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Contents Definition[edit] "Demographers tend to define infertility as childlessness in a population of women of reproductive age," whereas "the epidemiological definition refers to "trying for" or "time to" a pregnancy, generally in a population of women exposed to" a probability of conception.[8] Currently, female fertility normally peaks at age 24 and diminishes after 30, with pregnancy occurring rarely after age 50.[9] A female is most fertile within 24 hours of ovulation.[9] Male fertility peaks usually at age 25 and declines after age 40.[9] The time needed to pass (during which the couple tries to conceive) for that couple to be diagnosed with infertility differs between different jurisdictions. Polycystic ovarian syndrome is the most frequent indication for ovulation induction. A British study found that patients valued primary care physicians who were well informed about infertility and the treatment process.

Fibrosis of the oviducts or uterine horns, probably a result of inflammation after infection or trauma, leads to infertility. A Modern View of Male Infertility. (PDF, 7 MB) From The Infertile Male: Advanced Assisted Reproductive Technology, 1994. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it.

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Some problems stop an egg being released at all, while others prevent an egg being released during some cycles but not others. Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women. Treatment of Tubal and Peritoneal Factors The treatment of tubal-factor infertility underwent major changes, especially during the last quarter of the century when microsurgery became available. [126, 127] Tubal reconstruction was the only hope for those patients before assisted reproductive therapy became available.

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They can often recommend a counselor and others who can offer appropriate support. Requirements for Female Fertility (Continued) Other requirements for female fertility include: Adequate sexual drive and sexual function to permit coitus.

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Editorial: The Cure and Proliferation of Male Infertility. (PDF, 2 MB) The Journal of Urology, 1998. Secondary infertility When a woman is unable to bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to a live birth, she would be classified as having secondary infertility. Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur. Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control Secondary infertility is when they have previously conceived but are no longer able to. Transvaginal or abdominal paracentesis should be performed if the patient becomes uncomfortable. Most of infertile couples are aware of what can be offered to them from the media. Fibroids should be treated if they are associated with abnormal uterine bleeding or if they are thought to be the cause of infertility. A typical adverse effect can be ovarian hyperstimulation. The easiest and most successful treatment is intrauterine insemination (IUI). [104] Similar treatments apply when oligospermia, hypospermia, and ejaculatory disorders such as impotence, hypospadias, or retrograde ejaculation are present. [105, 106, 107] Patients with azoospermia that is not amenable to in vitro fertilization/intracytoplasmic sperm injection treatment benefit from artificial insemination (AI) with donor sperm. [108] Artificial insemination can be performed by depositing the sperm at the cervical level (cervical insemination) [106] or inside the endometrial cavity (intrauterine insemination). If the E2 and FSH levels are in the normal range, clomiphene citrate is the drug of choice, as previously described.