Vous êtes sur la page 1sur 27

Definisi dan etiologi

Infertilitas

Duru Shah

Definisi
Primer : Kegagalan pasangan suami istri untuk hamil, setelah senggama teratur tanpa kontrasepsi selama satu tahun (<35th) (>35th) 6 bulan Sekunder : Kegagalan pasangan suami istri untuk hamil yang sebelumnya pernah hamil

Duru Shah

WANITA

Duru Shah

Female Infertility
Ovulation Disorders:
Aging Diminished ovarian reserve Endocrine disorder Polycystic ovary syndrome (PCOS) Premature ovarian failure

Tubal Factors:

To Investigate Tubal Obstruction: History of pelvic inflammatory disease (PID) Tubal Surgery Previous ectopic pregnancy Salpingectomy

Uterine/Cervical Factors:

Congenital uterine anomaly Fibroids Poor cervical mucus quantity/quality Infection


Duru Shah

Uterine Types

Duru Shah

Duru Shah

Female Factors Hypothalamus


Pituitary

Follopian tube Uterine ovary Cervix Extra-genital tract


Thyroid

oocyte

Adrenal

Fig.1sperm

Duru Shah

Gangguan vagina dan serviks

Duru Shah

Kelainan uterus (rahim)

Duru Shah

Kerusakan Saluran Telur

Duru Shah

Kegagalan ovulasi

Duru Shah

Endometriosis

Duru Shah

PRIA

Duru Shah

Duru Shah

Male infertility

Causes 1. PRE-TESTICULAR CAUSES OF INFERTILITY a. Hypothalamic disease Isolated gonadotropin deficiency (Kallmann's syndrome) Isolated LH deficiency ("Fertile eunuch") Isolated FSH deficiency Congenital hypogonadrotropic syndromes

Duru Shah

b. Pituitary disease Pituitary insufficiency (tumors, infiltrative processes, operation, radiation) Hyperprolactinemia Hemochromatosis Exogenous hormones (estrogen-androgen excess, glucocorticoid excess, hyper and hypothyroidism).

Duru Shah

2. TESTICULAR CAUSES OF INFERTILITY a. Chromosomal abnormalities: Klinefelter's syndrome (XXY, karayotype), XX disorder (sex reversal syndrome), XYY syndrome Noonan's syndrome (male Turner's syndrome) Myotonic dystrophy- Bilateral anorchia (vanishing testes syndrome) Sertoli-cell-only syndrome (germinal cell aplasia)

b. c. d.

Duru Shah

e. f. g. h.

i. j. k.

Gonadotoxins (drugs, radiation) Orchitis Trauma Systemic disease (renal failure, hepatic disease, sickle cell disease) Defective androgen synthesis or action Cryptorchidism Varicocele

Duru Shah

3. POST-TESTICULAR CAUSES OF INFERTILITY

a. Disorders of sperm transport


Congenital disorders Acquired disorders Functional disorders b. Disorders of sperm motility or function Congenital defects of the sperm tail Maturation defects Immunologic disorders Infection 3. Sexual dysfunction

Duru Shah

Duru Shah

Causes of male infertility


Impaired production or function of sperm Impaired shape or movement of sperm Low sperm concentration Varicocele Undescended testicle Testosterone deficiency (male hypogonadism) Genetic defects Infections
Duru Shah

Causes of male infertility


Impaired delivery of sperm Sexual issues Retrograde ejaculation Blockage of epididymis or ejaculatory ducts No semen (ejaculate) Hypospadia Anti sperm antibodies Cystic fibrosis

Duru Shah

Causes of male infertility


General health and lifestyle Emotional stress Malnutrition Obesity Cancer and its treatment Alcohol and drugs Age Other medical conditions
Duru Shah

Causes of male infertility


Environmental exposure Pesticides and other chemicals Overheating the testicles Substance abuse Tobacco smoking

Duru Shah

Causes of female infertility


Fallopian tube damage or blockage Endometriosis Ovulation disorders Hyperprolactinemi a Polycystic ovary syndrome (PCOS) Early menopause Uterine fibroids Pelvic adhesions

Duru Shah

Causes of female infertility


Medications Thyroid problems Cancer and its treatment Caffeine intake Other medical conditions

Duru Shah

Risk factors
Age Tobacco smoking Alcohol use Being overweight Too much exercise Caffeine intake

Duru Shah