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Hypogonadotropic Hypopituitarism: Low pituitary gland output of LH and FSH.  This condition arrests sperm development and causes the progressive loss of germ cells from the testes and causes the seminiferous tubules and Leydig (testosterone producing) cells to deteriorate.  May be treated with the drug Serophene.  However, if all germ cells are destroyed before treatment commences, the male may be permanently infertile. Isolated LH deficiency (fertile eunuch) In these patients, LH levels are decreased while FSH levels are within the reference range. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. This may take the form of miscarriages or extrauterine pregnancies. Female age of 35 years or older: For unclear reasons, egg numbers decrease at a rapid rate as women age.

0 (A) The zona pellucida was drilled using piezo pulses, and the pipette was inserted deep into the oocyte and a single piezo pulse was applied. In patients with nonobstructive azoospermia, retrograde ejaculation can be the etiologic factor. [107] The treatment consists of recovering sperm from a urine sample collected immediately after ejaculation.

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In the 1980s, a pure form of FSH became available. The acrosome should be 40-70% of the size of the head, and no mid piece or tail abnormalities should be present. The treatment of uterine malformations depends on the severity of the problem. Prolactinomas or the intakes of dopamine antagonists (typical antipsychotics for example) cause hyperprolactinemia. The second type of laparoscope is very rare in the laparoscope market and in hospitals. Ovulation often can be detected by keeping a menstrual calendar or using an ovulation predictor kit.

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For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. Possible causes include the egg not being released at the right time, the egg’s inability to reach the fallopian tube, or the sperm’s inability to reach the egg. Men with Infertility Caused by AZFc Deletion can Produce Sons by Intracytoplasmic Sperm Injection, but are Likely to Transmit the Deletion and Infertility. (PDF, 102 KB) Human Reproduction, 1999.

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Regression of Metastases after Nephrectomy for Renal Cell Carcinoma. (PDF, 1 MB) British Journal of Urology, 1975. Fibroids should be treated if they are associated with abnormal uterine bleeding or if they are thought to be the cause of infertility. Only an additional 7% of couples will conceive in the second year. Many countries have special frameworks for dealing with the ethical and social issues around fertility treatment. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. If the woman reaches the age of 40 during treatment, complete the current full cycle but do not offer further full cycles. In women aged 40–42 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 1 full cycle of IVF, with or without ICSI. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous.