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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. The prevalence varies widely, being less in developed countries and more in developing countries where limited resources for investigation and treatment are available [2]. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation. Understanding the normal reproductive process is essential in knowing when to seek help. Microsurgery for Vasectomy Reversal and Vasoepididymostomy. (PDF, 13 MB) Urology, 1984.

Hypothyroidism has no effect on male libido or semen quality. Causes of infertility include genetic abnormalities, certain acute and chronic diseases, exposure to certain environmental toxins, smoking, and excessive alcohol use (2).

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Vause TD, Cheung AP, Sierra S, et al.; Society of Obstetricians and Gynecologists of Canada. Known uterine fibroids or endometrial polyps: Uterine abnormalities, such as fibroids that indent the endometrial cavity and endometrial polyps, can impair how the endometrium (the lining of the uterus) and embryo interact to lower implantation and pregnancy rates.

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Hyperandrogenemic ovarian insufficiency is characterized by an immoderate production of androgen. Ap cells mature into B spermatogonia, which then undergo mitotic division to become primary spermatocytes, which are recognized by their large centrally located nuclei and beaded chromatin. The most common identifiable causes of female fertility problems are outlined below: • Ovulatory dysfunction, (or anovulation) where an egg is not released from the ovary every month, is the single most common cause of female infertility.

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Gonadotrophins for idiopathic male factor subfertility. Most of infertile couples are aware of what can be offered to them from the media. This pill generally is taken from menstrual cycle days 3 – 7. Dealing with Fertility Problems After Vasectomy Reversal. (PDF, 7 MB) Contemporary OB/GYN, 1978. A specific portion of the androgen receptor gene, exon 1, has been studied in infertile males and a meta-analysis that involved males with idiopathic infertility and fertile controls found that infertility was directly correlated with the length of CAG repeats in this exon.[23] Y chromosome microdeletion syndrome The long arm of the Y chromosome (Yq) is considered critical for fertility, especially Yq11. Further investigations 18. Laparoscopy: - Invasive procedure. - to check for pelvic disease; such as endometriosis and to check tubal patency. - therapeutic as in laparoscpic myomectomy and ovarian drilling. Hysteroscopy: - to evaluate uterine cavity. - In case of repeated failed IVF cycles. - therapeutic as in intrauterine septum. This results in negative feedback stimulation of the hypothalamic-pituitary axis, causing an increase release of gonadotropins and testosterone. Furthermore, if there is a background of gynaecological or andrological issues in the couple, a study should be carried out as soon as possible. Three main events necessary for pregnancy to occur are: Ovulation: the process by which the mature egg is released from one of the woman’s ovaries. Women presenting with a history of this anomaly should be considered high-risk obstetrical patients. [115] Bicornuate uterus A bicornuate uterus causes only minimal problems with infertility (if any). Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. Treatment of Cervical Factors Chronic cervicitis may be treated with antibiotics. Less common factors The following other factors may also be responsible for infertility in a smaller proportion of cases: • Genetic abnormalities within eggs, sperm or both • An abnormal uterine cavity, including the presence of fibroids or polyps • Immunological infertility, whereby either the male or female partner produces anti-bodies against sperm cells or implantation of an embryo • Abnormal cervical mucus which hinders the passage of sperm to the uterus and fallopian tubes Unexplained infertility Even when investigations have been extensive, some couples will have no reason with which to explain their infertility. Gonadotropins can trigger ovulation when Clomid or Serophene don't work.