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Many countries have special frameworks for dealing with the ethical and social issues around fertility treatment. Ejaculatory Duct Obstruction. (PDF, 3 MB) The Journal of Urology, 1980.

Fibroids that distort the uterine cavity have an impact on the ability of an embryo to implant and should be removed surgically. Isodicentric Y Chromosomes and Sex Disorders as Byproducts of Homologous Recombination that Maintains Palindromes. (PDF, 1 MB) Cell, 2009. A doctor injects sperm directly into the egg in a dish and then places it into your uterus. Some women are infertile because their ovaries do not mature and release eggs. Treatment of tubal obstruction generally requires referral for subspecialty care. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair.

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It can also help if a man has severe erectile dysfunction. 9 Because anxiety over infertility may cause increased stress and decreased libido, further compounding the problem, formal counseling is encouraged for couples experiencing infertility.

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30% of women face reproduction issues at this age because ovarian reserve decreases, there are fewer eggs and they are of an inferior quality. Partners may become more anxious to conceive, increasing sexual dysfunction.[17] Marital discord often develops, especially when they are under pressure to make medical decisions. If you’ve been diagnosed with infertility, or fear you may have trouble conceiving in the future, you’re not alone. These time intervals would seem to be reversed; this is an area where public policy trumps science.

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Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing's syndrome, diabetes, and thyroid disease. Many of the same surgeries performed in humans can be applied to animal cases – everything from an egg-bound tortoise to a German Shepherd can benefit from MIS. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery. The pathophysiology of the disease is not well understood, but a massive extravascular accumulation of fluid occurs that is associated with a severe depletion of the intravascular volume responsible for dehydration, hemoconcentration, and electrolyte imbalance (ie, hyponatremia, hyperkalemia). [193] Ovarian hyperstimulation syndrome can be mild, moderate, or severe. [194] Mild ovarian hyperstimulation syndrome is characterized by ovarian enlargement (up to 5-12 cm in diameter), minimal ascites, and weight gain of less than 10 lb. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. We get information regarding the woman's potential for adequate ovarian stimulation with medications by counting antral follicles. Most of infertile couples are aware of what can be offered to them from the media. A variety of disorders ranging from hormonal disturbances to physical problems, to psychological problems can cause male infertility.  Although many treatment options are now available, in many cases treatment will not work.  In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm.  Once damaged, the testicle will not usually regain its sperm-making capabilities; this aspect of male infertility is analogous to menopause (though not natural like menopause) for women and cannot usually be treated.  Despite medicine�s limited ability to treat male infertility, many successful treatment options are available for its many causes.  Besides testicular damage, the main causes of male infertility are low sperm production and poor sperm quality.   The Causes of Male Infertility Male infertility has many causes--from hormonal imbalances, to physical problems, to psychological and/or behavioral problems.  Moreover, fertility reflects a man�s �overall� health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility--it is not all-inclusive: · Smoking--significantly decreases both sperm count and sperm cell motility. · Prolonged use of marijuana and other recreational drugs. · Chronic alcohol abuse. · Anabolic steroid use--causes testicular shrinkage and infertility. · Overly intense exercise--produces high levels of adrenal steroid hormones which cause a    testosterone deficiency resulting in infertility. · Inadequate vitamin C and Zinc in the diet. · Tight underwear--increases scrotal temperature which results in decreased sperm production. · Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive   substances, mercury,  benzene, boron, and heavy metals · Malnutrition and anemia. · Excessive stress! Sperm retrieval for azoospermia and intracytoplasmic sperm injection success rates – A personal overview. (PDF, 1 MB) Human Fertility, 2010. It could be caused by a tumour, taking illegal drugs, or Klinefelter syndrome, a rare syndrome where a man is born with an extra female chromosome.