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Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that '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'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. In humans, infertility is the inability to become pregnant after one year of intercourse without contraception involving a male and female partner.[2] There are many causes of infertility, including some that medical intervention can treat.[3] Estimates from 1997 suggest that worldwide about five percent of all heterosexual couples have an unresolved problem with infertility. The initial dosage of clomiphene is 50 mg daily for five days starting on day 3 to 5 of the menstrual cycle.

Diagnosis is based on history, physical examination, biochemical evaluation, ultrasonography, and laparotomy. The testes are at risk for both thermal and physical trauma because of their exposed position. Empirical treatment with controlled ovarian hyperstimulation followed by intrauterine insemination has improved the pregnancy rate in those patients. [214] If pregnancy does not occur during the first 4 intrauterine insemination cycles, other alternatives include IVF or any of the associated assisted reproductive technologies procedures.Background Infertility is a common clinical problem. Factors affecting Fertility Frequency/Timing of sexual intercourse: - Every 2 to 3 days optimises the chance of pregnancy Obesity: - Women who have BMI of over 30 should be informed that they are likely to take longer to conceive and will affect treatment success rates. Graft-versus-host Reactivity and Renal Allograft Survival in Rats Given Allogeneic Spleen Cells or Spleen Allografts.(PDF, 2 MB) Transplantation, 1976. These time intervals would seem to be reversed; this is an area where public policy trumps science.

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ART: Intracytoplasmic Sperm Injection (ICSI) Another ART procedure  Intracytoplasmic Sperm Injection (ICSI)  involves the injection of a single sperm into the egg. The resulting embryos are then transferred into the uterus of the future mother, known as the recipient.

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Ovulation disorders appear to be the most common cause of infertility in women. Seventy-five percent of patients have testicular atrophy and primary testicular failure due to degeneration of the seminiferous tubules. Symptoms depend on what is causing the infertility. Microsurgery in Pediatric Urology. (PDF, 13 MB) The National Foundation, 1977. Hypothyroidism: Low thyroid hormone levels--can cause poor semen quality, poor testicular function and may disturb libido.  May be caused by a diet high in iodine.  Reducing iodine intake or beginning thyroid hormone replacement therapy can elevate sperm count.  This condition is found in only 1 percent of infertile men. If stem cells remain viable after radiation therapy, patients may regain fertility within several years.

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Radiation therapy While Leydig cells are relatively radioresistant because of their low rate of cell division, the Sertoli and germ cells are extremely radiosensitive. These numbers are comparable to those of other industrialized nations. Sterility is the inability to conceive after two years of regular intercourse. Ovulation of the egg occurs approximately 2 weeks before the start of the next period. However, if the E2 level is greater than 100 pc/mL and the follicles are 10 mm in diameter, hMG should be continued at the same dose. Cholesterol One study has found that high cholesterol levels may have an impact on fertility in women. Gonadotropins can trigger ovulation when Clomid or Serophene don't work. Hypospadias: The urethral opening is under the penis, instead of its tip. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. Several methods are available to detect antisperm antibodies, such as radioimmunoassay and enzyme-linked immunosorbent assay, but the most specific test is the immunobead test. For women aged 35, about 94% who have regular unprotected sexual intercourse get pregnant after three years of trying. 5 IU q5d) until follicle development is detectable based on an elevation of the E2 levels and the presence of follicle development on sonograms.