 Anything pertaining to, or affecting reproduction  The physical ability to produce offspring  Awareness of what is normal and abnormal in regards to reproductive organs  Pre-conceptual health (nutrition, activity)  Prenatal health (nutrition, physical activity)

1. Environmental 2. Nutritional 3. Hormonal 4. Sexual History 5. General Health 6. Physiological Response to stress

 No contraception after 12 months of unprotected regular intercourse.  Infertility affects about 10% of young adults  In 40% of the cases, the fertility problem is with males, in 40% of the cases the problem is with the female, and 20% of the cases the problem is unknown.

 Sperm quality (radiation, tight clothing, heat)  Frequency of ejaculation (sperm not ejaculated within 1 month dies and mixes with new sperm thereby decreasing the count of live sperm)  Healthy weight  Healthy nutrition (deficiencies can effect development of sperm)  Alcohol (excess lowers sperm count and interferes with ability to maintain erection)

 PID (Pelvic Inflammatory Disease – scarring of fallopian tubes)  Endometriosis (uterine tissue growing outside the uterus, often on the ovaries)  Cycle irregularities  Smoking – interferes with egg production  Healthy weight and nutrition – % below health weight can interfere with menstrual cycle and obesity can decrease frequency of ovulation

EGG  Inadequate hormone signals from the brain  Stress  Excessive exercise  Excessive weight gain  Smoking, caffeine, alcohol, drugs  Poor nutrition  STI’s  Illness such as diabetes

SPERM  Genetic failure of sperm  Undescended testes  Infection of prostate or seminal vessicle  Smoking, caffeine, alcohol, drugs  Exposure to chemicals, radiation, etc  Poor nutrition  STI’s  Injury to testes

 Individual reactions and emotions  Impact on relationship  The decision to have or not to have a child

 Solving or treating the underlying problem if possible ( chemical, sperm wash, Invitrofertilization)  Adoption  Surrogate mother

1. Ovulation Induction - involves hormonal treatments like fertility pills to stimulate the production of eggs by the ovaries.

. Intrauterine Insemination - Involves isolating healthy male sperm than injecting them into the female uterus to increase the chances of successful conception.

Donor Sperm - Obtaining healthy sperm from a third party donor and injecting it into the female. 4. Donor Egg - Obtaining healthy eggs from a third party donor and implanting them into the female.

5. Tubal Surgery - Involves surgery to repair or open up damaged fallopian tubes to allow the egg to travel down fallopian tubes to the uterus.

Invitro Fertilization - Involves removing a female egg and fertilizing it with male sperm in a test tube, then reimplanting the fertilized egg back into the uterus of the female.

Fertility  Is the viability of a male and female to conceive. It involves the fertilization of female egg by male sperm. Infertility  Is the inability of male and female partners to conceive. You are considered infertile if not pregnant after 1 year of trying to conceive.

 Adopt the role of an advice columnist and respond to the following letter.