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Author disclosure: No relevant financial affiliations. CI or intrauterine insemination is the treatment of choice if more than 2 million sperm are recovered after the sperm wash. (See Treatment of Cervical Factors). [106, 109] Patients whose reproductive tract, FSH, LH, and testosterone levels are determined to be normal or those who have low testosterone in the absence of any other hormonal abnormalities can be treated empirically with cycles of CC (25 mg PO qd for at least 6-12 mo). Risk factors for the formation of antisperm antibodies in men include the breakdown of the blood‑testis barrier, trauma and surgery, orchitis, varicocele, infections, prostatitis, testicular cancer, failure of immunosuppression and unprotected receptive anal or oral sex with men.[23][24] Sexually transmitted infections[edit] Infections with the following sexually transmitted pathogens have a negative effect on fertility: Chlamydia trachomatis and Neisseria gonorrhoeae.

Treatment[edit] Treatment depends on the cause of infertility, but may include counselling, fertility treatments, which include in vitro fertilization. Author disclosure: No relevant financial affiliations.

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Careful monitoring during treatment and pregnancy can help reduce the risk of complications. Unexplained Even after a full fertility work-up, for one in five couples an exact cause of infertility cannot be determined. The cause of sterility can also be found in the tubes.

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On Regenerating the Ovary and Generating Controversy. (PDF, 37 KB) Cell, 2005. If the obstruction is caused by salpingitis isthmica nodosa or fibrosis, the best results are achieved through IVF. [142] Surgical preparation for IVF While the surgeon should be as conservative as possible, he or she should consider that the patient is better served with a single well-functioning fallopian tube than with 2 defective tubes, which elicits an increased risk for ectopic pregnancy or recurrence of pelvic adhesions.

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Structural abnormalities in the uterus: these can affect the cervix or the uterine corpus.  Anomalies can be anatomical (septate uterus, T-shaped uterus, etc.) or pathologies that generate embryo implantation issues or issues with how the pregnancy progresses: polyps, endometritis, Asherman's syndrome - synechiae or adherences of the walls of the uterine cavity - or myomas, a benign tumour that generates anatomical distortion and makes getting pregnant complicated (this is one of the most common pathologies but does not necessarily cause fertility issues). The Effect of Female Age and Ovarian Reserve on Pregnancy Rate in Male Infertility: Treatment of Azoospermia with Sperm Retrieval and Intracytoplasmic Sperm Injection. (PDF, 66 KB) Human Reproduction, 1997. Renal Transplantation Between Adults and Children. (PDF, 1 MB) Journal of the American Medical Association, 1974. A variety of hormonal imbalances can affect a man's fertility. Prolonged anestrus may be congenital or acquired. The laboratory evaluation begins with a semen analysis. 3  Sometimes, a couple who’ve already had a child can have trouble conceiving again. Where Dreams are Born. (PDF, 2 MB) Jewish Light, 2010.