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It is further sub-divided into primary and secondary sterility. Epidemiological definition of infertility (for monitoring and surveillance) Women of reproductive age (15–49 years) at risk of becoming pregnant (not pregnant, sexually active, not using contraception and not lactating) who report trying unsuccessfully for a pregnancy for two years or more. (Reproductive Health Indicators) Infertility as a disability Disability: Infertility generates disability (an impairment of function), and thus access to health care falls under the Convention on the Rights of Persons with Disability. In one study,  treatment with recombinant HBD1 in asthenozoospermic and leukocytospermic patients who were deficient in HBD1 resulted in improved bactericidal activity and sperm quality, which supports this protein’s role in fertility and its potential role in managing infertility.[28] Other causes Causes of testicular failure also include the following: Granulomatous disease – Leprosy and sarcoidosis may infiltrate the testicle Sickle cell disease – Sickling of cells within the testis leads to microinfarcts Excessive use of alcohol, cigarettes, caffeine, or marijuana Despite a thorough workup, nearly 25% of men have no discernible cause for their infertility. 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. Are Sequence Family Variants Useful for Identifying Deletions in the Human Y Chromosome? (PDF, 377 KB) The American Journal of Human Genetics, 2004.

Chemotherapy Chemotherapy is toxic to actively dividing cells. It has been suggested that infertility be classified as a form of disability.[22] Causes[edit] Immune infertility[edit] Antisperm antibodies (ASA) have been considered as infertility cause in around 10–30% of infertile couples.[23] In both men and women, ASA production are directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, inhibiting capacitation and acrosome reaction, impaired fertilization, influence on the implantation process, and impaired growth and development of the embryo. Consequently, the patient with PCOS becomes responsive to CC ovulation induction. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55] Another major cause of infertility in women may be the inability to ovulate. There is no reliable means to predict whether the use of any treatment option will be successful and after how many attempts.

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Low weight: Obesity is not the only way in which weight can impact fertility. In this article, learn about signs of infertility in both men and women, as well as when to see a doctor. Women attempting pregnancy at age 40 or older have a 50% decreased fertility rate and a two-fold to three-fold increased risk of spontaneous abortion compared with younger women. The final third may be due to a combination of both, other factors, or unknown causes. To help objectify sperm morphology and therefore enhance the consistency and reproducibility among laboratories, Kruger introduced a definition of "strict criteria" in 1986. The woman is instructed to measures her body temperature every morning as soon as she wakes up, before she gets out of bed or before she eats or drinks anything.

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Semen is the milky fluid that a man's penis releases during orgasm. The main reasons for fertility tourism are legal regulation of the sought procedure in the home country, or lower price. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. In 1985, Erich Mühe performed the first laparoscopic cholecystectomy. Varicocele: Surgically removing a varicose vein in the scrotum may help. If this is unsuccessful, the dosage may be increased to 100 mg daily.

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IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems. Many infertile couples have had some previous assessment for their infertility and this data should be cautiously reviewed. Infertility is more likely in men who have had this condition. In order to perform ICSI, an egg is held via a small suction pipette, while one sperm is injected into that egg using a very fine glass needle. An abnormal semen analysis warrants a further evaluation usually by a reproductive urologist. Outcome of Intracytoplasmic Sperm Injection with Testicular Spermatozoa in Obstructive and Non-obstructive Azoospermia. (PDF, 426 KB) Human Reproduction, 1996. It usually involves treatment implication counselling, emotional support counselling, and therapeutic counselling [38,39]. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects.