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Non-Endocrine Causes Of Infertility Essay Sample

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Non-Endocrine Causes Of Infertility Essay Sample

Infertility is described as the inability to conceive after a year of unprotected sex. Non-endocrine causes refer to those causes not related to secretion of hormones by glands directly into the blood. Causes of sterility are often because of feminine factors alone, male factors alone or a mix of each. Roughly 30-40% of infertility cases are as a result of a male factor, while the female factor contributes 40-50%. The remaining 10-30% of infertility cases may be due to tributary factors from each of the partners or unexplainable cause.

Female infertility

Endometriosis

It is one of the most common causes of female sterility. The condition is characterised by growth of endometrial tissue, almost similar to that of normal uterine endometrium, in the pelvic cavity. It may grow in areas around the uterus, fallopian tubes, or ovaries. Endometriosis leads to fibrosis throughout the pelvis. This fibrosis sometimes surrounds the ovaries that an ovum cannot be released into the abdominal cavity. Often, it may also occlude the fallopian tubes, either at the ends or somewhere else along their extent.

In order to treat endometriosis Danazol is used. It. is a steroid similar to testosterone that works by lowering the quantity of hormones created by the ovaries.

Salpingitis
Salpingitis is inflammation of the oviducts. This condition causes fibrosis in the tubes, causing occlusion in them. Such inflammation happens principally because of infection. Different conditions that give rise to infections are;

• Sexually Transmitted Diseases such as, Chlamydia trachomatis and gonorrhea
• Nonsterile abortions
• Ruptured appendix

Salpingitis is treated with antibiotics in order to fight the infection.

Obesity

Obesity is characterized by hyperleptinemia. The results of fatness on the female reproductive health is because of effects of leptin on the ovary and brain.

There is some evidence that weight reduction (including through bariatric surgery in the obese) can help reverse this.

Uterine Fibroids

Fibroid tumors that are benign in the uterus are mostly common in women during their thirties. However, large fibroids may lead to infertility by impairing the uterine lining, occluding the oviduct, or by destroying the shape of the uterine cavity or changing the cervix’s position

Medications given for treatment of uterine fibroids target the hormones that regulate the menstrual cycle. They treat symptoms such as pelvic pressure and heavy menstrual bleeding. They don’t get rid of fibroids, however may shrink them decreasing their size.

Asherman syndrome

It is otherwise known as uterine synechiae. This condition is characterized by formation of intrauterine adhesions and scarring inside the uterus, which can lead to occlusions and secondary amenorrhea. Could result from recurring injury, surgery, or unknown factors. Throughout treatment the goal of is to get rid of adhesions and ultimately restore the conventional size and shape of the uterine cavity. This is often ordinarily done by lysis of the adhesions via hysteroscopy. The resultant outcome correlates with the extent of uterine cavity occlusion and the sort of adhesions.

Male sterility

Torsion of testes (testicular torsion)
It arises when rotation of a testicle occurs resulting in the twisting of the spermatic cord. This causes a loss of flow of blood to the testicle and may lead to loss of the affected testicle unless treated promptly.

The cause of most cases is the bell clapper deformity. This is an anatomic abnormality present in some males that allows the spermatic cord to twist more easily, which may be associated with trauma or can occur spontaneously.
Surgery is the recommended treatment for testicular torsion, although on rare occasions, a physician may be capable of manually untwisting the testicle.

Sertoli-cell-only syndrome
It also known as germ cell aplasia, and it describes a condition of the testes in which only Sertoli cells line the seminiferous tubules. Sertoli cells help to make up the blood-testis barrier and are responsible assisting with sperm production

This condition is characterized by azoospermic semen due to the inability to produce sperm. The cause of Sertoli-cell-only syndrome is not exactly known. However, some researchers believe the condition develops from irradiation, hormonal therapy, environmental toxins, gonadotropin deficiencies, and other factors.
Those diagnosed with germ cell aplasia can only be treated by donor or de novo generated gametes.

Spermatogenic arrest

Spermatogenesis arrest is a process of interruption in the differentiation of germinal cells of specific cellular type that elicits an altered spermatozoa formation. It is usually caused by genetic factors resulting in irreversible azoospermia. However some cases may be consecutive to thermic, hormonal or toxic factors and may be reversible either after a specific treatment or spontaneously.
FSH treatment can increase the spermatogonial population in oligozoospermic men with normal hormonal profiles and improve sperm production quantitatively

Radiation therapy

Radiation therapy is used in cancer treatment. It will stop or curtail spermatozoon production if the testicle is in or close to the target area for the radiation. A lead shield can be used to help protect the testicles. However, the fact that radiation scatters within the body makes it impossible to protect the testicles utterly.

Idiopathic infertility

This is infertility in which the cause remains unknown even after an infertility work-up. A study was done in Italian and Spanish populations and it revealed that there are three recurrent deletions of X chromosome linked copy number variations (CNVs); CNV64, CNV67 and CNV69 associated with idiopathic male infertility, especially CNV67 resembling the azoospermia factor deletions.

References

Ma, X., Hayes, E., Prizant, H., Srivastava, R. K., Hammes, S. R., & Sen, A. (2016). Leptin-induced CART (cocaine-and amphetamine-regulated transcript) is a novel intraovarian mediator of obesity-related infertility in females. Endocrinology, 157(3), 1248-1257.
Hellstrom, W. J. (Ed.). (2012). Male infertility and sexual dysfunction. Springer Science & Business Media.
Hall, J. E., Guyton, A. C. (2010). Guyton and Hall Textbook of Medical Physiology. 12th Edition. Saunders, Philadelphia, USA
http://www.sciencedirect.com/science/article/pii/S0015028206006480

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