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Epidemiological definition of infertility (for monitoring and surveillance) Women of reproductive age (15–49 years) at risk of becoming pregnant (not pregnant, sexually active, not using contraception and not lactating) who report trying unsuccessfully for a pregnancy for two years or more. (Reproductive Health Indicators) Infertility as a disability Disability: Infertility generates disability (an impairment of function), and thus access to health care falls under the Convention on the Rights of Persons with Disability. A karyotype test and a Y chromosome test for microdeletions are indicated in patients with nonobstructive azoospermia or severe oligospermia (< 5 million sperm/mL), although indications are expanding.[20] Klinefelter syndrome Klinefelter syndrome is the most common chromosomal cause of male infertility, estimated to be present in 1 per 500-1000 male births. Young syndrome is a condition that leads to inspissation of material and subsequent blockage of the epididymis. Sperm Granuloma and Reversibility of Vasectomy. (PDF, 11 MB) Lancet, 1977.

Endometriosis (especially if chronic), uterine fibroids (myomas), or an abnormally-shaped uterus might interfere with conception as well.  Age  As women grow older, it usually becomes more challenging for them to conceive. Unexpected resilience of species with temperature-dependent sex determination at the Cretaceous–Palaeogene boundary. (PDF, 238 KB) Biology Letters, 2010. With the fast progression in reproductive medicine and the experiences gained through infertility management, a wider range of treatment options have become available to infertile couples [17-19,21-26,31,36], (Appendix 4). It's sometimes done while you're taking meds that help trigger the release of an egg. Around 1/3 of infertility cases are caused by fertility problems in men4 1/3 of infertility cases are caused by fertility problems in women4 1/3 of infertility cases are caused by a mixture of male and female problems, or by problems that cannot be determined4 Infertility doesn’t necessarily mean that you won’t ever have children, but you may need the help of fertility treatment to conceive. Fertilizing Capacity of Epididymal and Testicular Sperm with ICSI. (PDF, 5 MB) Frontiers in Endocrinology, 1995.

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It will take time until these studies can be available for clinics and patients as a regularity. In vitro fertilization (IVF). In this technique, your doctor places into your uterus that were fertilized in a dish. Fertility Evaluation: Obstetric and Gynecological History The obstetric and gynecological history should include: Reproductive history (children, mode of delivery, prematurity, stillbirth, extrauterine pregnancy, spontaneous and induced abortion, fertility and infertility in earlier relationships).

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Between 45 and 50 percent of cases are thought to stem from factors that affect the man. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. Abdominal myomectomy is a surgical procedure performed through a very low horizontal abdominal incision allowing access to the uterus for removal of fibroids.

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Sperm counts can fluctuate, so that several samples may be necessary. This sterile needle is attached to sterile suction tubing and a collecting vial. After fertilization, implantation may then take place in the uterus. Microsurgical Aspects of Varicocele. (PDF, 9 MB) Fertility and Sterility, 1979. Come and meet us to find out more about how we can help you. The fertilized embryo is then transferred to womb. Unexplained fertility affects about 10 percent of couples worldwide. Other causes of ovulation disorders include ovarian insufficiency and hypothalamic amenorrhea. This procedure is performed in the outpatient setting. Fertility awareness can help women and couples become more familiar with the signs of ovulation and menstrual cycle patterns. In women, both smoking and alcohol use are associated with lower rates of conception and increased rates of spontaneous abortion. It is in fact possible to restore ovulation using appropriate medication, and ovulation is successfully restored in approximately 90% of cases. Prozac and other SSRIs, Propecia).  Luckily, many treatment options exist for ED depending on the cause--these will be discussed in the treatment section.