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LINDSAY, MD, Saint Louis University Family Medicine Residency, Belleville, Illinois KIRSTEN R. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55] Another major cause of infertility in women may be the inability to ovulate. Fertilization: the process that takes place in the fallopian tube, when sperm unites with the egg. An estimated 34 million women, predominantly from developing countries, have infertility which resulted from maternal sepsis and unsafe abortion (long term maternal morbidity resulting in a disability).

The virus may either directly damage the seminiferous tubules or indirectly cause ischemic damage as the intense swelling leads to compression against the tough tunica albuginea. Passive smoking has also been linked to lower fertility. Recent Advances in Male Reproductive Surgery. (PDF, 10 MB) Chapter 13 from Annual Progress in Reproductive Medicine, 1993. The following hormones can be identified in the blood among others: FSH, LH, estradiol, prolactin, testosterone, DHEA-S and the thyroid hormones. It's sometimes done while you're taking meds that help trigger the release of an egg.

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If a cause for your fertility problems hasn't been identified, talk to your doctor about the next steps. 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.

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However, these tests have only poor to moderate predictive value despite widespread use. Women 35 and older should see their doctor after six months of trying. The chance of a multiple birth is lower with an oral fertility drug. 4) Uterine fibroids: Fibroids are very common (approximately 40% of women may have them) and the mere presence alone does not necessarily cause infertility. These drugs also can also help you get pregnant by causing your ovaries to release multiple eggs.

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These tests are used to determine gland failure or obstruction. 34 Although intrauterine insemination has been shown to be equally effective as timed intercourse in unstimulated cycles, there is a modest increase in live birth rates when combined with ovarian stimulation. This includes injuries to the testicles, epididymides, prostate, or the urethra. Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference. 6) Surgery – After a thorough history, physical examination, and ultrasound are performed, your doctor may recommend surgery to correct and abnormality. Coutifaris C, Myers ER, Guzick DS, et al.; NICHD National Cooperative Reproductive Medicine Network. Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment. 38,39 Family physicians may choose to attempt ovulation induction in anovulatory women (WHO group II) with clomiphene.