İnfertiliteye Genel Bakış
Özet
Bu çalışma, küresel nüfus dinamikleri ve bunun gelecekte yol açabileceği olası nüfus krizlerini ele alarak infertilite konusunu kapsamlı bir şekilde incelemektedir. Gelişmiş ülkelerde doğum oranlarının düşmesi ve yaşlı nüfusun hızla artması, çocuk sahibi olmayı teşvik eden politikalara rağmen ciddi bir nüfus azalışı riski doğurmaktadır. Nüfus artışının önündeki en büyük engellerden biri, dünya genelinde yaklaşık 140 milyon insanı etkileyen erkek ve kadın infertilitesidir. Düzenli ilişkiye rağmen belirli sürelerde gebelik oluşmaması olarak tanımlanan infertilite; multifaktöriyel bir süreç olup endüstriyel atıklar, ağır metaller, radyasyon maruziyeti, düzensiz beslenme, obezite, sirkadiyen ritim bozuklukları ve psikolojik stres gibi çevresel etkenlerden doğrudan etkilenmektedir. Ayrıca kromozomal anomaliler ve genetik kusurlar, hormonal düzensizliklere yol açan polikistik over sendromu ile hipogonadizm gibi endokrin problemler, ürogenital sistemi etkileyen bakteriyel, viral ve paraziter enfeksiyonlar, ilerleyen yaş faktörü ile otoimmün reaksiyonlar infertiliteye neden olan başlıca unsurlar arasında yer almaktadır. Vakaların yaklaşık %10'unu oluşturan açıklanamayan infertilite ise endometriyal reseptivite sorunları gibi alanlarda halen araştırılmaktadır. Sonuç olarak, üreme sağlığını tehdit eden bu faktörlerin giderilmesi ve yönetilmesi, gelecekteki nüfus krizlerinin önlenmesi açısından kritik bir öneme sahiptir.
This study comprehensively examines the issue of infertility by addressing global population dynamics and the potential population crises they may cause in the future. Decreasing birth rates and the rapidly aging population in developed countries pose a serious risk of population decline despite policies encouraging childbearing. One of the biggest obstacles to population growth is male and female infertility, which affects approximately 140 million people worldwide. Infertility, defined as the absence of pregnancy within specific periods despite regular intercourse, is a multifactorial process directly influenced by environmental factors such as industrial wastes, heavy metals, radiation exposure, malnutrition, obesity, circadian rhythm disruptions, and psychological stress. Additionally, chromosomal anomalies and genetic defects, endocrine problems like polycystic ovary syndrome and hypogonadism that cause hormonal imbalances, bacterial, viral, and parasitic infections affecting the urogenital system, advanced age, and autoimmune reactions are among the primary factors causing infertility. Unexplained infertility, which constitutes approximately 10% of cases, is still being investigated in areas such as endometrial receptivity issues. Consequently, eliminating and managing these factors that threaten reproductive health is of critical importance for preventing future population crises.
Referanslar
Max Roser, H.R.a.E.O.-O. World Population Growth. 2013; Available from: https://ourworldindata.org/world-population-growth.
Bureau, U.C. World Population by Country. 2022; Available from: https://worldpopulationreview.com/.
Roser, H.R.a.M. Age Structure. 2019; Available from: https://ourworldindata.org/age-structure.
Worlddata.info. The average age in global comparison. 2022; Available from: https://www.worlddata.info/average-age.php.
Issue, J.F.I. The History of Plague – Part 1. The Three Great Pandemics. History 2012; 20(2).
Taubenberger, J.K. and D.M. Morens. 1918 Influenza: the mother of all pandemics. Emerg Infect Dis, 2006; 12(1); 15-22. DOI: 10.3201/eid1201.050979.
Museum, N.W. Research Starters: Worldwide Deaths in World War II. 2022; Available from: https://www.nationalww2museum.org/students-teachers/student-resources/research-starters/research-starters-worldwide-deaths-world-war.
Britannica. World War 1: Killed, wounded, and missing. 2022; Available from: https://www.britannica.com/event/World-War-I/Killed-wounded-and-missing.
Adam, D. The pandemic's true death toll: millions more than official counts. Nature, 2022; 601(7893); 312-315. DOI: 10.1038/d41586-022-00104-8.
Agarwal, A., A. Mulgund, A. Hamada, et al. A unique view on male infertility around the globe. Reprod Biol Endocrinol, 2015; 13; 37. DOI: 10.1186/s12958-015-0032-1.
Bureau, U.C. Population estimates. U.S. Census Bureau, Methodology and Standards Council. ; Available from: http://www.census.gov.
Diagnosis.com, R. Statistics by country for infertility. 21 June 2014; Available from: http://www.rightdiagnosis.com/i/infertility/stats-country.htm.
Tiwari, A.K., P. Pragya, K. Ravi Ram, et al. Environmental chemical mediated male reproductive toxicity: Drosophila melanogaster as an alternate animal model. Theriogenology, 2011; 76(2); 197-216. DOI: 10.1016/j.theriogenology.2010.12.027.
Yilmaz, O. and H. Dinç. Ağır Metallerin Üreme Sistemi Üzerine Etkileri YYU Veteriner Fakultesi Dergisi, 2013; 24(2); 91 - 94
Hamlin, H.J. and L.J. Guillette, Jr. Birth defects in wildlife: the role of environmental contaminants as inducers of reproductive and developmental dysfunction. Syst Biol Reprod Med, 2010; 56(2); 113-21. DOI: 10.3109/19396360903244598.
Hart, R. PCOS and infertility. Panminerva Med, 2008; 50(4); 305-14.
Sreetharan, S., C. Thome, S. Tharmalingam, et al. Ionizing Radiation Exposure During Pregnancy: Effects on Postnatal Development and Life. Radiat Res, 2017; 187(6); 647-658. DOI: 10.1667/RR14657.1.
De Santis, M., E. Cesari, E. Nobili, et al. Radiation effects on development. Birth Defects Res C Embryo Today, 2007; 81(3); 177-82. DOI: 10.1002/bdrc.20099.
Copeland, P.M., N.R. Sacks and D.B. Herzog. Longitudinal follow-up of amenorrhea in eating disorders. Psychosom Med, 1995; 57(2); 121-6. DOI: 10.1097/00006842-199503000-00004.
Dag, Z.O. and B. Dilbaz. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc, 2015; 16(2); 111-7. DOI: 10.5152/jtgga.2015.15232.
Balen, A.H., S.L. Tan and H.S. Jacobs. Hypersecretion of luteinising hormone: a significant cause of infertility and miscarriage. Br J Obstet Gynaecol, 1993; 100(12); 1082-9. DOI: 10.1111/j.1471-0528.1993.tb15170.x.
Al-Aama, T., C. Brymer, I. Gutmanis, et al. Melatonin decreases delirium in elderly patients: a randomized, placebo-controlled trial. Int J Geriatr Psychiatry, 2011; 26(7); 687-94. DOI: 10.1002/gps.2582.
Attarchi, M., H. Darkhi, M. Khodarahmian, et al. Characteristics of menstrual cycle in shift workers. Glob J Health Sci, 2013; 5(3); 163-72. DOI: 10.5539/gjhs.v5n3p163.
Meczekalski, B., K. Katulski, A. Czyzyk, et al. Functional hypothalamic amenorrhea and its influence on women's health. J Endocrinol Invest, 2014; 37(11); 1049-56. DOI: 10.1007/s40618-014-0169-3.
Marcus, M.D., T.L. Loucks and S.L. Berga. Psychological correlates of functional hypothalamic amenorrhea. Fertil Steril, 2001; 76(2); 310-6. DOI: 10.1016/s0015-0282(01)01921-5.
Witchel, S.F. Disorders of sex development. Best Pract Res Clin Obstet Gynaecol, 2018; 48; 90-102. DOI: 10.1016/j.bpobgyn.2017.11.005.
Rey, R., N. Josso and C. Racine, Sexual Differentiation, in Endotext, K.R. Feingold, et al., Editors. 2000: South Dartmouth (MA).
Shamsi, M.B., K. Kumar and R. Dada. Genetic and epigenetic factors: Role in male infertility. Indian J Urol, 2011; 27(1); 110-20. DOI: 10.4103/0970-1591.78436.
Willemsen, R., J. Levenga and B.A. Oostra. CGG repeat in the FMR1 gene: size matters. Clin Genet, 2011; 80(3); 214-25. DOI: 10.1111/j.1399-0004.2011.01723.x.
Unuane, D., H. Tournaye, B. Velkeniers, et al. Endocrine disorders & female infertility. Best Pract Res Clin Endocrinol Metab, 2011; 25(6); 861-73. DOI: 10.1016/j.beem.2011.08.001.
Jarow, J.P. Endocrine causes of male infertility. Urol Clin North Am, 2003; 30(1); 83-90. DOI: 10.1016/s0094-0143(02)00117-9.
Hawksworth, D.J., A.A. Szafran, P.W. Jordan, et al. Infertility in Patients With Klinefelter Syndrome: Optimal Timing for Sperm and Testicular Tissue Cryopreservation. Rev Urol, 2018; 20(2); 56-62. DOI: 10.3909/riu0790.
Rhoton-Vlasak, A. Infections and infertility. Prim Care Update Ob Gyns, 2000; 7(5); 200-206. DOI: 10.1016/s1068-607x(00)00047-0.
Faddy, M.J., R.G. Gosden, A. Gougeon, et al. Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod, 1992; 7(10); 1342-6. DOI: 10.1093/oxfordjournals.humrep.a137570.
Spandorfer, S.D., O.M. Avrech, L.T. Colombero, et al. Effect of parental age on fertilization and pregnancy characteristics in couples treated by intracytoplasmic sperm injection. Hum Reprod, 1998; 13(2); 334-8. DOI: 10.1093/humrep/13.2.334.
Brazdova, A., H. Senechal, G. Peltre, et al. Immune Aspects of Female Infertility. Int J Fertil Steril, 2016; 10(1); 1-10. DOI: 10.22074/ijfs.2016.4762.
Mazzolli, A.B. and C. Barrera. [Role of the immune response in male infertility]. Medicina (B Aires), 1989; 49(3); 232-8.
Makker, A. and M.M. Singh. Endometrial receptivity: clinical assessment in relation to fertility, infertility, and antifertility. Med Res Rev, 2006; 26(6); 699-746. DOI: 10.1002/med.20061.
