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The general understanding of the word “INFERTILITY” is that despite regular sexual intercourse, without any form of contraception, a couple is unable to get pregnancy. For full understanding the series of tests should be conducted in both the man and woman. In many cases, men are examined for varicocele, which is a mass of dilated veins that develops within the scrotal sac.
Sometimes, during the medical history and initial physical exam, the physician may ask questions about the couple's sexual habits to make sure that sexual intercourse is indeed happening in a way that allows for conception.
Because fecundity (the ability to conceive) naturally decreases as people grow older, making it more difficult to conceive no matter how infertile one or both of the partners is, it is very important to begin diagnosis and treatment for infertility as early as possible. Women who are older than 35 (as well as couples who have been unsuccessful for several years) should have a CCCT (clomiphene citrate challenge test) performed so that their physicians can evaluate their ability to become pregnant on the basis of the number and quality of their remaining eggs.
If FSH levels are up to 15, women still may conceive, although not always with their own eggs.
Almost without exception, women who experience regular, predictable menstrual cycles are ovulating normally.
Blocked tubes and uterine abnormalities account for about 35% of all female infertility cases, thus it's essential that the tubes and uterus be examined during the workup, especially if anovulation doesn't appear to be the problem. Diagnosing uterine or tubal infertility factors usually involves an HSG as the first step and, depending on the results, could require a hysteroscopy or laparoscopy. HSG is an x-ray procedure known as a contrast study, which involves injecting a dye through the cervix into the uterus and fallopian tubes.
Severe hydrosalpinx can only be treated by removing the fallopian tube in a surgical procedure called salpingectomy. HSG is an essential first step for guiding the physician through the rest of the diagnosis and treatment.
While hysteroscopy is not a surgical procedure, laparoscopy and laparotomy are and these procedures are rarely used for diagnostics unless every other option has been explored. HSG should be scheduled before ovulation, so if there is an egg or developing embryo present it doesn't get flushed out when the dye is injected.
A hysteroscopy involves using a telescope-like instrument (called a hysteroscope) that is inserted through the cervix into the uterus and enables the physician to directly examine the inside of the uterus for abnormalities or growths. Like the hysteroscopy, this procedure involves using a long, thin, telescopelike instrument, but the telescope is inserted through the abdomen, not the cervix. The test involves analyzing the level of FSH (follicle-stimulating hormone) in a woman's blood on both the 3rd and 10th day of her period, the time between which she takes 100 mg of clomiphen citrate per day (a drug that induces ovulation and is in fact a frontline treatment for infertility). A semen analysis is a simple test designed to measure the quality and quantity of a man's sperm—how it moves, what it looks like, and how much is present in the semen. A normal sperm count generally means that there are more than 20 million sperm per milliliter of ejaculate, more than 30% of the sperm move normally, and more than 40% of the sperm look normal.
Another sperm parameter that is being used by some reproductive endocrinologists is the sperm DNA fragmentation assay. Damaged DNA in the single sperm cell that fertilizes a female egg can have a major impact on fetal development and on the health of the offspring. Semen samples that contain greater than 30% denatured DNA may result in few pregnancies through fertilization using IVF or ICSI.
As previously talked exists an obvious reality, as these charts demonstrate our hormonal profile is decreasing with age and this has a direct effect on our health and quality of life.
The sarcopenia is degenerative muscle loss due to old age or a drastic decrease in physical activity. A study in New Zealand with women over 80 years reduced by 40% the risk of fall with a program of training focused on strength and structural balance.

It has a direct impact on welfare, self-esteem and general mental state, improving the states of depression significantly due to biochemical changes that occur in the brain during intense exercises are performed.
Strength training is essential for weight control, since individuals who have more muscle mass have higher metabolic rate. Infertility means not being able to get pregnant after one year of trying OR six months, if a woman is 35 or older. The tests are done to check if the woman is ovulating and to look for any abnormalities in her uterus or fallopian tubes.
Varicocele can increase the temperature in the testes and affect sperm factors, such as sperm count.
It provides helpful clues about lifestyle and other factors that may be associated with infertility.
This is especially true for women who are older than 35 years old, since it's around that age that natural fecundity drops dramatically. Women who are experiencing any sort of abnormal bleeding may, on the other hand, be ovulating erratically or not at all.
Anovulation is usually diagnosed by measuring the level of luteinizing hormone (LH) in a woman's urine with a LH predictor kit.
The medical history often provides helpful clues about whether the tubes or uterus are involved. Up to 60% of positive HSGs are false positives, indicating that the tubes may spasmed and not scarred or blocked.
The procedure is usually fairly painless with only minor short-term discomfort, but it can be painful if there are blockages. The procedure is usually done during the first half of a woman's menstrual cycle, before the endometrium thickens, making it difficult to see clearly. It allows doctors to see directly inside the pelvic region and provides them with a close-up view of the fallopian tubes, ovaries, and the uterus. A laparotomy is a major medical procedure, requiring a hospital stay and several weeks recovery time. Women are born with a limited number of eggs, or oocytes, which decrease in number and diminish in quality as they grow older.
After the man ejaculates into a sterile container, his semen is sent to a laboratory where it must be examined within two hours for accurate results. If there are any significant abnormalities, the patient should be referred to a urologist to rule out any correctable diagnoses. Recent research indicates that sperm quality influences not only rates of fertilization, but also subsequent embryo development. Testing is indicated for male partners in couples who have a history of unexplained infertility, poor embryo quality after in vitro fertilization (IVF), implantation failure after IVF, recurrent chemical or occult pregnancy loss, or recurrent early spontaneous abortions. According to a study by the University of Columbia, sarcopenia appear when muscle cells are lost calciumThis limits the ability of contraction of muscle fibers.
Control your PH level in the urine, so that the ratio of acid base balance is not mismatch; so the consumption of vegetables should be present in our diet.
Another study at Tufts University a group of older men and women with severe knee osteoarthritis completed a program of strength training program for 16 weeks.
Muscle is an active tissue that burns calories even at rest, while fat stored just use energy. Once you discover that your couple is infertile, the next step is to check the real cause of infertility.
In men, the infertility workup involves performing a semen analysis to evaluate the quality and quantity of the man's sperm.

It's very important for the physician making the diagnosis to know, for example, whether the woman has endometriosis or has ever been diagnosed with pelvic inflammatory disease, or if the man has ever had testicular mumps or experienced an injury or trauma to his testicles. Acupuncture improves blood flow to the ovaries and increases the delivery of hormones, oxygen, and nutrients, and decreases the excretion of dead cells.
Anovulation - the absence of ovulation - accounts for approximately 25% of all female infertility cases. A lower than normal LH level indicates that the woman is not ovulating, which partially explains her inability to conceive. In most cases, women with no additional pathology are able to become pregnant after surgery.
If there are abnormalities or if initial treatment doesn't work, even though the HSG appeared normal, further surgical evaluation by means of a hysteroscopy, laparoscopy, or laparotomy may be necessary. If the fallopian tube is in fact blocked, it is often blocked by a mucous plug, which often is removed during the HSG procedure. Patients may want to talk to their doctor about taking pain medication before the procedure.
Laparoscopy is a standard exploratory procedure for diagnosing endometriosis, which, if found, may or may not explain a woman's infertility.
A semen analysis should only be performed after 2 or 3 days of abstinence from ejaculation.
The markers of sperm quality used to predict pregnancy outcomes are not parameters included in standard semen analysis (sperm concentration, motility, and morphology) but rather the results of a sperm DNA integrity assay (SDIA). It?s well known that this is a universal law that you can not fight, can not serve as an excuse not to continue on our way and slow the decline or even improve it in any way you can !. But today there is no accepted by science to measure the total loss on the muscle that causes sarcopenia method, but what best results is to determine the degree to which it is the patient is absorbimetry dual x-ray (DEXA) or CT scan of the abdomen with a measurement of the calf to verify existing muscle mass.
A simple way is to go fasting drink a glass of water with lemon or lime juice with flaked salt 30 minutes before breakfast. The results of this 16 weeks program showed that strength training reduced pain by 43%, increased muscle strength and physical performance, improved clinical signs and symptoms of disease and decreased disability. Strength training can increase your metabolic rate up to 15%, being of great help to control and weight loss.
About 50% of men who undergo varicocelectomy to correct infertility father children within the first year. This frequently improves egg quality and can naturally normalize, or at least lower, FSH levels and increase fecundity. The level of progesterone is tested 6 to 8 days after the LH surge that precedes ovulation.
In the case of a hydrosalpinx (a damaged fallopian tube filled with excess fluid), the HSG can evaluate the extent of damage and whether surgery is warranted.
Some physicians recommend two analyses several weeks apart, since sperm counts may fluctuate over time.
SDIA measures DNA damage in sperm reported as DNA fragmentation index (DFI) and high DNA staining (HDS). This is especially true if the man has been sick within the past 90 days, because sperm have about a 90-day life span and are affected by illness.

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