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Management of the infertile couple: an evidence-based protocol. However, a woman who does not ovulate at each menstrual cycle is not necessarily going through menopause. Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur.

They may go unnoticed until a man tries to have a baby. The follicles are suctioned and microscopically examined afterward. Illegal drugs: Some women who use marijuana or cocaine may have fertility problems. ICSI offers a high pregnancy rate and 70—80 % of eggs are fertilized through this technique.

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The idea is that for women beyond age 35, every month counts and if made to wait another six months to prove the necessity of medical intervention, the problem could become worse. 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. Gracia CR, Sammel MD, Coutifaris C, Guzick DS, Barnhart KT. 6-Mb Deletion of the Human Y Chromosome Persists Through Balance Between Recurrent Mutation and Haploid Selection. (PDF, 295 KB) Nature Genetics, 2003. Immunohistochemical stains are performed if more than 5-10 round cells/HPF are present.  Other tests Semen may be analyzed for levels of zinc, citric acid, acid phosphatase, and alpha-glucosidase. Exercise: Both too much and too little exercise can lead to fertility problems.

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In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. 8  A normal sample according to the 2010 World Health Organization (WHO) guidelines is described in Table 2. Overweight or obesity: This may reduce the chance of conceiving. Overweight or obesity: This may reduce the chance of conceiving. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980.

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In 30% of all cases, the cause is in both partners: combined sterility. Choice of infertility treatment often related to issues of efficacy, cost, ease of use or administration, and its side effects. Recombination Between Palindromes P5 and P1 on the HUman Y Chromosome Causes Massive Deletions and Spermatogenic Failure. (PDF, 786 KB) The American Journal of Human Genetics, 2002. Surgical ablation: - In minimal or mild endometriosis; surgical ablation or resection of endometriosis plus laparoscopic adhesiolysis improves the chance of pregnancy. - Laparoscopic resection of endometriomas may be beneficial, however recent RCTs suggest intervention only in endometriomas > 4cm. - In moderate or sever endometriosis; surgical treatment should be offered. (Debatable) - Post-operative medical treatment does not improve pregnancy rates. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months. Similarly, there is no need for testing tubal patency for couples who will require IVF or ICSI procedure. Treatment of Renal Trauma by Angiographic Injection of Autologous Clot. (PDF, 422 KB) British Journal of Urology, 1974.