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Understanding what defines normal fertility is crucial to helping a person, or couple, know when it is time to seek help. Of particular relevance amongst diseases affecting the testes are testicular infection or orchitis. Carcinoma in the Bladder Left Behind. (PDF, 3 MB) The Journal of Urology, 1973.

Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter. According to ESHRE recommendations, couples with an estimated live birth rate of 40% or higher per year are encouraged to continue aiming for a spontaneous pregnancy.[66] Treatment methods for infertility may be grouped as medical or complementary and alternative treatments.

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Empirical treatment with controlled ovarian hyperstimulation followed by intrauterine insemination has improved the pregnancy rate in those patients. [214] If pregnancy does not occur during the first 4 intrauterine insemination cycles, other alternatives include IVF or any of the associated assisted reproductive technologies procedures.Background Infertility is a common clinical problem. However, it could be the future for the treatment of multiple diseases, including infertility. As treatment begins, couples may experience cycles of optimism and despair with each passing menstrual cycle. Abnormalities of the uterus like the uterus bicornis, uterus septa or hypoplasia of the uterus less frequently result in contraceptional barriers but can cause miscarriages. For these reasons, minimally invasive surgery has emerged as a highly competitive new sub-specialty within various fields of surgery. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.[62] However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.[63][64] Diagnosis[edit] If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later.

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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. 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. Investigations Infertile couples are usually adviced to start their investigations after 12 months of trying to conceive or after 6 months if the female partner is more than 35 years old or immediately if there is an obvious cause for their infertility or subfertility [16]. The hypothalamus also produces thyrotropin-releasing hormone (TRH) and vasoactive intestinal peptide (VIP), both of which stimulate prolactin release from the anterior pituitary, and dopamine, which inhibits prolactin release. High-cost treatments are out of financial reach for some couples.

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Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. Thus, pelvic ultrasonography has become an important tool for monitoring ovulation induction. Full history taking of both partners usually denotes the underlying problem [17-23], (Appendix 1). In addition to functioning as a conduit, the vas also has absorptive and secretory properties. Adequate nutritional and health status to maintain nutrition and oxygenation of placenta and fetus. Listen to Professor Cheong talk about the fertility investigations we offer       Repeated pregnancy loss Some people may not have difficulty conceiving, but have suffered from miscarriages.