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We recommend immediate evaluation for a couple attempting pregnancy when the woman has a prior history of pelvic infection. Medical conditions Some medical conditions can affect fertility.

Ovarian Hyperstimulation Syndrome (OHSS) The syndrome occurs due to treatment with medicamentous ovulation inductors. The follicle should develop to a diameter of 23-24 mm before a spontaneous LH surge occurs. Trauma, previous attempts at sperm aspiration, and inguinal surgery may also result in ductal blockage. 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. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1.

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Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. Are Sequence Family Variants Useful for Identifying Deletions in the Human Y Chromosome? (PDF, 377 KB) The American Journal of Human Genetics, 2004. In a third of cases, the reason lies only with the man; in another third, it is because of the woman; and in the rest of the cases, it is a combination of both, or the cause is unknown. Infertility in women Infertility is most commonly caused by problems with ovulation, the monthly release of an egg. As a result, infertility has come to be defined as the inability to conceive within 12 months.

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The initial dosage of clomiphene is 50 mg daily for five days starting on day 3 to 5 of the menstrual cycle. Kidney Transplantation in Inbred Rats. (PDF, 6 MB) The American Journal of Surgery, 1973.

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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 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. About 10% of reproductive age women are affected by endometriosis. Through this process, gaps in knowledge and key areas of research required in developing countries and low resource settings will be identified. For instance, women with hyper or hypo-thyroidism sometimes have ovulation problems. The administration of hMG and its derivatives should be under the direct supervision of a reproductive endocrinologist. Sperm production problems One of the most common causes of male infertility is problems with sperm production. The normal working of the male reproductive system involves first the production of sufficient numbers of functional sperm cells and then the delivery of these sperm to the ejaculate.