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It has been suggested that infertility be classified as a form of disability.[22] Causes[edit] Immune infertility[edit] Antisperm antibodies (ASA) have been considered as infertility cause in around 10–30% of infertile couples.[23] In both men and women, ASA production are directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, inhibiting capacitation and acrosome reaction, impaired fertilization, influence on the implantation process, and impaired growth and development of the embryo. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Torsion: Is a common problem affecting fertility that is caused by a supportive tissue abnormality which allows the testes to twist inside the scrotum which is characterized by extreme swelling.  Torsion pinches the blood vessels that feed the testes shut which causes testicular damage.  If emergency surgery is not performed to untwist the testes, torsion can seriously impair fertility and cause permanent infertility if both testes twist. While BBT is an inexpensive way to monitor ovulation, it is often impractical.

If the epididymis is blocked, sperm may not be ejaculated properly. Certain medical conditions such as diabetes, thyroid disease and anemia may also affect fertility. Patients generally have long arms and legs due to a delayed closure of the epiphyseal plates, delayed puberty, and atrophic testis.

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The procedure is performed in an outpatient setting in the vast majority of cases, and recovery time can be as little as a few days. A lower concentration may lead to a lower chance for conception without treatment; 3) sperm motility or movement – a normal motility should be at least 50%. A British study found that patients valued primary care physicians who were well informed about infertility and the treatment process. Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form.

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Heavy alcohol use (more than four to five drinks a day). Semm established several standard procedures that were regularly performed, such as ovarian cyst enucleation, myomectomy, treatment of ectopic pregnancy and finally laparoscopic-assisted vaginal hysterectomy (nowadays termed as cervical intra-fascial Semm hysterectomy). Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way.[21] In the United States some treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for Family and Medical Leave Act leave. Release of GnRH is stimulated by melatonin from the pineal gland and inhibited by testosterone, inhibin, corticotropin-releasing hormone, opiates, illness, and stress. Assisted Reproductive Technology: Using Ejaculated, Fresh, and Frozen-thawed Epididymal and Testicular Spermatozoa Gives Rise to Comparable Results after Intracytoplasmic Sperm Injection. (PDF, 5 MB) Fertility and Sterility, 1995. 8 If a woman has irregular cycles, the testing should be conducted later in the cycle, starting seven days before presumed onset of menses, and repeated weekly until menses.

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Causes in women Infertility in women can also have a range of causes. The Treatment of Azoospermia with Surgery and ICSI. (PDF, 4 MB) Chapter 10 from Male Fertility & Infertility, 1998. Hystersalpingography (HSG): Further investigations 17. Investigation of suspected tubal and uterine abnormalities: 2. Many uterine and tubal abnormalities detected by the HSG can be surgically corrected. The most common disorders impacting ovulation include polycystic ovary syndrome (PCOS), hypogonadotropic hypogonadism (from signaling problems in the brain), and ovarian insufficiency (from problems of the ovary). 4 pmol/l for a low response and greater than or equal to 25. Pelvic inflammatory disease or STIs like chlamydia and gonorrhea may cause these blockages in the fallopian tubes. However, given that fertility in women is known to decline steadily with age, some providers evaluate and treat women aged ≥35 years after 6 months of intercourse without the use of contraception (1). Thoracentesis is rarely indicated in cases of pleural effusion. Primary infertility When a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. Religious leaders' opinions on fertility treatments; for example, the Roman Catholic Church views infertility as a calling to adopt or to use natural treatments (medication, surgery, or cycle charting) and members must reject assisted reproductive technologies. Because ovarian hyperstimulation syndrome does not occur, the patient's response is slow. Because 85% of couples conceive spontaneously within 12 months if having intercourse regularly,5 it is important to identify those who will benefit from infertility evaluation.