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Also searched were the Cochrane database, the National Guideline Clearinghouse database, Dynamed, and Essential Evidence Plus. Today, many patients do not receive the recommended medical care that based on the best available evidence [5]. Effects[edit] Psychological[edit] The consequences of infertility are manifold and can include societal repercussions and personal suffering. Acquired anestrus may result from previous oophorectomy, exogenous hormonal treatment (including glucocorticoids), profound hypothyroidism, or ovarian disease (cysts or neoplasia). Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. To Transplant or Not to Transplant – That Is the Question. (PDF, 3 MB) 2010.

Apparent Fertility of Human Spermatozoa from the Caput Epididymidis. (PDF, 4 MB) Journal of Andrology, 1989. Group II: hypothalamic-pituitary-ovarian dysfunction (predominately polycystic ovary syndrome). 38,39 Family physicians may choose to attempt ovulation induction in anovulatory women (WHO group II) with clomiphene. Cholesterol One study has found that high cholesterol levels may have an impact on fertility in women. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes.

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Female Infertility Genetics

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This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. Factors effecting normal expectancy of conception.

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Treatment of tubal obstruction generally requires referral for subspecialty care. Sometimes there may be simple ways to make lifestyle adjustments to improve fertility, while other underlying causes may require treatment. Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way.[21] In the United States some treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for Family and Medical Leave Act leave.

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Prior surgeries Certain surgeries may prevent you from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. Nonchromosomal testicular failure Testicular failure that is nonchromosomal in origin may be idiopathic or acquired by gonadotoxic drugs, radiation, orchitis, trauma, or torsion. In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. Their ability to move (> 60%) and forward progression (more than 2 on a 1-to-4 scale). Pretesticular causes of infertility Pretesticular causes of infertility include congenital or acquired diseases of the hypothalamus, pituitary, or peripheral organs that alter the hypothalamic-pituitary axis. Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive. Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance. These drugs also can also help you get pregnant by causing your ovaries to release multiple eggs. Diagnosis and Management of Hypogonadism, Infertility, and Impotence. (PDF, 13 MB) Chapter 22 of textbook,Male Reproductive Dysfunction, 1986. DEFINITION OF TERMS Source : Endometriosis & infertility PPT Presentation Summary : Fertility Issues. It plays a central role in the multiple imbalances and dysfunctions of polycystic ovary syndrome. Conventional In-vitro Fertilization vs Intracytoplasmic Sperm Injection for Patients Requiring Microsurgical Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1994. In 1978, the first baby was born as a result of IVF.


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See also
Research Topics in Infertility
Infertility in Cushing's
Infertility Treatment for Polycystic Ovarian Syndrome