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Definisi dan etiologiDefinisi dan etiologi

InfertilitasInfertilitas

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DefinisiDefinisi

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

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

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WANITAWANITA

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Female InfertilityFemale 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

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

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Uterine TypesUterine Types

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Female FactorsFemale Factors

Follopian tube

Uterine

ovary oocyte

Cervix

Extra-genital tract

Fig.1sperm

Pituitary

Thyroid Adrenal

Hypothalamus

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Gangguan vagina dan serviks

Gangguan vagina dan serviks

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Kelainan uterus (rahim)

Kelainan uterus (rahim)

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Kerusakan Saluran Telur

Kerusakan Saluran Telur

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Kegagalan ovulasiKegagalan ovulasi

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EndometriosisEndometriosis

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PRIAPRIA

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※ Male infertility

Causes

1. PRE-TESTICULAR CAUSES OF INFERTILITYa. Hypothalamic disease Isolated gonadotropin deficiency (Kallmann's

syndrome) Isolated LH deficiency ("Fertile eunuch") Isolated FSH deficiency Congenital

hypogonadrotropic syndromes

※ Male infertility

Causes

1. PRE-TESTICULAR CAUSES OF INFERTILITYa. Hypothalamic disease Isolated gonadotropin deficiency (Kallmann's

syndrome) Isolated LH deficiency ("Fertile eunuch") Isolated FSH deficiency Congenital

hypogonadrotropic syndromes

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b. Pituitary disease Pituitary insufficiency (tumors, infiltrative

processes, operation, radiation) Hyperprolactinemia Hemochromatosis Exogenous hormones (estrogen-androgen

excess, glucocorticoid excess, hyper and hypothyroidism).

b. Pituitary disease Pituitary insufficiency (tumors, infiltrative

processes, operation, radiation) Hyperprolactinemia Hemochromatosis Exogenous hormones (estrogen-androgen

excess, glucocorticoid excess, hyper and hypothyroidism).

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2. TESTICULAR CAUSES OF INFERTILITY

a. Chromosomal abnormalities: Klinefelter's syndrome (XXY, karayotype), XX disorder (sex reversal syndrome), XYY syndrome

b. Noonan's syndrome (male Turner's syndrome)

c. Myotonic dystrophy- Bilateral anorchia (vanishing testes syndrome)

d. Sertoli-cell-only syndrome (germinal cell aplasia)

2. TESTICULAR CAUSES OF INFERTILITY

a. Chromosomal abnormalities: Klinefelter's syndrome (XXY, karayotype), XX disorder (sex reversal syndrome), XYY syndrome

b. Noonan's syndrome (male Turner's syndrome)

c. Myotonic dystrophy- Bilateral anorchia (vanishing testes syndrome)

d. Sertoli-cell-only syndrome (germinal cell aplasia)

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e. Gonadotoxins (drugs, radiation)

f. Orchitis

g. Trauma

h. Systemic disease (renal failure, hepatic disease, sickle cell disease)

i. Defective androgen synthesis or action

j. Cryptorchidism

k. Varicocele

e. Gonadotoxins (drugs, radiation)

f. Orchitis

g. Trauma

h. Systemic disease (renal failure, hepatic disease, sickle cell disease)

i. Defective androgen synthesis or action

j. Cryptorchidism

k. Varicocele

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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

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

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Causes of male infertilityCauses of male infertilityImpaired production or function

of spermImpaired shape or movement of

spermLow sperm concentrationVaricoceleUndescended testicleTestosterone deficiency (male

hypogonadism)Genetic defectsInfections

Impaired production or function of sperm

Impaired shape or movement of sperm

Low sperm concentrationVaricoceleUndescended testicleTestosterone deficiency (male

hypogonadism)Genetic defectsInfections

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Causes of male infertilityCauses of male infertility

Impaired delivery of spermSexual issuesRetrograde ejaculationBlockage of epididymis or ejaculatory

ductsNo semen (ejaculate)HypospadiaAnti – sperm antibodiesCystic fibrosis

Impaired delivery of spermSexual issuesRetrograde ejaculationBlockage of epididymis or ejaculatory

ductsNo semen (ejaculate)HypospadiaAnti – sperm antibodiesCystic fibrosis

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Causes of male infertilityCauses of male infertilityGeneral health and

lifestyleEmotional stressMalnutritionObesityCancer and its

treatmentAlcohol and drugsAgeOther medical

conditions

General health and lifestyle

Emotional stressMalnutritionObesityCancer and its

treatmentAlcohol and drugsAgeOther medical

conditions

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Causes of male infertilityCauses of male infertility

Environmental exposurePesticides and other chemicalsOverheating the testiclesSubstance abuseTobacco smoking

Environmental exposurePesticides and other chemicalsOverheating the testiclesSubstance abuseTobacco smoking

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Causes of female infertilityCauses of female infertilityFallopian tube

damage or blockage

EndometriosisOvulation

disordersHyperprolactinemi

aPolycystic ovary

syndrome (PCOS)Early menopauseUterine fibroidsPelvic adhesions

Fallopian tube damage or blockage

EndometriosisOvulation

disordersHyperprolactinemi

aPolycystic ovary

syndrome (PCOS)Early menopauseUterine fibroidsPelvic adhesions

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Causes of female infertilityCauses of female infertilityMedications Thyroid problemsCancer and its treatmentCaffeine intakeOther medical conditions

Medications Thyroid problemsCancer and its treatmentCaffeine intakeOther medical conditions

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Risk factorsRisk factors

AgeTobacco smokingAlcohol useBeing overweightToo much exerciseCaffeine intake

AgeTobacco smokingAlcohol useBeing overweightToo much exerciseCaffeine intake