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Effects[edit] Psychological[edit] The consequences of infertility are manifold and can include societal repercussions and personal suffering. In current practice, an alternative for patients with more than 5 sizable follicles is to convert the treatment to IVF. Sperm are then collected, washed, and added to the eggs in the dish. For women aged 35, about 94% who have regular unprotected sexual intercourse get pregnant after three years of trying. Ovarian Transplantation in a Series of Monozygotic Twins Discordant for Ovarian Failure. (PDF, 188 KB) The New England Journal of Medicine, 2007. Successful Pregnancy after Microsurgical Transplantation of an Intact Ovary. (PDF, 438 KB) The New England Journal of Medicine, 2008.

Supplementation with acetyl L carnitine and antioxidants such as Vitamins C or E are encouraged to enhance sperm maturation and function. Less common factors The following other factors may also be responsible for infertility in a smaller proportion of cases: • Genetic abnormalities within eggs, sperm or both • An abnormal uterine cavity, including the presence of fibroids or polyps • Immunological infertility, whereby either the male or female partner produces anti-bodies against sperm cells or implantation of an embryo • Abnormal cervical mucus which hinders the passage of sperm to the uterus and fallopian tubes Unexplained infertility Even when investigations have been extensive, some couples will have no reason with which to explain their infertility. Although many of these can be treated through surgery or hormonal substitutions, some may be indefinite.[59] Infertility associated with viable, but immotile sperm may be caused by primary ciliary dyskinesia. Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984. 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.

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If left untreated, infections like chlamydia, gonorrhea, and mycoplasma can eventually lead to infertility.  The reproductive process In order to successfully conceive, certain reproductive steps must occur, and they are as follows: One of the ovaries releases a mature egg. After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. 5) Endometrial polyps: Endometrial polyps are finger-like growths in the uterine cavity arising from the lining of the uterus, called the endometrium, These abnormalities are rarely associated with cancer (<1% in a woman before menopause), but polyps are can decrease fertility by up to 50% according to some studies. 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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Semen and sperm Sometimes the sperm cannot travel effectively to meet the egg. Treatment of tubal obstruction generally requires referral for subspecialty care.

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8 Counseling on lifestyle modifications is reasonable because exposures to tobacco and alcohol are associated with lower rates of fertility. It has not been shown to improve patient outcomes but, rather, is helpful for research purposes. Analyses of the CFTR Gene in 67 Patients. (PDF, 4 MB) The American Journal of Human Genetics, 1995. Absence of the main sperm pipeline known as the vas deferens. American Urological Association Education and Research, Inc. 48 However, there is no firm evidence that preconception counseling leads to increased live birth rates, in part because no studies on this topic have been performed.