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Erectile Disfunction (ED): Also known as impotence, this condition is common and affects 20 million American men.  ED is the result of a single, or more commonly a combination of multiple factors.  In the past, ED was thought to be the result of psychological problems, but new research indicates that 90 percent of cases are organic in nature.  However, most men who suffer from ED have a secondary psychological problem that can worsen the situation like performance anxiety, guilt, and low self-esteem.  Many of the common causes of impotence include:  diabetes, high blood pressure, heart and vascular disease, stress, hormone problems, pelvic surgery, trauma, venous leak, and the side effects of frequently prescribed medications (i.e. Transplantation of a Human Testis for Anorchia. (PDF, 19 MB) Fertility and Sterility, 1978. A postoperative HSG should be performed 2 months later. 8,26,27 As opposed to laparoscopy or hysteroscopy, hysterosalpingography is a minimally invasive procedure with potentially therapeutic effects and should be considered before more invasive methods of assessing tubal patency. These may be purchased over the counter and allow couples to predict the most fertile days in the cycle.

Pregnancy after Vasovasostomy for Vasectomy Reversal: A Study of Factors Followed for 10 Years. (PDF, 3 MB)Human Reproduction, 1989. Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. 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. Y Chromosome Deletions in Azoospermic and Severely Oligozoospermic Men Undergoing Intracytoplasmic Sperm Injection after Testicular Sperm Extraction. (PDF, 336 KB) Human Reproduction, 1998. Another potential symptom is irregular menstruation, where five or more menstrual cycles a year are five or more days shorter or longer than the length of the average cycle. Reduced secretion of cervical mucus due to destruction of the endocervical glands by previous cervical conization, freezing, or laser vaporization responds poorly to low-dose estrogen therapy.

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Some physical effects may also result from treatment. The seminal vesicles provide 40-80% of the semen volume, which includes fructose for sperm nutrition, prostaglandins and other coagulating substances, and bicarbonate to buffer the acidic vaginal vault.

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The couple should have sex at least every two days between the 10th and 18th day after the woman starts her period. In natural intercourse, only a fraction of the sperm make it into the woman’s genital tract. Religious leaders' opinions on fertility treatments; for example, the Roman Catholic Church views infertility as a calling to adopt or to use natural treatments (medication, surgery, or cycle charting) and members must reject assisted reproductive technologies. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.

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In those with azoospermia and a varicocele, sperm may appear after repair in up to one third, but most of these men return to an azoospermic state within a few months. The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[65] Women over the age of 35 should see their physician or WHNP after six months as fertility tests can take some time to complete, and age may affect the treatment options that are open in that case. The Avon Longitudinal Study of Pregnancy and Childhood Study Team. It is an approach to disseminate the recommended medical care of infertile couple to the practicing clinicians. The success rate of IVF for live birth is 40% among women under 35 years of age. The eggs may never be released or they may only be released in some cycles. Prolonged estrus may be caused by ovarian cysts that produce estrogen, functional ovarian tumors, or exogenous estrogens (including human transdermal hormone replacement therapy). It will take time until these studies can be available for clinics and patients as a regularity. Endometriosis (especially if chronic), uterine fibroids (myomas), or an abnormally-shaped uterus might interfere with conception as well.  Age  As women grow older, it usually becomes more challenging for them to conceive.