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United Kingdom[edit] In the UK, previous NICE guidelines defined infertility as failure to conceive after regular unprotected sexual intercourse for two years in the absence of known reproductive pathology.[11] Updated NICE guidelines do not include a specific definition, but recommend that "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner, with earlier referral to a specialist if the woman is over 36 years of age."[12] Other definitions[edit] Researchers commonly base demographic studies on infertility prevalence on a five-year period.[13] Practical measurement problems, however, exist for any definition, because it is difficult to measure continuous exposure to the risk of pregnancy over a period of years. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery. A review of records from other fertility doctors that you have seen is also important.

Other causes of infertility affecting both partners include immunological incompatibility between sperm and the cervical mucus, which may in some instances cause sperm agglutination. Perspectives on infertility consultations in primary care: a qualitative study.

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Patients have eunuchoidal body habitus, large testis, and a low ejaculatory volume. 6-Mb Deletion of the Human Y Chromosome Persists Through Balance Between Recurrent Mutation and Haploid Selection. (PDF, 295 KB) Nature Genetics, 2003. IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. Common causes of infertility of females include: ovulation problems (e.g. polycystic ovarian syndrome, PCOS, the leading reason why women present to fertility clinics due to anovulatory infertility.[58]) tubal blockage pelvic inflammatory disease caused by infections like tuberculosis age-related factors uterine problems previous tubal ligation endometriosis advanced maternal age immune infertility Males[edit] The main cause of male infertility is low semen quality.

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25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. Hysterosalpingogram (HSG) – This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome). These endometrial cells can extend as far as the outside of the fallopian tubes, the ovaries and the bladder. Ovulation of the egg occurs approximately 2 weeks before the start of the next period. Povey AC, Clyma JA, McNamee R, et al.; Participating Centres of Chaps-UK. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries.

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8 Patients should be counseled that 50% of couples who have not conceived in the first year of trying will conceive in the second year. Temperature charting is a useful way of providing early clues about anovulation, and can help gynaecologists in their diagnosis. Women receiving fertility treatment have a slightly higher risk of an ectopic pregnancy. In 1981, Semm, from the gynecological clinic of Kiel University, Germany, performed the first laparoscopic appendectomy. On the other hand, swollen, painful, or tender testicles may be a sign of an underlying issue, such as an infection, that can also impact sperm quality and male fertility. For women, being underweight and having extremely low amounts of body fat are associated with ovarian dysfunction and infertility and they have a higher risk for preterm birth.


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See also
Infertility Treatment History
Infertility Ka Desi Ilaj
Prevention of Infertility