Sterility, an Overlooked Health Condition
Abstract
:1. Introduction
2. There Is a Need to Diagnose Sterility Prospectively
3. Most Treatments of Infertile Couples Fail to Deliver a Live Birth
3.1. Untreated Infertile Couples
3.2. Treated Infertile Couples
- (1)
- 10% of couples are infertile couples, and more than 4% are involuntarily childless or sterile;
- (2)
- At the least, 64% of infertile couples are not treated, and 70% of them fail to have a live birth;
- (3)
- 7.4% of infertile couples undergo IUI, and 69% of them fail to have a live birth;
- (4)
- ~33% of infertile men undergo varicocele treatment, and 69% of them fail to have a live birth;
- (5)
- ~3.1% of infertile women undergo ICSI, and 47% of them fail to have a live birth.
4. Understanding Sterility Will Benefit the Patient, Physician, and Researchers
5. Economic, Physical, and Psychological Burdens Contribute to Hardship Sterility
6. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Glossary
Clinical Sterility | The physiological inability of a couple to conceive a child even after medical intervention, including surgical intervention. |
Clinically Sterile Couple | A couple with 1% or less chance of achieving a live birth with reproductive medicine assistance. |
Cumulative Live Birth Rate | A couple’s chance to have a live birth after cumulative cycles of fertility treatment. |
Fertile Couple | A couple that conceives naturally within one year of trying. |
Hardship Sterility | The physiological inability of a couple to conceive a child even after medical intervention because of economic, psychological, or physical reasons. |
ICSI | Intracytoplasmic sperm injection; a fertility procedure in which sperm is injected into an egg. |
Infertility | A difficulty to conceive that is defined in most cases as the inability to conceive a biological child after one year of attempting. |
IUI | Intrauterine insemination; a fertility procedure in which sperm is placed inside a female’s uterus. |
IVF | In-vitro fertilization; a fertility treatment that combines the egg and sperm outside the body, and then the embryo is transferred into the uterus. |
Natural Sterility | The physiological inability of a couple to conceive a child without medical intervention (i.e., “natural means”). |
Prospective Determination | The ability to diagnose a patient with clinical sterility before beginning treatment. |
Reproductively Futile Couple | A couple with 1% or less chance of achieving a live birth with reproductive medicine assistance. |
Retrospective Determination | The ability to diagnose a patient with clinical sterility after treatments have failed. |
Retrospectively Clinically Sterile Couple | A couple with 1% or less chance of achieving a live birth after failing multiple treatments of reproductive medical assistance. |
Prospectively Clinically Sterile Couple | A couple with 1% or less chance of achieving a live birth with reproductive medicine assistance. |
Sterility | The inability to conceive due to natural, clinical, or hardship factors, determined either prospectively or retrospectively. |
Varicocele Repair | Repair of the enlarged veins within the scrotum |
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Total Population | Involuntarily Childless Prevalence | Method | Location | Year(s) | Study |
---|---|---|---|---|---|
N/A | 1–5% of women * | Data Analysis 1 | N/A | N/A | [37] |
N/A | 2.1% of women | Surveys | USA | 2011–2015 | [43] |
N/A | 1–9% of women ** | Data Analysis 2 | USA | 1982, 1988, 1995, 2002 | [44] |
3141 | 3% of women | Surveys | UK | 1993 | [45] |
1574 | 3% of women | Data Analysis 3 | UK | 1990 | [46] |
N/A | 5–10% of women | Data Analysis 4 | N/A | N/A | [47] |
N/A | 3.6% of women | Data Analysis 5 | Iran | 2010 | [48] |
3.9% | Average |
Number of Patients | Successful Pregnancy/Live Birth | Treatment Failure | Location | Study |
---|---|---|---|---|
654 | 343 live births | 48% | Australia | [75] |
107 | 35 pregnancies | 67% | Netherlands | [76] |
548 | 191 live births | 65% | United States | [77] |
108 | 28 pregnancies | 74% | United States | [78] |
16 | 4 pregnancies | 75% | United States | [79] |
126 | 27 pregnancies | 78% | United Kingdom | [80] |
100 | 14 pregnancies | 86% | Germany | [81] |
817 | 54 live births | 93% | Denmark | [82] |
100 | 9 live births | 91% | New Zealand | [83] |
98 | 42 pregnancies | 57% | Bosnia and Herzegovina | [84] |
1096 | 386 pregnancies | 65% | Denmark | [85] |
Total: 3770 | 70% | Weighted Average |
Patient Number | Treatment: | Successful Pregnancy/Live Birth | Treatment Failure | Location | Study |
---|---|---|---|---|---|
281 | Varicocele Repair | 61 pregnancies | 78% | N/A | [87] |
145 | Varicocele Repair | 66 pregnancies | 54% | China | [88] |
73 | Varicocele Repair | 24 pregnancies | 67% | N/A | [89] |
78 | Varicocele Repair | 15 pregnancies | 81% | USA | [90] |
148 | Varicocele Repair | 74 pregnancies | 50% | China | [91] |
10 | Varicocele Repair | 1 pregnancy | 90% | USA | [92] |
120 | Varicocele Repair | 25 pregnancies | 79% | Turkey | [93] |
20 | Varicocele Repair | 5 pregnancies | 75% | USA | [94] |
Total: 857 | 69% | Weighted Average | |||
12,488 | IUI | 4271 live births | 66% | Denmark | [97] |
533 | IUI | 111 live births | 79% | USA | [98] |
456 | IUI 1 | 96 live births | 79% | Turkey | [99] |
133 | IUI | 50 live births | 62% | France | [100] |
475 | CC/IUI | 92 live births | 81% | USA | [101] |
169 | FSH/IUI | 37 live births | 78% | USA | [101] |
817 | IUI | 81 live births | 90% | Denmark | [82] |
101 | IUI 2 | 31 live births | 69% | New Zealand | [83] |
Total: 15,172 | 69% | Weighted Average |
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Royfman, R.; Shah, T.A.; Sindhwani, P.; Nadiminty, N.; Avidor-Reiss, T. Sterility, an Overlooked Health Condition. Women 2021, 1, 29-45. https://doi.org/10.3390/women1010003
Royfman R, Shah TA, Sindhwani P, Nadiminty N, Avidor-Reiss T. Sterility, an Overlooked Health Condition. Women. 2021; 1(1):29-45. https://doi.org/10.3390/women1010003
Chicago/Turabian StyleRoyfman, Rachel, Tariq A. Shah, Puneet Sindhwani, Nagalakshmi Nadiminty, and Tomer Avidor-Reiss. 2021. "Sterility, an Overlooked Health Condition" Women 1, no. 1: 29-45. https://doi.org/10.3390/women1010003
APA StyleRoyfman, R., Shah, T. A., Sindhwani, P., Nadiminty, N., & Avidor-Reiss, T. (2021). Sterility, an Overlooked Health Condition. Women, 1(1), 29-45. https://doi.org/10.3390/women1010003