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The World Health Organization calculated that over 10% of women are affected by infertility and subfertility.
Fertility: refers to the capacity to conceive and produce offspring
Infertility: is the inability to conceive despite frequent coitus. Infertility refers to a state in which the capacity for fertility is diminished, but not necessarily absent
Pathology affecting fertility
- Ovulatory dysfunction: 21%
- Tubal damage: 14%
- Endometriosis: 6%
- Coital problems: 6%
- Cervical factor: 3%
- Unexplained: 28%
- Male factor (hypogonadism, post-testicular defects, seminiferous tubule dysfunction): 26%
Modifiable lifestyle factors affecting fertility
|Factors affecting fertility||Information|
Physiotherapists may be well positioned to assist patients with this aspect of their fertility journey. The first step for physiotherapists is to become educated on the topic and aid in educating the public on the importance of exercise and weight management in fertility. Physiotherapists can have a more direct role through creating and implementing an exercise program to suit the needs of their clients. Exercise is a relatively inexpensive addition to “usual care” in improving the outcomes of assisted fertilization. Additionally, exercise may aid in the mental health of clients during this challenging time. The ultimate goal is to aid individuals in reaching their fertility goals and it is important that as healthcare providers we are informative and proactive regarding the breadth of issues that could be affecting their assisted fertility outcomes.
The following tests are useful in most couples with infertility:
- Semen analysis to assess male factors.
- Menstrual history, assessment of luteinizing hormone surge in urine prior to ovulation, and/or luteal phase progesterone level to assess ovulatory function.
- Hysterosalpingogram or sonohysterogram with a test of tubal patency such as hysterosalpingo-contrast-sonography to assess tubal patency and the uterine cavity.
- Assessment of ovarian reserve with day 3 serum follicle-stimulating hormone and estradiol levels, anti-Müllerian hormone, and/or antral follicle count.
- Thyroid-stimulating hormone.
In select couples, the following additional tests may be warranted:
- Pelvic ultrasound to assess for uterine myomas and ovarian cysts
- Laparoscopy to identify endometriosis or other pelvic pathology
Assisted Reproductive Technology (ART):
- The use of ART is dependent on each individual's or couple's situation and reason for infertility, patient's should seek the advise of a fertility specialist for more information on this option
Podcasts by Natalie Crawford, MD
Assisted Reproductive Technology:
- An informative video on the process post egg retrieval
Diet and fertility:
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