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18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). At least one open tube is required for IUI, and any sperm abnormality cannot be severe, otherwise the sperm will not be able to swim to and fertilize the egg. Listen to Mr Brook talk about male infertility Find out more about ICSI. In 1901, Georg Kelling of Dresden, Germany, performed the first laparoscopic procedure in dogs, and, in 1910, Hans Christian Jacobaeus of Sweden performed the first laparoscopic operation in humans.[35] In the ensuing several decades, numerous individuals refined and popularized the approach further for laparoscopy.

42 Urinary luteinizing hormone kits indicate the midcycle luteinizing hormone surge that precedes ovulation by one to two days. Signs of infertility include irregular, excessively heavy, or absent periods as well as sudden weight gain, painful sex, or vaginal infections.

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The likelihood of fertilization improves significantly for men with low sperm concentrations. Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women. Although 60% of patients have evidence of antisperm antibodies after vasectomy, the clinical significance has not been completely elucidated.

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Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization. Microsurgery in Clinical Urology. (PDF, 5 MB) Urology, 1975.

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41 Treatment of Unexplained Infertility Jump to section + Couples who have no identified cause of infertility should be counseled on timing of intercourse for the most fertile period (i.e., the six days preceding ovulation). Classic Klinefelter syndrome has a 47, XXY karyotype and is caused by a nondisjunction during the first meiotic division, more commonly of maternal origin; mosaic forms are due to nondisjunction following fertilization. Surgeons must use tools to interact with tissue rather than manipulate it directly with their hands. 6-Mb Deletion of the Human Y Chromosome Persists Through Balance Between Recurrent Mutation and Haploid Selection. (PDF, 295 KB) Nature Genetics, 2003. Dr Barbieri of Harvard Medical School has indicated that cases of anovulation are quite frequent in women with a BMI (body mass index) over 27 kg/m2.[6][7][8] Unfortunately, not only does excess weight have a negative impact on ovulation itself,[9] but also on treatment efficacy and outcomes of ART (assisted reproductive technique).[10][11] Diagnosis[edit] Fertility awareness and LH measurement[edit] Symptoms-based methods of fertility awareness may be used to detect ovulation or to determine that cycles are anovulatory. These time intervals would seem to be reversed; this is an area where public policy trumps science. Secondary infertility When a woman is unable to bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to a live birth, she would be classified as having secondary infertility.