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A smaller amount may suggest a structural or hormonal problem leading to deficient semen production; 2) sperm concentration – normal concentration should be at least 20 million sperm per 1 ml of semen. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. 6 million (6%) married women aged 15–44 years in the United States reported difficulty getting pregnant (3). They may benefit from referral to a physician comfortable with prescribing pulsatile administration of gonadotropin-releasing hormone or gonadotropins with luteinizing hormone activity to induce ovulation.

The hypothalamus acts on the false information that the estrogen level in circulation is low, increasing production of FSH and LH, thus stimulating follicular growth. Mutations in the Cystic Fibrosis Gene in Patients with Congenital Absence of the Vas Deferens. (PDF, 5 MB) New England Journal of Medicine, 1995. Fertilizing Capacity of Epididymal and Testicular Sperm using Intracytoplasmic Sperm Injection (ICSI). (PDF, 7 MB)Reproduction, Fertility and Development, 1995. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous. Microsurgical Solutions to Male Infertility. (PDF, 2 MB) Contemporary OB/GYN, 2005.

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The treatment of uterine malformations depends on the severity of the problem. Sperm count often returns to normal after stopping the medication.

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Epidemiology of Sterility and Infertility Sterility and infertility affect about 10 – 15% of couples. Primary infertility When a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. Adequate nutritional and health status to maintain nutrition and oxygenation of placenta and fetus.

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Causes in men The following are common causes of infertility in men. Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome). The couple should make sure to have sex during the three days before ovulation. This is obviously extremely distressing for the couples involved. Reproductive Biology. (PDF, 147 KB) The Scientist, 1996. Peripheral organ The hypothalamus-pituitary axis may be interrupted by hormonally active peripheral tumors or other exogenous factors, due to cortical excess, cortical deficiency, or estrogen excess. When this happens, it causes something called a varicocele. Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001. World Health Organization[edit] The World Health Organization defines infertility as follows:[10] United States[edit] One definition of infertility that is frequently used in the United States by reproductive endocrinologists, doctors who specialize in infertility, to consider a couple eligible for treatment is: a woman under 35 has not conceived after 12 months of contraceptive-free intercourse. Environmental vs Genetic Sex Determination: A Possible Factor in Dinosaur Extinction? (PDF, 307 KB) Fertility and Sterility, 2004.