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Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. ART: Gamete Intrafallopian Transfer (GIFT) GIFT is a procedure that involves ovarian stimulation, egg retrieval, and placing a mixture of sperm and eggs directly into the woman’s fallopian tube to foster fertilization inside the female body. The male partner can be evaluated for infertility or subfertility using a variety of clinical interventions, and also from a laboratory evaluation of semen.” (Semen manual, 5th Edition3). Endometriosis may be treated through laparoscopic surgery.

A Modern Approach to Male Infertility. (PDF, 2 MB) Serono Symposia, Insights Into Infertility Newsletter, 1997. The fertilized embryo is then transferred to womb. In cases when the quality of sperm is very poor, or sperm is completely absent in the ejaculate (azoospermia), donor’s sperm can be used (if culturally acceptable). Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control Secondary infertility is when they have previously conceived but are no longer able to.

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Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. 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. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous. The quality and quantity of eggs begin to decline by the early 30s and drop even further as a woman approaches the age of 40.

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Causes Potential causes of male infertility are: The complete absence of sperm (azoospermia) Low sperm count (oligospermia) Abnormal sperm shape (teratozoospermia) Problems with sperm movement (asthenozoospermia) Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation Problems with erections or other sexual problems There are a variety of conditions that may lead to male infertility. Known male factor semen abnormalities: If a male partner has a history of infertility with a prior partner, or if there are abnormalities on his semen analysis, then we advise earlier fertility evaluation, ideally within 6 months of attempting pregnancy. The pulsatile nature of GnRH is essential to normal gonadotropin release; a continuous stimulation inhibits their secretion. Blood tests Depending on the individual couple's situation, various blood tests on either the female or the male may be needed. Open-ended Vasectomy, Sperm Granuloma, and Postvasectomy Orchialgia. (PDF, 13 MB) Fertility and Sterility, 1979.

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Normal cervical mucus to allow passage of the sperm to the upper genital tract. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy. Fertility Evaluation: General and Gynecological Examination For women, a visual evaluation of hair distribution and of body and breast development can indicate endocrinopathy or various development deficiencies. Counseling about options should be offered to couples who are not physically able to conceive (i.e., same-sex couples or persons lacking reproductive organs). 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. This technique involves an injection of a single healthy sperm directly injected into mature egg. The maximum recommended dosage is 150 mg/day for 5 days. The Varicocele Dilemma. (PDF, 139 KB) Human Reproduction, 2001. In some cases, simply removing the submucosal fibroid solves infertility. Sherman Silber: Be Fruitful and Multiply. (PDF, 6 MB) Lifestyles Magazine, 1999. Pain during sex Some women have experienced painful sex their entire lives, so they’ve convinced themselves it’s normal. Testicular Sperm Extraction (TESE) and Intracytoplasmic Sperm Injection (ICSI) for Non-obstructive Azoospermia.(PDF, 1 MB) 10th World Congress on In Vitro Fertilization and Assisted Reproduction, 1997. Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984. Isolated LH deficiency (fertile eunuch) In these patients, LH levels are decreased while FSH levels are within the reference range. 3  Sometimes, a couple who’ve already had a child can have trouble conceiving again. Fertility Evaluation Procedure Before the medical data are collected, the couple should be informed about the different causes of infertility, the tests and procedures required to make a diagnosis and the various therapeutic possibilities. Studies have shown that approximately 70% of miscarriages are due to chromosomal abnormalities.