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The couple should have sex at least every two days between the 10th and 18th day after the woman starts her period. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Ovulation disorders About one quarter of infertility cases are due to ovulation disorders. Hypospadias: The urethral opening is under the penis, instead of its tip. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Lifestyle Factors Jump to section + All couples should be counseled to abstain from tobacco use, limit alcohol consumption, and aim for a body mass index less than 30 kg per m2 to improve their chances of natural conception or using assisted reproductive technology. The Male-specific Region of the Human Y Chromsome is a Mosaic of Discrete Sequence Classes. (PDF, 754 KB) Nature, 2003.

Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. Women who have a body weight 10% to 15% below normal may have reduced fertility. A detailed history and physical examination is necessary for both partners. Gonadotropin release is modulated by various other signals, such as estradiol (a potent inhibitor of both LH and FSH release), and inhibin from the Sertoli cell, which causes a selective decrease in FSH release. This can result from: A medical condition: This could be a testicular infection, cancer, or surgery. Choose a single article, issue, or full-access subscription.

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The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects. Histologic endometrial dating is not considered reliable nor is it predictive of fertility. Vitrification of oocytes from endangered Mexican gray wolves (Canis lupus baileyi). (PDF, 319 KB) Theriogenology, 2010. Basic Work-up for Infertility It is very important to remember that infertility can occur as a result of one or more male or female factors.

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At least one open tube is required for IUI, and any sperm abnormality cannot be severe, otherwise the sperm will not be able to swim to and fertilize the egg. United Kingdom[edit] In the UK, previous NICE guidelines defined infertility as failure to conceive after regular unprotected sexual intercourse for two years in the absence of known reproductive pathology.[11] Updated NICE guidelines do not include a specific definition, but recommend that "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner, with earlier referral to a specialist if the woman is over 36 years of age."[12] Other definitions[edit] Researchers commonly base demographic studies on infertility prevalence on a five-year period.[13] Practical measurement problems, however, exist for any definition, because it is difficult to measure continuous exposure to the risk of pregnancy over a period of years. IVF in action Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure. Thus one of the requirements is normal spermatogenesis – normal sperm count, motility and biologic structure and function. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979. 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.

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Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive. Today, many patients do not receive the recommended medical care that based on the best available evidence [5]. Helping our patients develop a deep understanding of their fertility options will make the process smoother. The acrosome, a derivative of the Golgi process, surrounds the nucleus anteriorly and contains enzymes necessary to penetrate the ovum. Mannitol Induced Central Nervous System Toxicity in Renal Failure. (PDF, 4 MB) Investigative Urology, 1972. Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity. The resulting sperm count (also called spermiogram) allows identifying various pathologies.