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This study was carried out in accordance with the requirements of the University of Bristol Regulations and Code of Ethics for Research Programmes. Some uterine and tubal abnormalities, such as adhesions, uterine septum, or fibromyoma, may be corrected by surgical procedures. Changes in virility, often governed by hormones, could indicate issues with fertility.

The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility. Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability.

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Demographic definitions of infertility An inability of those of reproductive age (15-49 years) to become or remain pregnant within five years of exposure to pregnancy. (DHS2) An inability to become pregnant with a live birth, within five years of exposure based upon a consistent union status, lack of contraceptive use, non-lactating and maintaining a desire for a child. (Trends in prevalence4). In the majority of cases, there are no obvious symptoms that you may be infertile. The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization.

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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. Microscopic Technique for Reversal of Vasectomy. (PDF, 3 MB) Surgery, gynecology & obstetrics, 1976. Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". An abnormal semen analysis warrants a further evaluation usually by a reproductive urologist. Females[edit] The following causes of infertility may only be found in females.

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Women are advised not to use the drug for more than one day. If fimbriectomy was performed, no treatment is available other than IVF. Laparoscopic cholecystectomy is the most common laparoscopic procedure performed. This process bypasses the normal fertilization process, which may be compromised due to poor sperm function. The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. Alcohol: Any amount of alcohol consumption can affect the chances of conceiving. Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate. Ovulatory menstrual periods tend to be regular and predictable in terms of cycle length, duration and heaviness of bleeding, and other symptoms. Tumors Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. Congenital Absence of the Vas Deferens: The Fertilizing Capacity of Human Epididymal Sperm. (PDF, 3 MB) New England Journal of Medicine, 1990.