Infertility

In: Endocrinology · 2020 · pp. 211–233 · doi:10.1007/978-3-030-14782-2_11 · W4240342988
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Infertility is defined as the inability to achieve pregnancy after one year of unprotected intercourse, affecting 8-12% of couples worldwide, with female factors causing about 65% of cases.

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This chapter reviews infertility as a clinical condition defined by failure to establish a pregnancy after 12 months of regular, unprotected intercourse, estimating global prevalence around 8–12% of couples, and describes major causes and conceptual issues. It notes that a female factor accounts for about 65% of cases, highlighting advanced maternal age, tubal damage from infections, polycystic ovary syndrome, and endometriosis as frequent causes, while acknowledging that any disruption of reproductive anatomy, ovarian reserve, or the hypothalamic–pituitary–ovarian axis can impair fertility; it also states that 15–30% remains unexplained and that recurrent pregnancy loss is not fully captured by the infertility definition. A key caveat is that the chapter is descriptive and definitional rather than presenting new original experimental data. Relevance to endometriosis: the paper explicitly lists endometriosis among the most frequent causes of infertility in the context of female reproductive factors, though the chapter’s main focus is overall definitions and epidemiology of infertility.

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Abstract

Infertility is a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. It is estimated to affect between 8% and 12% of reproductive-aged couples worldwide and, since reproduction represents a biological and psychological requirement, the presence of infertility is a disease which generates disability as an impairment of function. In infertile couples, a female factor is present in about 65% of cases. Recent definitions related to female infertility and its causes are reported in this chapter. The most frequent causes of infertility are advanced maternal age, tubal damages due to infections, polycystic ovary syndrome, and endometriosis. However, any cause that impairs reproductive organs anatomy, ovarian reserve, or hypothalamic–pituitary–ovarian axis can cause infertility. However, in 15–30% of patients, infertility remains unexplained. Couples (2–3%) are able to conceive but experience a recurrent pregnancy loss, a condition that impairs fecundity as well as chances of childbearing, although this condition is not properly included in the infertility definition. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Ahmad A, Ahmed A, Patrizio P. Cystic fibrosis and fertility. Curr Opin Obstet Gynecol. 2013;25(3):167–72. American Fertility Society. The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil Steril. 1988;49(6):944–5. Capozzi A, Scambia G, Pontecorvi A, Lello S. Hyperprolactinemia: pathophysiology and therapeutic approach. Gynecol Endocrinol. 2015;31(7):506–10. Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390(10101):1550–62. Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D'Hooghe T, De Bie B, Heikinheimo O, Horne AW, Kiesel L, Nap A, Prentice A, Saridogan E, Soriano D, Nelen W, European Society of Human Reproduction and Embryology. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29(3):400–12. Eijkemans MJ, van Poppel F, Habbema DF, Smith KR, Leridon H, te Velde ER. Too old to have children? Lessons from natural fertility populations. Hum Reprod. 2014;29(6):1304–12. European Society for Human Reproduction and Embryology (ESHRE) Guideline Group on POI. ESHRE Guideline: management of women with premature ovarian insufficiency. Hum Reprod. 2016;31:926–37. Faddy MJ, Gosden RG, Gougeon A, Richardson SJ, Nelson JF. Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod. 1992;7:1342–6. Garrido-Gimenez C, Alijotas-Reig J. Recurrent miscarriage: causes, evaluation and management. Postgrad Med J. 2015;91:151–62. Gelbaya TA, Potdar N, Jeve YB, Nardo LG. Definition and epidemiology of unexplained infertility. Obstet Gynecol Surv. 2014;69(2):109–15. Gnoth C, Godehardt E, Frank-Herrmann P, Friol K, Tigges J, Freund G. Definition and prevalence of subfertility and infertility. Hum Reprod. 2005;20(5):1144–7. Goldsammler M, Merhi Z, Buyuk E. Role of hormonal and inflammatory alterations in obesity-related reproductive hypothalamic-pituitary-ovarian axis. Reprod Biol Endocrinol. 2018;16(1):45. Grimbizis GF, Gordts S, Di Spiezio Sardo A, Brucker S, De Angelis C, Gergolet M, Li T-C, Tanos V, Brölmann H, Gianaroli L, Campo R. The ESHRE–ESGE consensus on the classification of female genital tract congenital anomalies. Gynecol Surg. 2013;10:199–212. Gwirtsma HE, et al. Central and peripheral ACTH and cortisol levels in anorexia nervosa and bulimia. Arch Gen Psychiatry. 1989;78(1):61–9. Heidelbaugh JJ. Endocrinology update: hypopituitarism. FP Essent. 2016;451:25–30. Huhtaniemi I, Hovatta O, La Marca A, Livera G, Monniaux G, Persani L, Heddar A, Jarzabek K, Laisk-Podar T, Salumets A, Tapanainen JS, Veitia RA, Visser JA, Wieacker P, Wolczynski S, Misrahi M. Advances in the molecular pathophysiology, genetics, and treatment of primary ovarian insufficiency. Trends Endocrinol Metab. 2018;29(6):400–19. Hull MGR, Glazener CMA, Kelly NJ, Conway DI, Foster PA, Hinton RA, Coulson C, Lambert PA, Watt EM, Desai KM. Population study of causes, treatment, andoutcome of infertility. Br Med J (Clin Res Ed). 1985;291:1693–7. Jones KT. Meiosis in oocytes: predisposition to aneuploidy and its increased incidence with age. Hum Reprod Update. 2008;14:143–58. Klein NA, Battaglia DE, Miller PB, Branigan EF, Giudice LC, Soules MR. Ovarian follicular development and the follicular fluid hormones and growth factors in normal women of advanced reproductive age. J Clin Endocrinol Metab. 1996;81:1946–51. Kock J, Rowan K, Rombatus L, Yazdani A, Chapman M, Johnson N. Endometriosis and infertility – a consensus statement from ACCEPT (Australasian CREI Consensus Expert Panel on Trial evidence). Aust N Z J Obstet Gynaecol. 2012;52:513–22. Ludwin A, Ludwin I. Comparison of the ESHRE–ESGE and ASRM classifications of müllerian duct anomalies in everyday practice. Hum Reprod. 2015;30(3):569–80. Maheshwari A, Porter M, Shetty A, Bhattacharya S. Women’s awareness and perceptions of delay in childbearing. Fertil Steril. 2008;90:1036–42. Marion LL, Meeks GR. Ectopic pregnancy: history, incidence, epidemiology, and risk factors. Clin Obstet Gynecol. 2012;55(2):376–86. Mohamed AA, Al-Hussaini TK, Fathalla MM, El Shamy TT, Abdelaal II, Amer SA. The impact of excision of benign nonendometriotic ovarian cysts on ovarian reserve: a systematic review. Am J Obstet Gynecol. 2016;215(2):169–76. Munro MG, Critchley HO, Broder MS, Fraser IS, for the FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynecol Obstet. 2011;113:3–13. Nguyen HH, Milat F, Vincent A. Premature ovarian insufficiency in general practice: meeting the needs of women. AFP Focus. 2017;46(6):360–6. O’Connor KA, Holman DJ, Wood JW. Declining fecundity and ovarian ageing in natural fertility populations. Maturitas. 1998;30:127–36. Ombelet W, Cooke I, Dyer S, Serour G, Devroey P. Infertility and the provision of infertility medical services in developing countries. Hum Reprod Update. 2008;14(6):605–21. Ozkan S, Murk W, Arici A. Endometriosis and infertility: epidemiology and evidence-based treatments. Ann N Y Acad Sci. 2008;1127:92–100. Practice Committee of the American Society for Reproductive Medicine. Uterine septum: a guideline. Fertil Steril. 2016;106(3):0015–282. Practice Committee of the American Society for Reproductive Medicine. Smoking and infertility: a committee opinion. Fertil Steril. 2018;110(4):0015–282. Raffi F, et al. The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2012;97(9):3146–54. Rai R, Regan L. Recurrent miscarriage. Lancet. 2006;368:601–11. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25. Seungdamrong A. The impact and management of subclinical hypothyroidism for improving reproductive outcomes such as fertility and miscarriage. Semin Reprod Med. 2016;34(6):331–6. Shufelt CL, Torbati T, Dutra E. Hypothalamic amenorrhea and the long-term health consequences. Semin Reprod Med. 2017;35:256–62. Somigliana E, Vigano P, Benaglia L, Busnelli A, Berlanda N, Vercellini P. Management of endometriosis in the infertile patient. Semin Reprod Med. 2017;35(1):31–7. Talmor A, Dunphy B. Female obesity and infertility. Best Pract Res Clin Obstet Gynaecol. 2014;29(4):498–506. Tatone C, Carbone MC, Falone S, Aimola P, Giardinelli A, Caserta D, Marci R, Pandolfi A, Ragnelli AM, Amicarelli F. Age-dependent changes in the expression of superoxide dismutases and catalase are associated with ultrastructural modifications in human granulosa cells. Mol Hum Reprod. 2006;12(11):655–60. te Velde ER, Pearson PL. The variability of female reproductive ageing. Hum Reprod Update. 2002;8:141–54. Teede H, Deeks A, Moran LR. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010;8:41. The American College of Obstetricians and Gynecologists. Primary ovarian insufficiency in Adolescents and young women. Committee Opinion n 605. Obstet Gynecol. 2014;124(1):193–7. The Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertil Steril. 2012;98(3):591–8. The Practice Committee of the American Society for Reproductive Medicine. Role of tubal surgery in the era of assisted reproductive technology: a committee opinion. Fertil Steril. 2015;103(6):e37–43. Tranoulis A, Laios A, Pampanos A, Yannoukakos D, Loutradis D, Michala L. Efficacy and safety of pulsatile gonadotropin-releasing hormone therapy among patients with idiopathic and functional hypothalamic amenorrhea: a systematic review of the literature and a meta-analysis. Fertil Steril. 2018;109(4):0015–282. Tsevat DG, Wiesenfeld HC, Parks C, Peipert JF. Sexually transmitted diseases and infertility. Am J Obstet Gynecol. 2017;216(1):1–9. Vander BM, Wyns C. Fertility and infertility: definition and epidemiology. Clin Biochem. 2018;62:2–10. https://doi.org/10.1016/j.clinbiochem.2018.03.012. Wallace WH, Kelsey TW. Human ovarian reserve from conception to the menopause. PLoS One. 2010;5(1):e8772. Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, Rienzi L, Sunde A, Schmidt L, Cooke ID, Simpson JL, van der Poel S. The international glossary on infertility and fertility care. Fertil Steril. 2017;108(3):393–406. Zepiridis LI, Grimbizis GF, Tarlatzis BC. Infertility and uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2016;34:66–73. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2020 Springer Nature Switzerland AG About this entry Cite this entry La Marca, A., Mastellari, E. (2020). Infertility. In: Petraglia, F., Fauser, B. (eds) Female Reproductive Dysfunction . Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-14782-2_11 Download citation DOI: https://doi.org/10.1007/978-3-030-14782-2_11 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-14781-5 Online ISBN: 978-3-030-14782-2 eBook Packages: MedicineReference Module Medicine

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