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Twelve months is the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.[7] a woman over 35 has not conceived after six months of contraceptive-free sexual intercourse. A variety of disorders ranging from hormonal disturbances to physical problems, to psychological problems can cause male infertility.  Although many treatment options are now available, in many cases treatment will not work.  In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm.  Once damaged, the testicle will not usually regain its sperm-making capabilities; this aspect of male infertility is analogous to menopause (though not natural like menopause) for women and cannot usually be treated.  Despite medicine�s limited ability to treat male infertility, many successful treatment options are available for its many causes.  Besides testicular damage, the main causes of male infertility are low sperm production and poor sperm quality.   The Causes of Male Infertility Male infertility has many causes--from hormonal imbalances, to physical problems, to psychological and/or behavioral problems.  Moreover, fertility reflects a man�s �overall� health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility--it is not all-inclusive: · Smoking--significantly decreases both sperm count and sperm cell motility. · Prolonged use of marijuana and other recreational drugs. · Chronic alcohol abuse. · Anabolic steroid use--causes testicular shrinkage and infertility. · Overly intense exercise--produces high levels of adrenal steroid hormones which cause a    testosterone deficiency resulting in infertility. · Inadequate vitamin C and Zinc in the diet. · Tight underwear--increases scrotal temperature which results in decreased sperm production. · Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive   substances, mercury,  benzene, boron, and heavy metals · Malnutrition and anemia. · Excessive stress! Compensatory and Obligatory Renal Growth in Rats. (PDF, 1 MB) American Journal of Physiology, 1974.

Pulsatile GnRH and HCG have been used but result in only 20% achieving complete spermatogenesis. 8  A normal sample according to the 2010 World Health Organization (WHO) guidelines is described in Table 2.

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Simultaneous Treatment of the Wife in Infertile Couples with Oligospermia. (PDF, 4 MB) Fertility and Sterility, 1983. Obesity may also lead to less frequent ovulation or to less frequent intercourse, thereby contributing to fertility problems.

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Motility, adhesions and focusses of endometriosis can precisely be assessed by laparoscopy with blue instillation. Handled with pure professionalism and care from the very start!Table of Contents Are you more of a visual learner? Sign up for the free AFP email table of contents.Infertility definitions and terminology A couple sits at the bank of a lake in Ahmedabad, India. The severity usually depends on how near to the testicles the radiation was aimed. Get Permissions Email Alerts Don't miss a single issue.

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Down syndrome These patients have mild testicular dysfunction with varying degrees of reduction in germ cell number. 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. 25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. Sperm are then collected, washed, and added to the eggs in the dish. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation. United Kingdom[edit] In the UK, previous NICE guidelines defined infertility as failure to conceive after regular unprotected sexual intercourse for two years in the absence of known reproductive pathology.[11] Updated NICE guidelines do not include a specific definition, but recommend that "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner, with earlier referral to a specialist if the woman is over 36 years of age."[12] Other definitions[edit] Researchers commonly base demographic studies on infertility prevalence on a five-year period.[13] Practical measurement problems, however, exist for any definition, because it is difficult to measure continuous exposure to the risk of pregnancy over a period of years. Shaban says that by using some combination of ARTs for several months, “most couples can expect a pregnancy between 40 to 50% of the time.” Male infertility treatments to try at home But are there things you can do on your own to maximize your fertility? If the GI symptoms persist, the medication can be administered intravaginally. 42 However, none of these methods has been proven to increase pregnancy rates when used to predict timing of intercourse. Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur. Which drug can be used for induction of ovulation? When clomiphene binds to estrogen receptors in the hypothalamus, it leads to an increase release of an important signaling hormone called GnRH (gonadotropin releasing hormone). Thankfully, even when the cause of infertility is not known, various fertility treatments can overcome the unknown road block that was preventing pregnancy and eventually lead to delivery of a healthy baby. Diagnosis is based on history, physical examination, biochemical evaluation, ultrasonography, and laparotomy.