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Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55] Another major cause of infertility in women may be the inability to ovulate. After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. Counseling about options should be offered to couples who are not physically able to conceive (i.e., same-sex couples or persons lacking reproductive organs). Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb.

Each country has its own body or bodies responsible for the inspection and licensing of fertility treatment under the EU Tissues and Cells directive [78] Regulatory bodies are also found in Canada [79] and in the state of Victoria in Australia [80] See also[edit] [edit] Inhorn MC (2003). "Global infertility and the globalization of new reproductive technologies: illustrations from Egypt". American Urological Association Education and Research, Inc.

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Semen and sperm Sometimes the sperm cannot travel effectively to meet the egg. Couples who do not conceive after treatment for six cycles with documented ovulation should also consider referral to an infertility specialist. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue. When one year of sexual relationships without birth control measures has not lead to a pregnancy.

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Ejaculatory duct obstruction Complete and partial ejaculatory duct obstruction has been implicated as a cause of 1-5% of patients with male infertility. In order to conceive, your sperm must be:  Highly concentrated — normally, there should be at least 15 million sperm in every ml of semen5  Moving well (motile) — a lashing tail helps your sperm to swim to your partner’s egg  Normally shaped — healthy sperm should be shaped like a streamlined tadpole  You may find that your semen contains a very low number of sperm (oligozoospermia), or no sperm at all (azoospermia).

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Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments. Ovulation should be documented by serum progesterone level measurement at cycle day 21. A luteal phase defect results in low production of the hormone progesterone, which is necessary for maintaining a pregnancy. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Seminoma Discovered in Two Males Undergoing Successful Testicular Sperm Extraction for Intracytoplasmic Sperm Injection. (PDF, 807 KB) Human Reproduction, 1995. Recovery of Spermatogenesis after Testicle Autotransplantation in an Adult Male. (PDF, 2 MB) Fertility and Sterility, 1982. Unexplained infertility is not the same thing as having no explanation, but rather reflects the fact that the tests performed have been normal. An Azoospermic Man with a do novo Point Mutation in the Y-chromosome Gene USP9Y. (PDF, 381 KB) Nature Genetics, 1999. Uterine fibroids Fibroids are noncancerous growths in the uterus.