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If there is a history of recurrent miscarriages (2 or more) a lupus anticoagulant (LAC) and anti-cardiolipin antibody (ACL) are often done, as well as other tests. Three types are described: A dark (Ad), A pale (Ap), and B cells. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. An ultrasonography unit and an endocrine laboratory capable of performing daily determinations of E2, FSH, and LH are necessary. [186, 187, 188, 189] Multiple adverse effects and complications may occur during the use of the gonadotropins, including (1) multiple pregnancy (24-33%), (2) ectopic pregnancy (5-8%), (3) miscarriages (15-21%), (4) ovarian torsion and rupture, and (5) ovarian hyperstimulation syndrome, which is the most severe. [190, 191] Whittemore et al, using a large combined data set derived from case-controlled studies in the United States, showed that the increase of ovarian cancer associated with infertility might be due to the use of fertility drugs. [192] Ovarian hyperstimulation syndrome is an iatrogenic condition that occurs in patients undergoing ovulation induction with hMG or controlled ovarian hyperstimulation (COH) for assisted reproductive technologies. The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop.

Some methods may be used in concert with other methods. Treatment[edit] Treatment depends on the cause of infertility, but may include counselling, fertility treatments, which include in vitro fertilization. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization. Alcohol: Any amount of alcohol consumption can affect the chances of conceiving. Thus, an intravenous pyelogram must be performed once this diagnosis is made.

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The majority of men with varicocele present no symptoms. The use of Epididymal and Testicular Spermatozoa for Intracytoplasmic Sperm Injection: The Genetic Implications for Male Infertility. (PDF, 8 MB) Human Reproduction, 1995.

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Egg donation. This can help you if you have ovaries that don't work right but you have a normal uterus. Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance. Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate. Fertility Evaluation of the Male Partner: Other Tests Other tests for men include: Urine analysis to rule out an infection. Intracytoplasmic Sperm Injection and Infertility. (PDF, 53 KB) Nature Genetics, 2001.

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The key element is the use of a laparoscope, a long fiber optic cable system which allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location. In 1981, Semm, from the gynecological clinic of Kiel University, Germany, performed the first laparoscopic appendectomy. This process bypasses the normal fertilization process, which may be compromised due to poor sperm function. Cervical insemination has almost been abandoned because of its low success and has been relegated only to cases in which the sperm count is normal, such as in artificial insemination using donor sperm or if the sample has elevated white cells. The hypothalamus, the primary integration center, responds to various signals from the central nervous system (CNS), pituitary gland, and testicles to secrete gonadotropin-releasing hormone (GnRH) in a pulsatile pattern approximately every 70-90 minutes. ARTICLES FROM THE 2000s Evaluation and Treatment of Male Infertility. (PDF, 17 MB) Clinical Obstetrics and Gynecology, 2000. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole.