and peritonitis.

17. Uterine Fibroids and Pelvic Adhesions

Fibroids are benign tumors in
the wall of the uterus

May cause infertility by
blocking the fallopian tubes

Pelvic adhesions are bands of
scar tissue that bind organs
after pelvic infection,
appendicitis, or abdominal or
pelvic surgery

This scar tissue formation may
impair fertility.

18. Ovarian failure

Ovarian failure can be a consequence of medical
treatments, or the complete failure of the ovaries
to develop or contain eggs in the first place
(Turner's Syndrome).

Ovarian failure can also occur as a result of
treatments such as chemotherapy and pelvic
radiotherapy for cancers in other body areas.
These therapies destroy eggs in the ovary.

19. Hormonal Obstructions

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Ovulation disorders
Elevated prolactin
Polycystic ovary syndrome
Early menopause

20. Ovulation disorders

Disruption in the part of the brain that regulates
ovulation can cause low levels of luteinizing
hormone (LH) and follicle-stimulating hormone
(FSH).

Even slight irregularities in the hormone system
can affect ovulation.

21. Elevated prolactin

Also called hyperprolactinemia
Can cause irregular or no ovulation

Irregular periods

May cause galactorrehea,
milk production when not
pregnant


22. PCOS (Polycystic ovary syndrome )

Produces too
much androgen
hormone (male
hormones)

Causes an
irregular or no
menstrual cycle

23. Early menopause

Absence of menstruation

Early depletion of ovarian follicles before age 35

Although the cause is unknown, certain
conditions are associated with early menopause,

including immune system diseases, radiation or
chemotherapy treatment, and smoking etc.

24. Other Causes
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Medications
Thyroid problems
Cancer and treatment
Other medical conditions
conditions associated with
delayed puberty or amenorrhea
HIV/AIDS, kidney disease and
diabetes

25. Fertilization Problems
(1) = Anti-sperm antibodies (ASA)
(2) = Oocyte membrane proteins

26. Immune Infertility

The developing embryo may be miscarried due to
the mother’s immune system recognizing it as a
“foreign body” and attacking it.

Also, the woman may produce anti-sperm
antibodies (ASA) to her partner’s sperm.

27. 
ASA neutralize sperm by clumping them
together and destroying their membranes.

They also coat over receptors involved in
sperm-egg binding and fertilization.

An estimated 12 to 15 percent of unexplained
infertility in women is linked to ASA.

28. Oocyte Membrane Proteins


Reception, an oocyte membrane protein, is
responsible for binding sperm with the egg.
If this protein is not
receptive or present,
fertilization cannot occur.

29. Development Problems

Hard Egg

If egg is too 'hard', then the embryo cannot hatch
out of the zona pellucida and it dies.

To fix this problem, scientists can make a tiny
hole in the egg to give it a head start.

31. Teratogens

Damage from external sources, including viral
infections, x-rays and other radiation, and poor
nutrition

32. Treatment

Infertility can be treated with medicine, surgery,
artificial insemination or assisted reproductive
technology.
Stimulate ovulation with fertility drugs

About two-thirds of couples who are treated for
infertility are able to have a baby.

In most cases, infertility is treated with drugs or
surgery.

33. Assisted reproductive technology (ART)

In vitro fertilization (IVF)
Most effective
Recommended when both
fallopian tubes are blocked

ART works best when the
woman has a healthy uterus,
responds well to fertility
drugs, and ovulates naturally
or uses donor eggs.

34. Complications

Multiple pregnancy

Ovarian hyperstimulation syndrome (OHSS)
Ovaries may enlarge and cause pain and bloating
Higher risk in PCOS women



Bleeding or infection
Low birth weight
Birth defects

35. Medicine used are. . .

Clomid: cause ovulation , by acting on PG
Mostly used in PCOS syndrome It is taken by
mouth.

Repronex , Pergonal: used for non-ovulating
women who do not ovulate with their PG.

Gonal-F , Follistim: it cause the ovaries to begin
the process of ovulation , these are injected.
And many more . . .


36. Ways to Battle Infertility
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Regular exercise
Avoid alcohol, tobacco, and narcotics
Limit caffeine
No more than 250 mg per day

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Limit medications
Eat a balanced diet

37. Coping with Infertility

Consider other options
Adoption, donor sperm
or egg

Talk about your
feelings
To each other
Support groups
Counseling services
Stay in touch with loved
ones

38. THANK YOU VERY MUCH

39. NEXT SLIDES
by

41. Presenting
By
SAIMA

42. Male infertility

it refers to the inability of a male to achieve a
pregnancy in a fertile female.

15% of couples, 30%: male , 30% female &
both , 25% unexplained & 5% others.

44. 
Male infertility is commonly due to deficiencies in
the semen, and semen quality is used as a
surrogate measure of male fecundity.

45. Causes
Factors relating to male infertility are:

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Pre-testicular causes
Tobacco smoking
Testicular factors
DNA damage
Post-testicular causes

46. Pre-testicular causes

It refer to conditions that impede less support of
the testes and include situations of poor
hormonal support and poor general health
including:

Drugs, alcohol
riding (bicycle riding, horseback riding)
Medications, including those that affect spermatogenesis
such as chemotherapy, anabolic steroids, cimetidine,
spironolactone; those that decrease FSH levels such as
phenytoin; those that decrease sperm motility such as
sulfasalazine and nitrofurantoin.



47. Tobacco smoking

Male smokers also have approximately 30%
higher odds of infertility. There is increasing
evidence that the harmful products of tobacco
smoking kill sperm cells.

48. DNA damage

Common inherited variants in genes that encode
enzymes employed in DNA mismatch repair are
associated with increased risk of sperm DNA
damage and male infertility.

49. Testicular factors

Testicular factors refer to conditions where the testes
produce semen of low quantity and/or poor quality
despite adequate hormonal support and include:

Age
Genetic defects on the Y chromosome
Abnormal set of chromosomes (Klinefelter syndrome)
Neoplasm e.g. seminoma
Idiopathic failure
Trauma
Hydrocele
Mumps
Malaria
Testicular cancer
Acrosomal defects affecting egg penetration
Idiopathic oligospermia - unexplained sperm deficiencies account for
30% of male infertility.
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50. Post-testicular causes

It decrease male fertility due to conditions that
affect the male genital system after testicular
sperm production and include defects of the
genital tract as well as problems in ejaculation:

Vas deferens obstruction
Lack of Vas deferens, often related to genetic markers for Cystic
Fibrosis
Infection, e.g. prostatitis
Retrograde ejaculation
Ejaculatory duct obstruction
Hypospadias
Impotence
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51. Diagnosis

The diagnosis of infertility begins with a medical
history and physical exam by a physician,
preferably a specialist with experience or who
specializes in male infertility.

52. Medical history

The history should include prior testicular or
penile insults (torsion, cryptorchidism, trauma)

infections mumps orchitis, epididymitis

Environmental factors
excessive heat, radiation, medications, and
Drug use
anabolic steroids, alcohol, smoking etc


53. Physical examination

Usually, the patient disrobes completely and puts
on a gown. The physician will perform a
continuous examination of the penis, scrotum,
testicles, anus and rectum.

54. Sperm sample

The volume of the semen sample, approximate
number
of
total
sperm
cells,
sperm
motility/forward progression, and % of sperm with
normal morphology are measured. This is the
most common type of fertility testing.

55. Semen deficiencies are often
labeled as follows:

Oligospermia or Oligozoospermia
- decreased number of spermatozoa in semen

Aspermia - complete lack of semen

Hypospermia - reduced seminal volume

Azoospermia - absence of sperm cells in semen

Teratospermia - increase in sperm with abnormal morphology

Asthenozoospermia - reduced sperm motility

56. Blood sample

Common hormonal test include determination of
FSH and testosterone levels. A blood sample can
reveal genetic causes of infertility, e.g. Klinefelter
syndrome, a Y chromosome microdeletion, or
cystic fibrosis.

57. Prevention
Some strategies suggested or proposed
for avoiding male infertility include the following:

1.
Avoiding smoking as it damages sperm DNA
2.
Avoiding heavy marijuana and alcohol use.

58. 3. Avoiding excessive heat to the testes.
4. Sperm counts can be depressed
by daily coital activity and sperm motility may be
depressed by coital activity that takes place too
infrequently.

59. 5. When participating in contact sports, wear an
Protective Cup (safe guard) and Jockstrap to
protect the testicles.

60. 
Sports such as Baseball, Football,
Cricket, Hockey, Softball, Motorcross, Wrestling,
Karate or other Martial Arts
or any sport where a ball, foot, arm, knee or bat
can come into contact with the groin.

61. THANK YOU
VERY MUCH
QUEsTiONs?