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As a result, infertility has come to be defined as the inability to conceive within 12 months. An on-line WHO infertility virtual consultation course includes a 5 module WHO evidence-based medicine course, as well as a 16 module ASRM eLearning course which reviews the evidence-base for the basic diagnosis of the infertile male and female, coupled with management and treatment. In order to accomplish this, the semen is washed with a solution safe to sperm and eggs, and then centrifuged to separate motile sperm from immotile sperm and other cells.

Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries. In 10% of cases, alterations in the chemical signals from the hypothalamus can easily seriously affect the ovaries.

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Costs for fertility testing and treatments History The doctor will ask questions to try to get clues as to the cause of your infertility. Some facts about conception and fertility A doctor can give advice and carry out some preliminary assessments.

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Factors that Contribute to Sterility There are many factors that contribute to sterility such as age, lifestyle, physical, and environmental conditions. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery. A bicornuate uterus can be associated with a history of recurrent miscarriages, and its repair is indicated only if other etiologies for the miscarriage have been excluded (see Surgical intervention below). 42 Urinary luteinizing hormone kits indicate the midcycle luteinizing hormone surge that precedes ovulation by one to two days. Techniques for the Resolution of Testicular Obstruction. (PDF, 8 MB) Chapter 78 from textbook, Reconstructive Urology, 1992.

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8 Couples with unexplained infertility may want to consider another year of intercourse before moving to more costly and invasive therapies, such as assisted reproductive technology. These include: Infrequent menstrual periods: When a woman has regular menstrual periods, defined as regular cycles occurring every 21 to 35 days, this almost always indicates that she ovulates regularly. Irregular ovulation can be due to many issues, including polycystic ovary syndrome (PCOS), obesity, being underweight, and thyroid issues. It has been suggested that infertility be classified as a form of disability.[22] Causes[edit] Immune infertility[edit] Antisperm antibodies (ASA) have been considered as infertility cause in around 10–30% of infertile couples.[23] In both men and women, ASA production are directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, inhibiting capacitation and acrosome reaction, impaired fertilization, influence on the implantation process, and impaired growth and development of the embryo. The main side effects are hot flushes, gastrointestinal events (nausea and vomiting), headache, back pain, and leg cramps. The main approach to correcting or removing these uterine abnormalities is by hysteroscopy, a surgical method by which a narrow scope with a camera is placed within the uterine cavity. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. A woman who keeps having miscarriages is also considered infertile. Additionally, the quality of her eggs also decreases increases the chance of chromosomal abnormalities. Regrettably, this often leads to untruly high expectations of assisted reproduction techniques (ART) [40].