Infertility

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Infertility in women was ranked the 5th highest serious global disability5&6 (among populations under the age of 60). Infertility might contribute to stress, anxiety, and depression in couples trying to conceive, and treatment can be medically invasive and expensive. In cases when the quality of sperm is very poor, or sperm is completely absent in the ejaculate (azoospermia), donor’s sperm can be used (if culturally acceptable). 6,8 It is important for primary care physicians to be familiar with the workup and prognosis for infertile couples. Primary Lymphoma of Kidney. (PDF, 586 KB) The Journal of Urology, 1973.

Factors effecting normal expectancy of conception. If resistant to the above, offer: - laparoscopic ovarian drilling, or, - ovulation induction via gonadotrophins. Women attempting pregnancy at age 40 or older have a 50% decreased fertility rate and a two-fold to three-fold increased risk of spontaneous abortion compared with younger women.

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Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body. This leads to the final maturation and release of the egg. Both pituitary insufficiency and pituitary excess cause infertility.

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These rates, of course, readjusted down for the older women with long durations of infertility [42]. The application of artificial insemination usually is made after previous medicamentous treatment. IVF was a major breakthrough because it allowed for successful pregnancies in women that were previous deemed permanently infertile, such as when the fallopian tubes are both markedly damaged. In such circumstances, it is recommended not to prescribe any medication until all basic investigations are done and its results received. An evaluation by a physician is the only way to sort it out. If oligospermia or azoospermia is noted, hypogonadism should be suspected.

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Diagnostic evaluation of the infertile female: a committee opinion. Low sperm mobility (motility): The sperm cannot "swim" as well as they should to reach the egg. No Differences in Outcome after Intracytoplasmic Sperm Injection with Fresh or with Frozen-thawed Epididymal Spermatozoa. (PDF, 66 KB) Human Reproduction, 1999. Medications in use for this effect are mainly clomifene citrate and tamoxifen (both being selective estrogen-receptor modulators), as well as letrozole (an aromatase inhibitor.[17] Follicle-stimulating hormone (FSH), directly stimulating the ovaries. Adhesions with the surrounding tissue can develop as well, and reduce the motility of the tubes. In one study,  treatment with recombinant HBD1 in asthenozoospermic and leukocytospermic patients who were deficient in HBD1 resulted in improved bactericidal activity and sperm quality, which supports this protein’s role in fertility and its potential role in managing infertility.[28] Other causes Causes of testicular failure also include the following: Granulomatous disease – Leprosy and sarcoidosis may infiltrate the testicle Sickle cell disease – Sickling of cells within the testis leads to microinfarcts Excessive use of alcohol, cigarettes, caffeine, or marijuana Despite a thorough workup, nearly 25% of men have no discernible cause for their infertility. The patient's electrolyte levels must be checked to consider the need for diuretics. If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. Simultaneous Treatment of the Wife in Infertile Couples with Oligospermia. (PDF, 4 MB) Fertility and Sterility, 1983. Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. Biopsy reveals maturation arrest or germ cell aplasia. Some surgeons perform these procedures completely laparoscopically, making the larger incision toward the end of the procedure for specimen removal, or, in the case of a colectomy, to also prepare the remaining healthy bowel to be reconnected (create an anastomosis). They can also carry out some basic tests on both partners to see if there is an identifiable reason for not having achieved a pregnancy.


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See also
Infertility Expert Singapore
Secondary Infertility on the Rise
Prevalence of Infertility in Tanzania