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Some causes are more common in some countries than others, such as pelvic inflammatory diseases (PID) and sexually transmitted infections (STI) in Africa [10]. 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.

For a man to be fertile, the testicles must produce enough healthy sperm to be ejaculated effectively into the woman's vagina. Testosterone therapy may allow patients to achieve normal height but does not improve spermatogenesis.

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Other symptoms of endometriosis include: chronic pelvic pain (not only during menstruation) pain during sex back pain fatigue nausea irregular periods and spotting bowel problems or pain with bowel movements Dark or pale menstrual blood If menstrual blood is regularly paler than usual, this may be a cause for concern. With irregular periods, the cycle is so unpredictable that it’s impossible to know when the next one will come. This study was carried out in accordance with the requirements of the University of Bristol Regulations and Code of Ethics for Research Programmes. Perspectives on infertility consultations in primary care: a qualitative study.

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We get information regarding the woman's potential for adequate ovarian stimulation with medications by counting antral follicles. Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J. What’s on the Mind of IVF Consumers? (PDF, 627 KB) Reproductive BioMedicine Online, 2009. From that point onwards, there is a progressive decline up to the point when a woman reaches 37 years of age. Many infertile couples have had some previous assessment for their infertility and this data should be cautiously reviewed. Intracytoplasmic Sperm Injection and Infertility. (PDF, 53 KB) Nature Genetics, 2001.

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Other testing may be needed based on circumstances, including testicular biopsy, genetic testing, and imaging (Table 36–8,10,19,20). Follicular puncture Embryo transfer Ovarian stimulation Postcoital test In-vitro cultivation 3. Because of the intimate relationship between the fallopian tubes and the other pelvic organs and because, in the great majority of the cases, peritoneal pathology involves tubal pathology, the treatments of these factors are discussed together. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. The male phenotype proves that androgen was present in utero. ART includes all fertility treatments in which both eggs and sperm are manipulated. Congenital Absence of the Vas Deferens: The Fertilizing Capacity of Human Epididymal Sperm. (PDF, 3 MB) New England Journal of Medicine, 1990. At this point, psychological consultation and support should be provided [44]. Exercise: Both too much and too little exercise can lead to fertility problems.