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Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility. Additionally, transvaginal ultrasound affords the opportunity for your physician to assess the relative number of available eggs. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer. If the epididymis is blocked, sperm may not be ejaculated properly. Infertility caused by DNA defects on the Y chromosome is passed on from father to son. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992.

A high serum estradiol level (greater than 60 to 80 pg per mL [220 to 294 pmol per L]) in conjunction with a normal FSH level has also been associated with lower pregnancy rates. The initial dose is 500 mg PO qd for 7 days, then 500 mg bid for another 7 days, and, finally, 500 mg tid. 7) Endometriosis: Endometriosis is a condition whereby cells very similar to the ones lining the uterine cavity, or endometrium, are found outside the uterine cavity.

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Epididymal and Testicular Spermatozoa and Intracytoplasmic Sperm Injection. (PDF, 7 MB) Assisted Reproduction Reviews, 1996. Stem cell therapy[edit] Nowadays, there are several treatments (still in experimentation) related with stem cell therapy. The fertilized egg is then implanted in the uterus.

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Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW. Because 85% of couples conceive spontaneously within 12 months if having intercourse regularly,5 it is important to identify those who will benefit from infertility evaluation. The NICE guidance has more about unexplained infertility. Secondary fertility involves one or both partners who have conceived previously, but are now unable to do so because of a possible physical or medical condition impairing fertility. Source : (1).pptx Evaluation of Fertility: A Cornerstone to Improved ...

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This can result from: A medical condition: This could be a testicular infection, cancer, or surgery. Y Chromosome Deletions in Azoospermic and Severely Oligozoospermic Men Undergoing Intracytoplasmic Sperm Injection after Testicular Sperm Extraction. (PDF, 336 KB) Human Reproduction, 1998. The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter. Listen to Mr Brook talk about male infertility Find out more about ICSI. Treatment of the cause: 30. Unexplained infertility: - Ovarian stimulation should not be considered as does not improve pregnancy or birth rates. - Advise to try to conceive for two years of unprotected sexual intercourse before other options. - After two years of failure to conceive, consider IVF/ICSI. Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory. In one study,  treatment with recombinant HBD1 in asthenozoospermic and leukocytospermic patients who were deficient in HBD1 resulted in improved bactericidal activity and sperm quality, which supports this protein’s role in fertility and its potential role in managing infertility.[28] Other causes Causes of testicular failure also include the following: Granulomatous disease – Leprosy and sarcoidosis may infiltrate the testicle Sickle cell disease – Sickling of cells within the testis leads to microinfarcts Excessive use of alcohol, cigarettes, caffeine, or marijuana Despite a thorough workup, nearly 25% of men have no discernible cause for their infertility. 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.