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Infertility
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Infertility is the failure of a couple to conceive after one year of having regular, unprotected sexual intercourse. In women over the age of 35, it is often prudent to begin an evaluation of the couple after only 6 months. Nearly one in five couples experience infertility and seek treatment. There is a natural decline in fertility that comes with aging; this decline occurs more quickly after age 30. Primary infertility describes a couple who has never conceived, while secondary infertility refers to a couple who has achieved a pregnancy in the past but is unable to do so again. There are some differences in evaluation and treatment for couples with secondary infertility, since theoretically, a couple who previously achieved a pregnancy had all the basic components of their reproductive systems intact.
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Infertility is on the rise in many countries. The proportion of women in the US having their first baby at or after age 30 has quadrupled since the mid-70s. This is important because the probability of having a baby decreases by 3 to 5% a year after age 30 and even faster after age 40. The switch from condoms and diaphragms to nonbarrier methods of contraception has ... raised the risk that an STD (sexually transmitted disease) will compromise the ability to conceive and bear a child.
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Infertility may have profound psychological effects. Partners may become more anxious to conceive, ironically increasing sexual dysfunction. Marital discord often develops in infertile couples, especially when they are under pressure to make medical decisions. Women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer[3]. Even couples undertaking IVF face considerable stress, especially the female partner [4]
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Infertility treatment has risks for both the woman and the baby. Sometimes fertility drugs can enlarge a woman’s ovaries. The woman may feel pain, bloating, nausea or vomiting. If the condition becomes severe, the woman may have to be hospitalized.
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Infertility affects millions of people, both men and women. Although there is no one cause for the inability to have children naturally, many causes have been identified and can be treated. Today, fertility specialists offer many infertility treatment options such as in vitro fertilization (IVF). In vitro fertilization is a procedure in which the sperm and embryo are united in the lab. Other infertility treatment options include intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), the use of donor eggs or donor sperm, surrogacy, and tubal reversal (an operation to “untie” fallopian tubes). In addition to this, advances in genetics allow couples to select the gender if their child or children or to help ensure that their child will not be genetically predisposed to certain disorders (preimplantation genetic diagnosis, or PGD).
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Infertility tests might reveal antisperm antibodies in the female's cervical mucus. If this is the case, intrauterine insemination (IUI) will be a first level treatment. Mild male factor can ... be treated with IUI. If moderate to severe male factor is present, some couples opt to use a donor and some choose IVF combined with intracytoplasmic sperm injection ( ICSI ).
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