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About
Male Infertility
Female Infertility
Causes
Symptoms
Prevention
Aazoospermia
Oligospermia
Necrospermia
Antisperm Antibodies
Premature Ejaculation
Erectile Dysfunction
Testicular Problems
Low Testosterone
Varicocele
Prostatitis
Infections and Infertility
Blood in Semen
Male Infertility and Obesity
Immunology
of Male InfertilityStructural Problems
Male Biological Clock
Understanding Semen Analysis
Retrograde Ejaculation
Increase Male Fertility
Evaluation of Male Infertility
Male Reproductive Physiology
IVF - In Vitro Fertilization Tips
What is ICSI?
Predetermining Sex of Your Child
Pus in Semen
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>>> Click to watch video ![]() Infertility If getting pregnant has been a challenge for you and your partner, you're not alone. Ten percent to 15 percent of couples in the United States are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year. If you've been trying to conceive for more than a year, there's a chance that something may be interfering with your efforts to have a child. Infertility may be due to a single cause in either you or your partner, or a combination of factors that may prevent a pregnancy from occurring or continuing.
What is Infertility?
Most experts define infertility as not being able to get pregnant after at least one year of trying. Women who are able to get pregnant but then have repeat miscarriages are also said to be infertile.
Is Infertility a Common Problem? About 12 percent of women (7.3 million) in the United States aged 15-44 had difficulty getting pregnant or carrying a baby to term in 2002, according to the National Center for Health Statistics of the Centers for Disease Control and Prevention. Is Infertility Just a Woman's Problem?
No, infertility is not always a woman's problem. In only about one-third of cases is infertility due to the woman (female factors). In another one third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors. Over the past twenty years, fertility problems have increased dramatically. At least 25 percent of couples planning a baby will have trouble conceiving, and more and more couples are turning to fertility treatments to help them have a family. What is the cause? From a medical point of view, infertility is believed to be caused by the following factors, and in these proportions. Problem Percentage of Causes
Causes of Infertility
In Male
A number of causes exist for male infertility that may result in impaired sperm count or mobility, or impaired ability to fertilize the egg. The most common causes of male infertility include abnormal sperm production or function, impaired delivery of sperm, conditions related to a man's general health and lifestyle, and overexposure to certain environmental elements: Abnormal Sperm Production or Function. Most cases of male infertility are due to sperm abnormalities, such as:
In many instances, no cause for reduced sperm production is found. When sperm concentration is less than 5 million per milliliter of semen, genetic causes could be involved. A blood test can reveal whether there are subtle changes in the Y chromosome. Impaired Delivery of Sperm
Problems with the delivery of sperm from the penis into the vagina can cause infertility. These may include:
General Health and Lifestyle
A man's general health and lifestyle may affect fertility. Some common causes of infertility related to health and lifestyle include:
Environmental Exposure
Overexposure to certain environmental elements such as heat, toxins and chemicals can reduce sperm count either directly by affecting testicular function or indirectly by altering the male hormonal system. Specific causes include:
In Female
The most common causes of female infertility include fallopian tube damage or blockage, endometriosis, ovulation disorders, elevated prolactin, polycystic ovary syndrome, early menopause, benign uterine fibroids and pelvic adhesions: Fallopian Tube Damage or Blockage
This condition usually results from inflammation of the fallopian tube (salpingitis). Chlamydia is the most frequent cause. Tubal inflammation may go unnoticed or cause pain and fever. Tubal damage with scarring is the major risk factor of a pregnancy in which the fertilized egg is unable to make its way through the fallopian tube to implant in the uterus (ectopic pregnancy). One episode of tubal infection may cause fertility difficulties. The risk of ectopic pregnancy increases with each occurrence of tubal infection. Endometriosis
Endometriosis occurs when the tissue that makes up the lining of the uterus grows outside of the uterus. This tissue most commonly is implanted on the ovaries or the lining of the abdomen near the uterus, fallopian tubes and ovaries. These implants respond to the hormonal cycle and grow, shed and bleed in sync with the lining of the uterus each month, which can lead to scarring and inflammation. Pelvic pain and infertility are common in women with endometriosis. Infertility in endometriosis also may be due to:
Ovulation Disorders
Some cases of female infertility are caused by ovulation disorders. Disruption in the part of the brain that regulates ovulation (hypothalamic-pituitary axis) can cause deficiencies in luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Even slight irregularities in the hormone system can affect ovulation. Specific causes of hypothalamic-pituitary disorders include:
Elevated Prolactin (Hyperprolactinemia)
The hormone prolactin stimulates breast milk production. High levels in women who aren't pregnant or nursing may affect ovulation. An elevation in prolactin levels may also indicate the presence of a pituitary tumor. In addition, some drugs can elevate levels of prolactin. Milk flow not related to pregnancy or nursing (galactorrhea) can be a sign of high prolactin. Polycystic Ovary Syndrome (PCOS)
An increase in androgen hormone production causes PCOS. In women with increased body mass, elevated androgen production may come from stimulation by higher levels of insulin. In lean women, the elevated levels of androgen may be stimulated by a higher ratio of luteinizing hormone (LH). Lack of menstruation (amenorrhea) or infrequent menses (oligomenorrhea) are common symptoms in women with PCOS. In PCOS, increased androgen production prevents the follicles of the ovaries from producing a mature egg. Small follicles that start to grow but can't mature to ovulation remain within the ovary. A persistent lack of ovulation may lead to mild enlargement of the ovaries. Without ovulation, the hormone progesterone isn't produced and estrogen levels remain constant. Elevated levels of androgen may cause increased dark or thick hair on the chin, upper lip or lower abdomen as well as acne and oily skin. Early Menopause (Premature Ovarian Failure)
Early menopause is the absence of menstruation and the early depletion of ovarian follicles before age 35. Although the cause is often unknown, certain conditions are associated with early menopause, including:
Benign Uterine Fibroids
Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s. Occasionally they may cause infertility by interfering with the contour of the uterine cavity, blocking the fallopian tubes. Pelvic Adhesions
Pelvic adhesions are bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery. They may limit the functioning of the ovaries and fallopian tubes and impair fertility. Scar tissue formation inside the uterine cavity after a surgical procedure may result in a closed uterus and ceased menstruation (Asherman's syndrome). This is most common following surgery to control uterine bleeding after giving birth. Other Causes A number of other causes can lead to infertility in women:
Risk FactorsMany of the risk factors for both male and female infertility are the same. They include:
What's Normal? Most pregnancies occur during the first six cycles of intercourse in the fertile phase. Overall, after 12 months of unprotected intercourse, approximately 85 percent of couples will become pregnant. Over the next 36 months, about 50 percent of the remaining couples will go on to conceive spontaneously. Conditions Affecting Both Partners
A number of factors that affect males and females alike can increase the risk of infertility. Perhaps the most common problem is age the older a person is, the more difficult it is to become pregnant. Over the last 20 to 30 years there has been a trend to delay childbearing, often until women are in their 30s. A woman reaches her peak fertility at age 18 or 19, with little change until the mid-20s. As she approaches age 30, her hormone levels start to decline and her fertility also begins a slow decline, with a more rapid decline after age 35. Menopause, which occurs in the late 40s to early 50s in most women, marks the end of a woman’s natural ability to bear children. A man’s fertility decline is not as rapid and has no clear-cut end point, but a man of 50 has lower hormone levels and is likely less fertile than he was at age 25 or 30.What Are Infertility, Sub fertility, and Sterility?
Doctors use these and other terms to define different types of fertility-related conditions. Even so, the definitions of the above terms have changed as technology has advanced. Sterility is the absolute inability to procreate. For instance, a woman has no uterus or a man has no testes (the male sex organs). In years past, a woman with blocked fallopian tubes or a man with an obstructed vas deferens would be considered sterile and beyond help. With the advent of assisted reproductive technology (ART), however, this is no longer the case. Many couples who were once in this category can now get help. Infertility is usually defined as the inability to achieve pregnancy after one year of frequent, unprotected intercourse. This is not an exact measurement. Over time many couples in this category may, in fact, achieve pregnancy. Statisically, after five years, nearly one half of so-called "infertile" couples do conceive. Subfertility is used to describe the gray area between normal fertility and sterility; the term is often used interchangeably with infertility. Fecundability, from "fecunditas," the Latin word for fertility, is the average pregnancy rate after one menstrual cycle. The normal rate in humans is 20%. Seventy-five percent of normally fertile couples are expected to have conceived in six months, and almost 100% by one year. Normal fertility can be considered from the point of view of the couple, the female, or the male. We are going to look at male fertility its biological steps and mechanisms, defects, the causes of those defects and what can be done to remedy them. Normal Male Fertility
As male factors have been increasingly implicated as a major cause of infertility, investigators have focused on the underlying physical processes in men. If the sperm count is low, then why? Or, if the sperm count is normal, why do the sperm not fertilize? That there are literally dozens of factors leading to a completely normal spermatozoon, the form of sperm that is present in semen. These involve the structure of the testis; the hormones that influence its function; the receptors for these hormones; the maturation process through which the germ cell develops into a spermatozoon; the composition of the seminal plasma; and all the enzymes, receptors, and reactions that make the sperm capable of fertilizing the egg. In these steps, there are dozens of occasions for mistakes and problems. Normal Female Fertility
Knowing your own body and being able to tell when you are fertile or ovulating is an important skill that every woman should have. You will save yourself an enormous amount of worry and anxiety when you get to know your body and can control your risk of unwanted pregnancy. The fact is that there are only certain times during your menstrual cycle when you are fertile or can get pregnant in. So it pays off to know when those times are. Your body will give you clear clues and signals as to when fertility is approaching and happening. A woman is fertile when she is ovulating and for a few days before ovulation when fertile cervical mucus is present. Ovulation usually occurs mid cycle. More precisely, ovulation usually occurs 14 days before the onset of bleeding. Not at day 14 of the menstrual cycle as is commonly believed. However - ovulation can be upset and delayed by many factors, eg, sickness, alcohol, travel, stress etc which is why simply counting the days can be inaccurate. You will find your success in tracking your fertility will be far greater when you become adept at recognizing your own personal fertility signals rather than just counting the days. Ovulation can also spontaneously occur during your natal lunar phase. Your natal lunar (moon) phase fertile time can occur at any time during your menstrual cycle, including before, during and after your period. Your natal lunar fertile time is individual to you and is calculated from your birth data - it is all to do with which phase of the moon you were born under. COMPLETE TREATMENT
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