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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. Laparotomy is indicated in patients with severe pelvic adhesions that compromise the bowel, ovaries, and tubes, with obliteration of the cul-de-sac. [129] The aim of the procedure is to correct what is necessary to allow the normal transport of the gametes; complete restoration of the anatomy is not intended. [130] Lysis of adhesions should be meticulous, using hydrodissection and fine instruments.

Cryopreservation: Cryopreservation of semen, oocytes or embryos should be offered to anyone who may undergo treatment that may affect his/her fertility. (e.g.: chemotherapy for cancer). For cancer-related fertility preservation, do not apply the eligibility criteria used for conventional infertility treatment. Do not use a lower age limit for cryopreservation for fertility preservation in people diagnosed with cancer. Sterilisation involves blocking the fallopian tubes to make it impossible for an egg to travel to the womb. 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.

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Infertility is caused by primary testicular failure, and most patients are azoospermic. Many uterine and tubal abnormalities detected by the HSG can be surgically corrected. The Relationship of Abnormal Semen Parameters to Male Fertility. (PDF, 4 MB) Human Reproduction, 1989.

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Women in group III can conceive only with oocyte donation and in vitro fertilization. This produces a sensation of pain that may extend to the patient's shoulders. A luteal phase defect results in low production of the hormone progesterone, which is necessary for maintaining a pregnancy.

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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. Men with Infertility Caused by AZFc Deletion can Produce Sons by Intracytoplasmic Sperm Injection, but are Likely to Transmit the Deletion and Infertility. (PDF, 102 KB) Human Reproduction, 1999. The corollary to this is that, by definition, failure to conceive in women under 35 isn't regarded with the same urgency as it is in those over 35. Factors affecting Fertility Frequency/Timing of sexual intercourse: - Every 2 to 3 days optimises the chance of pregnancy Obesity: - Women who have BMI of over 30 should be informed that they are likely to take longer to conceive and will affect treatment success rates. Also searched were the Cochrane database, the National Guideline Clearinghouse database, Dynamed, and Essential Evidence Plus. 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. The WHO lower reference limit (5th percentile) is 15 million sperm per mL, or 39 million sperm per ejaculate.