INFERTILITY
INVESTIGATING INFERTILITY
First, a general check-up and/or a personal interview regarding
sexual behaviour are carried out. If no cause for infertility is
found at this stage, more specialized tests may be performed.
It is important that both partners are tested for infertility,
because infertility can be attributed to one person, to both
people, or to mutual incompatibility.
CAUSES OF INFERTILITY
Conception is a complicated
process; the reproductive organs
can be affected in numerous ways,
resulting in infertility. Some of the
principal underlying causes of
infertility in men and in women
are illustrated on the right.
P e n i s
T h e r e m a y b e f a i l u r e t o a c h i e v e
o r m a i n t a i n a n e r e c t i o n , o r
a b n o r m a l i t y o f e j a c u l a t i o n .
T e s t e s
T o o f e w s p e r m m a y b e p r o d u c e d ;
s p e r m c o u l d b e a b n o r m a l l y
s h a p e d , t o o s h o r t - l i v e d , o r h a v e
i m p a i r e d m o t i lit y .
V a s d e f e r e n s
B l o c k a g e o r s t r u c t u r a l a b n o r m a l i t y
m a y i m p e d e t h e p a s s a g e
o f s p e r m .
F a l l o p i a n t u b e s
B l o c k a g e m a y p r e v e n t
s p e r m f r o m r e a c h i n g
a n e g g ; o n e o r b o t h
t u b e s m a y b e a b s e n t
o r d a m a g e d .
O v a r ie s
E g g s m a y f a i l to
m a t u r e o r m a y n o t b e
r e l e a s e d .
U t e r u s
A b n o r m a l i t y o r
d i s o r d e r m a y p r e v e n t
im p l a n t a t i o n o f a
f e r t i l i z e d e g g .
C e r v ix
C e r v ic a l m u c u s m a y d a m a g e
o r d e s t r o y s p e r m .
FEMALEINFERTILITY
Investigations to discover the
cause of a woman’s infertility may
include taking a menstrual history
and a study ofthe woman’s body
temperature during her menstrual
cycle (below). There may also be
blood and urine tests to discover
whether ovulation is normal,
hysterosalpingography (right),
and/or laparoscopy (below right).
■9
H
Hysterosalpingography
This is an X-raytechnique
that is used to show the
uterus and/or fallopian
tubes. Here, the right-
hand tube (on the left
ofthe image) istotally
blocked, and the left-hand
tube appears enlarged.
°C
37
3 6.5
3 6
Body temperature and ovulation
Charting the changes in a woman’s body
temperature during her menstrual cycle
can reveal abnormalities of ovulation.
The chart above shows typical daily
temperature fluctuations during a
normal menstrual cycle (blue line) and
temperature changes associated with
failure to ovulate (greyline).
r
V
A
f
V
I f
- -
10 11
12
13
14
15
16
17
18
Day of cycle
Laparoscopy
In this technique, a laparoscope (a type ofviewing
tube) is inserted through the abdominal wall to
examine the woman’s reproductive organs and
determine whether an abnormality or disorder,
such as blocked fallopian tubes or endometriosis,
is present. The laparoscopicview above shows
an ovarian cyst.
O v a r ia n c y s t
MALE INFERTILITY
The first test for investigating male
infertility is semen analysis (below).
Ifit reveals a low sperm count, more
tests may be needed to investigate
the underlying cause.
Semen analysis
Semen produced bymasturbation is examined
as soon as possible, and the number, shape,
and degree of motility (movement) ofthe sperm
are determined. A postcoital semen test may
also be performed.
Abnormal sperm
If a man’s semen
contains large
numbers of
abnormally shaped
sperm, such as the
two-headed one at
the top ofthis
image, his fertility
maybe reduced.
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