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Definition of Infertility Infertility is defined as the inability to conceive after 12 months of having sexual intercourse with average frequency, without the use of any form of birth control. Intrauterine insemination is performed during a natural cycle or after ovulation induction with CC or gonadotropins. There is no reliable means to predict whether the use of any treatment option will be successful and after how many attempts. World Health Organization reference values for human semen characteristics. Intracytoplasmic Sperm Injection and Infertility. (PDF, 53 KB) Nature Genetics, 2001. There are four parameters analyzed: 1) semen volume – should be at least 1.

Torsion: Is a common problem affecting fertility that is caused by a supportive tissue abnormality which allows the testes to twist inside the scrotum which is characterized by extreme swelling.  Torsion pinches the blood vessels that feed the testes shut which causes testicular damage.  If emergency surgery is not performed to untwist the testes, torsion can seriously impair fertility and cause permanent infertility if both testes twist. Estrogen causes negative feedback on the pituitary gland, inhibiting LH and FSH release. Society and culture[edit] Perhaps except for infertility in science fiction, films and other fiction depicting emotional struggles of assisted reproductive technology have had an upswing first in the latter part of the 2000s decade, although the techniques have been available for decades.[76] Yet, the number of people that can relate to it by personal experience in one way or another is ever growing, and the variety of trials and struggles is huge.[76] Pixar's Up contains a depiction of infertility in an extended life montage that lasts the first few minutes of the film.[77] Other individual examples are referred to individual subarticles of assisted reproductive technology Ethics[edit] There are several ethical issues associated with infertility and its treatment. 8 Couples with unexplained infertility may want to consider another year of intercourse before moving to more costly and invasive therapies, such as assisted reproductive technology. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993.

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Both infertility and subfertility are defined as the inability to conceive after a certain period of time (the length of which vary), so often the two terms overlap. A history and physical examination can help direct the evaluation. Germ cells and white blood cells both appear as round cells on microscopic examination, so immunohistochemical stains are used to differentiate the 2 cell types. Certain medical conditions such as diabetes, thyroid disease and anemia may also affect fertility. Cystic fibrosis: This is a chronic disease that results in the creation of a sticky mucus. Outside pregnancy and lactation, women with high levels of prolactin may have irregular ovulation cycles and fertility problems.

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For this reason, it is less likely to adversely affect the endometrium and cervical mucus. ED may be the consequence of the conversion of androgens to estradiol. It binds in a part of the brain called the hypothalamus, which is essential in stimulating the ovary to grow and release an egg.

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Today, assisted reproductive techniques (ARTs) offer powerful new options. Prolactin inhibits the production of GnRH from the hypothalamus and LH and FSH from the pituitary. Because of the antiestrogenic effect, CC may thicken the cervical mucus, creating an iatrogenic cervical factor that can be responsible for the lack of pregnancy in a patient who has otherwise ovulated. [165] Other adverse effects associated with CC are hot flashes, scotomas, dryness of the vagina, headache, and ovarian hyperstimulation, which, although rare, has been reported in patients who are sensitive to CC. [166, 167] Whether the use of CC increases the risk of ovarian cancer is unknown, although 2 articles illustrate a potential risk. [168] Other authorities disagree with this assumption. Diagnosis is based on history, physical examination, biochemical evaluation, ultrasonography, and laparotomy. Choice of infertility treatment often related to issues of efficacy, cost, ease of use or administration, and its side effects. High-cost treatments are out of financial reach for some couples. Environmental toxins, including pesticides and lead. Factors Affecting Fertility: STIs and Other Infections Gonorrhea and chlamidia in women can cause cervicitis and pelvic inflammatory disease (PID); and in men, urethritis, epididymitis, and, possibly, accessory gland infection. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 2 MB) Human Reproduction, 1996. Treatment of Female Infertility: Assisted Reproductive Technology (ART) Assisted Reproductive Technology (ART) is a term used to collectively describe a number of noncoital methods of conception that treat causes of infertility not responsive to conventional methods. A normal testicle contains 600-1200 seminiferous tubules with a total length of approximately 250 meters. Epidemiological definition of infertility (for monitoring and surveillance) Women of reproductive age (15–49 years) at risk of becoming pregnant (not pregnant, sexually active, not using contraception and not lactating) who report trying unsuccessfully for a pregnancy for two years or more. (Reproductive Health Indicators) Infertility as a disability Disability: Infertility generates disability (an impairment of function), and thus access to health care falls under the Convention on the Rights of Persons with Disability. Further investigations may be requested according to the clinical presentation and the results of preliminary tests.