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Although relatively uncommon, eating disorders can negatively affect menstruation, fertility, and maternal and fetal well-being. A decreased testosterone level with an increased FSH level points to primary hypogonadism. Role of Semen Analysis in Subfertile Couples. (PDF, 250 KB) Fertility and Sterility, 2010. However, if the woman has previously been pregnant, regardless of the outcome (which may have been a premature or full-term delivery, spontaneous abortion, induced abortion or ectopic pregnancy), and is now unable to conceive, it is considered secondary infertility. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements.

It is in fact possible to restore ovulation using appropriate medication, and ovulation is successfully restored in approximately 90% of cases. If this is unsuccessful, the dosage may be increased to 100 mg daily.

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Physical exam A directed physical exam that may include a pelvic ultrasound should be performed. Evaluation of cervical mucus is unreliable; therefore, investigation is not helpful with the management of infertility. If endometriosis is found, it can be surgically removed by various methods, and its removal may lead to a decrease in pain as well as improvement in the ability to conceive naturally. A doctor injects sperm directly into the egg in a dish and then places it into your uterus. Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[56] or her age as female fertility declines after the age of 30.[57] Sometimes it can be a combination of factors, and sometimes a clear cause is never established. Hypogonadotropic Hypopituitarism: Low pituitary gland output of LH and FSH.  This condition arrests sperm development and causes the progressive loss of germ cells from the testes and causes the seminiferous tubules and Leydig (testosterone producing) cells to deteriorate.  May be treated with the drug Serophene.  However, if all germ cells are destroyed before treatment commences, the male may be permanently infertile.

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8,26,27 As opposed to laparoscopy or hysteroscopy, hysterosalpingography is a minimally invasive procedure with potentially therapeutic effects and should be considered before more invasive methods of assessing tubal patency. Experts differ as to when genetic tests should be done. Histologic endometrial dating is not considered reliable nor is it predictive of fertility. Gynecological history, including operations and medical treatment. Thankfully, there are several options available for treatment, and many useful tips to prepare for conceiving.

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European Association of Urology guidelines on male infertility: the 2012 update. 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. In these methods, fertilization occurs inside the body. Factors contributing to the formation of antisperm antibodies in women are disturbance of normal immunoregulatory mechanisms, infection, violation of the integrity of the mucous membranes, rape and unprotected oral or anal sex. Laboratory testing – Depending on the results of the evaluation discussed above, your physician may request specific blood tests. Radiation therapy: This can impair sperm production. Oligospermia is defined as fewer than 20 million sperm/mL, severe oligospermia is less than 5 million/mL, and azoospermia is defined as no sperm present. Chronic conditions: These include AIDS or cancer. Results of Microsurgical Vasoepididymostomy: Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Human Reproduction, 1989. Similarly, bilateral obstruction of the sperm ducts can cause azoospermia and infertility.