Infertility affects both men and women and can stem from a number of causes. A variety of treatments for infertility are available, but they are not effective for all individuals.
Addressing the issues related to infertility in both men and women is a central part of the NICHD mission. To this end, the NICHD conducts and supports research on the causes of infertility and on new treatments to help individuals with infertility achieve pregnancy.
Researchers at and supported by the NICHD are investigating the causes of infertility and identifying new effective treatments. One line of research examines the contributions of environmental factors to infertility. Another explores how the physical changes associated with diseases, such as endometriosis, relate to infertility. Investigators are also studying why African American women have lower success rates using assisted reproductive technology. In addition, research is being conducted to determine new ways to preserve fertility in women undergoing cancer treatments and to better understand the effect of aspirin on live-birth rates.
Research on the effects of environmental factors on infertility is conducted in the NICHD's Division of Intramural Population Health Research (DIPHR). For example, researchers in the Division collaborated with scientists at the University of Buffalo to study the relationship between hormone levels and oxidative stress during the menstrual cycle to elucidate the effects of diet, smoking, and caffeine on fertility. DIPHR scientists also studied the link between psychological stress and infertility in women. Additionally, DIPHR scientists are looking at the effect of environmental toxins and lifestyle factors on men and women's fertility. The Longitudinal Investigation of Fertility and the Environment (LIFE) Study is examining the long-term effects of lifestyle factors, including stress, cigarette smoking, caffeine intake, and alcohol usage, on fertility. Recently, researchers found that couples with high levels of exposure to persistent chemicals, like polychlorinated biphenyls, take longer to conceive.
The Epidemiology Branch within DIPHR conducts research and provides services and training. Its epidemiologic research focuses on reproductive, perinatal, and pediatric health endpoints to identify underlying etiologic mechanisms, at-risk subgroups, and interventions aimed at diagnosing or treating disease. An ongoing investigation, called the Effects of Aspirin on Gestation and Reproduction (EAGeR) Study, is investigating the effects of aspirin on blood flow and placental health to reduce the risk for adverse pregnancy events, such as early pregnancy loss and preterm delivery.
The Unit on Reproductive Endocrinology and Infertility (UREI) in the Division of Intramural Research (DIR) is also actively researching both treatments for and causes of infertility. For example, women and girls with cancer who undergo chemotherapy treatments are exposed to chemicals that can affect the ovaries and lead to infertility. Studies conducted by UREI scientists have examined ways to prevent this damage in women who undergo chemotherapy. Another study conducted by UREI scientists examined procedural differences in assisted reproductive technologies that might account for differences in pregnancy rates among African American women and whether access to care and economic issues affect use of the technologies by minority women.
Intramural scientists within the Program in Reproductive and Adult Endocrinology at the NICHD are examining possible causes and treatments for infertility associated with POI. Animal studies have explored molecular pathways involved in the loss of ovarian function and ways to intervene within the pathways to prevent loss of ovarian function. These investigators have studied women with POI to better understand the features of the disease, how it causes infertility, and how infertility can be treated in these women.
The NICHD Fertility and Infertility (FI) Branch, within the Division of Extramural Research (DER), supports research on a variety of topics related to infertility.
Preserving fertility is a topic of considerable interest at the Institute. Current investigations address the concerns of fertility preservation for men, women, and children, for circumstances covering cancer treatment and certain non-cancer conditions. Specifically, Institute-sponsored research investigates measures to prevent gamete damage, options to restore fertility after damage, developing biomarkers of gamete reserve, and the developing technologies that will enable reproductive-age adults to have biological children. One FI Branch-supported study found that granulocyte colony-stimulating factor, which stimulates endogenous bone marrow production, also prevented ovarian follicle loss in female mice undergoing chemotherapy. Another study explored the efficacy of freezing sperm stem cells from pre-pubertal boys undergoing chemotherapy and re-implanting them after treatment.
FI Branch-supported research also covers:
Research supported by the NICHD Pregnancy and Perinatology Branch (PPB) focuses on maternal health, pregnancy, fetal well-being, labor and delivery, and the developing child.
Other DER research supported by the Populations Dynamics Branch focuses on understanding changing patterns of family formation, including cohabitation, marriage, non-marital fertility, infertility, and low fertility.
Recent Institute advances in infertility research include the following:
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