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Normal Pregnancies Resulting from Testicular Sperm Extraction and Intracytoplasmic Sperm Injection for Azoospermia Due to Maturation Arrest. (PDF, 6 MB) Fertility and Sterility, 1996. 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.

Those who prefer surgery first argue that because the size of endometriosis decreases, lesions that cannot be observed during surgery may be present; therefore, the operation is less than ideal and is associated with an increased chance for early recurrence. Bhaskar Dutta/Photoshare Clinical definitions Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”… (WHO-ICMART glossary1). “Infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. Infertility in men Semen and sperm The most common cause of infertility in men is poor-quality semen, the fluid containing sperm that's ejaculated during sex. If conception does not occur after many months or years of trying, it can lead to stress and possibly depression.

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Bromocriptine (Parlodel): This drug inhibits prolactin production. Therefore, we recommend an evaluation if menstrual cycles are infrequent or irregular in a couple attempting pregnancy. A low testosterone level with a low FSH level signals a secondary cause. This should be followed by documentation of ovulation via serum progesterone.

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Their cumulative probabilities of conception are 60% within the first 6 months, 84% within the first year, and 92% within the second year of regular fertility-focused sexual activity. Other hormones including inhibin B and leptin, may also be affected by obesity. Most people will have the strong desire to conceive a child at some point during their lifetime.

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Klinefelter�s Syndrome: Is a genetic condition in which each cell in the human body has an additional X chromosome--men with Klinefelter�s Syndrome have one Y and two X chromosomes.  Physical symptoms include peanut-sized testicles and enlarged breasts.  A chromosome analysis is used to confirm this analysis.  If this condition is treated in its early stages (with the drug hCG), sperm production may commence and/or improve.  However, Klinefelter�s Syndrome eventually causes all active testicular structures to atrophy.  Once testicular failure has occurred, improving fertility is impossible. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Bilateral anorchia (vanishing testes syndrome) Patients have a normal male karyotype (46, XY) but are born without testis bilaterally. It has been proven useful in overcoming infertility conditions, such as blocked or damaged tubes, endometriosis, repeated IUI failure, unexplained infertility, poor ovarian reserve, poor or even nil sperm count. 18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment. Regrettably, this often leads to untruly high expectations of assisted reproduction techniques (ART) [40]. Men can still ejaculate with a low sperm count or poor-quality sperm. Your doctor will analyze your semen analysis carefully and help you decide if ICSI is an appropriate treatment for you. Moderate alcohol consumption has not been shown to lower fertility in most men, but it may affect those who already have a low sperm count. It does not induce ovulation, but reduces the production of prolactin by the pituitary.[20] Bromocriptine is only prescribed in cases of overproduction of prolactin (hyperprolactinemia). Paternal age > or = 40 years: an important risk factor for infertility. Any abnormality in the tubes can affect or impede conception: hydrosalpinx, tubal occlusion or salpingitis. When anatomic variance or obstruction is suspected, referral for surgical evaluation and treatment is appropriate.