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Testicular histology reveals hyalinization of seminiferous tubules.[21] Some men with Klinefelter syndrome may be able to conceive with the help of assisted reproductive techniques. Polycystic ovary syndrome causes infrequent periods or a total absence of them and is the most common cause of anovulation (an absence of ovulation). Couples who do not conceive after treatment for six cycles with documented ovulation should also consider referral to an infertility specialist.

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. They can be blocked due to numerous causes, including infections,  trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.

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Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995. Recombination Between Palindromes P5 and P1 on the HUman Y Chromosome Causes Massive Deletions and Spermatogenic Failure. (PDF, 786 KB) The American Journal of Human Genetics, 2002. Laparoscopy with hydrotubation - if the clinical situation suggests this is required . Most of infertile couples are aware of what can be offered to them from the media. As there is surplus medical information everyday that can not be cached by healthcare providers, clinical guidelines created to endorse up-to-date evidence-based practice to improve patients' outcome [6]. Ovulation should be documented by serum progesterone level measurement at cycle day 21.

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In some cases, the cause of infertility or subfertility could not be suspected from the history taking and clinical examination. Although the sperm count may be slightly decreased by an intercourse frequency of once per day or once every other day, the motility and number of sperm in the healthy male would be sufficient to achieve pregnancy. If an endocrinopathy, such as hyperprolactinemia, is diagnosed, the underlying cause should be treated. 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.

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Health problems such as mumps or hormone problems. Medicamentous Induction of Ovulation Ovulation inductors are used for dysfunctions in the hypophyseal-hypothalamic area. Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory. Meticulous hemostasis is imperative. [131, 132, 133] Operative laparoscopy was reintroduced into the surgical armamentarium in the 1950s; however, in the 1970s, Semm developed different procedures and operative instruments that currently allow for the outpatient laparoscopic surgical treatment of multiple tuboperitoneal pathologies, [91] electrocautery, endocoagulation, lasers, and ultrasonography scalpels facilitate the performance of operations that otherwise used to require a laparotomy. Ovulation often can be detected by keeping a menstrual calendar or using an ovulation predictor kit. Results of one study investigating a cohort of 315 men revealed changes within the hinge region of SF-1 and no rare allelic variants in fertile control men. Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. Perfect Anatomical Reconstruction of Vas Deferens with a new Microscopic Surgical Technique. (PDF, 19 MB)Fertility and Sterility, 1977. Source : How To Use California’s Department Of Managed Health Care ...