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ART techniques generally start with stimulating the ovaries to increase egg production. 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. Treatment options available for any particular infertile couple will depend also on the duration of their infertility, which partner is affected, the age of the female partner and if any has a previous children or not, the underlying pathological cause, and if the treatment will be covered by the National Health System (NHS) or funded by their own. Treatment Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health.

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. Treatment of tubal obstruction generally requires referral for subspecialty care.

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When anatomic variance or obstruction is suspected, referral for surgical evaluation and treatment is appropriate. A high serum estradiol level (greater than 60 to 80 pg per mL [220 to 294 pmol per L]) in conjunction with a normal FSH level has also been associated with lower pregnancy rates. Intracytoplasmic Sperm Injection. (PDF, 4 MB) Chapter 47 from textbook Current Therapy in Equine Reproduction, 2006. A history and physical examination can help direct the evaluation. Growth of Baby Kidneys Transplanted into Adults. (PDF, 1 MB) Archives of Surgery, 1976.

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Successful Pregnancy after Microsurgical Transplantation of an Intact Ovary. (PDF, 438 KB) The New England Journal of Medicine, 2008. The Leydig cells in the testicles control the LH, and the cells build androgens. The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop. Tubal occlusion A tubal occlusion means there is a blockage in the fallopian tube. FSH stimulates the Sertoli cells to facilitate sperm production, while LH stimulates testosterone release from the Leydig cells.

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Treatment of Renal Trauma by Angiographic Injection of Autologous Clot. (PDF, 422 KB) British Journal of Urology, 1974. Fertilization: the process that takes place in the fallopian tube, when sperm unites with the egg. Submucosal fibroids: Benign or non-cancerous tumors occur in the muscular wall of the uterus. Combined infertility[edit] In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these conditions. Edwards; the physiologist who developed the treatment, was awarded the Nobel Prize in Medicine in 2010. What’s on the Mind of IVF Consumers? (PDF, 627 KB) Reproductive BioMedicine Online, 2009. Those who prefer surgery first argue that because the size of endometriosis decreases, lesions that cannot be observed during surgery may be present; therefore, the operation is less than ideal and is associated with an increased chance for early recurrence. Where Dreams are Born. (PDF, 2 MB) Jewish Light, 2010. Live Birth Following Day Surgery Reversal of Female Sterilisation in Women Older then 40 Year: A Realistic Option in Australia? (PDF, 156 KB) Medical Journal of Australia, 2007. Sulfasalazine: This anti-inflammatory drug can significantly lower a man's sperm count. Government, the Department of Defense, or the Department of the Air Force. It also shows if there are any abnormalities in the uterine cavity, such as polyps or submucous fibroids; or abnormalities of the tubes, such as evidence of salpingitis. For a woman to conceive, certain things have to happen: vaginal intercourse must take place around the time when an egg is released from her ovary; the system that produces eggs has to be working at optimum levels; and her hormones must be balanced.[54] For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs. What’s on the Mind of IVF Consumers? (PDF, 627 KB) Reproductive BioMedicine Online, 2009.