BIOLOGY

INVESTIGATORY
PROJECT: INFERTILITY

BY ......................................
CLASS...........
Infertility
 Infertility
Specialty Urology, gynecology
Causes common causes of
infertility in females
are annouvulation,
blocked fallopian
tube ,hormonal
imbalance e.t.c.
while the common
causes in men is low
sperm
count,abnormal
sperm morphology.
Frequency 113 million (2015)[1]
Infertility is the inability of a person, animal or plant to reproduce by natural means. It is
usually not the natural state of a healthy adult, except notably among
certain eusocial species (mostly haplodiploid insects).
In humans, infertility is the inability to become pregnant after one year of intercourse
[2]
without contraception involving a male and female partner.  There are many causes of
[3]
infertility, including some that medical intervention can treat.  Estimates from 1997
suggest that worldwide about five percent of all heterosexual couples have an
unresolved problem with infertility. Many more couples, however, experience involuntary
[4]
childlessness for at least one year: estimates range from 12% to 28%.  Male
infertility is responsible for 20–30% of infertility cases, while 20–35% are due to female
[2][5]
infertility, and 25–40% are due to combined problems in both parts.  In 10–20% of
[5]
cases, no cause is found.  The most common cause of female infertility is ovulatory
problems, which generally manifest themselves by sparse or absent menstrual periods.
[6]
 The most frequent cause of infertility today in occidental population is the delay of
maternity, because the quality of oocytes decreases dramatically with age, especially
after 35 years. Male infertility is most commonly due to deficiencies in the semen,
[7]
and semen quality is used as a surrogate measure of male fecundity.
Women who are fertile experience a natural period of fertility before and
during ovulation, and they are naturally infertile for the rest of the menstrual
cycle. Fertility awareness methods are used to discern when these changes occur by
tracking changes in cervical mucus or basal body temperature.

Definition[edit]
"Demographers tend to define infertility as childlessness in a population of women of
reproductive age," whereas "the epidemiological definition refers to "trying for" or "time
to" a pregnancy, generally in a population of women exposed to" a probability of
[8]
conception.  Currently, female fertility normally peaks at age 24 and diminishes after
[9]
30, with pregnancy occurring rarely after age 50.  A female is most fertile within 24
[9]
hours of ovulation.  Male fertility peaks usually at age 25 and declines after age 40.
[9]
 The time needed to pass (during which the couple tries to conceive) for that couple to
be diagnosed with infertility differs between different jurisdictions. Existing definitions of
infertility lack uniformity, rendering comparisons in prevalence between countries or
over time problematic. Therefore, data estimating the prevalence of infertility cited by
[8]
various sources differs significantly.  A couple that tries unsuccessfully to have a child
after a certain period of time (often a short period, but definitions vary) is sometimes
said to be subfertile, meaning less fertile than a typical couple. Both infertility and
subfertility are defined as the inability to conceive after a certain period of time (the
length of which vary), so often the two terms overlap.
World Health Organization[edit]
[10]
The World Health Organization defines infertility as follows:
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 (and there is no other reason, such as breastfeeding or
postpartum amenorrhoea). Primary infertility is infertility in a couple who have never had
a child. Secondary infertility is failure to conceive following a previous pregnancy.
Infertility may be caused by infection in the man or woman, but often there is no obvious
underlying cause.

United States[edit]
One definition of infertility that is frequently used in the United States by reproductive
endocrinologists, doctors who specialize in infertility, to consider a couple eligible for
treatment is:
 a woman under 35 has not conceived after 12 months of contraceptive-free
intercourse. Twelve months is the lower reference limit for Time to Pregnancy (TTP)
[7]
by the World Health Organization.
 a woman over 35 has not conceived after six months of contraceptive-free sexual
intercourse.
These time intervals would seem to be reversed; this is an area where public policy
trumps science. The idea is that for women beyond age 35, every month counts and if
made to wait another six months to prove the necessity of medical intervention, the
problem could become worse. The corollary to this is that, by definition, failure to
conceive in women under 35 isn't regarded with the same urgency as it is in those over
35.
United Kingdom[edit]
In the UK, previous NICE guidelines defined infertility as failure to conceive after regular
unprotected sexual intercourse for two years in the absence of known reproductive
[11]
pathology.  Updated NICE guidelines do not include a specific definition, but
recommend that "A woman of reproductive age who has not conceived after 1 year of
unprotected vaginal sexual intercourse, in the absence of any known cause of infertility,
should be offered further clinical assessment and investigation along with her partner,
[12]
with earlier referral to a specialist if the woman is over 36 years of age."
Other definitions[edit]
Researchers commonly base demographic studies on infertility prevalence on a five-
[13]
year period.  Practical measurement problems, however, exist for any definition,
because it is difficult to measure continuous exposure to the risk of pregnancy over a
period of years.
Primary vs. secondary infertility[edit]
Primary infertility is defined as the absence of a live birth for women who desire a child
and have been in a union for at least 12 months, during which they have not used any
[14]
contraceptives.  The World Health Organisation also adds that 'women whose
pregnancy spontaneously miscarries, or whose pregnancy results in a still born child,
[14]
without ever having had a live birth would present with primarily infertility'.
Secondary infertility is defined as the absence of a live birth for women who desire a
child and have been in a union for at least 12 months since their last live birth, during
[14]
which they did not use any contraceptives.
Thus the distinguishing feature is whether or not the couple have ever had a pregnancy
which led to a live birth.

Effects[edit]
Psychological[edit]
The consequences of infertility are manifold and can include societal repercussions and
personal suffering. Advances in assisted reproductive technologies, such as IVF, can
offer hope to many couples where treatment is available, although barriers exist in
terms of medical coverage and affordability. The medicalization of infertility has
unwittingly led to a disregard for the emotional responses that couples experience,
which include distress, loss of control, stigmatization, and a disruption in the
[15]
developmental trajectory of adulthood.  One of the main challenges in assessing the
distress levels in women with infertility is the accuracy of self-report measures. It is
possible that women "fake good" in order to appear mentally healthier than they are. It
is also possible that women feel a sense of hopefulness/increased optimism prior to
initiating infertility treatment, which is when most assessments of distress are collected.
Some early studies concluded that infertile women did not report any significant
differences in symptoms of anxiety and depression than fertile women. The further into
treatment a patient goes, the more often they display symptoms of depression and
anxiety. Patients with one treatment failure had significantly higher levels of anxiety, and
patients with two failures experienced more depression when compared with those
without a history of treatment. However, it has also been shown that the more
depressed the infertile woman, the less likely she is to start infertility treatment and the
more likely she is to drop out after only one cycle. Researchers have also shown that
despite a good prognosis and having the finances available to pay for treatment,
[16]
discontinuation is most often due to psychological reasons.  Fertility does not seem
to increase when the women takes antioxidants to reduce the oxidative stress brought
[17]
by the situation.
Infertility may have psychological effects. Partners may become more anxious to
[18]
conceive, increasing sexual dysfunction.  Marital discord often develops, especially
when they are under pressure to make medical decisions. Women trying to conceive
often have depression rates similar to women who have heart disease or cancer.
[19]
 Emotional stress and marital difficulties are greater in couples where the infertility
[20]
lies with the man.
[21]
Older people with adult children appear to live longer.  Why this is the case is unclear
and may dependent in part on those who have children adopting a healthier lifestyle,
[21]
support from children, or the circumstances that led to not having children.
Social[edit]
In many cultures, inability to conceive bears a stigma. In closed social groups, a degree
of rejection (or a sense of being rejected by the couple) may cause considerable anxiety
and disappointment. Some respond by actively avoiding the issue altogether; middle-
[22]
class men are the most likely to respond in this way.
In the United States some treatments for infertility, including diagnostic tests, surgery
and therapy for depression, can qualify one for Family and Medical Leave Act leave. It
[23]
has been suggested that infertility be classified as a form of disability.