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One-third of couples will discover fertility problems in only the woman. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.[62] However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.[63][64] Diagnosis[edit] If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later.

The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects. An ultrasound scan can detect an ectopic pregnancy.

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If a weight gain greater than 2 lb occurs, the patient should be evaluated to determine if hospitalization is required. Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high. Primary sterility is the complete inability to become pregnant, while secondary sterility refers to the failure to conceive after a previous successful pregnancy. Surgeons who choose this hand-assist technique feel it reduces operative time significantly versus the straight laparoscopic approach. 7 million women reported impaired ability to get pregnant or carry a baby to term.

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Egg donation. This can help you if you have ovaries that don't work right but you have a normal uterus. Benign prostatic hyperplasia does not affect fertility. Antibodies can abnormally attack a man's own sperm on their way to the egg. In women, both smoking and alcohol use are associated with lower rates of conception and increased rates of spontaneous abortion. Do you have pain with menstrual periods or intercourse?

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Exogenous testosterone should never be administered in an attempt to boost sperm production because it actually decreases intratesticular testosterone levels owing to feedback inhibition of GnRH release. Just before those eggs would otherwise be ovulated, they are retrieved under mild anesthesia in an operating room. Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. Clomiphene citrate for unexplained subfertility in women. 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. What’s on the Mind of IVF Consumers? (PDF, 627 KB) Reproductive BioMedicine Online, 2009. Treatment of tubal obstruction generally requires referral for subspecialty care.