Title Treatment of idiopathic infertility Title (croatian) Liječenje idiopatske neplodnosti Author Priyanka Rani Oseatunro Ugbade Mentor Maja Banović (mentor) Committee member Maja Banović (predsjednik povjerenstva) Committee member Dinka Pavičić Baldani (član povjerenstva)Committee member Držislav Kalafatić (član povjerenstva)Granter University of Zagreb Defense date and country 2020-07-17, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Idiopathic infertility is defined as the failure to achieve pregnancy after 12 months of unprotected sexual intercourse, without a known cause. Idiopathic infertility affects 15-30% of couples trying to conceive. Various aetiologies have been suggested as the cause of idiopathic infertility. In men and women, the immune system plays a role in conception, hence defects in this pathway could be a possible cause. Lifestyle and habits, such as having a high BMI or poor sleep quality, have also been suggested as being implicated in idiopathic infertility. Diagnosis requires a thorough history and physical examination, followed by multiple diagnostic tests for women and semen analysis for men. Despite adequate diagnostic protocol, women are often misdiagnosed with idiopathic infertility instead of age-related ovarian reserve decline. The treatment options vary for each couple. Hence, treatment is individualised and requires personcentred care. The optimal treatment strategy needs to be based on the individual patient characteristics such as age, treatment efficacy, side-effect profile, and cost considerations. Various studies have been conducted on the available treatment options. Expectant management is the starting point for women under 32 years of age with less than 2 years of infertility. Clomiphene citrate is a common first-step in anovulatory disorders but its use in idiopathic infertility has been questioned. When used in combination with intrauterine insemination, pregnancy rates are higher than when CC is used alone. Male treatment options also vary but ultimately requires assisted reproductive technology. There are various avenues
for research, regarding aetiology, diagnosis and treatment. Here I summarise the treatment options available for both male and female idiopathic infertility.
Abstract (croatian) Idiopatska neplodnost definira se kao neuspjeh u postizanju trudnoće nakon 12 mjeseci nezaštićenog spolnog odnosa, bez poznatog uzroka. Idiopatska neplodnost pogađa 15-30% parova koji pokušavaju začeti. Uzrok idiopatske neplodnosti nije definiran i moguće su različite etiologije. Kod muškaraca i žena, imunološki sustav ima bitnu ulogu u začeću, te se poremećaji u istom smatraju mogućim uzrokom neplodnosti. Životni stil i navike, poput visokog indeksa tjelesne mase ili loše kvalitete sna, također mogu biti povezani s idiopatskom neplodnošću. Dijagnoza zahtijeva temeljitu anamnezu i fizikalni pregled, nakon čega slijede dijagnostički testovi za žene te analiza sperme za muškarce. Unatoč odgovarajućem dijagnostičkom protokolu, ženama se često pogrešno dijagnosticira idiopatska neplodnost umjesto smanjene rezerve jajnika povezane s dobi. Mogućnosti liječenja se razlikuju za svaki par. Liječenje zahtijeva individualizirani pristup kod svakog pacijenta. Optimalna strategija liječenja mora se temeljiti na individualnim karakteristikama pacijenta, poput dobi, učinkovitosti liječenja, profila nuspojava i troškova. Provedena su razna istraživanja o dostupnim mogućnostima liječenja. Liječenje žena mlađih od 32 godine s poznatom neplodnošću unazad 2 godine, započinje promatranjem. Klomifen citrat često je lijek izbora u anovulacijskim poremećajima, no njegova uporaba kod idiopatske neplodnosti jest upitna. Kada se koristi u kombinaciji s intrauterinskom inseminacijom, stopa trudnoće jest viša nego kada se koristi isključivo klomifen citrat. Mogućnosti liječenja kod muškaraca također su različite, ali u konačnici zahtijevaju potpomognutu oplodnju. Postoje razna istraživanja na temu etiologije, dijagnoze i terapije. U ovom diplomskom radu, sažete su opcije liječenja idiopatske neplodnosti kod muškaraca i žena.
Keywords
idiopathic infertility
assisted reproductive technology
in vitro fertilisation
ovarian reserve
anovulatory
clomiphene citrate
intrauterine insemination
body mass index
Keywords (croatian)
idiopatska neplodnost
potpomognuta reproduktivna tehnologija
izvantjelesna oplodnja
anovulacija
klomifen citrat
unutarmaternična inseminacija
indeks tjelesne mase
Language english URN:NBN urn:nbn:hr:105:229702 Study programme Title: Medicine (in English language) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-10-15 11:12:43
