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6 million (6%) married women aged 15–44 years in the United States reported difficulty getting pregnant (3). In-Vitro Fertilization (IVF) Image: “Assisted Reproductive Technology” by BruceBlaus. Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate. Dealing with Fertility Problems After Vasectomy Reversal. (PDF, 7 MB) Contemporary OB/GYN, 1978. Transmission of Male Infertility to Future Generations: Lessons from the Y Chromosome. (PDF, 303 KB) Human Reproduction Update, 2002. A failure of GnRH neurons to migrate to the proper location in the hypothalamus has been implicated.

This test measures the ability of the sperm to penetrate a specially prepared egg from an animal, usually a hamster. Polyps and submucous fibroids can be removed during this procedure. Bhaskar Dutta/Photoshare Clinical definitions Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”… (WHO-ICMART glossary1). “Infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. The presence of open tubes is essential for natural conception, as sperm must traverse the tubes in order to reach and fertilize the ovulated egg.

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One of the common causes of infertility is infrequent intercourse. New Concepts in Operative Andrology: A Review. (PDF, 7 MB) International Journal of Andrology, 2000. Risk factors for both men and women are the same and these include age, stress, being underweight or overweight, diet, smoking, alcohol and drugs. Two hormones signal to the testes to make sperm and testosterone: luteinizing hormone and follicle-stimulating hormone. Both infertility and subfertility are defined as the inability to conceive after a certain period of time (the length of which vary), so often the two terms overlap. The AZFc Region of the Y Chromosome Features Massive Palindromes and Uniform Recurrent Deletions in Infertile Men. (PDF, 5 MB) Nature Genetics, 2001.

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This indicates whether the fallopian tubes are open or blocked. Compensatory and Obligatory Renal Growth in Rats. (PDF, 1 MB) American Journal of Physiology, 1974. The more fetuses there are, the higher the risk of premature labor. Infertility, on the other hand, is the inability to successfully carry a baby to term and give birth; i.e., conception is feasible but the pregnancy cannot be completed. In addition to sperm immobility, patients experience sinusitis, bronchiectasis, and respiratory infections. Alcohol: Any amount of alcohol consumption can affect the chances of conceiving.

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This abnormality is usually surgically corrected in infancy. Fertility Evaluation of the Female Partner: Evidence of Ovulation There are a variety of tests to check if and when the woman is ovulating. Premature Ejaculation: Is defined as an inability to control the ejaculatory response for at least thirty seconds following penetration.  Premature ejaculation becomes a fertility problem when ejaculation occurs before a man is able to fully insert his penis into his partner�s vagina.  Premature ejaculation can be overcome by artificial insemination or by using a behavioral modification technique called the �squeeze technique� which desensitizes the penis. Most often, the problem lies in the process of either making or moving thesperm. Treatment The cost of infertility treatment is high [34]. Treatment of tubal obstruction generally requires referral for subspecialty care. Testicular Transplantation and Autotransplantation. (PDF, 8 MB) Chapter 22 of textbook, Extracorporeal and Microvascular Surgery, 1982. Cystic Fibrosis and Infertility Caused by Congenital Bilateral Absence of the Vas Deferens and Related Clinical Entities. (PDF, 2 MB) Human Reproduction, 1996. Lack of pregnancy Lack of pregnancy can be related to disruption of the cervical mucus, inadequate follicular development, presence of luteinized unruptured follicle syndrome, progesterone deficiency, and premature administration of hCG to trigger 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. Injuries to the bowel can cause a delayed peritonitis. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982. Postcoital testing and antisperm antibody testing are no longer considered useful in this evaluation.