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Primary infertility When a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. Veltman-Verhulst SM, Cohlen BJ, Hughes E, Heineman MJ. Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment. Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects.

Couples may decide to go ahead regardless if the desire to become pregnant is very strong. Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). Oligozoospermia refers to a low sperm count under 20 million per milliliter. In order to perform ICSI, an egg is held via a small suction pipette, while one sperm is injected into that egg using a very fine glass needle. Many countries have special frameworks for dealing with the ethical and social issues around fertility treatment.

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Many more couples, however, experience involuntary childlessness for at least one year: estimates range from 12% to 28%.[4] Male infertility is responsible for 20–30% of infertility cases, while 20–35% are due to female infertility, and 25–40% are due to combined problems in both parts.[2][5] In 10–20% of cases, no cause is found.[5] The most common cause of female infertility is ovulatory problems, which generally manifest themselves by sparse or absent menstrual periods.[6] Male infertility is most commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.[7] Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile for the rest of the menstrual cycle. It can also help if a man has severe erectile dysfunction.

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A doctor or WHNP takes a medical history and gives a physical examination. If the woman is over the age of 35 years old, she may be infertile if she has not become pregnant after 6 months of trying.

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Semen and sperm Sometimes the sperm cannot travel effectively to meet the egg. Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high. For women aged 35, about 94% who have regular unprotected sexual intercourse get pregnant after three years of trying. The vas is divided into the convoluted, scrotal, inguinal, retroperitoneal, and ampullary regions and receives its blood supply from the inferior vesical artery. The Prevention of Acute Tubular Necrosis in Renal Transplantation by Chronic Salt Loading of the Recipient. (PDF, 627 KB) ANZ Journal of Surgery, 1974. Risk factors for the formation of antisperm antibodies in men include the breakdown of the blood‑testis barrier, trauma and surgery, orchitis, varicocele, infections, prostatitis, testicular cancer, failure of immunosuppression and unprotected receptive anal or oral sex with men.[23][24] Sexually transmitted infections[edit] Infections with the following sexually transmitted pathogens have a negative effect on fertility: Chlamydia trachomatis and Neisseria gonorrhoeae. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. These include advancing maternal age, severe male factor infertility (whereby ICSI can be used to fertilize the egg), and endometriosis, amongst many others.