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Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity. Premature Ejaculation: Is defined as an inability to control the ejaculatory response for at least thirty seconds following penetration.  Premature ejaculation becomes a fertility problem when ejaculation occurs before a man is able to fully insert his penis into his partner�s vagina.  Premature ejaculation can be overcome by artificial insemination or by using a behavioral modification technique called the �squeeze technique� which desensitizes the penis. The seminal vesicles provide 40-80% of the semen volume, which includes fructose for sperm nutrition, prostaglandins and other coagulating substances, and bicarbonate to buffer the acidic vaginal vault. If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s. A prolactin level of more than 150 mcg/L suggests a pituitary adenoma, while levels greater than 300 mcg/L are nearly diagnostic. This is called luteinised unruptured follicle syndrome (LUFS).

18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). 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. In the majority of cases, there are no obvious symptoms that you may be infertile. As the rate of getting spontaneous pregnancy among infertile or subfertile couples is lower than that among normal fertile population, it is recommended to carry out the following diagnostic, evidence-based, work-up to detect any hidden treatable cause.

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One of the best known is the HFEA – The UK's regulator for fertility treatment and embryo research. Changes in testicles Healthy testicles are an important aspect of male fertility.

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2/7/15 our son was born all thanks to the assistance of Dr. Genetic karyotyping, if a recurrent miscarriage is a problem. Fertility may improve after adopting a gluten-free diet.Infertility: Introduction Infertility is a significant social and medical problem affecting couples worldwide. Intrauterine insemination 33. Consider unstimulated intrauterine insemination as a treatment option in the following groups as an alternative to vaginal sexual intercourse: - people who are unable to, or would find it very difficult to, have vaginal intercourse - people with conditions that require specific consideration in relation to methods of conception (for example, after sperm washing where the man is HIV positive) - people in same-sex relationships Do not offer IUI for people with unexplained infertility, mild endometriosis or mild male factor. Always take in consideration the ages of the couple. A history and physical examination can help direct the evaluation. The main symptom of infertility is not getting pregnant.

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One of the requirements for this procedure is that a woman should have at least 1 undamaged fallopian tube. 8 A high serum FSH level (greater than 30 to 40 mIU per mL [30 to 40 IU per L]) with a low estradiol level can distinguish ovarian failure from hypothalamic pituitary failure, which typically reveals a low or normal FSH level (less than 10 mIU per mL [10 IU per L]) and a low estradiol level. Ovarian hyperstimulation syndrome The ovaries can swell, leak excess fluid into the body, and produce too many follicles, the small fluid sacs in which an egg develops. Contents Definition[edit] "Demographers tend to define infertility as childlessness in a population of women of reproductive age," whereas "the epidemiological definition refers to "trying for" or "time to" a pregnancy, generally in a population of women exposed to" a probability of conception.[8] Currently, female fertility normally peaks at age 24 and diminishes after 30, with pregnancy occurring rarely after age 50.[9] A female is most fertile within 24 hours of ovulation.[9] Male fertility peaks usually at age 25 and declines after age 40.[9] The time needed to pass (during which the couple tries to conceive) for that couple to be diagnosed with infertility differs between different jurisdictions. 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. This sterile needle is attached to sterile suction tubing and a collecting vial.