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Secondary infertility is used to refer to those cases in which miscarriages occur after having had one successful pregnancy.Infertility has traditionally been thought of as a woman's problem. 1 Among couples 15 to 44 years of age, nearly 7 million have used infertility services at some point.

In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. For example, treatment for Hodgkin disease has been estimated to lead to infertility in as many as 80-100% of patients. Some medications increase the risk of fertility problems in men. Oei SG, Helmerhorst FM, Bloemenkamp KW, Hollants FA, Meerpoel DE, Keirse MJ.

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Hormone changes Signs of hormonal changes can be nonspecific, and a person may not notice them or know the underlying cause. In addition to sperm immobility, patients experience sinusitis, bronchiectasis, and respiratory infections.

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Infection and Disease: Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy.  A low sperm count and low sperm motility are indicators of this condition.  Also, elevated FSH levels and other hormonal problems are indicative of testicular damage.  Some STDs like gonorrhea and chlamydia can cause infertility by blocking the epididimis or tubes.  These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage. Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying. It occurs when a woman either doesn’t ovulate regularly or doesn’t ovulate at all. It makes the pituitary gland release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years.

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Perspectives on infertility consultations in primary care: a qualitative study. Similarly, there is no need for testing tubal patency for couples who will require IVF or ICSI procedure. Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". Psychic causes are possible in women just like they are in men. Female factor Dysfunction of the female reproductive organs is also apparent in around 40% of infertile couples. A sperm count of under 15 million is considered low. The Takeaway Around 15 to 20 percent of couples trying to conceive will have trouble with infertility. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. Oei SG, Helmerhorst FM, Bloemenkamp KW, Hollants FA, Meerpoel DE, Keirse MJ. Endometriosis may be treated through laparoscopic surgery. Prevalence of Premature Ovarian Failure in Monozygotic and Dizygotic Twins. (PDF, 90 KB) Human Reproduction, 2007. Choose a single article, issue, or full-access subscription. Experts differ as to when genetic tests should be done. Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference.