Infertility Case study
L. B. and her husband, J.B., come to the clinic, saying they want to become pregnant. LB. is 29
years old and a self-employed photographer. J.B. is 31 years old and a dispatcher with a local oil
and gas company. They have been married for 4 years and have been trying to become pregnant
for just over 2 years. LB. has not been pregnant previously; J.B. says he has never gotten a girl
pregnant “that he knows of.
1. Is this couple infertile? Defend your response.
In industrialized countries, are finding conception more difficult and damaged babies more
common. The sows that metals and chemicals in air, gas, oil, water, food, and health-and-beauty
aids are damaging fertility in many ways. These toxicants are causing men to experience
relentlessly decreasing sperm count and function while women are suffering progressively worse
anovulation, impaired implantation, and loss of fetal viability.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396757/
2. What type of infertility does the couple have, primary or secondary?
Primary infertility refers to couples who have not become pregnant after at least 1year
having sex without using birth control methods.
3. What are the common causes of male infertility?
Varicocele. A varicocele is a swelling of the veins that drain the testicle. It's the most
common reversible cause of male infertility. Although the exact reason thatvaricoceles
cause infertility is unknown, it may be related to abnormal blood flow.Varicoceles lead to
reduced sperm quantity and quality.
Infection. Some infections can interfere with sperm production or sperm healthor can
cause scarring that blocks the passage of sperm. These include inflammation of the
epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted
infections, including gonorrhea or HIV. Although some infections can result in
permanent testicular damage, most often sperm can stillbe retrieved.
Ejaculation issues. Retrograde ejaculation occurs when semen enters the bladder
during orgasm instead of emerging out the tip of the penis. Various health conditions
can cause retrograde ejaculation, including diabetes, spinalinjuries, medications, and
surgery of the bladder, prostate or urethra.
, Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that
mistakenly identify sperm as harmful invaders and attempt to eliminate them.
Tumors. Cancers and nonmalignant tumors can affect the male reproductive organs
directly, through the glands that release hormones related to reproduction, such as the
pituitary gland, or through unknown causes. In some cases, surgery, radiation or
chemotherapy to treat tumors can affect male fertility.
Undescended testicles. In some males, during fetal development one or both testicles fail
to descend from the abdomen into the sac that normally contains thetesticles (scrotum).
Decreased fertility is more likely in men who have had this condition.
Hormone imbalances. Infertility can result from disorders of the testicles
themselves or an abnormality affecting other hormonal systems including the
hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male
hypogonadism) and other hormonal problems have a number of possible underlying
causes.
Defects of tubules that transport sperm. Many different tubes carry sperm. They
can be blocked due to various causes, including inadvertent injury from surgery, prior
infections, trauma or abnormal development, such as with cystic fibrosis or similar
inherited conditions.
Blockage can occur at any level, including within the testicle, in the tubesthat
drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts
or in the urethra.
Chromosome defects. Inherited disorders such as Klinefelter's syndrome — in which a
male is born with two X chromosomes and one Y chromosome (insteadof one X and one
Y) — cause abnormal development of the male reproductive organs. Other genetic
syndromes associated with infertility include cystic fibrosisand Kallmann's syndrome.
Problems with sexual intercourse. These can include trouble keeping ormaintaining
an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful
intercourse, anatomical abnormalities such as having aurethral opening beneath the
penis (hypospadias), or psychological or relationship problems that interfere with sex.
L. B. and her husband, J.B., come to the clinic, saying they want to become pregnant. LB. is 29
years old and a self-employed photographer. J.B. is 31 years old and a dispatcher with a local oil
and gas company. They have been married for 4 years and have been trying to become pregnant
for just over 2 years. LB. has not been pregnant previously; J.B. says he has never gotten a girl
pregnant “that he knows of.
1. Is this couple infertile? Defend your response.
In industrialized countries, are finding conception more difficult and damaged babies more
common. The sows that metals and chemicals in air, gas, oil, water, food, and health-and-beauty
aids are damaging fertility in many ways. These toxicants are causing men to experience
relentlessly decreasing sperm count and function while women are suffering progressively worse
anovulation, impaired implantation, and loss of fetal viability.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396757/
2. What type of infertility does the couple have, primary or secondary?
Primary infertility refers to couples who have not become pregnant after at least 1year
having sex without using birth control methods.
3. What are the common causes of male infertility?
Varicocele. A varicocele is a swelling of the veins that drain the testicle. It's the most
common reversible cause of male infertility. Although the exact reason thatvaricoceles
cause infertility is unknown, it may be related to abnormal blood flow.Varicoceles lead to
reduced sperm quantity and quality.
Infection. Some infections can interfere with sperm production or sperm healthor can
cause scarring that blocks the passage of sperm. These include inflammation of the
epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted
infections, including gonorrhea or HIV. Although some infections can result in
permanent testicular damage, most often sperm can stillbe retrieved.
Ejaculation issues. Retrograde ejaculation occurs when semen enters the bladder
during orgasm instead of emerging out the tip of the penis. Various health conditions
can cause retrograde ejaculation, including diabetes, spinalinjuries, medications, and
surgery of the bladder, prostate or urethra.
, Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that
mistakenly identify sperm as harmful invaders and attempt to eliminate them.
Tumors. Cancers and nonmalignant tumors can affect the male reproductive organs
directly, through the glands that release hormones related to reproduction, such as the
pituitary gland, or through unknown causes. In some cases, surgery, radiation or
chemotherapy to treat tumors can affect male fertility.
Undescended testicles. In some males, during fetal development one or both testicles fail
to descend from the abdomen into the sac that normally contains thetesticles (scrotum).
Decreased fertility is more likely in men who have had this condition.
Hormone imbalances. Infertility can result from disorders of the testicles
themselves or an abnormality affecting other hormonal systems including the
hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male
hypogonadism) and other hormonal problems have a number of possible underlying
causes.
Defects of tubules that transport sperm. Many different tubes carry sperm. They
can be blocked due to various causes, including inadvertent injury from surgery, prior
infections, trauma or abnormal development, such as with cystic fibrosis or similar
inherited conditions.
Blockage can occur at any level, including within the testicle, in the tubesthat
drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts
or in the urethra.
Chromosome defects. Inherited disorders such as Klinefelter's syndrome — in which a
male is born with two X chromosomes and one Y chromosome (insteadof one X and one
Y) — cause abnormal development of the male reproductive organs. Other genetic
syndromes associated with infertility include cystic fibrosisand Kallmann's syndrome.
Problems with sexual intercourse. These can include trouble keeping ormaintaining
an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful
intercourse, anatomical abnormalities such as having aurethral opening beneath the
penis (hypospadias), or psychological or relationship problems that interfere with sex.
