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Description Infertility is a condition that currently affects some five million Americans. The condition is defined by the inability to conceive a child after having healthy sexual relations for one year without using birth control. The condition can be caused by a problem with either the male or the female reproductive system. In fact, in approximately 40 percent of infertility cases, the problems are attributed to the man; and 40 percent are related to the woman. In approximately 20 percent of infertility cases, no cause is determined. There are a multitude of physical factors, in both men and women, that can lead to infertility. In men, infertility can be caused by impotence, low sperm count, absence of sperm in the semen, or production of malformed sperm. In women, the condition can result from irregular ovulation, obstruction or dysfunction of the fallopian tubes, or abnormalities of the cervix or uterus, such as polyps. One major risk factor for infertility in women is age. Many women today are waiting until their thirties or forties to conceive a child, which increases their risk of becoming infertile. Signs and Symptoms The inability to conceive after one year of regular, unprotected sexual intercourse Conventional Medical Treatment If you (or your partner) are unable to conceive after a year of trying, visit your physician or fertility specialist for a fertility evaluation. This evaluation involves ruling out underlying conditions in both partners that can impair fertility, such as sexually transmitted diseases, an overactive or underactive thyroid, substance abuse, pelvic conditions, and prostate conditions. A man should visit his urologist for an examination and tests, many of which are non-invasive and painless. Usually, ejaculated semen is collected or is examined for quality and quantity. A woman should visit her gynecologist for examination and testing. These tests include any of the following: Hormonal tests to confirm that ovulation is occurring monthly Endometrial biopsy-a small portion of endometrial tissue is tested to determine whether and when ovulation is occurring and whether the uterine lining is hormonally prepared Hysteroscopy-a flexible fiberoptic device used to examine the interior of the cervix and uterus for irregularities Hysterosalpingography-radiography (often performed under general anesthesia) to evaluate the condition of the uterus and fallopian tubes Laparoscopy-an incision is made beneath the navel, and a needle inserted into the abdominal cavity to test whether there are any block ages in the fallopian tubes and uterus If any of these tests reveal an underlying condition that is affecting fertility, the condition is treated and fertility may be restored. For example, if a man has a low sperm count, artificial insemination-implanting healthy donor sperm into a woman's uterus-is one option. Women who do not produce eggs regularly may be prescribed a medication-such as clomipene citrate (Clomid) or human menopausal gonadotropin (Pergonal)-to induce ovulation or encourage the body to produce more than one egg at a time. For those in whom no precise cause for infertility is found, or for whom other treatments have failed, there are still available options. In vitro fertilization, a form of assisted fertility, is one possibility. During this procedure, the man's sperm and an egg extracted from the woman are combined in a petri dish; the fertilized egg is then implanted into the woman's uterus. It is important to remember that many of these tests and therapies are stressful, expensive, and time-consuming. Counseling is often essential for the couple experiencing infertility.
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