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Infertility

Infertility

Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, including some that medical intervention can treat.

Women

For a woman to conceive, certain things have to happen: intercourse must take place around the time when an egg is released from her ovary; the systems that produce eggs and sperm have to be working at optimum levels; and her hormones must be balanced. Some women are infertile because their ovaries do not mature and release eggs. Other factors that can affect a woman’s chances of conceiving include being over- or underweight, or her age as female fertility declines sharply after the age of 35. Sometimes it can be a combination of factors, and sometimes a clear cause is never established.
Common causes of infertility of females include:

  • Ovulation problems (e.g. polycystic ovarian syndrome)
  • Tubal blockage
  • Pelvic inflammatory disease
  • Age-related factors
  • Uterine problems
  • Previous tubal ligation
  • Endometriosis
  • Advanced maternal age
Men

Male infertility refers to the inability of a male to achieve a pregnancy in a fertile female. In humans it accounts for 40-50% of infertility.  Male infertility is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.  Factors relating to male infertility include:

  • Hypogonadotropic hypogonadism
  • Drugs, alcohol
  • Strenuous riding (bicycle riding, horseback riding)
  • Medications, including those that affect spermatogenesis such as chemotherapy, anabolic steroids, cimetidine, spironolactone; those that decrease FSH levels such as phenytoin; those that decrease sperm motility such as sulfasalazine and nitrofurantoin
  • Tobacco smoking
  • Age
  • Genetic defects on the Y chromosome
  • Mumps
  • Malaria
  • Testicular cancer
  • Vas deferens obstruction
  • Infection, e.g. prostatitis
  • Retrograde ejaculation
  • Ejaculatory duct obstruction
  • Hypospadias
  • Impotence

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