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As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). Varicoceles are observed more commonly on the left side than the right. The pregnancy test is then performed 2 weeks after the egg retrieval. Up to 2 percent of men are thought to have suboptimal sperm. When the eggs are mature, your doctor collects them with a device called a vaginal ultrasound probe.

If GnRH is not secreted, the pituitary does not release LH and FSH. 8–16 One retrospective case-control study of 650 men with infertility and 698 control participants questioned the role of environmental risk; no association could be determined after assessing for multiple factors including shift work, stress, and pesticides.

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Assisted conception The following methods are currently available for assisted conception. Secondary fertility involves one or both partners who have conceived previously, but are now unable to do so because of a possible physical or medical condition impairing fertility.

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10 Data Sources: A PubMed search was completed using the key terms infertility, subfertility, treatment, etiology, and diagnosis. Risk factors for male infertility include obesity, age (over 40 -- yes, men also have biological clocks), current or previous infection of an STD, smoking, or excessive drinking. Typical drugs are clomifene, cyclofenil, tamoxifen, and epimestrol among others. In addition, if a man’s sperm do not move correctly, they may not be able to meet with and fertilize an egg. Androgen receptor dysfunction Because the androgen receptor is essential for the process of spermatogenesis, dysfunctions in this receptor can cause infertility. Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg.

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Cervical stenosis (a narrowed cervix) or the lack of cervical mucus often make it harder for sperm to travel through the cervix into the uterus. These may be purchased over the counter and allow couples to predict the most fertile days in the cycle. 8,37 Women in WHO group II, including those who are overweight and who have polycystic ovary syndrome, can benefit from weight loss, exercise, and lifestyle modifications to restore ovulatory cycles and achieve pregnancy. Chronic conditions: These include AIDS or cancer. Around one third of couples have difficulty conceiving due to a low sperm count. Partners may become more anxious to conceive, increasing sexual dysfunction.[17] Marital discord often develops, especially when they are under pressure to make medical decisions. Chemotherapy: Some chemotherapy drugs can result in ovarian failure. An increased volume is rarely observed and is often caused by a contaminant, such as urine. These injections are taken nightly, typically for 5 – 10 days, and act directly on the cells of the ovary to stimulate egg development. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer. Cervical surgery can sometimes cause scarring or shortening of the cervix. It may also prevent the sperm from reaching the egg. Treatment of the Normal Infertile Couple The prognosis for the normal infertile couple is poor and unpredictable. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. The number of days in between each period varies each month.