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Patients with azoospermia or severe oligospermia are more likely to have a chromosomal abnormality (10-15%) than infertile men with sperm density within the reference range (1%). Your physician will refer you to a reproductive urologist if appropriate. Listen to Professor Cheong talk about the fertility investigations we offer       Repeated pregnancy loss Some people may not have difficulty conceiving, but have suffered from miscarriages. The ICSI process takes place following a cycle during which fertility drugs are administered to the female partner to aid in the production of multiple eggs. Idiopathic hypogonadotropic hypogonadism A failure of GnRH secretion without any discernible underlying cause may be observed alone (isolated) or as part of Kallmann syndrome, which is associated with midline defects such as anosmia, cleft lip and cleft palate, deafness, cryptorchidism, and color blindness. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity.

Several studies have reported different causes of infertility [7-9]. Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. 25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance. You take gonadotropins that trigger the development of more than one egg. Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988.

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MESA or TESA? (PDF, 115 KB) Human Reproduction, 1996. Microscopic Vasoepididymostomy: Specific Microanastomosis to the Epididymal Tubule. (PDF, 15 MB) Fertility and Sterility, 1978. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. Hypothalamic-pituitary-gonadal axis stimulatory and inhibitory signals. 43 Other low-cost methods of monitoring for ovulation, although less effective, include basal body temperature measurements and cervical mucus changes. 4 IU per L]) can help differentiate between primary and secondary disorders.

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It will take time until these studies can be available for clinics and patients as a regularity. This can be made laparoscopically as well as sonographically. Microscopic Vasectomy Reversal 30 Years Later: A Summary of 4010 Cases by the Same Surgeon. (PDF, 295 KB)Journal of Andrology, 2004.

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Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. 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. Problems with sexual intercourse These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex. Requirements for Female Fertility One of the requirements for female fertility is a functioning reproductive anatomy and physiology. A doctor or WHNP takes a medical history and gives a physical examination. The volume provides clear guidelines and a logical sequence of steps which will quickly lead the clinician or physician to an accurate diagnosis of the underlying cause of infertility. Even with the testis shielded, radiation therapy below the diaphragm may lead to infertility due to the release of reactive oxygen free radicals.