R T IL IT Y IN V E ST IG A T I O N

INFE A YOVINNA T
BY: VELL
 WHAT IS INFERTILITY?
Male Infertility
• Any disorder of the reproductive system affecting
males, characterized by dysfunctionalities in the
ejection of semen or an abnormal absence in the
measurable level of sperm in semen.
Female Infertility
• Disease of the reproductive system defined by
the failure to achieve a clinical pregnancy after
12 months or more of regular unprotected sexual WHO, 2020
intercourse.
 CLASSIFICATION
Primary Secondary
Infertility Infertility
Munir, 2019
EPIDEMIOL0GY

• AT LEAST 50 MILLION COUPLES WORLDWIDWE EXPERIENCE INFERTILITY

• APPROXIMATELY 10,5% OF WOMEN AROUND THE WORLD EXPERIENCED
SECONDARY INFERTILITY, ROUGHLY 2% EXPERIENCED PRIMARY INFERTILITY

• INFECTIOUS DISEASE CONTRIBUTES

Mascarenhas, Flaxman, Boerma, Vanderpoel, & Stevens, (2012)

PREVALENCE OF PRIMARY INFERTILITY AND SECONDARY INFERTILITY, PRESENTED AS
THE PERCENT OF WOMEN WHO SEEK A CHILD, AND AS THE PERCENT OF ALL WOMEN
OF REPRODUCTIVE AGE, IN 1990 AND 2010

Mascarenhas , Flaxman , Boerma , Vanderpoel, & Stevens, (2012)

 CAUSES OF INFERTILITY
Personal Habit Male Factor Female Factor
• Alcohol intake • Sperm • Ovulation
• Cigarette smoking abnormalities dysfunction
• Bad lifestyle • Previous disease • Fallopian tube
obstructions
• Infections (PID;STI)

Kamel, 2010
Kamel, 2010
IMPLICATION
Need widespread community education to alleviate patients’ fears before and during consultations
Need to educate patients to understand early presentation will increase the effectiveness of fertility treatment
Bennet, et al., 2012
WHAT IS INFERTILITY INVESTIGATION?
Source: Indonesian Association for IVF (IA-IVF) report - 2013
 INFERTILITY INVESTIGATION
Investigation
Focused history taking for infertile couple

Focused clinical examination for infertile couple

Focused investigatios for infertile couples

Kamel, 2010
Treatment
Life style Folic acid supplementation
Counselling
Sexual intercourse Chlamydial prophylaxis
Occupation Aging and fertility

Comprehensive examination

Unexplained Sperm Anovulation Endometriosis Tubal factor

Uterine factor

Ovulation induction Surgery

Ovarian stimulation
3 – 6 cycles

Intra uterine insemination

4 cycles

IN VITRO FERTILIZATION
REFERENCES
• BENNETT, L.R., ET ALL. (2015). REPRODUCTIVE KNOWLEDGE AND PATIENT EDUCATION NEEDS AMONG INDONESIAN WOMEN INFERTILITY
PATIENTS ATTENDING THREE FERTILITY CLINICS. PATIENT EDUCATION AND COUNSELING 98 (2015): 364-369. HTTP://
DX.DOI.ORG/10.1016/J.PEC.2014.11.016

• BENNETT, L.R., WIWEKO, B., HINTING, A., ADNYANA, I.B.P., & PANGESTU, M. (2012). INDONESIAN INFERTILITY PATIENT’S HEALTH SEEKING
BEHAVIOUR AND PATTERNS OF ACCESS TO BIOMEDICAL INFERTILITY CARE: AN INTERVIEWER ADMINISTERED SURVEY CONDUCTED IN THREE
CLINICS. REPRODUCTIVE HEALTH, 9(24). HTTPS://DOI.ORG/10.1186/1742-4755-9-24

• KAMEL, R. (2010). MANAGEMENT OF THE INFERTILE COUPLE: AN EVIDENCE-BASED PROTOCOL. REPRODUCTIVE BIOLOGY AND
ENDOCRINOLOGY, 8(1): 21. HTTPS://DOI.ORG/10.1186/1477-7827-8-21

• MASCARENHAS MN, FLAXMAN SR, BOERMA T, VANDERPOEL S, STEVENS GA (2012) NATIONAL, REGIONAL, AND GLOBAL TRENDS IN
INFERTILITY PREVALENCE SINCE 1990: A SYSTEMATIC ANALYSIS OF 277 HEALTH SURVEYS. PLOS MEDICINE 9(12): E1001356. HTTPS://
DOI.ORG/10.1371/JOURNAL.PMED.1001356

• MUNIR , M. (2019). INFERTILITAS. DIAKSES PADA TANGGAL 22 MARET 2020 DARI HTTP://WWW.YANKES.KEMKES.GO.ID/READ--INFERTILITAS-7828.HTML
• ROWE, P.J., COMHAIRE, F.H., HARGREAVE, B., & MAHMOUD, A.M.A. (2000). WHO MANUAL STANDARDIZED INVESTIGATION, DIAGNOSIS AND
MANAGEMENT OF THE INFERTILE MALE. CAMBRIDGE UNIVERSITY PRESS

• WHO. (2020). INFERTILITY DEFINITIONS AND TERMINOLOGY. DIAKSES PADA 22 MARET 2020 DARI
HTTPS://WWW.WHO.INT/REPRODUCTIVEHEALTH/TOPICS/INFERTILITY/DEFINITIONS/EN/