Talk:Infertility

From Wikipedia, the free encyclopedia

WikiProject Medicine This article is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at the doctor's mess.
B This page has been rated as B-Class on the quality assessment scale
High This article has been rated as High-importance on the importance assessment scale
Peer review Infertility has had a peer review by Wikipedia editors which is now archived. It may contain ideas you can use to improve this article.

Contents

[edit] Fact checking

  • Can someone fact-check this statement, please?
In other rare cases, they may each be fertile, but genetically or immunologically incompatible with one another, so that they might each be able to be fertile with other people, but not with one another.

This is my understanding, but I am not an expert in this field. Karada 13:19, 24 Jan 2005 (UTC)

[edit] Changes

  • I just saved a bunch of little changes and a few sentence-sized changes. The psychological, ethical and social affects of IF and treatment could use some attention - there are some "people say" statements in there (I think I added one or two more) that need to be cleaned out of there sometime when it's not 2 AM. I would love to hear that another set of eyes have gone over my rewrites and fixed any of my stupid mistakes. I'll look back myself in a couple of days.

[edit] Treatments-- what about Traditional Chinese Medicine?

It is unclear to me why acupuncture and Chinese herbs have been left off the treatment list. Study after study has demonstrated their efficacy, and they represent a significantly safer and/or cheaper alternative to the treatments listed. I hope to see this oversight corrected.

Thank you for your suggestion! When you feel an article needs improvement, please feel free to make whatever changes you feel are needed. Wikipedia is a wiki, so anyone can edit almost any article by simply following the Edit this page link at the top. You don't even need to log in! (Although there are some reasons why you might like to…) The Wikipedia community encourages you to be bold. Don't worry too much about making honest mistakes—they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. JFW | T@lk 18:53, 13 July 2005 (UTC)

[edit] Genetic cause?

I feel the line that states transsexuality can be a genetic cause of infertility in women should be removed. Transsexuality itself has no effect on the ability to bare children in women who choose to become men, only treatment of the condition with testosterone injections or estrogen blockers can cause infertility and I doubt injecting yourself with testosterone is a ‘genetic cause’ of infertility. —The preceding unsigned comment was added by DJ Izumi (talk • contribs) 17:44, 13 October 2005.

If this was what that part said, then you'd be right. However, you're confusing your terms. (No worries though, if you're not familiar with them then they are, well, confusing terms!) A man who was born with a female body, what you seem to be trying to describe, is a transman. The section under female infertility, on the other hand, was in reference to transwomen. Because of their lack of uteri and overies, which is caused by their XY chromosome configuration, they lack the type of fertility that other women have. From this angle, a transwoman's genetic makeup is indeed what makes her an infertile woman. --Icarus (Hi!) 04:46, 8 July 2006 (UTC)
There is no conclusive proof that a transsexual suffers any form of genetic issue that makes them a transsexual. As it stands it is accepted as a psychological issue. A biological XY male, with a psychological condition in which they precive themselves as female, does not make them an infertile woman, reguardless of surgical or hormonal status. It's like saying a cause of infertility in dogs includes your dog actually being a human who THINKS they're a dog and thusly can't have puppies. I'm quite certian that if someone included 'Being a Furry' as a cause of infertility in dogs it would be edited out quite quickly.
Like I said, it depends on what angle you're viewing the situation from. While there's at least a little bit of research showing that transsexuality may have an inborn biological cause (not necessarily genetic), and it's possible at least in theory because males and females are pressed from the same mold, so to speak, there is no evidence at all that a member of one species can actually have the brain of another, and there is no even remotely plausible mechanism by which this could happen. Yes, the lack of research makes it hard to know the exact cause of transsexuality (which is why I decided to avoid the edit war that would certainly follow if I'd added it back into the article), but the comparison to furries is ridiculous. --Icarus (Hi!) 22:00, 23 July 2006 (UTC)

[edit] NPOV

Women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer the article needs such statement'

It needs a source or it's out. JFW | T@lk 15:38, 30 November 2005 (UTC)
It's got a source and it makes perfect sense. If you think it is not so, please provide evidence support for your POV. JFW | T@lk 15:49, 30 November 2005 (UTC)

[edit] Although more research needs to be done, parents may want to consider alternatives to disposable diapers for male infants.

Source please. This sounds like bunk created by environmentalists. Nothing else in the article - besides heredity and injury/disease - suggests reasons for worrying about male infertility in infants. It may be a legitimate point with a scientific basis, but it's badly presented.

I agree! Brian Pearson 18:17, 21 November 2006 (UTC)

[edit] Chromosomal Abnormalities and Infertility

why would chromosomal abnormalities cause infertility? such as aneuploidy, kleinfelter's syndrome or even 48,XXYY syndrome, turner syndrome, robertsonian translocation, Small supernumerary marker chromosome and so on. Does having an extra chromosme prevent spermogenesis from not occurring? I don't understand how people with a trisomy (Down Syndrome) are infertile. Raccoon Fox • Talk • Stalk 23:32, 10 September 2006 (UTC)

I mean, would even in-vitro vertilisation work for someone with kleinfelter's syndrome? Raccoon Fox • Talk • Stalk 21:05, 11 September 2006 (UTC)

[edit] Hamster test?

I just came across an article called hamster test. I wondered if it was still used and if so, whether or not it could be inserted under Diagnosis and tests. Brian Pearson 18:13, 21 November 2006 (UTC)

I thought you would be writing on male infertility alone and not include female infertility. [Tolulope Ogunbiyi] 14:44, 16 March 2007(BCH)

[edit] Great Information Resource about Fertility...

Hey everyone,

This website helped me out alot during my research for more information. It is called FertilityProRegistry.com. It has legit FAQ’s and detailed info links (very helpful) to different possible procedures and stuff. It made my searching much easier because everything is in one place instead of having to aimsley search for different information and advertisements (annoying). I figured I would pass it on. It also lists a bunch of info on Fertility Centers and Specialists throughout the states. I know its a tough situation, but I thought I would relay what really helped me with my information about the topic.

Best of luck with everything!!

Kevin - June 21st, 2007


[edit] External link

I removed an external link from this article and received this reply on my talk page:

Hi - Based on your request, I would like to discuss your removal of the external link Infertility Doctors & Clinics Find Infertility Doctors & Clinics in the U.S. Based on my research of what external links should be linked, this seems like a perfect fit for the page because it is a "value-add" for the reader and it is something that can't be included in the content of the page directly (i.e. we can't list every individual infertility specialist on the site directly). Here is the wiki article that I'm referencing for justification on why it should be linked:[External_links] —Preceding unsigned comment added by 67.177.242.71 (talk) 15:17, 23 September 2007 (UTC)

I'd like others to chime in on whether they think the link is usefull or not. If others agree that it is, I'm fine with having the link added back in. Deli nk 14:11, 24 September 2007 (UTC)

I'd say it was indeed a fair removal.--Christian B 21:35, 24 September 2007 (UTC)
funny you should ask.....I was actually just going to leave a comment about not finding that link. I was on wikipedia a few weeks ago at work and utilized that link to contact a clinic and I was actually just coming back here to find that link b/c I misplaced it. Having said that, I would say it is useful and should be put back on. —Preceding unsigned comment added by Jbelle00 (talk • contribs) 00:53, 2 October 2007 (UTC)

- I had posted the initial request to add this link back in and just wanted to check on its status and/or the date that you will be making a decision. Thanks!!. —Preceding unsigned comment added by 67.177.242.71 (talk) 22:18, 21 October 2007 (UTC)

There is a bit of advertising in the link, but yet I think it does more good than harm in the article. Mikael Häggström 04:59, 22 October 2007 (UTC)

Based on a final comment in Deli nk Talk page, I'm adding this link back in "Feel free to go ahead and add it back in. Deli nk 17:56, 6 November 2007 (UTC)". —Preceding unsigned comment added by 67.177.242.71 (talk)

[edit] Abortion and infertility

Under the section for "Female infertility", induced abortion was listed as a risk factor for subsequent miscarriage. However, conflicting reports state that abortion is not a risk factor for subsequent miscarriage. I have removed the section for discussion; it is here:

  1. “Induced abortions, miscarriages, and tobacco smoking as risk factors for secondary infertility.” Tzonou A, Hsieh CC, Trichopoulos D, Aravandinos D, Kalandidi A, Margaris D, Goldman M, Toupadaki N. J Epidemiol Community Health. 1993 Feb;47(1):36-9.
  2. “Association of induced abortion with subsequent pregnancy loss”. A. A. Levin, S. C. Schoenbaum, R. R. Monson, P. G. Stubblefield and K. J. Ryan. JAMA Vol. 243 No. 24, June 27, 1980.

One such conflicting report is here, supplied by the American Journal of Public Health. This report states: "In general there was no significant association between prior induced abortion and risks of pregnancy loss with the relative risks of 1.10, 0.88, and 0.81 for the first to third trimester respectively."

Another conflicting report is mentioned in Atrash and Hogue, The Effect of Pregnancy Termination on Future Reproduction, Baillière’s Clinical Obstetrics and Gynecology 391-405 (June 1990).

Another: A leading obstetrics textbook states that other than the “small risk” of infection, “Fertility is not altered by an elective abortion.” F. Gary Cunningham et al., Williams Obstetrics 21st Edition, 877 (2001).

Furthermore, Abortion#Health considerations makes no mention of abortion as a risk factor for subsequent miscarriage or infertility. In light of these conflicting reports, I have removed this section from the article, pending clarification on the matter. Photouploaded 17:28, 7 November 2007 (UTC)

The study you cited states, “A slight increase of first-trimester spontaneous loss was noted with the D&C/Suction procedure and early induced abortion.” Also, that study is older than the 1993 study I cited.
Studies bear more weight than textbooks, so the textbook is irrelevant.
Look again. Abortion#Health considerations lists “sterility”.
While a list is a poor vehicle for conveying nuanced information (such as the fact that multiple abortions are more likely to damage fertility than single abortions), removal of the info is not warranted.LCP 17:47, 7 November 2007 (UTC)
The study I cited is also newer than "The effect of pregnancy termination on future reproduction" that you mentioned, so that article also has no bearing on the source I used. In other words, it is outdated.LCP 17:50, 7 November 2007 (UTC)
"Sterility" is indeed listed at Abortion#Health considerations, but it's notable that the reference listed there is the same reference as the first of the two listed to support the claim here.
"Newer" does not necessarily mean "more accurate" or "more credible". This information is contested in medical literature, and it should not be included until the facts become clear. I will post this to Wikiproject:Medicine to see if anyone can shed some light on the subject. Photouploaded 17:57, 7 November 2007 (UTC)
Newer is better in this case as your study is a survey and states, “there is no evidence of an association between induced abortion and secondary infertility or ectopic pregnancy”. That is blatantly contradicted in light of subsequent research. Your study itself also states, "In conclusion, except for the association between pregnancies following dilatation and evacuation procedures and premature delivery and low birthweight, no significantly increased risk of adverse reproductive health has been observed following induced abortion." LCP
If different procedures propose different levels of risk, that should be made clear. The blanket term "Abortion" should not be applied as "A Risk Factor". I have posted to WP:MED and await their input. Photouploaded 18:11, 7 November 2007 (UTC)
I am adding the following as it is in no way contracticted by any literature:
I am adding the Totallydisputed template to this section, due to your revert to include this contested material. Photouploaded 18:11, 7 November 2007 (UTC)
Contested? I don’t think so. The only leg you have to stand on is a textbook. Of the other sources you brought to bear, both support the text I have included—as I have demonstrated by taking text directly from those sources. Regarding “The effect of pregnancy termination on future reproduction,” even it includes the caveat, “except for the association between pregnancies following dilatation and evacuation procedures….”LCP 18:25, 7 November 2007 (UTC)
Look, I saw that you posted an angrier response and then deleted it. I don't want an edit-war or a personal argument. Please, just give it 24 hours and see if any of the WP:MED members have anything useful to say. One of them may bring some new sources and ideas. That will allow for time to cool down as well. Photouploaded 18:35, 7 November 2007 (UTC)
Cooling off is a great suggestion. I appreciate you suggesting it.LCP 22:57, 7 November 2007 (UTC)
This is what you wrote at [1]: “… a user claims that there is an established causal effect between induced abortions and subsequent infertility, risk of miscarriage, and sterility. I have found three references which state that there is not a causal link between abortion and infertility.” That is hardly an unbiased presentation of the case. An unbiased statement would have looked like this: “…a user has found references that support a link between…. I have found references to the contrary.” Do you see the difference? It is this type of thing that gets under my skin in our conversation.LCP 23:32, 7 November 2007 (UTC)
I honestly didn't see much of a difference. Before I said anything, I included links to the section and footnotes that support your claim. I provided the evidence for the existing claim, before I mentioned the contradicting evidence. If I worded it poorly, I apologize. If you think it would improve future communication between us, my offer is: if you will remove your comment from WP:MED, I will change it to something like, "this section had references which say x, but I have found references which say y". Photouploaded 16:18, 8 November 2007 (UTC)


(unindent)I am removing the contested tag as Photouploaded was only one contesting edits and is now retired.LCP 22:02, 14 November 2007 (UTC)

Secondary sources are preferred over primary sources. If there are textbooks that weigh in on this, that might be a good approach to take. Antelan talk 22:02, 7 November 2007 (UTC)

Why do you say? I don't see this anywhere in Wikipedia guidelines.LCP 22:57, 7 November 2007 (UTC)
See Wikipedia:No_original_research#Primary.2C_secondary.2C_and_tertiary_sources.-Andrew c [talk] 23:59, 19 November 2007 (UTC)
I looked up the ref, and I still do not see how a secondary source is preferable to a primary source—especially when the primary source presents a summary of its own conclusions. Regarding text book vs. study, I think the following supports the use of the study: “As a rule of thumb, the more people engaged in checking facts, analyzing legal issues, and scrutinizing the writing, the more reliable the publication.” Also, how do you deal with a secondary source contradicting a primary source—which is what is really at stake here?LCP (talk) 00:11, 20 November 2007 (UTC)

I think it might be useful for this article to shed a bit more light on the circumstances under which abortion may pose a risk to fertility. For instance, having one caesarean section usually won't negatively impact the chance of becoming pregnant again in the future, but having more than one may.[2] According to one source I found, "What Causes Female Infertility?", the situation with abortion is similar:

"Abortion performed under sterile conditions is very safe and carries few risks. Frequent abortions, however, may impair a woman's fertility. The cervix can weaken and be unable to sustain a pregnancy. Scar tissue may form inside the uterine cavity after multiple abortions resulting in a closed uterus, known as Asherman's syndrome. Infertility, therefore, results from implantation failure."

Contraception was not widely used in Russia until recently, and, thus, women often ended up having multiple abortions during their reproductive years.[3] I think, if we were willing to delve deeply into the topic, Russia might provide us with a good case study of how having more than one abortion effects (or does not effect) fertility.

The risk of infertility associated with abortion is greater in regions where adequate medical treatment is unavailable due to the increased risk of infection.[4] The World Health Organization estimates that 24 million women in the world are effected by secondary infertility as a result of having had an unsafe abortion.[5]

The British Parliament recently convened an inquiry into induced abortion, and a portion of the report they produced, "Impact of abortion on women's health: Future reproductive outcomes," contains references to a number of studies which examined the effect of abortion on fertility.

That said, though, I don't have any objection to including information on how abortion may or may not effect fertility in this article, as long as it's supported by sources. I just think we need to be careful to present the information in a context which avoids undue weight. -Severa (!!!) 01:43, 20 November 2007 (UTC)

I have to agree with PhotoUploaded, the statements in this article about abortion and infertility are blanket, without context and misleading. Also, the very titles of the articles cited as evidence to the contrary suggest that the authors do not make a causal connection between abortion and infertility: “Association of induced abortion with subsequent pregnancy loss” (note the word "Association," not effect). Also, the second and the other study cited to contend that abortion has a causal effect on abortion includes tobacco use among subjects. Because of the consideration of the other factor, this should be the first indication that the study is not seeking to find a causal relationship with only abortion and infertility.
PhotoUploaded has provided several studies that show abortion has no significant impact on fertility. References to abortion as a cause of infertility should be removed until we have a consensus on how these studies should be represented on the page.--70.173.47.6 (talk) 04:21, 21 November 2007 (UTC)
You obviously didn’t read the articles.LCP (talk) 18:49, 29 November 2007 (UTC)

[edit] where

Infertility affects approximately 10% of people of reproductive age [3], and 15% of couples. Roughly 40% of cases involve a male contribution or factor, 40% involve a female factor, and the remainder involve both sexes. [4]

The section and its refs fail to be specific about where this applies - USA? global? hardly. This is not the USPedia. Also at least the last ref is pretty meager. --84.159.167.79 (talk) 16:12, 12 February 2008 (UTC)

[edit] lack of generality

I wanted to link to "sterile" to describe plants which cannot reproduce sexually and I found this should disambiguate to this page, described as: "The quality or state of being unable to reproduce; of being infertile. The term may be used of higher animals." To my dismay, however, this page is extremely non-general, talking about human infertility rather than the general phenomenon. I don't mean to criticize this page — I agree that most people searching on "infertility" are going to want to know about human infertility — but how should we resolve this? Any suggestions? Madeleine ✉ ✍ 20:53, 8 March 2008 (UTC)