Page 99 - 86 human physiology part-2

Chapter 16

• Anovulation
• Diminished ovarian reserve
• Luteal dysfunction
• Premature menopause
• Gonadal dysgenesis (Turner syndrome)
• Ovarian neoplasm
• Tubal/peritoneal factors
• Endometriosis
• Pelvic adhesions
• Pelvic inflammatory disease(PID, usually due to chlamydia)
• Tubal occlusion
• Uterine factors
• Uterine malformations
• Uterine fibroids (leiomyoma)
• Asherman's Syndrome
• Cervical factors
• Cervical stenosis
• Antisperm antibodies
• Insufficient cervical mucus (for the travel and survival of sperm)
• Vaginal factors
• Vaginismus
• Vaginal obstruction
• Genetic factors
• Various intersexuality|intersexed conditions, such as androgen insensitivity
syndrome

Combined Infertility

In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility
arises from the combination of these factors. In other cases, the cause is suspected to be immunological
or genetic; it may be that each partner is independently fertile but the couple cannot conceive together
without assistance.

Unexplained Infertility

In about 15% of cases of infertility, investigation will show no abnormalities. In these cases
abnormalities are likely to be present but not detected by current methods. Possible problems could be
that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube,
sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be
disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance.

Diagnosis of Infertility

Diagnosis of infertility begins with a medical history and physical exam. The healthcare provider
may order tests, including the following:

314 | Human Physiology