Infertility Research Paper

Infertility is described as the inability to conceive a baby after a year of regular unprotected intercourse. One does not have to be “trying’ to conceive in order to. Couples can have regular intercourse for years without “trying” to conceive and wind up conceiving. The act of “trying is not what determines whether or not conception happens. If all fertility factors are normal conception WILL happen regardless of wanting it to or not. Infertility cannot be a possibility until after 1 year of regular unprotected intercourse for those who are apparently healthy and about 6 months for couples in their late thirties or forties or those with already identified potential problems. Infertility can affect males, females, all ages, and races. It currently

affects about 15% of couples in the U.S trying to conceive. Out of this15% 40% of the woman are the cause, 40% of the men are the cause and the other 20% is due to either both partners having infertility issues or no cause can be found in either partner. Infertility affects minority women at a lower rate than Caucasian women. About 15% of white ages 25 to 44 compared to 8% of black women, and 7.6 of Hispanic women experience infertility.
There are several risk factors that can cause infertility, and the factor is ones social experiences. It was common decades ago for women to finish high school, get married and become pregnant right away, but now women are going on to college and graduate school, therefore, getting married later and obtaining financial stability before trying to conceive. Conception is no longer happening as much in women in their late teens and twenties but now in their late thirties and forties. Not only does a woman’s egg count drastically decrease as she ages due to continuous menstruation monthly, but she opens a larger window to contract a gynecologic disease and other medical conditions that can interfere with fertility. Couples who have previously conceived, infertility rate is lowered than those who have never conceived. It is believed that those who have bear a child previously have a lower contraction rate of sexually transmitted disease because of monogamy and child bearing may protect against gynecological disease.
Another factor is sexually transmitted diseases. Studies have shown that 11 to 12% of women that experience an episode of tubal infections will become infertile. This percentage rises to 23% after two episode and above 50% after the third one. Gonorrhea and chlamydia have the greatest impact on tube damage.
The most common risk factor is Endometriosis which occurs in about 25% of infertility cases.

Endometriosis is a disorder where the tissues that typically lines the uterus lines other surfaces outside of the uterus such as the ovaries, bowels or the lining of the pelvis. It is painful and the tissue continues to grow, thicken, shed and bleed during menstruation. It is caused by chronic reverse flow of menstrual blood back into the tubes. Since the blood typically gets trapped the cells implant and grow around the tubes and ovaries which creates inflammation and scarring and this aids in infertility. This disorder has a decreasing risk factor with early child bearing. Child birth decrease retrograde menstruation by widening the cervical opening thus preventing cells from implanting in unwanted places. Endometriosis has been dubbed “the career woman’s disease’ because it is typically found in women who wait until they have aged to bear a

child.
Lack of ovulation known as anovulation is the second leading infertility cause in women.

This inability deprives the woman’s reproductive system to attempt conception. Anovulation can be caused by failure from one of three things; the ovaries, the reproductive centers, or a malfunction in certain parts of the reproductive system that results from a disruption in the orderly sequence of hormonal changes that controls the release of the egg. Ovarian failure prior to the normal age of menopause is known as premature ovarian failure. This is caused by high levels of gonadotropins. These levels are typically two to three times higher than the normal levels. This comes as a result from the hypothalamus and pituitary gland overreacting to a lack of feedback signals from the ovaries. When ovaries are not responding they send signals to the hypothalamus to release gonadotropins to make them work, thus if they continuously not work there will be elevated levels of the hormone. Low levels of this hormone results from stress, anxiety, excessive exercise, crash dieting, and anorexia nervosa, which causes the hypothalamus to malfunction and reduce

menstruation.
Failure of the reproductive centers in the brain and pituitary, occurs when the hypothalamic- pituitary axis is unable to respond, yet it is receiving adequate and properly timed signals. This can be caused by interference in the pituitary either by a pituitary tumor known as micro adenoma or an overactive pituitary which secretes excess prolactin hormone. These levels can be elevated without causing menstrual irregularity.
Polycystic ovarian syndrome is a result of increases insulin levels in the blood as a response to an increased resistance to insulin. This causes the adrenal gland and ovaries to produce increased male hormones. Fat tissue in the body converts these hormones at an increased rate. This rate disturbs the proper functioning of the pituitary gland which will in return secrete abnormally high levels of L.H. Increased L.H levels causes ovaries to secrete higher amounts of male hormones. As a result small cystic follicles develop within the ovary. PCO becomes a suspect when there is a lifelong occurrence of infrequent or absent periods, with or without the occurrence of excessive hair growth or body weight. Lack of periods or irregular periods, abnormal hair growth, lack of menstrual and premenstrual symptoms, severe acne and breast secretions are symptoms that may signal a problem with ovulation.