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A hypothalamic-hypophyseal ovarian failure can lead to a reduced GnRH production, which, in turn, leads to an insufficient release of LH and FSH. 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.

Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001. Restrict the treatment to 4 ovulatory cycles because 85% of patients conceive by the fourth ovulatory cycle. [204] If pregnancy is not achieved, further evaluation is required to exclude other factors that may be associated with infertility and may interfere with the success of CC therapy.

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Many men with low sperm counts or abnormal semen are still fertile. First, ovarian stimulation takes place; therefore, the patient initially is pre-treated with GnRH-antagonists.

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Having an irregular cycle, including missing periods, can contribute to infertility, as it means a woman may not be regularly ovulating. The Avon Longitudinal Study of Pregnancy and Childhood Study Team.

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Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. This may be because the ovaries do not contain eggs. The Three-kidney Rat Model. (PDF, 2 MB) Investigative Urology, 1974. Ejaculation disorders: If the ejaculatory ducts are blocked, semen may be ejaculated into the bladder Hormonal imbalance: Hypogonadism, for example, can lead to a testosterone deficiency. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes. Clark AM, Thornley B, Tomlinson L, Galletley C, Norman RJ. It is important to undergo a thorough fertility evaluation to determine the problem. Intrauterine insemination is performed during a natural cycle or after ovulation induction with CC or gonadotropins. This can damage the ovaries or fallopian tubes and cause fertility problems. Religious leaders' opinions on fertility treatments; for example, the Roman Catholic Church views infertility as a calling to adopt or to use natural treatments (medication, surgery, or cycle charting) and members must reject assisted reproductive technologies. The basic work-up, or fertility evaluation, includes: Semen analysis of the male partner. 8–16 One retrospective case-control study of 650 men with infertility and 698 control participants questioned the role of environmental risk; no association could be determined after assessing for multiple factors including shift work, stress, and pesticides.