Guys advice here please, i have been trying to get my wife pregenant?

she won't go to the dr. cause she thinks she is fine, does anyone know how to inprove my sperm count without going to the dr. and is there any guys out there that r depressed cause they want to a child with the woman they love, please any advice will so greatly appericatedGuys advice here please, i have been trying to get my wife pregenant?
Original Article:http://www.mayoclinic.com/health/inferti鈥?/a>





Infertility


Introduction


You and your partner have tried for months, perhaps for even more than a year. But despite sexual intercourse without birth control, you've been unable to conceive a child.


If you've been trying to conceive for more than a year, there's a good chance that something may be interfering with your efforts to have a child. Infertility, also known as subfertility, is the inability to conceive a child within one year. 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.


Infertility differs from sterility. Being sterile means you're unable to conceive a child. With sterility, you or your partner has a physical problem that precludes the ability to conceive. A diagnosis of infertility simply means that becoming pregnant may be a challenge rather than an impossibility.


Signs and symptoms


Most men with fertility problems have no signs or symptoms. Some men with hormonal problems may note a change in their voice or pattern of hair growth, enlargement of their breasts, or difficulty with sexual function. Infertility in women may be signaled by irregular menstrual periods or associated with conditions that cause pain during menstruation or intercourse.


Causes





The human reproductive process is complex. To accomplish a pregnancy, the intricate processes of ovulation and fertilization need to work just right. For many couples attempting pregnancy, something goes wrong in one or both of these complex processes and causes infertility. Because of the intricate series of events required to begin a pregnancy, many factors may cause a delay in starting your family.


Every month the pituitary gland in a woman's brain sends a signal to her ovaries to prepare an egg for ovulation. The pituitary hormones 鈥?follicle-stimulating hormone (FSH) and luteinizing hormone (LH) 鈥?are involved in stimulating the ovaries to bring an egg to ovulation. A large boost in LH carries a message to the ovarian follicle to release its egg (ovulate). A woman is most fertile at the time of ovulation 鈥?around day 14 of her menstrual cycle 鈥?although the exact time of ovulation varies among women due to different lengths of menstrual cycles.


The egg is then captured by a fallopian tube and is viable for about 24 hours, but its best chance of being fertilized is within the first 12 hours following ovulation. For pregnancy to occur, a sperm must unite with the egg in the fallopian tube during this time. Sperm are capable of fertilizing the egg for up to 72 hours and must be present in the fallopian tube at the same time as the egg for conception to occur. If fertilized, the egg moves into the uterus two to four days later. There it attaches to the uterine lining and begins a nine-month process of growth.


In order for a sperm to reach an egg, many factors are involved in the male fertility process. There must be enough sperm, they must be of the right shape and they must move in the right way. There must be enough semen to transport the sperm. The man also needs to be able to have an erection, and must be able to ejaculate the semen and deliver it into the vagina.


The cause or causes of infertility can involve one or both partners. For many couples having problems with fertility, the male partner is either the sole or a contributing cause. Problems with female fertility are common as well, but present less often than those in the male partner. In both men and women, multiple factors can account for difficulty with fertility. Sometimes the problem isn't really one of infertility, but a more general sexual problem such as erectile dysfunction. Other times, the problem may involve an abnormality in the structure of the reproductive hormones or organs. Certain infections and diseases also can affect fertility.


Causes of male infertility


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:


路Impaired shape and movement of sperm. Sperm must be properly shaped and able to move rapidly and accurately toward the egg for fertilization to occur. If the shape and structure (morphology) of the sperm are abnormal or the movement (motility) is impaired, sperm may not be able to reach the egg.


路Absent sperm production in testicles. Complete failure of the testicles to produce sperm is rare, affecting very few infertile men.


路Low sperm concentration. A normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. A count of 10 million or fewer sperm per milliliter of semen indicates low sperm concentration (subfertility). A count of 40 million sperm or higher per milliliter of semen indicates increased fertility.


路Varicocele. A varicocele is a varicose vein in the scrotum that may prevent normal cooling of the testicle and raise testicular temperature, preventing sperm from surviving.


路Undescended testicle (cryptorchidism). This occurs when one or both testicles fail to descend from the abdomen into the scrotum during fetal development. Undescended testicles can cause mild to severely impaired sperm production. Because the testicles are exposed to the higher internal body temperature compared to the temperature in the scrotum, sperm production may be affected.


路Testosterone deficiency (male hypogonadism). Infertility can result from disorders of the testicles themselves, or an abnormality affecting the hypothalamus or pituitary glands in the brain that produce the hormones that control the testicles.


路Klinefelter's syndrome. In this disorder of the sex chromosomes, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production. Testosterone production also may be lower.


路Infections. Infection may temporarily affect sperm motility. Repeated bouts of sexually transmitted diseases (STDs), such as chlamydia and gonorrhea, are most often associated with male infertility. These infections can cause scarring and block sperm passage. Mycoplasma is an organism that may fasten itself to sperm cells, making them less motile. If mumps, a viral infection usually affecting young children, occurs after puberty, inflammation of the testicles can impair sperm production. Inflammation of the prostate (prostatitis), urethra or epididymis also may alter sperm motility.


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:


路Sexual issues. Often treatable, problems with sexual intercourse or technique may affect fertility. Difficulties with erection of the penis (erectile dysfunction), premature ejaculation, painful intercourse (dyspareunia), or psychological or relationship problems can contribute to infertility. Use of lubricants such as oils or petroleum jelly can be toxic to sperm and impair fertility.


路Retrograde ejaculation. This occurs when semen enters the bladder during orgasm rather than emerging out through the penis. Various conditions can cause retrograde ejaculation including diabetes, bladder, prostate or urethral surgery, and the use of psychiatric or antihypertensive drugs.


路Blockage of epididymis or ejaculatory ducts. Some men are born with blockage of the part of the testicle that contains sperm (epididymis) or ejaculatory ducts. And some men who seek treatment for infertility lack the tubes that carry sperm (vasa deferentia).


路No semen (ejaculate). The absence of ejaculate may occur in men with spinal cord injuries or diseases. This fluid transports sperm through the penis into the vagina.


路Misplaced urinary opening (hypospadias). A birth defect can cause the urinary (urethral) opening to be abnormally located on the underside of the penis. If not surgically corrected, this condition can prevent sperm from reaching the cervix.


路Anti-sperm antibodies. Antibodies that target sperm and weaken or disable them usually occur after surgical blockage of part of the vas deferens for male sterilization (vasectomy). Presence of these antibodies may complicate the reversal of a vasectomy.


路Cystic fibrosis. Men with cystic fibrosis often have missing or obstructed vasa deferentia.


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:


路Emotional stress. Stress may interfere with certain hormones needed to produce sperm. Your sperm count may be affected if you experience excessive or prolonged emotional stress. A problem with fertility itself can sometimes become long term and discouraging, producing more stress. Infertility can affect social relationships and sexual functioning.


路Malnutrition. Deficiencies in nutrients such as vitamin C, selenium, zinc and folate may contribute to infertility.


路Obesity. Increased body mass may be associated with fertility problems in men.


路Cancer and its treatment. Both radiation and chemotherapy treatment for cancer can impair sperm production, sometimes severely. The closer radiation treatment is to the testicles, the higher the risk of infertility. Removal of one or both testicles due to cancer also may affect male fertility. You may want to consider freezing (cryopreserving) your sperm before cancer treatment to ensure future fertility.


路Alcohol and drugs. Alcohol or drug dependency can be associated with general ill health and reduced fertility. The use of certain drugs also can contribute to infertility. Anabolic steroids, for example, which are taken to stimulate muscle strength and growth, can cause the testicles to shrink and sperm production to decrease.


路Other medical conditions. A severe injury or major surgery can affect male fertility. Certain diseases or conditions, such as diabetes, thyroid disease, HIV/AIDS, Cushing's syndrome, anemia, heart attack, and liver or kidney failure, may be associated with infertility.


路Age. A gradual decline in fertility is common in men older than 35.


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:


路Pesticides and other chemicals. Herbicides and insecticides may cause female hormone-like effects in the male body and may be associated with reduced sperm production. Exposure to such chemicals also may contribute to testicular cancer. Men exposed to hydrocarbons, such as ethylbenzene, benzene, toluene, xylen and aromatic solvents used in paint, varnishes, glues, metal degreasers and other products, may be at risk of infertility. Men with high exposure to lead also may be more at risk.


路Testicular exposure to overheating. Frequent use of saunas or hot tubs can elevate your core body temperature. This may impair your sperm production and lower your sperm count.


路Substance abuse. Cocaine or heavy marijuana use may temporarily reduce the number and quality of your sperm.


路Tobacco smoking. Men who smoke may have a lower sperm count than do those who don't smoke.


Causes of female infertility


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:


路Ovarian cysts (endometriomas). Ovarian cysts may indicate advanced endometriosis and often are associated with reduced fertility. Endometriomas can be treated with surgery.


路Scar tissue. Endometriosis may cause rigid webs of scar tissue between the uterus, ovaries and fallopian tubes. This may prevent the transfer of the egg to the fallopian tube.


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:


路Direct injury to the hypothalamus or pituitary gland


路Pituitary tumors


路Excessive exercise


路Anorexia nervosa


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:


路Autoimmune disease. The body produces antibodies to attack its own tissue, in this case the ovary. This may be associated with hypothyroidism (too little thyroid hormone).


路Radiation or chemotherapy for the treatment of cancer.


路Tobacco smoking.


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:


路Medications. Temporary infertility may occur with the use of certain medications. In most cases, fertility is restored when the medication is stopped.


路Thyroid problems. Disorders of the thyroid gland, either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism), can interrupt the menstrual cycle and cause infertility.


路Cancer and its treatment. Certain cancers 鈥?particularly female reproductive cancers 鈥?often severely impair female fertility. Both radiation and chemotherapy may affect a woman's ability to reproduce. Chemotherapy may impair reproductive function and fertility more severely in men than in women.


路Other medical conditions. Medical conditions associated with delayed puberty or amenorrhea, such as Cushing's disease, sickle cell disease, HIV/AIDS, kidney disease and diabetes, can affect a woman's fertility.


Risk factors


Many of the risk factors for both male and female infertility are the same. They include:


路Age. Age is the strongest predictor of female fertility. After about age 32, a woman's fertility potential gradually declines. A woman does not renew her oocytes (eggs). Infertility in older women may be due to a higher risk of chromosomal abnormalities that occur in the eggs as they age. Older women are also more likely to have health problems that may interfere with fertility. The risk of miscarriage also increases with a woman's age. A gradual decline in fertility is possible in men older than 35.


路Tobacco smoking. Women who smoke tobacco may reduce their chances of becoming pregnant and the possible benefit of fertility treatment. Miscarriages are more frequent in women who smoke.


路Alcohol. There's no certain level of safe alcohol use during conception or pregnancy.


路Body mass. Extremes in body mass 鈥?either too high (body mass index, or BMI, of greater than 25.0) or too low (BMI of lower than 20.0) 鈥?may affect ovulation and increase the risk of infertility.


路Being overweight. Among American women, infertility often is due to a sedentary lifestyle and being overweight.


路Being underweight. Women at risk include those with eating disorders, such as anorexia nervosa or bulimia, and women following a very low-calorie or restrictive diet. Strict vegetarians also may experience infertility problems due to a lack of important nutrients such as vitamin B-12, zinc, iron and folic acid. Marathon runners, dancers and others who exercise very intensely are more prone to menstrual irregularities and infertility.


When to seek medical advice


In general, don't be concerned about infertility unless you and your partner have been trying regularly to conceive for at least one year. However, if you plan to conceive and you're a woman older than 30 or haven't had a menstrual flow for longer than six months, seek a medical evaluation. If you have a history of irregular or painful menstrual cycles, pelvic pain, endometriosis, pelvic inflammatory disease (PID) or repeated miscarriages, schedule a consultation with your doctor sooner. If you're a man with a low sperm count or a history of testicular, prostate or sexual problems, consider seeking help earlier.


Screening and diagnosis


If you and your partner are unable to achieve conception within a reasonable time and would like to do so, seek help. The woman's gynecologist, the man's urologist or your family doctor can determine whether there's a problem that requires a specialist or clinic that treats infertility problems.


Some infertile couples have more than one cause of their infertility. Thus, your doctor will usually begin a comprehensive infertility examination of both you and your partner.


Before undergoing infertility testing, be aware that a certain amount of commitment is required. Your doctor or clinic will need to determine what your sexual habits are and may make recommendations about how you may need to change those habits. The tests and periods of trial and error may extend over several months.


Evaluation is expensive and in some cases involves operations and uncomfortable procedures, and the expenses may not be reimbursed by many medical plans. Finally, there's no guarantee, even after all testing and counseling, that conception will occur. However, for couples who are eager to have their own child, such an evaluation is best. It may result in a successful pregnancy.


Tests for men


For a man to be fertile, the testicles must produce enough healthy sperm, and the sperm must be ejaculated effectively into the woman's vagina. Tests for male infertility attempt to determine whether any of these processes are impaired.


路General physical examination. This includes examination of your genitals and questions concerning your medical history, illnesses and disabilities, medications and sexual habits.


路Semen analysis. Your doctor may ask for a specimen of ejaculated semen. This is generally obtained by masturbating or by interrupting intercourse and ejaculating your semen into a clean container. Your doctor will provide instructions. Such a specimen may be required more than once. A laboratory analyzes your semen specimen for quantity, color and presence of infections or blood. Detailed analysis of the sperm also is done. The laboratory will determine the number of sperm present and any abnormalities in the shape and movement (motility) of the sperm. Often sperm counts fluctuate from one specimen to the next.


路Hormone testing. A blood test to determine the level of testosterone and other male hormones is common.


Tests for women


For a woman to be fertile, the ovaries must release healthy eggs regularly, and her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes for a possible union. Her reproductive organs must be healthy and functional.


After your doctor asks questions regarding your health history, menstrual cycle and sexual habits, you'll undergo a general physical examination. This includes a regular gynecologic examination. Specific fertility tests may include:


路Confirmation of ovulation. A blood test is sometimes performed to determine the levels of hormones involved in successful ovulation.


路Hysterosalpingography. This test evaluates the condition of your uterus and fallopian tubes. Fluid is injected into your uterus, and an X-ray is taken to determine whether the fluid progresses out of the uterus and into your fallopian tubes and general peritoneal cavity. Blockage or problems often can be located and may be corrected with medication or surgery.


路Laparoscopy. Performed under general anesthesia, this surgical procedure involves inserting a thin viewing device into your abdomen and pelvis to examine your fallopian tubes, ovaries and uterus. A small incision (8 to 10 millimeters) is made beneath your navel, and a needle is inserted into your abdominal cavity. A small amount of gas (usually carbon dioxide) is inserted into the abdomen to create space for entry of the laparoscope 鈥?an illuminated, fiber-optic telescope.


The most common problems identified by laparoscopy are endometriosis and scarring. Your doctor can also detect blockages or irregularities of the fallopian tubes and uterus. Often a blue dye is injected into the cervical canal and through the uterus and fallopian tubes to determine whether they are open. At the end of the procedure, the gas and laparoscope are drawn out and the incision is closed. Laparoscopy generally is done on an outpatient basis.


路Basal body temperature. Although this test was once a standard, basal body temperature charting is used less often today. Charting a woman's body temperature doesn't give as precise time of ovulation as earlier believed.


路Urinary luteinizing hormone (LH) detector kits. A number of at-home kits are available to test your LH level. Although these kits may be helpful, they also can be inaccurate and misleading. Consult your doctor before using one.


路Ovarian reserve testing. Testing may be done to determine the potential effectiveness of the eggs after ovulation. This approach often begins with hormone testing early in a woman's menstrual cycle.


Not everyone needs to undergo all, or even many, of these tests before the cause of infertility is found. Which tests are used and their sequence depend on discussion and agreement between you and your doctor.


Unexplained infertility


In some infertile couples, no specific cause is found (unexplained infertility). Couples receiving the diagnosis of unexplained infertility are more likely to seek multiple health care providers and be influenced by the experiences of family and friends or literature that promises new hope. Although infertility is unexplained, the pregnancy rate for these couples is among the highest.


Complications


Complications of being infertile often involve strong emotions and may trigger negative feelings between you and your partner. These may include:


路Depression


路Guilt


路Anger


路Stress


路Disappointment


路Resentment


路Blame


路Fear of losing partner because of infertility


路Diminished confidence and self-esteem


Treatment


Treatment of infertility depends on the cause, the duration of the problem, the age of the partners and their specific wishes. Some causes of infertility can't be corrected. However, various means of insemination or embryo transfer may be possible so that a woman can still become pregnant.


Nonsurgical fertility treatment falls into two main categories:


路Restoring or bringing about fertility


路Assisted reproductive technology (ART)


Restoring or bringing about fertility


These approaches can involve steps related to the male or to the female, or both.


Sperm survive in the female reproductive tract for up to 72 hours, and an egg can be fertilized for up to 24 hours after ovulation. Increasing the frequency of intercourse increases the chances for conception.


Other approaches that involve the male include:


路Treatment of general sexual problems. Addressing impotence or premature ejaculation can improve fertility. Treatment for these problems often is with medication or behavioral approaches.


路Addressing lack of sperm. When the source of infertility lies in the man's sperm, or lack of it, restoring or initiating fertility is sometimes possible. For example, in some instances, surgical correction of a varicocele will restore fertility. Problems with the testicles, prostate gland, seminal vesicle and urethra also can be treated. When sperm production is impaired because of damage to the sperm-producing areas of the testicle, drug treatment has little benefit. In rare instances when sperm production is impaired because of a pituitary problem, treatment with pituitary hormones called gonadotropins may help. When infection hampers sperm production, both you and your partner will need treatment.


Fertility drugs (ovulation induction)


Fertility drugs are the primary treatment for women who are infertile due to ovulation disorders. These medications regulate or induce ovulation. In general, they exert actions designed to work like natural follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Commonly used fertility drugs include:


路Clomiphene citrate (Clomid, Serophene). This drug is taken orally and stimulates ovulation in women who have PCOS or other ovulatory disorders. It causes the pituitary gland to release more FSH and LH, which stimulate the growth of an ovarian follicle containing an egg.


路Human menopausal gonadotropin, or hMG (Repronex, Pergonal). This injected prescription medication is for women who don't menstruate on their own due to the failure of the pituitary gland to stimulate ovulation. Unlike clomiphene, which stimulates the pituitary gland, hMG and other gonadotropins directly stimulate the ovaries. This drug contains both FSH and LH.


路Follicle-stimulating hormone, or FSH (Gonal-F, Follistim, Bravelle). FSH is essentially hMG without the LH. Like hMG, it works by stimulating the ovaries to mature egg follicles.


路Human chorionic gonadotropin, or hCG (Ovidrel, Pregnyl). Used in combination with clomiphene, hMG and FSH, this drug stimulates the follicle to release its egg (ovulate).


路Gonadotropin-releasing hormone (Gn-RH) analogs. This treatment is for women with irregular ovulatory cycles or who ovulate prematurely 鈥?before the lead follicle is mature enough 鈥?during hMG treatment. Gn-RH analogs deliver constant Gn-RH to the pituitary gland, which alters hormone production, so that a physician can induce follicle growth with FSH.


路Letrozole (Femara). This drug is in a class of medications called aromatase inhibitors, which are approved for treatment of advanced breast cancer. Doctors sometimes prescribe letrozole for women who don't ovulate on their own and who haven't responded to treatment with clomiphene citrate. Letrozole is not approved by the U.S. Food and Drug Administration for inducing ovulation. The drug's manufacturer has warned doctors not to use the drug for fertility purposes because of possible adverse health effects. These adverse effects may include birth defects and miscarriage.


路Metformin (Glucophage). This oral drug is taken to boost ovulation. It's used when insulin resistance is known or suspected.


路Bromocriptine. This medication is for women whose ovulation cycles are irregular due to elevated levels of prolactin, the hormone that stimulates milk production in new mothers. Bromocriptine inhibits prolactin production.


Injectable fertility drugs significantly increase the chance of multiple births. The use of these drugs requires careful monitoring with a combination of blood tests of hormones and ultrasound measurement of ovarian follicle size. Generally, the greater the number of fetuses, the higher the risk of premature labor. Babies born prematurely are at increased risk of health and developmental problems. The risk is greater for triplets than it is for twins or single pregnancies.


The risk of multiple pregnancies can be reduced. If a woman requires an hCG injection to trigger ovulation, and ultrasound exams show that too many follicles have developed, she and her doctor can decide to withhold the hCG injection. For many couples, however, the desire to become pregnant overrides concerns about conceiving multiple babies.


When too many babies are conceived, removal of one or more fetuses (multifetal pregnancy reduction) can offer improved survival odds for the surviving fetuses. This presents serious emotional and ethical challenges for many people. If you and your partner are considering fertility drug treatment, discuss this possibility with your doctor before starting treatment.


There may be a link between fertility drugs and an increased, long-term risk of ovarian cancer. However, the association between fertility drugs and ovarian cancer hasn't been confirmed.


Surgery


Depending on the cause, surgery may be a treatment option for infertility. Blockages or other problems in the fallopian tubes usually can be surgically repaired. Laparoscopy allows delicate operations on the fallopian tubes.


Infertility due to endometriosis often is more difficult to treat. Although hormones such as those found in birth control pills are effective for treating endometriosis and relieving pain, they haven't been useful in treating infertility. If you have endometriosis, your doctor may treat you with ovulation therapy, in which medication is used to stimulate or regulate ovulation, or in vitro fertilization, in which the egg and sperm are joined in the laboratory and transferred to the uterus.


Assisted reproductive technology (ART)


ART has revolutionized the treatment of infertility. Each year thousands of babies are born in the United States as a result of ART. Medical advances have enabled many couples to have their own biological child. An ART health team includes physicians, psychologists, embryologists, laboratory technicians, nurses and allied health professionals who work together to help infertile couples achieve pregnancy.


The most common forms of ART include:


路In vitro fertilization (IVF). This is the most effective ART technique. IVF involves retrieving mature eggs from a woman, fertilizing them with a man's sperm in a dish in a laboratory and implanting the embryos in the uterus three to five days after fertilization. IVF often is recommended as a first-line therapy and is the treatment of choice if both fallopian tubes are blocked. It's also widely used for a number of other conditions, such as endometriosis, unexplained infertility, cervical factor infertility, male factor infertility and ovulation disorders.


路Electroejaculation. Electric stimulus brings about ejaculation to obtain semen. This procedure can be used in men with a spinal cord injury who can't otherwise achieve ejaculation.


路Surgical sperm aspiration. This technique involves removing sperm from part of the male reproductive tract such as the epididymis, vas deferens or testicle. This allows retrieval of sperm if blockage is present.


路Intracytoplasmic sperm injection (ICSI). This technique consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure. ICSI has been especially helpful in couples who have previously failed to achieve conception with standard techniques. For men with low sperm concentrations, ICSI dramatically improves the likelihood of fertilization.


路Assisted hatching. This technique attempts to assist the implantation of the embryo into the lining of the uterus.


ART works best when the woman has a healthy uterus, responds well to fertility drugs, and ovulates naturally or uses donor eggs. The man should have healthy sperm, or donor sperm should be available. The success rate of ART gradually diminishes after age 32.


Complications of treatment


Certain complications exist with the treatment of infertility. These include:


路Multiple pregnancy. Although the most common complication of ART is multiple pregnancy, ART isn't the direct cause of a number of the extreme cases of septuplets or octuplets reported in the media. The number of quality embryos kept and matured to fetuses and birth ultimately is a decision made by the couple. If too many babies are conceived, the removal of one or more fetuses (multifetal pregnancy reduction) is possible to improve survival odds for the other fetuses.


路Ovarian hyperstimulation syndrome (OHSS). If overstimulated, a woman's ovaries may enlarge and cause pain and bloating. Mild to moderate symptoms often resolve without treatment, although pregnancy may delay recovery. Rarely, fluid accumulates in the abdominal cavity and chest, causing abdominal swelling and shortness of breath. This accumulation of fluid can deplete blood volume and lower blood pressure. Severe cases require emergency treatment. Younger women and those who have polycystic ovary syndrome have a higher risk of developing OHSS than do other women.


路Bleeding or infection. As with any invasive procedure, there is a risk of bleeding or infection.


路Low birth weight. The greatest risk for low birth weight is a multiple pregnancy. In single live births, there may be a greater chance of low birth weight associated with ART.


路Birth defects. Significant concern exists regarding the possible relationship between ART and birth defects. More research is necessary to confirm these findings. Weigh this factor if you're considering whether to take advantage of this treatment. ART is the most successful fertility-enhancing therapy to date.


Prevention


Most types of male infertility aren't preventable. However, avoid drug and tobacco use and excessive alcohol consumption, which may contribute to male infertility. Also, high temperatures can affect sperm production and motility. Although this effect is usually temporary, avoid hot tubs and steam baths.


If you're a man who's uncertain about whether you would eventually like to become a father, don't undergo permanent sterilization, such as a vasectomy. Although surgery to reverse this condition is possible, risks are involved that could affect fertility in other ways.


A woman can increase her chances of becoming pregnant in a number of ways:


路Exercise moderately. Regular exercise is important, but if you're exercising so intensely that your periods are infrequent or absent, your fertility is likely to be impaired.


路Avoid weight extremes. Being overweight or underweight can affect your hormone production and cause infertility.


路Avoid alcohol, tobacco and street drugs. These substances may impair your ability to conceive or produce a healthy child. Don't drink alcohol or smoke tobacco. Avoid illegal drugs such as marijuana and cocaine.


路Limit medications. The use of both prescription and nonprescription drugs can decrease your chance of getting pregnant or keeping a pregnancy. Talk with your doctor about any medications you take regularly.


Coping skills


Coping with infertility can be difficult. It's an issue of the unknown 鈥?you can't predict how long it will last or what the outcome will be. Infertility isn't necessarily solved with hard work. The emotional burden on a couple is considerable, and plans for coping can help.


Planning for emotional turmoil


路Set limits. Decide in advance how many and what kind of procedures are emotionally and financially acceptable for you and your partner and attempt to determine a final limit. Fertility treatments may be expensive and often not covered by insurance companies, and a successful pregnancy often depends on repeated attempts. Some couples become so focused on treatment that they continue with fertility procedures until they are emotionally and financially drained.


路Consider other options. Determine alternatives 鈥?adoption, donor sperm or egg, or even having no children 鈥?as early as possible in the fertility process. This can reduce anxiety during treatments and feelings of hopelessness if conception doesn't occur.


路Talk about your feelings. Locate support groups or counseling services for help before and after treatment to help endure the process and ease the grief should treatment fail.


Managing emotional stress during treatment


路Acupuncture. This ancient therapy may benefit couples who are undergoing fertility treatment.


路Practice relaxation. Cognitive behavior therapy, which uses methods that include relaxation training and stress management, has been associated with higher pregnancy rates.


路Express yourself. Reach out to others rather than repressing guilt or anger.


路Stay in touch with loved ones. Talking to your partner, family and friends can be very beneficial. The best support often comes from loved ones and those closest to you.


Managing emotional effects of the outcome


路Failure. The emotional stress of failure can be devastating even on the most loving and affectionate relationships and for people who've prepared well for the possibility of failure. Don't hesitate to seek professional help if the emotional burdens become too heavy for you or your partner.


路Success. Some studies have indicated that even if fertility treatment is successful, women experience increased stress and fear of failure during pregnancy. Other research suggests that women who achieved pregnancy using fertility treatments felt increasingly better and had higher self-esteem and less anxiety as the pregnancy progressed than did women whose pregnancies didn't involve medical intervention.


路Multiple births. A successful pregnancy that results in multiple births introduces new complexities and emotional problems. The risk of depression is higher in women who have multiple births.


路Parenting. Once a child arrives, parents are more likely to be more anxious and have less confidence and self-esteem. Discuss becoming parents with your partner and plan for the many changes 鈥?challenging and rewarding 鈥?that a child will bring to your lives.











By Mayo Clinic Staff


Jun 15, 2006


漏 1998-2006 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. ';Mayo,'; ';Mayo Clinic,'; ';MayoClinic.com,'; ';Mayo Clinic Health Information,'; ';Reliable information for a healthier life'; and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.





Watch these videos, they may help!


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http://video.google.com/videoplay?docid=鈥?/a>Guys advice here please, i have been trying to get my wife pregenant?
Wear boxers. If the ';boys'; are hot because they are too close to your body heat, it can lower your sperm count. Taking vitamins like vitamin E and zinc, and even altering your diet can also increase sperm counts. Don't take really hot baths or showers either (for the same reason). Stress, smoking, and being overweight can also decrease counts. How long have you been trying? It can sometimes take 6 months or more for a couple to conceive, even if neither partner have any problems. There are many books on the subject. I suggest you do some research at a library.
How is she on wetness/dryness. My husband and I have to use lubes often. We already have a daughter, so dryness doesn't predict fertility. But, we found a lube that is better for trying to conceive because it has the same Ph Balance as sperm. It's called PreSeed..google it! Make sure no spit is added to the baby making if you know what I mean because it harms sperm.


After finishing, make sure she lays there for 20-30 mins to allow sperm to not have to fight gravity. This is optional, but with our first, I would prop my legs against the head board. Don't know if that helped, but we did get prenant within the first 6 wks of trying. We also had sex a couple times a day in succession, but that was luck that my hubbys sperm seemed strong. We are TTC and will find out soon if these methods have worked in our favor again.


Best of luck to you and your wife!
ok, to start you need to make sure that both of you are relative stress free because stress makes it hard for the sperm to reach the egg, second the need (and this is the tricky part) to try to give her miltiple orgasms, studies show that women who have miltiple orgasms have a higher chance of retaining sperm. keep trying with the kid and good luck
first off, stop trying; just have lots of sex and enjoy it.





Second for you - go commando to allow your scrotum to control the positioning of your testicles for maximum sperm production; underwear inhibit the natural action of warmign and cooling and can lower yoru count.





third, avoid medications and other ingestables that will interfere with normal functioning. Also, get more exercise together by walking or swimming or whatever. And make sur eyou are both eating well, sleeping well and generally feeling good.





fourth, remove stress whether at work or school ro at home. Relax; life is too short to spend it being all steressed out over things especially if they are things you can;t change anyway.





sixth, get romantic - both of you need ot be a cross between a hopeless romantic and a horny teenager. Put that zing back into yoru life together as well as your sex. Try new ways, be spontaneous and even go for erotic weekends in a remote chalet or whaerever you can escape to.





seventh - if nothign works after three months then it;s time to take yoru genitals to a doctor and get them thoroughly checked. Insist yoru doctor examine everything and check your sperm count as well. If he finds a problem then you can work with yoru doctor on it. If you are okay then it is her turn to see her doctor. I always suggest the guy go frst since it is muich easier and less invasive (although still embarassing) for a guy to strip off and get all his private parts examined).