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What is a Myomectomy?
It is a procedure in which myomas (uterine fibroids) are surgically removed from the uterus
Layers of the uterus affected by the mayoma uteri?
Uterine myomas are also known as uterine fibroids. These fibroids grow from the smooth muscle layer of the uterus. This smooth muscle wall is known as the myometrium. The fibroids are most commonly benign (non-cancerous) tumors that are typically found during a woman's child-bearing years.
What are myomatous changes?
Myomatous changes refer to the development of myomas, which are benign tumors made of muscle tissue. These changes can occur in various organs but are most commonly associated with the uterus (uterine fibroids). Myomatous changes are usually non-cancerous but can cause symptoms such as heavy menstrual bleeding and pelvic pain.
Do mx3 capsule can treat myoma?
MX3 capsules are marketed as a dietary supplement and are often promoted for various health benefits, including support for immune function and overall wellness. However, there is no scientific evidence to support their effectiveness in treating myomas (uterine fibroids). It's essential to consult a healthcare professional for appropriate diagnosis and treatment options for myomas.
How is a coloptomy used in the removal of myomas?
Myomas are fibroid tumors of the muscle tissue of the uterus and they are sometimes removed vaginally by colpotomy.
What are the main causes of myoma?
Myomas, also known as uterine fibroids, are noncancerous growths in the uterus, and their exact cause remains unclear. However, they are believed to be influenced by hormonal factors, particularly estrogen and progesterone, which promote their growth. Genetic predispositions and environmental factors, such as diet and lifestyle, may also play a role in their development. Additionally, obesity and certain reproductive factors, such as early onset of menstruation and having never given birth, can increase the risk of developing myomas.
What are the sign of mayoma?
Signs of myoma, commonly known as uterine fibroids, can vary but often include heavy menstrual bleeding, prolonged periods, pelvic pain or pressure, and frequent urination. Some women may also experience bloating, back pain, or complications during pregnancy. In many cases, myomas are asymptomatic and may be discovered incidentally during routine examinations. If symptoms are present, it's advisable to consult a healthcare professional for proper evaluation and management.
What is the cpt code for myomectomy for excision of fibroid tumors abdominal approach?
58140-Myomectomy, excicion of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach
What does abnormal pap smear means?
It could mean many things, most likely it will go away on its own but you will need to have a pap every six months to keep an eye on it. If its at a higher level then they may have to freeze those cells off. It could be the hpv virus or it could be signs of cervical cancer. Please keep up with your doctor and have it checked regularly. Answer They will check again using a dye to determine the severity. If severe they will do a biopsy.
What is four letter word with as in the middle?
2-letter wordsas3-letter wordsaas, bas, fas, gas, has, kas, las, mas, pas, ras, tas, vas, was4-letter wordsabas, agas, alas, amas, anas, baas, bias, boas, bras, eras, etas, eyas, goas, kaas, keas, koas, kvas, leas, moas, ocas, okas, peas, pias, pyas, rias, ryas, seas, skas, spas, teas, twas, upas, utas, yeas5-letter wordsabbas, aghas, agmas, albas, alfas, algas, alias, almas, amias, angas, anlas, annas, anoas, antas, aquas, areas, arias, arras, atlas, atmas, auras, avgas, babas, balas, bemas, betas, bimas, bolas, boras, botas, buras, cacas, camas, chias, cocas, codas, colas, comas, cycas, cymas, dadas, degas, devas, ditas, divas, donas, dopas, dumas, duras, ephas, etnas, eyras, fetas, fleas, galas, gamas, getas, gigas, glias, hahas, horas, hoyas, hulas, hylas, ideas, iotas, isbas, ixias, javas, jotas, jubas, judas, kakas, kanas, kapas, kavas, kinas, kivas, kolas, lamas, lavas, limas, liras, litas, lotas, lunas, mamas, manas, mayas, mesas, micas, minas, molas, monas, moras, moxas, muras, mynas, nanas, nemas, nipas, nomas, nonas, novas, obias, ohias, okras, ollas, orcas, pacas, papas, paras, picas, pikas, pimas, pinas, pitas, pleas, proas, psoas, pujas, pumas, punas, pupas, ragas, raias, rajas, rayas, rheas, rotas, sagas, sheas, simas, skuas, sodas, sofas, sojas, somas, soras, soyas, stoas, subas, suras, talas, tapas, tepas, texas, togas, tolas, toras, tubas, tufas, tunas, ulnas, ulvas, ureas, uveas, varas, vigas, vinas, visas, vivas, wekas, yogas, yugas, zetas, zoeas6-letter wordsabacas, abakas, abomas, agamas, agoras, agrias, ajivas, ajugas, akelas, aliyas, alohas, alphas, amebas, amigas, anabas, animas, aortas, apneas, arecas, arenas, aromas, babkas, baizas, balsas, belgas, bettas, biogas, biotas, boheas, boylas, bravas, brazas, bunyas, bursas, bwanas, callas, cannas, canvas, capias, ceibas, cerias, cestas, charas, chelas, chinas, chufas, coalas, cobias, cobras, cocoas, colzas, commas, congas, copras, cottas, cuppas, cutlas, dachas, daggas, deltas, dermas, dipsas, doblas, dobras, dogmas, dolmas, dongas, donnas, doumas, douras, dramas, dulias, durras, edemas, enemas, ericas, extras, facias, faenas, fangas, faunas, fellas, ferias, floras, flotas, foveas, fracas, galeas, gambas, gammas, ganjas, genoas, gramas, guavas, gummas, halvas, hamzas, hansas, hennas, hollas, hondas, hookas, hostas, huzzas, hydras, hyenas, ixoras, jagras, jnanas, juntas, kalpas, kappas, karmas, khedas, kiblas, koalas, koppas, kurtas, lamias, lampas, larvas, lauras, lehuas, lemmas, lianas, libras, limbas, limpas, lingas, llamas, loofas, luffas, lyssas, lyttas, madras, mafias, magmas, mambas, mammas, manias, mannas, mantas, matzas, mbiras, meccas, medias, mensas, milpas, mirzas, mochas, mommas, moolas, mudras, mullas, murras, myomas, nachas, ninjas, norias, nubias, nyalas, omegas, operas, outgas, pachas, paisas, pampas, pandas, pangas, parkas, pietas, pinnas, pintas, pizzas, playas, plazas, polkas, poppas, primas, punkas, purdas, quotas, reatas, redias, riatas, riojas, ruanas, rumbas, sabras, saigas, salpas, salsas, sambas, sangas, saunas, scenas, schwas, scubas, selvas, sennas, sepias, shamas, shivas, sigmas, silvas, sirras, softas, spicas, stomas, stupas, sulfas, summas, sunnas, surras, sutras, suttas, sylvas, syngas, tablas, tafias, taigas, tankas, tazzas, teguas, tenias, terras, teslas, tetras, thetas, thujas, thuyas, tiaras, tibias, tineas, tongas, tronas, ulamas, ulemas, ultras, umbras, urbias, usneas, uvulas, vandas, varnas, veenas, vestas, villas, vincas, violas, virgas, vistas, vodkas, volvas, vulvas, wallas, whenas, xenias, yentas, yerbas, yuccas, zamias, zanzas, zebras7-letter wordsabulias, acacias, acedias, aftosas, agendas, ahimsas, albatas, alexias, alpacas, altheas, amoebas, amritas, amusias, anemias, anginas, angoras, anopias, anoxias, anurias, apnoeas, areolas, argalas, aristas, armadas, arnicas, arrobas, ataxias, aucubas, auroras, axillas, azaleas, balatas, balboas, bananas, barytas, befleas, belugas, berthas, bhaktas, bilboas, boccias, bodegas, bonitas, brahmas, bugshas, buqshas, bushwas, cabalas, cabanas, caeomas, calesas, cameras, camisas, canchas, canulas, cardias, carinas, caritas, catenas, cedulas, cesuras, chacmas, chakras, challas, charkas, chimlas, chollas, choreas, chromas, chukkas, cicadas, cicalas, cinemas, citolas, clivias, cloacas, codeias, contras, coppras, copulas, corneas, coronas, coryzas, cowpeas, cuestas, cupolas, curaras, czardas, dagobas, dahlias, datchas, daturas, defleas, dharmas, dharnas, dhooras, dhurnas, duennas, eczemas, elodeas, encinas, enigmas, erratas, eupneas, exactas, fajitas, fanegas, farinas, favelas, fedoras, ferulas, fibulas, fiestas, funkias, galenas, gambias, geishas, geladas, genevas, gliomas, glorias, glossas, goannas, grappas, guineas, halalas, halloas, hamadas, hegiras, hejiras, hernias, hilloas, holloas, hooplas, hulloas, hutzpas, hyaenas, iguanas, impalas, indabas, intimas, jacanas, jarinas, jerboas, jicamas, jojobas, judokas, kabakas, kabalas, kabayas, kahunas, kalmias, kamalas, kerrias, kinemas, kishkas, korunas, kwanzas, lacunas, lagunas, lambdas, laminas, latrias, ligulas, lipomas, lithias, loggias, maculas, maffias, malthas, mananas, manilas, mantras, mantuas, maracas, marinas, markkas, mazumas, medakas, medinas, medusas, metepas, mezuzas, mimosas, misbias, morulas, mucosas, muletas, murrhas, myopias, myricas, myxomas, naganas, nauseas, nebulas, novenas, nutrias, obelias, oedemas, ottavas, paellas, pagodas, pajamas, panadas, panamas, papayas, paruras, patacas, patinas, payolas, pelotas, pesetas, pesewas, phobias, piazzas, picaras, pinatas, piranas, pirayas, pleuras, pneumas, posadas, proteas, psyllas, puranas, pyemias, pyjamas, pyrolas, pyurias, quaggas, quinoas, quokkas, radulas, raffias, ranulas, raphias, redowas, reginas, remoras, remudas, resedas, retinas, rhumbas, rugolas, salinas, salivas, salvias, samaras, samosas, sapotas, sataras, schemas, scillas, scleras, scotias, senecas, senegas, senoras, serosas, shammas, sheilas, sheltas, sherpas, siennas, sierras, siestas, sifakas, silicas, smegmas, sonatas, spireas, sradhas, stadias, stanzas, stellas, stemmas, stigmas, stratas, strumas, sulphas, taenias, taffias, talukas, tantras, taramas, tarsias, teargas, telegas, tephras, terbias, thorias, thulias, torulas, traumas, troikas, tundras, ultimas, uranias, uremias, utopias, vaginas, valutas, verglas, veritas, vicunas, vizslas, whereas, womeras, yantras, yautias, yttrias, zananas, zarebas, zaribas, zenanas, zeugmas, zinnias, zonulas, zoysias, zygomas
What scrabble words end with the letters AS?
2-letter wordsas3-letter wordsaas, bas, fas, gas, has, kas, las, mas, pas, ras, tas, vas, was4-letter wordsabas, agas, alas, amas, anas, baas, bias, boas, bras, eras, etas, eyas, goas, kaas, keas, koas, kvas, leas, moas, ocas, okas, peas, pias, pyas, rias, ryas, seas, skas, spas, teas, twas, upas, utas, yeas5-letter wordsabbas, aghas, agmas, albas, alfas, algas, alias, almas, amias, angas, anlas, annas, anoas, antas, aquas, areas, arias, arras, atlas, atmas, auras, avgas, babas, balas, bemas, betas, bimas, bolas, boras, botas, buras, cacas, camas, chias, cocas, codas, colas, comas, cycas, cymas, dadas, degas, devas, ditas, divas, donas, dopas, dumas, duras, ephas, etnas, eyras, fetas, fleas, galas, gamas, getas, gigas, glias, hahas, horas, hoyas, hulas, hylas, ideas, iotas, isbas, ixias, javas, jotas, jubas, judas, kakas, kanas, kapas, kavas, kinas, kivas, kolas, lamas, lavas, limas, liras, litas, lotas, lunas, mamas, manas, mayas, mesas, micas, minas, molas, monas, moras, moxas, muras, mynas, nanas, nemas, nipas, nomas, nonas, novas, obias, ohias, okras, ollas, orcas, pacas, papas, paras, picas, pikas, pimas, pinas, pitas, pleas, proas, psoas, pujas, pumas, punas, pupas, ragas, raias, rajas, rayas, rheas, rotas, sagas, sheas, simas, skuas, sodas, sofas, sojas, somas, soras, soyas, stoas, subas, suras, talas, tapas, tepas, texas, togas, tolas, toras, tubas, tufas, tunas, ulnas, ulvas, ureas, uveas, varas, vigas, vinas, visas, vivas, wekas, yogas, yugas, zetas, zoeas6-letter wordsabacas, abakas, abomas, agamas, agoras, agrias, ajivas, ajugas, akelas, aliyas, alohas, alphas, amebas, amigas, anabas, animas, aortas, apneas, arecas, arenas, aromas, babkas, baizas, balsas, belgas, bettas, biogas, biotas, boheas, boylas, bravas, brazas, bunyas, bursas, bwanas, callas, cannas, canvas, capias, ceibas, cerias, cestas, charas, chelas, chinas, chufas, coalas, cobias, cobras, cocoas, colzas, commas, congas, copras, cottas, cuppas, cutlas, dachas, daggas, deltas, dermas, dipsas, doblas, dobras, dogmas, dolmas, dongas, donnas, doumas, douras, dramas, dulias, durras, edemas, enemas, ericas, extras, facias, faenas, fangas, faunas, fellas, ferias, floras, flotas, foveas, fracas, galeas, gambas, gammas, ganjas, genoas, gramas, guavas, gummas, halvas, hamzas, hansas, hennas, hollas, hondas, hookas, hostas, huzzas, hydras, hyenas, ixoras, jagras, jnanas, juntas, kalpas, kappas, karmas, khedas, kiblas, koalas, koppas, kurtas, lamias, lampas, larvas, lauras, lehuas, lemmas, lianas, libras, limbas, limpas, lingas, llamas, loofas, luffas, lyssas, lyttas, madras, mafias, magmas, mambas, mammas, manias, mannas, mantas, matzas, mbiras, meccas, medias, mensas, milpas, mirzas, mochas, mommas, moolas, mudras, mullas, murras, myomas, nachas, ninjas, norias, nubias, nyalas, omegas, operas, outgas, pachas, paisas, pampas, pandas, pangas, parkas, pietas, pinnas, pintas, pizzas, playas, plazas, polkas, poppas, primas, punkas, purdas, quotas, reatas, redias, riatas, riojas, ruanas, rumbas, sabras, saigas, salpas, salsas, sambas, sangas, saunas, scenas, schwas, scubas, selvas, sennas, sepias, shamas, shivas, sigmas, silvas, sirras, softas, spicas, stomas, stupas, sulfas, summas, sunnas, surras, sutras, suttas, sylvas, syngas, tablas, tafias, taigas, tankas, tazzas, teguas, tenias, terras, teslas, tetras, thetas, thujas, thuyas, tiaras, tibias, tineas, tongas, tronas, ulamas, ulemas, ultras, umbras, urbias, usneas, uvulas, vandas, varnas, veenas, vestas, villas, vincas, violas, virgas, vistas, vodkas, volvas, vulvas, wallas, whenas, xenias, yentas, yerbas, yuccas, zamias, zanzas, zebras7-letter wordsabulias, acacias, acedias, aftosas, agendas, ahimsas, albatas, alexias, alpacas, altheas, amoebas, amritas, amusias, anemias, anginas, angoras, anopias, anoxias, anurias, apnoeas, areolas, argalas, aristas, armadas, arnicas, arrobas, ataxias, aucubas, auroras, axillas, azaleas, balatas, balboas, bananas, barytas, befleas, belugas, berthas, bhaktas, bilboas, boccias, bodegas, bonitas, brahmas, bugshas, buqshas, bushwas, cabalas, cabanas, caeomas, calesas, cameras, camisas, canchas, canulas, cardias, carinas, caritas, catenas, cedulas, cesuras, chacmas, chakras, challas, charkas, chimlas, chollas, choreas, chromas, chukkas, cicadas, cicalas, cinemas, citolas, clivias, cloacas, codeias, contras, coppras, copulas, corneas, coronas, coryzas, cowpeas, cuestas, cupolas, curaras, czardas, dagobas, dahlias, datchas, daturas, defleas, dharmas, dharnas, dhooras, dhurnas, duennas, eczemas, elodeas, encinas, enigmas, erratas, eupneas, exactas, fajitas, fanegas, farinas, favelas, fedoras, ferulas, fibulas, fiestas, funkias, galenas, gambias, geishas, geladas, genevas, gliomas, glorias, glossas, goannas, grappas, guineas, halalas, halloas, hamadas, hegiras, hejiras, hernias, hilloas, holloas, hooplas, hulloas, hutzpas, hyaenas, iguanas, impalas, indabas, intimas, jacanas, jarinas, jerboas, jicamas, jojobas, judokas, kabakas, kabalas, kabayas, kahunas, kalmias, kamalas, kerrias, kinemas, kishkas, korunas, kwanzas, lacunas, lagunas, lambdas, laminas, latrias, ligulas, lipomas, lithias, loggias, maculas, maffias, malthas, mananas, manilas, mantras, mantuas, maracas, marinas, markkas, mazumas, medakas, medinas, medusas, metepas, mezuzas, mimosas, misbias, morulas, mucosas, muletas, murrhas, myopias, myricas, myxomas, naganas, nauseas, nebulas, novenas, nutrias, obelias, oedemas, ottavas, paellas, pagodas, pajamas, panadas, panamas, papayas, paruras, patacas, patinas, payolas, pelotas, pesetas, pesewas, phobias, piazzas, picaras, pinatas, piranas, pirayas, pleuras, pneumas, posadas, proteas, psyllas, puranas, pyemias, pyjamas, pyrolas, pyurias, quaggas, quinoas, quokkas, radulas, raffias, ranulas, raphias, redowas, reginas, remoras, remudas, resedas, retinas, rhumbas, rugolas, salinas, salivas, salvias, samaras, samosas, sapotas, sataras, schemas, scillas, scleras, scotias, senecas, senegas, senoras, serosas, shammas, sheilas, sheltas, sherpas, siennas, sierras, siestas, sifakas, silicas, smegmas, sonatas, spireas, sradhas, stadias, stanzas, stellas, stemmas, stigmas, stratas, strumas, sulphas, taenias, taffias, talukas, tantras, taramas, tarsias, teargas, telegas, tephras, terbias, thorias, thulias, torulas, traumas, troikas, tundras, ultimas, uranias, uremias, utopias, vaginas, valutas, verglas, veritas, vicunas, vizslas, whereas, womeras, yantras, yautias, yttrias, zananas, zarebas, zaribas, zenanas, zeugmas, zinnias, zonulas, zoysias, zygomas8-letter wordsaboulias, abrosias, acapnias, accidias, acequias, acerolas, acholias, aciculas, actinias, adenomas, agnosias, alamedas, albizias, alfalfas, alforjas, algebras, althaeas, aluminas, amanitas, amboinas, amboynas, amentias, ammonias, amnesias, amphoras, amreetas, anaemias, analgias, anchusas, ancillas, anergias, angarias, angiomas, anhingas, anopsias, anosmias, antennas, antibias, aphagias, aphonias, apraxias, ararobas, arcadias, ariettas, armillas, arugolas, arugulas, atalayas, atresias, aureolas, babesias, baccaras, baklavas, baklawas, bandanas, bandoras, banksias, barillas, bazookas, begonias, berettas, bermudas, bidarkas, birettas, bisnagas, biznagas, boffolas, bohemias, bolivias, bolognas, bonanzas, bravuras, breccias, britskas, britzkas, bubingas, bulimias, cabbalas, cabombas, cadenzas, caesuras, calderas, camelias, camisias, camorras, candelas, candidas, canellas, cannulas, cantalas, cantatas, cantinas, canzonas, carboras, cariocas, catalpas, catawbas, cavallas, cedillas, celestas, celosias, cervelas, chalazas, charkhas, chimeras, choleras, chutzpas, citharas, clarkias, cochleas, codeinas, copaibas, copperas, coquinas, corbinas, cordobas, corollas, corridas, corvinas, curacoas, curcumas, czarinas, daphnias, deciduas, deodaras, deutzias, dhourras, digammas, dilemmas, dioramas, diplomas, diptycas, dongolas, drachmas, droseras, dyspneas, dysurias, echidnas, ectopias, empyemas, ephedras, episcias, eugenias, euglenas, eulogias, eupnoeas, exurbias, falbalas, farinhas, fazendas, feluccas, fermatas, fibromas, fistulas, fontinas, formulas, foveolas, freesias, fuchsias, galabias, galateas, galletas, gerberas, gondolas, gorillas, grandmas, grandpas, granolas, gravidas, gravitas, haftaras, haggadas, halachas, halakhas, hammadas, harianas, hemiolas, hetaeras, hetairas, hexaplas, hosannas, hyponeas, hypoxias, ignatias, ikebanas, impresas, indicias, inertias, infantas, infaunas, ipomoeas, jellabas, kabbalas, kachinas, kalimbas, katcinas, keitloas, khalifas, kitharas, lamellas, lantanas, latakias, lempiras, leucomas, leukomas, lobelias, lordomas, madeiras, madonnas, madronas, magentas, mahatmas, mahonias, majaguas, malaccas, malangas, malarias, mandalas, mandolas, manillas, maniocas, marantas, marimbas, marsalas, matildas, maxillas, mazurkas, medullas, melismas, melodias, meropias, mestizas, militias, minorcas, mochilas, mojarras, monardas, morphias, moviolas, mozettas, myalgias, myelomas, naphthas, neuromas, neurulas, nirvanas, novellas, ocarinas, opuntias, organzas, osmundas, osteomas, otalgias, overseas, paisanas, palabras, palmyras, palookas, panaceas, pancreas, pandoras, panduras, panochas, papricas, paprikas, pareiras, partitas, patellas, pelorias, pembinas, pergolas, perillas, personas, petunias, pintadas, piraguas, piranhas, piscinas, platinas, plugolas, podagras, podestas, pogonias, polentas, polynyas, polyomas, primulas, prosomas, purpuras, pyaemias, pyrexias, queridas, quinelas, quininas, ratafias, regattas, replicas, retsinas, rhodoras, rickshas, ricottas, rikishas, rivieras, roseolas, rotundas, rubellas, rubeolas, sambucas, samsaras, sangrias, sarcomas, sardanas, satsumas, savannas, saxtubas, scandias, scapulas, scopulas, scotomas, senhoras, senopias, sequoias, seriemas, seringas, sestinas, shortias, signoras, silesias, sinopias, spatulas, spiraeas, spirulas, squillas, sraddhas, staminas, sthenias, strettas, subareas, subideas, subpenas, sultanas, synovias, syringas, taffetas, talookas, tambalas, tamburas, tampalas, tantaras, tapiocas, tarantas, tartanas, tavernas, temperas, tempuras, tequilas, tilapias, titanias, toccatas, tombolas, tostadas, toxemias, tracheas, trehalas, tritomas, tsarinas, tuataras, tuateras, turistas, tzarinas, uraemias, urethras, vaccinas, valonias, vanillas, variolas, vedalias, verandas, verbenas, vicugnas, viremias, wakandas, weigelas, whooplas, wommeras, woodsias, woomeras, yamalkas, yamulkas, yeshivas, zamarras, zareebas, zelkovas, zenaidas, zoogleas, zorillas
Infertility?
DefinitionPrimary infertility describes couples who have never been able to become pregnant after at least 1 year of unprotected sex (intercourse).Secondary infertility describes couples who have been pregnant at least once, but have not been able to become pregnant again.Alternative NamesInability to conceive; Unable to get pregnantCauses, incidence, and risk factorsCauses of infertility include a wide range of both physical and emotional factors. A couple's infertility may be due to female factors, male factors, or both:FEMALE INFERTILITY:Female infertility may be due to:Problems with a fertilized egg or embryo being able to survive once it is attached to the lining of the uterusProblems with the fertilized egg being able to attach to the lining of the uterusProblems with the eggs being able to move from the ovary to the uterusProblems with the ovaries producing eggsFemale infertility may be caused by:Autoimmune disorders, such as antiphospholipid syndrome (APS)Clotting disordersDefects of the uterus and cervix (myomas or fibroids, polyps, birth defects)Excessive exercising, eating disorders, or poor nutritionExposure to certain medications or toxinsHeavy use of alcoholHormone imbalance or deficienciesLong-term (chronic) disease, such as diabetesObesityOvarian cystsand polycystic ovary syndrome (PCOS)Pelvic infection or pelvic inflammatory disease(PID)Scarring from sexually transmitted infection or endometriosisTumorMALE INFERTILITY:Male infertility may be due to:A decrease in the number of spermSperm being blocked from being releasedSperm that do not work properlyMale infertility can be caused by:Environmental pollutantsExposure to high heat for prolonged periodsGenetic abnormalitiesHeavy use of alcohol, marijuana, or cocaineHormone deficiency or taking too much of a hormoneImpotenceInfections of the testes or epididymisOlder agePrevious chemotherapyPrevious scarring due to infection (including sexually transmitted diseases), trauma, or surgeryRadiation exposureRetrograde ejaculationSmokingSurgery or traumaUse of prescription drugs, such as cimetidine, spironolactone, and nitrofurantoinIn healthy couples both under age 30, having sex regularly, the chance of getting pregnant is only 25 - 30% per month. A woman's peak fertility occurs in her early 20s. As a woman ages beyond 35 (and especially after age 40), the likelihood of getting pregnant drops to less than 10% per month.When to seek help for infertility depends on your age. For women under age 30, it is generally recommended to try to conceive for at least a year before seeking testing.SymptomsThe physical symptom of infertility is the inability to become pregnant.Experiencing infertility can bring on a range of painful emotions in one or both members of the couple. In general, having at least one child already tends to soften these painful emotions.Signs and testsA complete medical history and physical examination of both partners is essential.Tests in women may include:Blood hormone levelsFSH and clomid challenge test to check ovarian reserveHysterosalpingography(HSG)Pelvic ultrasoundLaparoscopy(especially if endometriosis is suspected)Luteinizing hormone urine test (ovulation predictor kit)Pelvic examProgestin challenge if periods are infrequentSerum progesteroneTemperature first thing in the morning to check for ovulation (basal body temperature charting)Thyroid function testsTests in men may include:Semen analysisTesticular biopsy (rarely done)TreatmentIncrease your chance of becoming pregnant each month by having sexual intercourse at least every 3 days in the weeks leading up to and through the expected time of ovulation. Ovulation occurs about 2 weeks before the next period starts. So, if you get your period every 28 days, you should have sexual intercourse at least every 3 days between the 10th and 18th day after you get your period, and concentrating on the 72 hours before ovulation occurs.Treatment depends on the cause of infertility. It may involve:Education and counselingMedical procedures such as intrauterine insemination (IUI) and in vitro fertilization (IVF)Medicines to treat infections and clotting disorders, or promote ovulationIt is important to recognize and discuss the emotional impact that infertility has on you and your partner, and to seek medical advice from your health care provider.Support GroupsMany organizations provide informal support and referrals for professional counseling. See infertility - support group.Expectations (prognosis)Up to 60% of couples who were considered infertile become pregnant after receiving appropriate therapies (not including advanced techniques such as in vitro fertilization).However, as many as 1 in 5 couples diagnosed as infertile eventually become pregnant without treatment.ComplicationsAlthough infertility itself does not cause physical illness, it can have a major emotional impact on the couples and individuals it affects.Couples may have problems with their marriage. Individuals may experience depression and anxiety.Calling your health care providerCall for an appointment with your health care provider if you are unable to get pregnant.PreventionBecause sexually transmitted infections (STIs) often cause infertility, practicing safer sex behaviors may minimize the risk. Gonorrhea and chlamydia are the two most common causes of STI-related infertility.STIs often don't have symptoms at first, until PID or salpingitis develops. These conditions scar the fallopian tubes and lead to decreased fertility, infertility, or an increased risk of ectopic pregnancy.Getting a mumps vaccine in men has been shown to prevent mumps and its complication, orchitis. The vaccine prevents mumps-related sterility.Some forms of birth control, such as the intrauterine device (IUD), carry a risk for pelvic infection, especially in women with more than one sex partner and when sexually transmitted infections occur.Maintain a healthy diet, weight, and lifestyle to optimize your chances for getting pregnant and having a healthy pregnancy.Remember to take either prenatal or multivitamins containing folate starting before you are trying to become pregnant to decrease your risk for miscarriage and problems with the baby.ReferencesJose-Miller AB, Boyden JW, Frey KA. Infertility. Am Fam Physician. 2007;75(6):894-856.Lobo RA. Infertility: etiology, diagnostic evaluation, management, prognosis. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap 41.Speroff L, Fitz M, eds. Clinical Gynecologic Endocrinology and Infertility. 7th ed. Philadelphia, Pa; Lippincott Williams & Wilkins; 2005.Brassard M, Melk YA, Baillargeon JP. Basic Infertility Including Polycystic Ovary Syndrome. Medical Clinics of North America. Sept 2008;92(5).
