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Programming of Ovarian Stimulation with Norethindrone Acetate in IVF/GIFT Cycles. (PDF, 2 MB) Human Reproduction, 1989. 6-Mb Deletion of the Human Y Chromosome Persists Through Balance Between Recurrent Mutation and Haploid Selection. (PDF, 295 KB) Nature Genetics, 2003.

Polycystic ovary syndrome causes infrequent periods or a total absence of them and is the most common cause of anovulation (an absence of ovulation). Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying. In the majority of cases, there are no obvious symptoms that you may be infertile.

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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. There is a consistent association of Mycoplasma genitalium infection and female reproductive tract syndromes. Patients who are suffering from Stein-Leventhal syndrome (also referred to as polycystic ovary syndrome, or PCOS) can also suffer from anovulation.[3] Up to 90% of cases of anovulation are caused by PCOS; this syndrome is usually hereditary.[4][5] Weight loss or anorexia can also cause hormonal imbalance, leading to irregular ovulation (dysovulation).

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The likelihood of fertilization improves significantly for men with low sperm concentrations. The patients are classified as WHO1 (15%) - hypo-gonadotropic, hypo-estrogenic, WHO2 (80%) - normo-gonadotropic, normo-estrogenic, and WHO3 (5%) - hyper-gonadotropic, hypo-estrogenic.

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Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization. Existing definitions of infertility lack uniformity, rendering comparisons in prevalence between countries or over time problematic. However, a woman who does not ovulate at each menstrual cycle is not necessarily going through menopause. For example; a woman who has no history suggestive of previous pelvic inflammatory disease or endometriosis, there is no justification to request a laparoscopy especially after normal hysterosalpingography study [33]. Epidemiology[edit] Prevalence of infertility varies depending on the definition, i.e. on the time span involved in the failure to conceive. Mumps, leading to orchitis (testicular inflammation), may cause secondary testicular atrophy in the small number of men infected after puberty. Additional risk factors may include smoking, alcohol use, obesity, and older age; however, the data are hampered by a lack of pregnancy-related outcomes. Sterility is classified into two groups, primary and secondary. Other factors, such as luteal phase defect or production of anti-sperm antibodies. A mouse study has suggested that ingredients in some household detergents may reduce fertility. The prevalence varies widely, being less in developed countries and more in developing countries where limited resources for investigation and treatment are available [2].