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Definition “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” NICE guideline, CG156 Primary infertility; couple have failed to conceive before. Secondary infertility; woman has previously been pregnant regardless of the outcome of the pregnancy and now unable to conceive. And as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases as well. Normal fertility is observed in three fourths of patients with unilateral mumps orchitis and in one third of patients in bilateral orchitis. Congenital blockage of the ductal system An increased rate of duct obstruction is observed in children of mothers who were exposed to DES during pregnancy. Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity.

Hysterosalpingography: Fluid is injected into the woman's uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. Treatment of the cause: 30. Unexplained infertility: - Ovarian stimulation should not be considered as does not improve pregnancy or birth rates. - Advise to try to conceive for two years of unprotected sexual intercourse before other options. - After two years of failure to conceive, consider IVF/ICSI. LINDSAY, MD, Saint Louis University Family Medicine Residency, Belleville, Illinois KIRSTEN R. Semen is the milky fluid that a man's penis releases during orgasm. The pathophysiology of the disease is not well understood, but a massive extravascular accumulation of fluid occurs that is associated with a severe depletion of the intravascular volume responsible for dehydration, hemoconcentration, and electrolyte imbalance (ie, hyponatremia, hyperkalemia). [193] Ovarian hyperstimulation syndrome can be mild, moderate, or severe. [194] Mild ovarian hyperstimulation syndrome is characterized by ovarian enlargement (up to 5-12 cm in diameter), minimal ascites, and weight gain of less than 10 lb.

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The Most Common Causes of Male Sterility There are several causes of male sterility, including: Abnormal sperm production Impaired delivery of sperm Testosterone deficiency Genetic defects Undescended testes Also, erectile dysfunction or low libido can make the process of procreation that much more difficult. Fertility treatment with donor eggs is usually done using IVF. Linthicum, Md.: American Urological Association, Inc.; 2010. In humans, infertility is the inability to become pregnant after one year of intercourse without contraception involving a male and female partner.[2] There are many causes of infertility, including some that medical intervention can treat.[3] Estimates from 1997 suggest that worldwide about five percent of all heterosexual couples have an unresolved problem with infertility. The pulsatile nature of GnRH is essential to normal gonadotropin release; a continuous stimulation inhibits their secretion. The initial dose is 500 mg PO qd for 7 days, then 500 mg bid for another 7 days, and, finally, 500 mg tid.

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Management of ejaculatory failure: - Can be of great value as in retrograde ejaculation. Because the sperm have a short life span outside the human body, the semen specimen must be evaluated within a short time frame. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months. For women, being underweight and having extremely low amounts of body fat are associated with ovarian dysfunction and infertility and they have a higher risk for preterm birth.

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Patients present with oligospermia but have LH levels within the reference range. Epidemiology of infertility For healthy young couples, the probability of getting pregnancy per a reproductive cycle is about 20% to 25%. Mumps: If this occurs after puberty, inflammation of the testicles may affect sperm production. This semiautomated technique is thought to potentially standardize the evaluation of semen. Do you have pain with menstrual periods or intercourse? 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.