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According to the lecture, in Malaysia, the total fertility rate (TFR) declined dramatically from 4.9 children per woman in 1970 to ______ in 2020
1.7
In the diagnosis of infertility, ______ of the causes are related to female factors, ______ to male factors, and ______ are unexplained or both
1/3, 1/3, 1/3
Fertility in women decreases by ______% at the age of 40
50
One of the female factors causing infertility is ______, which involves a severe pain during sexual intercourse
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Assisted Reproductive Technology (ART) includes techniques such as ______, ICSI, GIFT, and ZIFT
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Intrauterine insemination (IUI) is a type of ______ treatment
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One of the male specific causes of infertility is ______, which is an obstruction in the male reproductive ducts leading to azoospermia
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Pre-implantation genetic testing (PGT) is a type of ______ used to diagnose genetic disorders in embryos
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The process of ________________ is used to preserve gametes or embryos for future use.
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The first step in IVF or ICSI is ________________ ovarian stimulation.
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In semen analysis, the normal volume of semen is typically between ________________ ml.
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The WHO guidelines define a normal sperm concentration as greater than ________________ x 10^6/ml.
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Oligozoospermia refers to a condition where the semen has a low ________________ of sperm.
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In semen analysis, the pH of normal semen is slightly ________________ with a pH greater than 7.0.
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Sperm morphology is an important parameter in semen analysis, and it includes the evaluation of ________________ morphology.
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The ________________ transfer is a type of assisted reproductive technology where the eggs are fertilized in the fallopian tube.
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Sperm preparation for ART involves the removal of ________________ fluid.
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In semen analysis, total motility is calculated as the percentage of sperm with ________________ and slow progressive motility.
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Study Notes
Infertility
- Definition: inability to conceive after one year of regular, unprotected sexual intercourse
- Primary infertility: infertility in a person who has never had a child
- Secondary infertility: infertility in a person who has had a child before
- 48.5 million couples worldwide suffer from infertility
- Fertility rate in Malaysia declined from 4.9 children per woman in 1970 to 1.7 in 2020
Causes of Infertility
General Causes
- Genetic factors
- Health conditions: diabetes, thyroid, STD, cancer, hypothalamic-pituitary factors
- Environmental factors: pesticides, chemicals, heavy metals, radiation
- Lifestyle: Excessive alcohol intake, smoking, drug abuse
- Medications: anti-depression, NSAIDs, uncertified local products
- Chemotherapy
- Dietary factors: nutrient deficiencies, high cholesterol, caffeinated coffee
Female Factors
- Vaginismus
- Tubal factors: history of PID, tubal surgery, previous ectopic pregnancy
- Pelvic causes: endometriosis, adhesions
- Ovarian disorders: aging, diminished ovarian reserve, endocrine disorder, PCOS
- Uterine/cervical factors: congenital uterine anomaly, fibroids, poor cervical mucus, infection
Male Specific Causes
- Obstruction in male reproductive ducts: azoospermia
- Hormonal disorders: abnormalities in hormones produced by pituitary gland, hypothalamus, and testicles
- Varicocele, accessory gland infection, hydrocele
- Psychosexual problem: erectile dysfunction, premature ejaculation, physical disabilities
Fertility Treatment
- Timed sexual intercourse
- Intrauterine insemination (IUI)
- Assisted Reproductive Technology (ART)
- In vitro fertilization (IVF)
- Intracytoplasmic sperm injection (ICSI)
- Gamete intrafallopian transfer (GIFT)
- Zygote intrafallopian transfer (ZIFT)
- Cryopreservation – gametes, embryos
- Pre-implantation genetic testing (PGT)
Important Steps for IVF or ICSI
- Controlled ovarian stimulation
- Oocyte retrieval
- Oocyte freezing
- Insemination of gametes – IVF or ICSI
- Embryo culture
- Embryo transfer
Semen Analysis
- Abstinence 2-5 days before test
- Collected by masturbation or coitus interruptus
- Collected in a sterile container
- Do not use lubricant or condom
- Must bring to lab within 45min – 1 hr (kept in body temperature)
- Macroscopic analysis: color, liquefaction, viscosity, volume, pH
- Microscopic analysis: sperm concentration, sperm motility, sperm morphology
- Sperm agglutination
- Sperm viability
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Description
This quiz covers the definition, types, and causes of infertility, including genetic factors and health conditions. It also touches on global statistics and declining fertility rates.
