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Infertility is not rare affecting
approximately 11% or more of couples at sometime during
their reproductive lives. When a woman is under 35, infertility
is defined as the inability to conceive after one year of
unprotected intercourse. After age 35, infertility is defined
as the inability to conceive after three-six months of unprotected
intercourse. Advancing age has a direct negative effect
on a female's fertility and women >= 35 years of age
should not delay consulting a specialist.
Infertility was once thought
to be a "female problem" and while there are many
causes of female infertility, a male
contributing factor is present in almost half of cases.
The evaluation of the infertile couple should always include
a semen analysis, preferably conducted by a lab with fertility
experience.
Many organ system "disease"
conditions can cause infertility. To achieve pregnancy,
the following steps must occur:
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The male must produce sperm
of sufficient quality and quantity to travel to, and
fertilize the egg.
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The sperm
must be ejaculated into the vaginal tract, travel through
the cervix, and reach the end of the fallopian tubes.
They must not be destroyed by the females immune system.
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The female
must have ovaries that can produce eggs of sufficient
quality to be fertilized.
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Under
hormonal stimulation, the eggs must develop inside the
follicles and be ovulated.
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The eggs
must travel from the ovaries through the fallopian tubes
to the end of the tube where fertilization occurs.
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Through
a complex series of cellular/physiologic events, a sperm
penetrates the egg and cellular division begins.
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The fertilized
egg must travel to and implant in the lining of the
uterus where further development takes place.
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The developing
embryo must be supported throughout the course of the
pregnancy.
A disease affecting
any one (or more) of the above events can cause infertility.
Diseases in the female include: cervical
factor, uterine
factor, tubal
factor, endometriosis,
ovarian dysfunction,
hormonal abnormalities, immune system dysfunction, pelvic
inflammatory disease, and others.
Male
Factor
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