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18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. This procedure can, in selected cases, also be performed laparoscopically, often with the assistance of a robot.Laparoscopy (from Ancient Greek λαπάρα (lapara), meaning 'flank, side', and σκοπέω (skopeo), meaning 'to see') invented by George Kelling in 1901, in Germany, is an operation performed in the abdomen or pelvis using small incisions (usually 0. About 10% of reproductive age women are affected by endometriosis. Around 1/3 of infertility cases are caused by fertility problems in men4 1/3 of infertility cases are caused by fertility problems in women4 1/3 of infertility cases are caused by a mixture of male and female problems, or by problems that cannot be determined4 Infertility doesn’t necessarily mean that you won’t ever have children, but you may need the help of fertility treatment to conceive.

Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome). Most people will have the strong desire to conceive a child at some point during their lifetime. Author disclosure: No relevant financial affiliations.

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6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs. Editorial: The Cure and Proliferation of Male Infertility. (PDF, 2 MB) The Journal of Urology, 1998.

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The corollary to this is that, by definition, failure to conceive in women under 35 isn't regarded with the same urgency as it is in those over 35. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982.

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18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). Benefits of laparoscopy are especially the possibility to simultaneously remove adhesions in one session. Expectant therapy Expectant therapy should be based on a complete workup with diagnosis of very early stages of the disease (minimal) in patients without clinical symptoms, ie, an incidental finding. [145] A second-look laparoscopy is required for follow-up observation within 6-18 months. Symptoms can also depend on what is causing the infertility. Calcification of the Seminal Vesicles and Vas Deferens in a Uremic Patient. (PDF, 3 MB) The Journal of Urology, 1971. Hysterosalpingography: Fluid is injected into the woman's uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. Charting of the menstrual cycle may be done by hand, or with the aid of various fertility monitors. An evaluation by a physician is the only way to sort it out. Female factor Dysfunction of the female reproductive organs is also apparent in around 40% of infertile couples. The idea is that for women beyond age 35, every month counts and if made to wait another six months to prove the necessity of medical intervention, the problem could become worse.