Genes and chromosomes that cause female infertility

Definition and causes of infertility

Infertility is a common problem affecting one couple in six. It can be defined as the incapacity to fulfill pregnancy after reasonable time of sexual intercourse with no contraceptive measures taken. The evidence for changes in the prevalence of infertility is difficult to establish. This increase could be due to at least four factors: delayed childbearing, alterations in semen quality due to habits such as cigarette smoking and alcohol, changes in sexual behaviour and eliminations of most taboos. The study of infertile couple has always been focussed on different factors: ovulatory factor (present in about 20% of couples), utero-tubal peritoneal factor (present in ~30% of couples), semen migration factor (10% of cases) and male factor (30% of couples). Around 40% of all infertile couples exhibit a combination of factors and about 15% of couples may not display any objective alteration leading to a definite diagnosis. During the past two decades there have been three important changes in infertility practice. First, the introduction of assisted reproduction technologies has provided an opportunity to study basic reproductive processes. Second, societal changes have occurred such as the increase in the proportion of women over 35 years old seeking pregnancy. This fact is due to a later age for marriage and postponement of pregnancy. Third, the development of molecular biology and genetics has become very important for the study, diagnosis and assessment of couples, many of them considered until now as "unexplained infertile couples".

Ethnography, epidemiology and infertility in Egypt

Infertility in the developing world has been relatively neglected as an international health problem and a topic of social scientific and epidemiological inquiry. In this study, we examine factors placing poor urban Egyptian men and women at risk of infertility, and we explore the sociocultural and political-economic contexts in which these health-demoting factors are perpetuated. Our approach to the problem of Egyptian infertility attempts an explicit merging of ethnographic and epidemiological research designs, methods of data collection and analysis, and interpretive insights to provide improved understanding of the factors underlying infertility in the urban Egyptian setting.

No HLA-DR specificity is associated with endometriosis

Thirty-one patients with endometriosis were typed for HLA-A, B and DR antigens. No association was found between the disease and any DR specificity, which may be taken as evidence against an autoimmune aetiology.

Methodological considerations in the study of frequency, risk factors and outcome of reduced fertility

Infertility is a major health problem for many couples. Many clinicians believe that its prevalence is increasing. This may be attributable to greater concern about infertility in society and development of new treatment methods. Infertility is also a complex medical, social and individual problem. We do not know enough about the risk factors and their mechanisms of action. In the study of reduced fertility there is a need for clear definitions and careful selection of study populations. There are several sources of bias. One is selection bias in the ascertainment of infertility couples, others are recall bias and exposure assessment bias. Furthermore, medical classification of causes is difficult in population based studies. This paper will discuss problems in the interpretation of results of past studies and in methods already in use. Some new design options in future research are presented.

Diagnostic laparoscopy in apparent uterine agenesis

We report a case of an adolescent female with apparent agenesis of the uterus with chromosomally competent ovarian dysgenesis. In our case, the apparent absence of the uterus on the laparoscopy constituted a severe hypoplasia of the organ prior to estrogen stimulation, rather than aplasia. Following a year of estrogen/progesterone replacement, an infantile but otherwise normal uterus could be demonstrated by hysterosalpinogogram. In gonadal dysgenesis, therefore, it is not possible to differentiate the absence of the uterus from severe hypoplasia using laparoscopy.