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Pretesticular causes of infertility Pretesticular causes of infertility include congenital or acquired diseases of the hypothalamus, pituitary, or peripheral organs that alter the hypothalamic-pituitary axis. Sermondade N, Faure C, Fezeu L, Lévy R, Czernichow S; Obesity-Fertility Collaborative Group. CASA measures the following parameters: Curvilinear velocity – The average distance per unit time between successive sperm positions) Straight-line velocity – The speed of forward direction Linearity – The straight-line velocity divided by the curvilinear velocity In addition, the program measures the average path velocity, the amplitude of lateral head displacement, and the flagellar beat frequency, and it is used to evaluate for evidence of hyperactivation. A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men. Successful Vitrification of Bovine and Human Ovarian Tissue. (PDF, 3 MB) Reproductive BioMedicine Online, 2009.

Clean, Intermittent Self-catheterization in the Treatment of Urinary Tract Disease. (PDF, 2 MB) The Journal of Urology, 1972. An estimated 28% of all couples seeking reproductive assistance may have normal findings on their clinical evaluation, making the unexplained infertility a more common provisional diagnosis.

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It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Compensatory and Obligatory Renal Growth in Rats. (PDF, 1 MB) American Journal of Physiology, 1974. This technique involves an injection of a single healthy sperm directly injected into mature egg. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). Supplementation with acetyl L carnitine and antioxidants such as Vitamins C or E are encouraged to enhance sperm maturation and function.

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6,8 It is important for primary care physicians to be familiar with the workup and prognosis for infertile couples. Perspectives on infertility consultations in primary care: a qualitative study. Some people find that joining a support group helps, as it offers the chance to talk to others in a similar situation. Epididymal and Testicular Spermatozoa and Intracytoplasmic Sperm Injection. (PDF, 7 MB) Assisted Reproduction Reviews, 1996. Aetiology of Congenital Absence of Vas Deferens: Genetic Study of Three Generations. (PDF, 4 MB) Human Reproduction, 1993.

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Options include intrauterine insemination (also known as IUI) or IVF with intracytoplasmic sperm injection (also known as ICSI). 8,46 Obesity impairs fertility and the response to fertility treatments, including in vitro fertilization; therefore, it is advisable to counsel patients who are obese to lose weight before conception or infertility treatments. 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. Before surgery, the HSG films and results of previous laparoscopies should be thoroughly reviewed to decide on the type of surgical technique that is required and to explain to the patient the expected degree of success and risks involved with the procedure. Associated conditions[edit] For most women, alteration of menstrual periods is the principal indication of chronic anovulation. Treatment of the cause: Male Factor: (Liaise with the andrologist) 1. Symptoms include: bloating constipation dark urine diarrhea nausea abdominal pain vomiting They are usually mild and easy to treat. Thus 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. (Trends in prevalence4). Malformation of the eggs themselves may complicate conception. This situation can be related to the presence of other endocrine disorders such as hyperprolactinemia, congenital adrenal hyperplasia, adrenal tumors, Cushing syndrome, thyroid dysfunction, and extreme obesity. Existing definitions of infertility lack uniformity, rendering comparisons in prevalence between countries or over time problematic. 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.


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