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A history and physical examination can help direct the evaluation. Post-testicular causes of infertility Post-testicular causes of infertility include problems with sperm transportation through the ductal system, either congenital or acquired. Factors Affecting Fertility (Continued) Among other factors affecting the probability of conception are: Age of women.

Those motile and viable sperm are then placed in a very small amount of solution, and then very gently and painlessly injected into the uterine cavity using a very thin, soft, and flexible catheter. ART techniques generally start with stimulating the ovaries to increase egg production. But if you haven’t had a period in months, it’s time to get your fertility checked. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years.

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Defects in cilia Immotile cilia syndrome may occur as an isolated disorder or as part of Kartagener syndrome with situs inversus. Transitions of the tube mucosa with luminal adhesions develop from recent infections of the genitalia involving the adnexa. I cannot stress enough how amazing this staff is, they make you feel like family!

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Next, the spermatids undergo the process of spermiogenesis (through stages named Sb1, Sb2, Sc, Sd1, and Sd2), which involves the casting of excess cytoplasm away as a residual body, the formation of the acrosome and flagella, and the migration of cytoplasmic organelles to their final cellular location. Careful monitoring during treatment and pregnancy can help reduce the risk of complications. CI or intrauterine insemination is the treatment of choice if more than 2 million sperm are recovered after the sperm wash. (See Treatment of Cervical Factors). [106, 109] Patients whose reproductive tract, FSH, LH, and testosterone levels are determined to be normal or those who have low testosterone in the absence of any other hormonal abnormalities can be treated empirically with cycles of CC (25 mg PO qd for at least 6-12 mo).

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Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988–1989). There are also a number of sperm production problems that can contribute to infertility, including: Scrotal varicose veins (varicoceles)  Scrotal varicose veins (varicoceles) are swollen veins causing your testicles to get hotter and affect the production of sperm  These are treated with surgery  Testicular injury   Serious trauma to the testicles such as becoming twisted (torsion) can affect sperm production  Damage from playing sports or an accident can rupture the vessels that supply blood to the testicles  Previous injuries can’t be treated, but an ART treatment may help you to conceive Undescended testicles  In the uterus, baby boys’ testicles form in their abdomen and descend into their scrotum shortly before birth  Some men’s testicles don’t descend before they are born (cryptorchidism), although in these cases they usually drop in the first six months after birth  If left untreated, undescended testicles can affect fertility Testicular cancer  This happens when a malignant tumour in the testicle destroys testicular tissue  If undetected, testicular cancer can spread to other parts of the body  This is treated either by surgery, medication, radiotherapy or chemotherapy  However, cancer therapy can also damage sperm production  Genetic defects  Sometimes, genetic information on the Y chromosome (which is only present in men) is deleted (micro-deletions),6 which can reduce the production of sperm  Depending on where the micro-deletion is on the chromosome, this may be treated by surgically extracting sperm from part of your reproductive tract  However, some couples may need to consider using a donor sperm to conceive Mumps Contracting mumps (or mumps-related orchitis) after puberty may damage the sperm-producing cells in your testicles,  causing infertility or subfertility7 Usually, only one testicle is affected and if you have one functioning testicle you may not need treatment  However, some couples may need to use a sperm donor in order to conceive Anti-sperm antibodies  Anti-sperm antibodies are large proteins in your blood that are hostile to sperm  They can cause sperm to clump together and prevent them from swimming, or they may mistake sperm cells for an infection and try to destroy them  This can be treated using an ART treatment   Lifestyle   Sperm production can be affected by a range of lifestyle factors, including smoking, drinking, drugs, stress, overweight and unhealthy food Environmental factors can also affect your sperm quality, including overheating of your testicles, some sexual lubricants, the chemicals involved in certain manufacturing, painting or printing jobs   These factors are treated by making lifestyle changes, such as wearing loose clothing to avoid overheating Hormonal problems  Hormonal problems are rarely the cause of male infertility problems  However, some men have a natural deficiency in follicle-stimulating hormone (FSH) and luteinising hormone (LH), which prevents the testicles from producing testosterone or developing healthy sperm  Hormonal problems can usually be treated with medication Obstruction problems Blocked sperm ducts  Occasionally, male sperm ducts (epididymis and vas deferens) can become blocked, meaning that your semen doesn’t contain any sperm  This can be treated with surgery, or sperm may be surgically extracted from part of your reproductive tract  Vasectomy  Some men have had a previous vasectomy to stop them being able to conceive  This can sometimes be reversed using surgery  The procedure’s success depends on how long ago your vasectomy was performed  Previous infections  Infections can cause scarring or adhesions (organs sticking together) in your sperm ducts  This can usually be treated with surgery  Does age affect male fertility? 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. The following problems are possible: Low sperm count: The man ejaculates a low number of sperm. Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity. Women receiving fertility treatment have a slightly higher risk of an ectopic pregnancy. 6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs. Men should undergo evaluation with a semen analysis. Myotonic dystrophy This is an autosomal dominant defect in the dystrophin gene that causes a delay in muscle relaxation after contraction. Prior to its conception, laparoscopy was a surgical approach with very few applications, mainly for purposes of diagnosis and performance of simple procedures in gynecologic applications.[citation needed] The first publication on modern diagnostic laparoscopy by Raoul Palmer appeared in 1947,[36] followed by the publication of Hans Frangenheim and Kurt Semm, who both practised CO 2 hysteroscopy from the mid-1970s.[37] In 1972, Clarke invented, published, patented, presented, and recorded on film laparoscopic surgery, with instruments marketed by the Ven Instrument Company of Buffalo, New York.[38] In 1975, Tarasconi, from the Department of Ob-Gyn of the University of Passo Fundo Medical School (Passo Fundo, RS, Brazil), started his experience with organ resection by laparoscopy (Salpingectomy), first reported in the Third AAGL Meeting, Hyatt Regency Atlanta, November 1976 and later published in The Journal of Reproductive Medicine in 1981.[39] This laparoscopic surgical procedure was the first laparoscopic organ resection reported in medical literature. 43 Other low-cost methods of monitoring for ovulation, although less effective, include basal body temperature measurements and cervical mucus changes.


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See also
Infertility Multiple Choice Questions
Infertility Specialist Education
Pelvic Ultrasound Infertility Testing