Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Infertility”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1996

Incidence of varicoceles in men with primary and secondary infertility.

OBJECTIVES: To determine whether varicoceles are more prevalent in men with secondary infertility than in men with primary infertility. METHODS: The records of 2188 consecutive men attending three infertility centers were reviewed to determine the incidence of varicoceles in men with primary and secondary infertility. In addition, other factors affecting both male and female infertility were assessed in these patients. RESULTS: The incidence of varicoceles was not significantly different between the 1447 men with primary infertility versus the 741 men with secondary infertility: 44% and 45%, respectively. The incidence of vasal agenesis was significantly greater in men with primary infertility (P < 0.001). In addition, the female partner was significantly older in couples with secondary infertility (P < 0.001). CONCLUSIONS: These findings do not support the conclusion that varicoceles have a progressive adverse effect on fertility over time and suggest that further study is needed to determine whether varicocele repair is indicated in patients with normal semen parameters.

Adult↗
PubMedDate not supplied

Primary infertility after genital mutilation in girlhood in Sudan: a case-control study.

BACKGROUND: In theory, infections that arise after female genital mutilation (FGM) in childhood might ascend to the internal genitalia, causing inflammation and scarring and subsequent tubal-factor infertility. Our aim was to investigate this possible association between FGM and primary infertility. METHODS: We did a hospital-based case-control study in Khartoum, Sudan, to which we enrolled women (n=99) with primary infertility not caused by hormonal or iatrogenic factors (previous abdominal surgery), or the result of male-factor infertility. These women underwent diagnostic laparoscopy. Our controls were primigravidae women (n=180) recruited from antenatal care. We used exact conditional logistic regression, stratifying for age and controlling for socioeconomic status, level of education, gonorrhoea, and chlamydia, to compare these groups with respect to FGM. FINDINGS: Of the 99 infertile women examined, 48 had adnexal pathology indicative of previous inflammation. After controlling for covariates, these women had a significantly higher risk than controls of having undergone the most extensive form of FGM, involving the labia majora (odds ratio 4.69, 95% CI 1.49-19.7). Among women with primary infertility, both those with tubal pathology and those with normal laparoscopy findings were at a higher risk than controls of extensive FGM, both with borderline significance (p=0.054 and p=0.055, respectively). The anatomical extent of FGM, rather than whether or not the vulva had been sutured or closed, was associated with primary infertility. INTERPRETATION: Our findings indicate a positive association between the anatomical extent of FGM and primary infertility. Laparoscopic postinflammatory adnexal changes are not the only explanation for this association, since cases without such pathology were also affected. The association between FGM and primary infertility is highly relevant for preventive work against this ancient practice.

Adult↗
PubMed1997

Autoantibodies and infertility: a review of the literature.

The role that autoantibodies play in infertility remains uncertain. There are conflicting data regarding the prevalence of autoantibodies in women with endometriosis. Certainly no one has demonstrated an association between the presence of antibodies in women with endometriosis and infertility. Despite intensive study, there is also no consensus on a role of autoantibodies to the zona pellucida as a cause of infertility. Recently, much attention has been focused on autoantibodies and infertility particularly with regards to phospholipid antibodies and their effect on IVF success rates. The literature suggests that women with infertility have an increased prevalence of phospholipid antibodies compared to fertile women. However, the presence of these antibodies has not been associated with a worsened prognosis for IVF cycles. Many questions remain to be answered. What is the cause of this apparently increased prevalence of autoantibodies in infertile women? Do these autoantibodies cause infertility or are they merely associated with some other condition which is actually causitive? Finally, can treatment of autoantibodies improve pregnancy rates in infertile couples after IVF or other infertility treatments? The answers to these questions should be sought by carefully conducted trials with appropriate control groups. Subjecting patients to expensive testing and 'treatments' before these answers are known is not consistent with good scientific or medical practice.

Animals↗
PubMed2000

Living with infertility: experiences among Urban slum populations in Bangladesh.

This paper explores the perceived causes of infertility, treatment-seeking for infertility and the consequences of childlessness, particularly for women, among a predominantly Muslim population in urban slums of Dhaka in Bangladesh. In-depth interviews were conducted with 60 women and 60 men randomly selected from Urban Surveillance System clusters of the International Centre for Diarrhoeal Disease Research, Bangladesh. Case studies of 20 self-perceived infertile women who had previously participated in a study on the prevalence of sexually transmitted diseases and other reproductive tract infections were taken, and three traditional healers were interviewed as key informants. In both groups of respondents, the leading causes of infertility were perceived to be evil spirits and physiological defects in women and psychosexual problems and physiological defects in men. Herbalists and traditional healers were considered the leading treatment option for women, while for men it was remarriage, followed by herbalists and traditional healers. Childlessness was found to result in perceived role failure, with social and emotional consequences for both men and women, and often resulted in social stigmatisation of the couple, particularly of the woman. Infertility places women at risk of social and familial displacement, and women clearly bear the greatest burden of infertility. Successful programmes for dealing with infertility in Bangladesh need to include both appropriate and effective sources of treatment at community level and community-based interventions to demystify the causes of infertility, so that people know why infertility occurs in both men and women and and where best to seek care.

Adolescent↗
PubMed2000

Unmet needs, beliefs and treatment-seeking for infertility among migrant Ghanaian women in the Netherlands.

Studies on infertility in the Netherlands have little information on migrant Ghanaian women, even though Ghanaians are the third largest migrant group in Amsterdam. An exploratory study on the unmet needs, attitudes, and beliefs of migrant Ghanaian women with infertility problems living in the Netherlands, and the kinds of treatment they sought was undertaken in 1999. Qualitative data were collected from 12 women with primary or secondary infertility through narratives and 20 key informant interviews. The women described seeking treatment for infertility in Ghana, the Netherlands and other European countries, included use of infertility drugs, surgery, donor insemination and in vitro fertilisation. Illegal migrant women are not entitled to treatment paid by the national health system, and being of low income they cannot afford to pay directly for this or to obtain private health insurance. Herbalists and spiritual healers in both Amsterdam and Ghana were regularly consulted, especially for their willingness to address the social and spiritual aspects of infertility. To produce a pregnancy where male infertility was suspected, transfer of sexual rights to another man in the husband/partner's family, or a healer or priest, was a practical remedy that kept male infertility hidden. This study revealed difficulties experienced in clinical settings due to language barriers and cultural differences. Ghanaian women living in the Netherlands need much more information on the causes of infertility and their options.

Adoption↗
PubMed2002

The effects of type of female circumcision on infertility and fertility in Sudan.

This study explores the association between type of female circumcision and infertility and fertility in Sudan using the 1989-90 Demographic and Health Survey. It is hypothesized that women with either Pharaonic or Intermediate circumcision would have higher infertility and lower fertility compared with women with Sunna circumcision, and that uncircumcised women would have the lowest infertility and highest fertility of the three groups. This hypothesis, a widely held assumption, proved to be largely incorrect. Though women with Pharaonic or Intermediate circumcision did have a higher prevalence of primary infertility than uncircumcised women, women with Sunna circumcision had even lower rates of primary infertility compared with uncircumcised women. This pattern prevailed in multivariate models controlling for confounding variables, where women with Pharaonic or Intermediate circumcision had significantly higher primary infertility. Moreover, though women with Pharaonic or Intermediate circumcision also had the highest prevalence of secondary infertility, once confounding covariates were controlled in multivariate models, there was no significant difference among the three groups of women. With respect to fertility, the total fertility rate was 7.6 for women with Pharaonic or Intermediate circumcision, 8.1 for women with Sunna circumcision and 8.3 for uncircumcised women. Differences in fertility were found to be insignificant when covariates were controlled. The multivariate models were estimated using logistic regression. In conclusion, Pharaonic or Intermediate circumcision may be associated with higher primary infertility while there was no evidence suggesting that either secondary infertility or fertility was associated with a woman's circumcision status.

Circumcision, Female↗
PubMed1998

Diagnostic laparoscopy in primary and secondary infertility.

PURPOSE: Our purpose was to compare the diagnostic efficacy of laparoscopy between primary and secondary infertility and to define a subgroup in which the positive findings are low. METHODS: A retrospective review of the cases of 206 infertile women who underwent laparoscopy was conducted. RESULTS: Eighty-two (39.8%) patients were found to have evidence of pelvic disease--20 (22.2%) with primary infertility and 62 (54.3%) with secondary infertility. The ratio of positive findings in secondary infertility was significant in comparison with the positive findings in primary infertility. In only 3 of the 20 patients with primary infertility was there no history of an abdominal operation, pelvic inflammatory disease, or an abnormal hysterosalpingography. Of the 62 women who suffered secondary infertility and had positive findings in laparoscopy, 15 had no history of suspect findings. CONCLUSIONS: The diagnostic yield of laparoscopy for primary infertility in the absence of indications of mechanical factors is low. Therefore the need for diagnostic laparoscopy in these cases should be reconsidered.

Adult↗
PubMed1997

Microdeletions in the Y chromosome of infertile men.

BACKGROUND: Some infertile men with azoospermia or severe oligospermia have small deletions in regions of the Y chromosome. However, the frequency of such microdeletions among men with infertility in general is unknown. We sought to determine the prevalence of Y-chromosome microdeletions among infertile men and to correlate the clinical presentation of the men with specific deletions. METHODS: We studied 200 consecutive infertile men. Each man was evaluated comprehensively for known causes of infertility, and Y-chromosome microdeletions were studied with use of the polymerase chain reaction to amplify specific regions of the chromosome. The Y chromosomes of 200 normal men were also analyzed. RESULTS: Fourteen infertile men (7 percent) and four normal men (2 percent) had microdeletions of the Y chromosome. Nine of the infertile men had azoospermia or severe oligospermia (sperm concentration, <5 million per milliliter), four had oligospermia (sperm concentration, 5 million to <20 million per milliliter), and one had normospermia (sperm concentration, > or = 20 million per milliliter). The size and location of the deletions varied and did not correlate with the severity of spermatogenic failure. The fathers of six infertile men with microdeletions were studied; two had the same deletions as their sons, and four had no deletions. CONCLUSIONS: A small proportion of men with infertility have Y-chromosome microdeletions, but the size and position of the deletions correlate poorly with the severity of spermatogenic failure, and a deletion does not preclude the presence of viable sperm and possible conception.

Adult↗
PubMedDate not supplied

Molecular biology of male infertility.

About 15% of couples have reduced fertility and in approximately one-half of all cases the reason is male infertility, usually of genetic origin. Thus, in the context of research in genes involved in reproduction and sex determination, genetic anomalies in gametogenesis are being extensively studied. The most frequent pathogenic causes of male infertility are Y-chromosomal microdeletions (8-15%) in the long arm of the Y chromosome, which, by loss of specific DNA segments, leads to loss of vital genes for sperm production. Infertile men, who attend infertility clinics, rise to 15% among those with azoospermia or spermatogenesis problem. The new technique of intracytoplasmic sperm injection has allowed many infertile men to achieve their dreams of fatherhood. However, the spermatogenic defect is genetic anomalies, which might be a potential risk of transmitting this defect to future offspring. Therefore, genetic counseling of all couples with the diagnosis of male infertility is recommended before their enrolment in intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection. The important role of genetic abnormalities in the causation of human male infertility is increasingly recognized. While much remains to be learned in this fast-moving field, considerable progress has been made in the clinical delineation of genetic forms of male infertility and in the characterization of the responsible genes and their mutations or deletions. This review should provide insight into the understanding of parthenogenesis of male infertility in the human.

Female↗
PubMedDate not supplied

Ultrastructural defects of acrosome in infertile men.

To study the ultrastructural changes of acrosomes in fertile and infertile males and to identify the morphological alterations closely related to male infertility, forty spermatozoa from 8 fertile males and 60 spermatozoa from 12 infertile males were collected and observed by scanning electron microscope. There were significant changes in the morphology of the circular sulcus, acrosome membrane and head of the infertile sperm. The circular sulcus of spermatozoa was more serrated (39/60 vs 2/40) and blurred (40/60 vs 4/40) in the infertile group than in the fertile group. The acrosome of infertile group occupied a bigger proportion of sperm head (70+/-8% vs 57+/-6%) than in the fertile group. The acrosome membrane in the infertile group was less intact (18/60 vs 31/40) and less smooth (19/60 vs 32/40) than in the fertile group. More droplets were attached to the acrosome membrane in the infertile (39/60 vs 11/40) than in the fertile groups. The abnormality in acrosome ultrastructure seems to be significantly higher in infertile than in fertile males, suggesting a potential role of such defects for male fertility defect.

Acrosome↗
PubMed2003

Age-related changes in ovarian volume, antral follicle counts and basal follicle stimulating hormone levels: comparison between fertile and infertile women.

Our objective was to compare the relationship between age, basal follicle stimulating hormone (FSH) level and ultrasound-measured mean ovarian volume (MOV) and mean antral follicle counts (MFC) in a group of infertile and fertile women between the ages of 35 and 45 years. Menstrual cycle day 3 serum FSH, MOV and MFC were analyzed in 62 infertile and 53 fertile women. Basal FSH and MFC did not differ between infertile and fertile women, whereas MOV was significantly smaller in infertile women (p < 0.05). In the infertile group, there was a negative correlation between MOV and age (rho = -0.389, p < 0.05), between MOV and basal FSH (rho = 0.495, p < 0.01), and between MFC and age (rho = -0.553, p < 0.01). In the fertile group, there was a strong negative correlation between MOV and basal FSH (rho = -0.631, p < 0.01), and between MFC and basal FSH (rho = -0.710, p < 0.01). Mean basal FSH, MOV and MFC did not differ between subgroups of patients with different causes of infertility. In the infertile group, patients with small ovaries of volume less than 1.8 cm(3) (mean volume -1 SD) had higher mean basal FSH (p < 0.05) and lower MFC (p < 0.01) levels than patients with normal ovarian volume. In conclusion, transvaginal ultrasound (TVU) indices and indirect hormonal parameters of ovarian reserve were similar in infertile and fertile women aged between 35 and 45 years. It is suggested that, in infertile women above 35 years of age, TVU rather than hormonal parameters be preferred, based on our data showing a stronger association between age and TVU indices of ovarian reserve than between age and increase in basal FSH level. Thus, TVU assessment of ovarian volume and antral follicle counts is a practical and cost-effective, if not better, technique for ovarian reserve testing.

Adult↗
PubMed1999

The reactive oxygen species-total antioxidant capacity score is a new measure of oxidative stress to predict male infertility.

The imbalance between reactive oxygen species (ROS) production and total antioxidant capacity (TAC) in seminal fluid indicates oxidative stress and is correlated with male infertility. A composite ROS-TAC score may be more strongly correlated with infertility than ROS or TAC alone. We measured ROS, TAC, and ROS-TAC scores in semen from 127 patients and 24 healthy controls. Of the patients, 56 had varicocele, eight had varicocele with prostatitis, 35 had vasectomy reversals, and 28 had idiopathic infertility. ROS levels were higher among infertile men, especially those with varicocele with prostatitis (mean +/- SE, 3.25 +/- 0.89) and vasectomy reversals (2.65 +/- 1.01). All infertile groups had significantly lower ROS-TAC scores than control. ROS-TAC score identified 80% of patients and was significantly better than ROS at identifying varicocele and idiopathic infertility. The 13 patients whose partners later achieved pregnancies had a mean ROS-TAC score of 47.7 +/- 13.2, similar to controls but significantly higher than the 39 patients who remained infertile (35.8 +/- 15.0; P < 0.01). ROS-TAC score is a novel measure of oxidative stress and is superior to ROS or TAC alone in discriminating between fertile and infertile men. Infertile men with male factor or idiopathic diagnoses had significantly lower ROS-TAC scores than controls, and men with male factor diagnoses that eventually were able to initiate a successful pregnancy had significantly higher ROS-TAC scores than those who failed.

Antioxidants↗
PubMed2000

The prognostic power of the post-coital test for natural conception depends on duration of infertility.

Controversy about the value of the post-coital test (PCT) has prompted us to re-analyse data from 207 couples, originally studied between 1982 and 1983, with at least 12 months' infertility at presentation, complete diagnostic information and exclusion of female factors, to clarify the effect of duration of infertility on the prediction of conception. In couples with less than 3 years infertility and a positive PCT, 68% conceived within 2 years compared with 17% of those with a negative result. After 3 years, corresponding rates were 14% and 11%. The relative risks of conception [95% confidence interval (CI)] calculated using the Cox's proportional hazards model were 0.23 (0.12-0.43) for a negative PCT (reference positive PCT) and 0.25 (0.13-0.51) for more than 36 months infertility (reference 12-23 months). Semen analysis had no extra predictive power given the duration of infertility and the PCT. The PCT is an effective predictor of conception where defined female causes of infertility are absent and duration of infertility is less than 3 years. Once infertility is prolonged (beyond 3 years) the conception rate is low even with a positive test because a large proportion of couples remaining childless so long have true unexplained infertility. Use of the PCT will enable clinicians to allocate scarce, expensive and invasive resources effectively.

Adult↗
PubMed2001

Emotional distress of infertile women in Japan.

Although recent papers have suggested that psychological factors are implicated in the experience of infertility, few studies have assessed this relationship in a sample of Japanese infertile women. This study was carried out in order to clarify whether Japanese infertile women experience emotional distress. A cross-sectional questionnaire study was performed to assess the psychological states of 101 infertile women compared to 81 healthy pregnant women. The hospital anxiety and depression scale (HADS) and the profile of mood states (POMS) were administered. These questionnaires produced scores for depression/dejection, anxiety, aggression/hostility, lack of vigour, fatigue, tension anxiety, and confusion. The HADS and the POMS scores of infertile women were significantly higher than those of pregnant women, except for fatigue score. Infertile women with positive HADS indicating emotional disorders (39/101, 38.6%) were significantly (P = 0.0008, chi(2) test) more than those of pregnant women (13/81, 16.0%) when the threshold was set at 12/13 of total HADS scores. The HADS scores were not affected by the women's age, duration of infertility, experience of conception, routine tests, and work states. In this Japanese population, infertile women reported higher levels of emotional distress than pregnant women, suggesting psychological support is needed for infertile women.

Adult↗
PubMed2001

Psychosocial characteristics of infertile couples: a study by the 'Heidelberg Fertility Consultation Service'.

BACKGROUND: The aim of the study was to identify differences in psychological characteristics between couples with fertility disorders, especially idiopathic infertility, and a representative sample. MATERIAL AND METHODS: A total of 564 couples was examined using psychological questionnaires pertaining to sociodemographic factors, motives for wanting a child, dimensions of life satisfaction and couple relationships, physical and psychic complaints, and a personality inventory. RESULTS: Specific to our sample was the high educational level of the couples, and the large number with idiopathic infertility (27% of all diagnoses). There were no remarkable differences in psychological variables between the infertile couples and a representative sample, except that the infertile women showed higher scores on the depression and anxiety scales. Couples with idiopathic infertility showed no remarkable differences in the questionnaire variables compared with couples with other medical diagnoses of infertility. CONCLUSIONS: A typical psychological profile for infertile couples could not be identified using standardized psychometric rating methods. This may be an effect of the specific characteristics of our sample. For some couples, the infertility crisis can be seen as a cumulative trauma, which indicates that these couples have a marked need for infertility counselling.

Adaptation, Psychological↗
PubMed2002

Anxiety, depression and anger suppression in infertile couples: a controlled study.

BACKGROUND: Although several authors have suggested an important pathogenic role for psychosocial factors in 'functional' infertility, the extent to which depression, anxiety and expressed emotional patterns correlate to infertility is not yet clear. METHODS: This study included 156 infertile couples (recruited at intake) and 80 fertile couples, whose personal characteristics were recorded. They were examined using scales for the evaluation of the degree of psychopathology [Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D)], and anger expression [State-Trait Anger Expression Inventory (STAXI)]. The 156 infertile couples were then subdivided into groups based on the cause of infertility ('organic', 'functional' or 'undetermined'). The psychometric evaluation was double-blind with respect to the causes of infertility. RESULTS: Differences emerged in the degree of psychopathology between 'organic' and 'functional' infertile subjects and fertile controls. In women, logistic regression identified three variables able to predict the diagnosis subtype; these variables are HAM-A, HAM-D, and tendency toward anger suppression. In men, anger did not emerge as a predictor for diagnosis, whereas HAM-A and HAM-D did. CONCLUSIONS: The 'functional' infertile subjects of this sample showed particular psychopathological and psychological features, independent from the stress reaction following the identification of the cause of infertility.

Adult↗
PubMed1991

Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988-1989).

To estimate the prevalence and main causes of infertility, a multicentre survey was conducted over 1 year (July 1988-June 1989) in three regions of France. All the 1686 couples in these regions, who consulted a practitioner for primary or secondary infertility during this period, were included in the investigation. The prevalence rate of infertility was found to be 14.1%, indicating that one woman out of seven in France will consult a doctor for an infertility problem during her reproductive life. The main causes of female infertility were ovulation disorders (32%) and tubal damage (26%), and of male infertility oligo-terato-asthenozoospermia (21%), asthenozoospermia (17%), teratozoospermia (10%) and azoospermia (9%). Infertility was also found to be caused by disorders in both the male and female partners together; thus in 39% of cases both the man and woman presented with disorders. The woman alone was responsible for infertility in one-third of cases and the man alone in one-fifth. Unexplained infertility was found in 8% of the couples surveyed.

Adult↗
PubMed1994

Infertility prevalence, needs assessment and purchasing.

A postal questionnaire was used to assess the prevalence of primary and secondary infertility in Somerset. Three age groups of women were surveyed: those aged 36-40 (n = 965), 41-45 (n = 1115) and 46-50 years (n = 1061). Using these three age groups, most of whom had completed their reproductive lifespan, time trends both in the prevalence of infertility and service use were obtained. A 75.7 per cent response rate was achieved. No trends towards increasing prevalence of infertility were seen, but greater use was made of services in the younger age group. The overall prevalence of primary infertility was 16.1 per cent (95 per cent confidence interval (Cl) 14.6-17.6) if failure to conceive after one year is used as the definition of infertility. Similarly, the prevalence of secondary infertility was 15.8 per cent. It was found that 26.4 per cent (95 per cent Cl 24.6-28.2) of women were likely to suffer from infertility at some time and only 3.0 per cent of women were involuntarily childless. Twenty-five women (1.1 per cent) suffered recurrent miscarriages. There was no change in the likelihood of conception in the three age groups of women suffering infertility. Those in lower socio-economic groups were less likely to consult their general practitioners (GPs) when difficulties in conceiving were experienced. Examinations of a sample of responders' and non-responders' medical records suggested that the use of postal questionnaires in assessing the prevalence of infertility may, to some extent, be prone to bias.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗