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Factors Affecting Fertility: Timing of Intercourse Intercourse prior to ovulation is key to maximizing the chance of pregnancy. If it stays in there, complications can develop, such as the rupture of the fallopian tube. 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. 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. Some medications increase the risk of fertility problems in men. Signs of infertility in men Signs of infertility in men can include the following: Hormonal imbalances A doctor can test for infertility in men.

Reifenstein syndrome in males involves partial androgen insensitivity in males and presents as a spectrum of abnormal external genitalia and infertility.[22] Because cells inadequately respond to androgen stimulation, spermatogenesis is impaired. Passing very dark, old blood at the beginning of a period can also be a sign of endometriosis. If you and your partner agree, extra embryos can be frozen and saved to use later. Of adults with who are infected with mumps, 25% develop orchitis; two thirds of cases are unilateral, and one third are bilateral. Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis.(PDF, 958 KB) Reproductive BioMedicine Online, 2010.

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The other cases are caused by a mixture of male and female problems or by unknown problems. Full history taking of both partners usually denotes the underlying problem [17-23], (Appendix 1).

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WHO categorizes ovulatory disorders into three groups: group I is caused by hypothalamic pituitary failure (10%), group II results from dysfunction of hypothalamic-pituitary-ovarian axis (85%), and group III is caused by ovarian failure (5%). The effects of age on fertility are moderate and do not begin to take an effect until the late 30s. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Pelvic inflammatory disease or STIs like chlamydia and gonorrhea may cause these blockages in the fallopian tubes.

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This abnormality is usually surgically corrected in infancy. Signs of infertility in women In women, signs of infertility may include: Pain during sex Pain during sex, or dyspareunia, can be a sign of an underlying health problem that may influence a woman's fertility. Genetics of Male Infertility: Evolution of the X and Y Chromosome and Transmission of Male Infertility to Future Generations. (PDF, 10 MB) Chapter 5 from Essential IVF, 2004. 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. If this is unsuccessful, the dosage may be increased to 100 mg daily. Sperm from the head move with immature wide arcs and are generally unable to penetrate the egg, while those from the tail propel forward and have better penetration capacity. Growth of Baby Kidneys Transplanted into Adults. (PDF, 1 MB) Archives of Surgery, 1976. Many more couples, however, experience involuntary childlessness for at least one year: estimates range from 12% to 28%.[4] Male infertility is responsible for 20–30% of infertility cases, while 20–35% are due to female infertility, and 25–40% are due to combined problems in both parts.[2][5] In 10–20% of cases, no cause is found.[5] The most common cause of female infertility is ovulatory problems, which generally manifest themselves by sparse or absent menstrual periods.[6] Male infertility is most commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.[7] Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile for the rest of the menstrual cycle. Author disclosure: No relevant financial affiliations. Outcome of Intracytoplasmic Sperm Injection with Testicular Spermatozoa in Obstructive and Non-obstructive Azoospermia. (PDF, 426 KB) Human Reproduction, 1996. Seminoma Discovered in Two Males Undergoing Successful Testicular Sperm Extraction for Intracytoplasmic Sperm Injection. (PDF, 807 KB) Human Reproduction, 1995. ICSI offers a high pregnancy rate and 70—80 % of eggs are fertilized through this technique. Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance. They can often recommend a counselor and others who can offer appropriate support. 7) Endometriosis: Endometriosis is a condition whereby cells very similar to the ones lining the uterine cavity, or endometrium, are found outside the uterine cavity. Duration of Fertility after Fresh and Frozen Ovary Transplantation. (PDF, 606 KB) Fertility and Sterility, 2010.