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Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity. 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. Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW.

High-cost treatments are out of financial reach for some couples. On Regenerating the Ovary and Generating Controversy. (PDF, 37 KB) Cell, 2005. 2 This encompasses couples with infertility and impaired ability to get pregnant, but it does not capture those who are not married, so actual numbers may be underestimated.

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Basal body temperatures are no longer considered a reliable indicator of ovulation, and are not recommended for evaluating ovulation. Prevalence of Premature Ovarian Failure in Monozygotic and Dizygotic Twins. (PDF, 90 KB) Human Reproduction, 2007.

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Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. Infertility caused by DNA defects on the Y chromosome is passed on from father to son. Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count. Female age of 35 years or older: For unclear reasons, egg numbers decrease at a rapid rate as women age. Cervical factors are also thought to play a minor role, although they are rarely the sole cause.

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Many more couples, however, experience involuntary childlessness for at least one year: estimates range from 12% to 28%.[4] Male infertility is responsible for 20–30% of infertility cases, while 20–35% are due to female infertility, and 25–40% are due to combined problems in both parts.[2][5] In 10–20% of cases, no cause is found.[5] The most common cause of female infertility is ovulatory problems, which generally manifest themselves by sparse or absent menstrual periods.[6] Male infertility is most commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.[7] Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile for the rest of the menstrual cycle. The farther from the scrotum, and the longer duration that the testicle resides outside the scrotum, the greater the likelihood of infertility. A low testosterone level with a low FSH level signals a secondary cause. Unexplained fertility affects about 10 percent of couples worldwide. Many cases are treated with medication or may require surgical procedures. Hjollund NH, Storgaard L, Ernst E, Bonde JP, Olsen J. Psychological/Physical/Behavioral Problems: Several sexual problems exist that can affect male fertility.  These problems are most often both psychological and physical in nature:  it is difficult to separate the physiological and physical components. Ovulation disorders About one quarter of infertility cases are due to ovulation disorders. The HSG is usually scheduled between days 6 and 13 of the cycle - after bleeding and before ovulation. As the duration of treatment prolonged, psychological suffering is likely to increase [6].