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Gepubliceerd in:

2019 | OriginalPaper | Hoofdstuk

13. Infertility

Auteurs : Jesper M. J. Smeenk, MD, PhD, Simone L. Broer, MD, PhD

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

Summary

If a couple has failed to conceive spontaneously in 12 months of unprotected intercourse we speak of infertility. About 1 out of 7 couples seek medical guidance for infertility. Due to postponing childbearing this number might increase in the future. Infertility is a disability and should be investigated properly. Factors influencing fertility should be assessed and a work-up for both men and women should be performed. This includes a semen analysis, assessment of the menstrual cycle and evaluation of tubal pathology or other diseases that could influence fertility. If results reveal that a couple cannot conceive spontaneously, they are infertile and appropriate treatment should be offered. Idiopathic infertility means that no cause for infertility was found. In those cases a prognosis should be predicted to evaluate whether a couple should be advised to enter a fertility treatment program or still has sufficient chances of a spontaneous pregnancy within 6–12 months and should therefore be counselled for expectant management.

vorige hoofdstuk The normal and abnormal menstrual cycle

volgende hoofdstuk Assisted reproductive technology

Alleen toegankelijk voor geautoriseerde gebruikers

Subfertility

The failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. A term that should be used interchangeably with infertility, according to the International Glossary on Infertility and Fertility Care (Fertility and Sterility 2017). Although the difference between ‘infertility’ and ‘sterility’ lies in the fact that no work-up has been done yet to establish the cause and treatment possibilities, for reasons of clarity only the term ‘infertility’ will be used in this chapter

Infertility

A disease characterized by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity to reproduce either as an individual or with his/her partner

Primary infertility

The couple has never conceived a pregnancy before

Secondary infertility

The couple has conceived before, however is now faced with infertility

Note: within a couple the woman or man can separately have a primary or secondary infertility, meaning that they did achieve a pregnancy in the previous relationship but not with this partner. For example, a woman can have primary infertility while her partner has secondary infertility as he had a child with a previous partner

Ovarian reserve

Quantity and quality of the remaining primordial follicle pool of a woman, reflecting the ability to reproduce

Sterility

The inability to conceive a pregnancy. A permanent state of infertility

Salpingitis

Infection of the fallopian tubes

Pelvic inflammatory disease

Infection of the female genital tract

Idiopathic infertility

When fertility investigations did not find a cause for the infertility

Cryptorchidism

The absence of one or both testes from the scrotum. Generally, the testis will not have descended into the scrotum before birth

Azoospermia

There is a complete lack of sperm in the ejaculate

Oligozoospermia

Refers to semen with a low concentration of sperm

Asthenozoospermia

Refers to reduced sperm motility

Teratozoospermia

If less than 4 % of the sperm show normal morphology

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Dreyer K, et al. Oil-based or water-based contrast for hysterosalpingography in infertile women. N Engl J Med. 2017 May 25;376(21):2043–52.

ESHRE Capri Workshop Group. Europe the continent with the lowest fertility. Hum Reprod Update 2010;16(6):590–602.

ESHRE Task Force on Ethics and Law, including, Dondorp W, Wert G de, Pennings G, Shenfield F, Devroey P, Tarlatzis B, Barri P Diedrich K. Oocyte cryopreservation for age-related fertility loss. Hum Reprod. 2012;27(5):1231–37.

Gameiro S, Boivin J, Dancet E, et al. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction–a guide for fertility staff. Hum Reprod. 2015;30(11):2476–85.

Gameiro S, Finnigan A. Long-term adjustment to unmet parenthood goals following ART: a systematic review and meta-analysis. Hum Reprod Update 2017 May 1;23(3):322–37.CrossRef

Grimbizis GF, Gordts S, ADi Spiezio Sardo A, et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2016;31(1):2–7.

Lambalk CJ van, Disseldorp J van, Koning CH de, Broekmans FJ. Testing ovarian reserve to predict age at menopause. Maturitas 2009; 63:280–91.CrossRef

Laven et al. Richtlijn Orienterend Fertiliteitsonderzoek (OFO). 2015 (Dutch). www.nvog.nl.

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Leuhuis E, Steeg JW van der, Steures P, Bossuyt PM, Eijkemans MJC, Mol BWJ. Prediction models in reproductive medicine: a critical appraisal. Hum Reprod Update 2009;15(5): 537–52.

11.

NHG-Standaard Subfertiliteit (Tweede herziening). Van Asselt KM, Hinloopen RJ, Silvius AM, Van der Linden PJQ, Van Oppen CCAN, Van Balen JAM. Huisarts Wet 2010;53:203–14.

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NICE guidelines. Fertility problems: assessment and treatment (2013, updated 2016). https://www.nice.org.uk/.

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Ovarian reserve testing. Committee opinion No. 618. American college of obstetricians and gynecologists. Obstet Gynecol. 2015;125:268–73.CrossRef

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Wiersma et al. Landelijke netwerkrichtlijn subfertiliteit. 2010 (Dutch).

Titel: Infertility
Auteurs: Jesper M. J. Smeenk, MD, PhD
Simone L. Broer, MD, PhD
Uitgeverij: Bohn Stafleu van Loghum
Boek: Textbook of Obstetrics and Gynaecology
Print ISBN: 978-90-368-2130-8

Elektronisch ISBN: 978-90-368-2131-5

Copyright: 2019
DOI: https://doi.org/10.1007/978-90-368-2131-5_13

Bohn Stafleu van Loghum

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