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A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3).

Treatment of the cause: Male Factor: (Liaise with the andrologist) 1. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. Furthermore, as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases.

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Genetics of Male Infertility: Evolution of the X and Y Chromosome and Transmission of Male Infertility to Future Generations. (PDF, 10 MB) Chapter 5 from Essential IVF, 2004. The results of these tests help determine the best fertility treatment. Once the fluid containing the eggs is removed from the follicles into the vials, they are handed to the embryologist who finds the eggs, places them in tiny droplets on a Petri dish, and then fertilizes the eggs using their partner’s or donor sperm. The main symptom of infertility is not getting pregnant. Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. Surprisingly, the complete absence of sperm in the semen (a condition known as azoospermia), can be a good thing.

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6) Male factors affecting sperm function: Male factor infertility has been associated as a contributing factor causing infertility in 40-50% percent of cases, and as the sole cause for infertility in 15-20% percent of cases. Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. As soon as it reaches a specific size, the administration of beta-HCG takes place. There may be testicular malformations, hormone imbalance, or blockage of the man's duct system. Outlook For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before.

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Patients with a high number of immature sperm should be evaluated for excessive exposure to heat or radiation or for infectious processes. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. Frustratingly, sometimes there may be no clear reason and you may be diagnosed with unexplained infertility. 42 However, none of these methods has been proven to increase pregnancy rates when used to predict timing of intercourse. Spermatogonia and Sertoli cells lie on the basement membrane of the seminiferous tubules. Men should undergo evaluation with a semen analysis. The quality of the cervical mucus can be improved with the administration of a small dose of estrogens, or the problem can be bypassed by intrauterine insemination. [163, 209] If the follicle is smaller than 23-24 mm at the time of ovulation, a better size can be obtained by starting the CC therapy on the menstrual cycle day 2. Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women. Treatment of the cause: 27. Tubal and uterine factors: 1. The doctor may ask about the couple's sexual habits and make recommendations regarding these. The incidence of congenital malformation in IVF babies ranges between 2% and 3% worldwide and is similar to that in babies conceived naturally [45].