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The Use of Epididymal Sperm in Assisted Reproduction. (PDF, 8 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. Religious leaders' opinions on fertility treatments; for example, the Roman Catholic Church views infertility as a calling to adopt or to use natural treatments (medication, surgery, or cycle charting) and members must reject assisted reproductive technologies. Guidance from the National Institute for Health and Care Excellence (NICE) says women under the age of 42 should be offered three full cycles of IVF, with access for same-sex couples if surrogacy or privately funded fertility treatment fails. Ross says it might suggest a blockage in the “plumbing” that can be corrected with surgery. This semiautomated technique is thought to potentially standardize the evaluation of semen. Risk factors for male infertility include obesity, age (over 40 -- yes, men also have biological clocks), current or previous infection of an STD, smoking, or excessive drinking.

Calcification of the Seminal Vesicles and Vas Deferens in a Uremic Patient. (PDF, 3 MB) The Journal of Urology, 1971. Another requirement for male fertility is a normal ductal system. The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. Lifetime prevalence of infertility and infertility treatment in the UK: results from a population-based survey of reproduction. Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995. Infection and Disease: Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy.  A low sperm count and low sperm motility are indicators of this condition.  Also, elevated FSH levels and other hormonal problems are indicative of testicular damage.  Some STDs like gonorrhea and chlamydia can cause infertility by blocking the epididimis or tubes.  These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage.

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Unhealthy living and poor eating habits, as well as exposure to toxic substances such as alcohol, tobacco and other contaminants, also have a negative impact on fertility. These specimens benefit most from layering a washed pellet of sperm with nutrient media and allowing the motile fraction to swim up into the media before being separated. [109] After sperm preparation, the spermatozoa are enhanced in motility and become activated and ready to fertilize an oocyte. 33 Use of antioxidants such as zinc, vitamin E, or l-carnitine showed increased live birth rates in three small randomized controlled trials in couples undergoing assisted reproductive technology.

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Before surgery, the HSG films and results of previous laparoscopies should be thoroughly reviewed to decide on the type of surgical technique that is required and to explain to the patient the expected degree of success and risks involved with the procedure. Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity. Renal Echinococcus. (PDF, 1 MB) The Journal of Urology, 1972. Long-term Economic Benefits Attributed to IVF-conceived Children: A Lifetime Tax Calculation. (PDF, 225 KB) The American Journal of Managed Care, 2008. Inhibin B levels have been reported to decrease with increasing weight, which results in decreased Sertoli cells and sperm production. They can be blocked due to numerous causes, including infections,  trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.

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Oocyte Vitrification – Women’s Emancipation Set in Stone. (PDF, 70 KB) Fertility and Sterility, 2008. Other medical techniques are e.g. tuboplasty, assisted hatching, and preimplantation genetic diagnosis. The rate increases to 10-12% after CC ovulation induction and to 12-15% per cycle after hMG/hCG ovulation induction. The quality and quantity of eggs begin to decline by the early 30s and drop even further as a woman approaches the age of 40. In response to FSH stimulation at puberty, germ cells become spermatogonia and undergo an ordered maturation to become spermatozoa. A variety of hormonal imbalances can affect a man's fertility. Pelvic inflammatory disease Pelvic inflammatory disease (PID) is an infection of the upper female genital tract, which includes the womb, fallopian tubes and ovaries. The Disappearing Y Chromosome – “I Told You So!” (PDF, 266 KB) Human Reproduction, 1997. Factors contributing to the formation of antisperm antibodies in women are disturbance of normal immunoregulatory mechanisms, infection, violation of the integrity of the mucous membranes, rape and unprotected oral or anal sex. 30–32 Other treatment options include antiestrogens and gonadotropin therapy, which showed a trend toward increased live birth rates in a Cochrane review. The 3 classes of surgical techniques are conventional laparotomy, operative laparoscopy, and operative hysteroscopy, as follows: Laparotomy: This technique is indicated for large myomas, for submucous myomas larger than 3 cm in diameter, or for myomas that, regardless of being submucous, have a portion of the myoma that compromises the myometrium so that a complete resection through the hysteroscopy is not feasible.