Infertility and Rheumatic Disease Please rate this page (bottom of page)

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Definition

Infertility is involuntary childlessness and is present if one attempts, but does not become pregnant within a year or when miscarriages or stillbirths prevent from becom children. (World Health Organization, WHO). Rheumatic disease or associated medication may be of importance.

When should one be investigated for childlessness?

  • It is generally recommended to seek advice from a doctor, usually the GP, if you have attempted to have children in 12 months without success. Especially women who are 35 years of age or older or have rheumatic or other chronic illness should not wait long
  • The doctor may refer to one of the public clinics in Oslo, Bergen, Porsgrunn, Tromsø or Trondheim, depending on where you live in the country
  • You can also contact the gynecologist yourself, either a private practitioner or contact directly with one of the private clinics involved in assisted fertilization. There are private clinics in Oslo, Trondheim, Bergen and Haugesund

Causes of Infertility

The reason for infertility is approximately as often in the woman as in the man

Possible causesby the woman

  • Ovulation problem. May be due to hormonal problems
  • PCO (polycystic ovaries)
    • More immature egg bags with few or no ovulation
  • Damage to fallopian tube (the connection between ovaries and uterus)
    • May occur after infections such as chlamydia or after stomach surgery, such as appendicitis
  • Problems with uterus (uterus)
    • Es may occur myomas, partition of the uterine cavity or adhesions inside the uterine cavity
    • Endometriosis
      • Benign growth outside the uterus (for example ovaries and fallopian tube) of tissues usually located on the inside of the uterus
  • Treatment that harm the egg cells, such as some types of chemotherapy
  • Reduced fertility due to age
    • Fertility age for women is often defined 15-49 years) (Ref. WHO)
  • Early developement of Menopause. May be hereditary. Early menopause by their own mother may be of importance
  • Inexplicable Infertility

Possible causes of the man

  • Reduced or no sperm production
    • May be caused by genetic or infection in the testicles and epididymis
  • Hormonal causes
  • Obstruction of vas deferens
    • May occur after surgery or infection
  • Reduced ability for erection or release
  • Drugs and anabolic steroids. Reduced sperm production by use of:
    • Sulfazalazine (Salazopyrin) (By even 80%)
    • Cortison (Prednisolone) in high doses (less often)
    • Methotrexate (less frequent)
    • Azathioprine (Imurel) (less often)
  • Cyclophosphamide (Sendoxan) can cause lasting reduced fertilization
    • Freezing of sperm prior to treatment may be relevant
  • Testicular Cancer
  • Inexplicable Infertility

Other that may affect fertility

  • Smoking
  • Alcohol
  • Significant overweight
  • Some drugs that reduce fertility as long as they are used (inhibits ovulation in women)
  • NSAIDs (dikofenac, naproxen, ibumetin and more)

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