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Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur. Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance. ICSI with Epididymal and Testicular Sperm in Azoospermic Men. (PDF, 2 MB) From Treatment of Infertility: The New Frontiers, 1998.

The later they are detected, the more complicated having children becomes. Patients are often short, with small firm testis and gynecomastia, but they have a normal-sized penis. It is an approach to disseminate the recommended medical care of infertile couple to the practicing clinicians. The prevalence varies widely, being less in developed countries and more in developing countries where limited resources for investigation and treatment are available [2]. Conventional In-vitro Fertilization vs Intracytoplasmic Sperm Injection for Patients Requiring Microsurgical Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1994. Financing fertility treatment can also be costly, but there are programs that can help with this.Infertility is the inability of a person, animal or plant to reproduce by natural means.

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Adhesions with the surrounding tissue can develop as well, and reduce the motility of the tubes. Tests and trials are available, but testing does not always reveal a specific cause. As new technology becomes available, fertility treatment is now accessible to more people, and success rates and safety are improving all the time. Twelve months is the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.[7] a woman over 35 has not conceived after six months of contraceptive-free sexual intercourse.

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Pregnancy After Testicular Transplant: Importance of Treating the Couple. (PDF, 5 MB) Fertility and Sterility, 1980. Mutations in the Cystic Fibrosis Gene in Patients with Congenital Absence of the Vas Deferens. (PDF, 5 MB) New England Journal of Medicine, 1995. Primary infertility refers to cases in which no pregnancy has gone satisfactorily full term. 8) Unexplained/other: Sometimes a full evaluation does not reveal the cause of infertility. Nevertheless, scientists have found these stem cells, which may generate new oocites in postnatal conditions.

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Microsurgery in Clinical Urology. (PDF, 5 MB) Urology, 1975. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. Hypothyroidism has no effect on male libido or semen quality. Modifiable and non-modifiable risk factors for poor semen quality: a case-referent study. Instructions for collecting the sample should include abstinence from ejaculation for 48 to 72 hours. Causes Potential causes of male infertility are: The complete absence of sperm (azoospermia) Low sperm count (oligospermia) Abnormal sperm shape (teratozoospermia) Problems with sperm movement (asthenozoospermia) Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation Problems with erections or other sexual problems There are a variety of conditions that may lead to male infertility. Further investigations 18. Laparoscopy: - Invasive procedure. - to check for pelvic disease; such as endometriosis and to check tubal patency. - therapeutic as in laparoscpic myomectomy and ovarian drilling. Hysteroscopy: - to evaluate uterine cavity. - In case of repeated failed IVF cycles. - therapeutic as in intrauterine septum. The following problems are possible: Low sperm count: The man ejaculates a low number of sperm. We recommend immediate evaluation for a couple attempting pregnancy when the woman has a prior history of pelvic infection. An estimated 34 million women, predominantly from developing countries, have infertility which resulted from maternal sepsis and unsafe abortion (long term maternal morbidity resulting in a disability). Endometriosis can only be confirmed by surgery, usually laparoscopy.