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Opinion: Microsurgical TESE and the Distribution of Spermatogenesis in Non-obstructive Azoospermia. (PDF, 5 MB)Human Reproduction, 2000. Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus.

Vasectomy and its Microsurgical Reversal. (PDF, 17 MB) Urologic Clinics of North America, 1978. 41 Treatment of Unexplained Infertility Jump to section + Couples who have no identified cause of infertility should be counseled on timing of intercourse for the most fertile period (i.e., the six days preceding ovulation).

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22 Treatment of Male Infertility Jump to section + Underlying etiology determines the therapeutic course, although male infertility is unexplained in 40% to 50% of cases. The prostate also secretes zinc, phospholipids, phosphatase, and spermine. Problems with sperm If a man makes too few sperm or none at all, the woman cannot become pregnant.

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Society and culture[edit] Perhaps except for infertility in science fiction, films and other fiction depicting emotional struggles of assisted reproductive technology have had an upswing first in the latter part of the 2000s decade, although the techniques have been available for decades.[76] Yet, the number of people that can relate to it by personal experience in one way or another is ever growing, and the variety of trials and struggles is huge.[76] Pixar's Up contains a depiction of infertility in an extended life montage that lasts the first few minutes of the film.[77] Other individual examples are referred to individual subarticles of assisted reproductive technology Ethics[edit] There are several ethical issues associated with infertility and its treatment. A treatment plan should be generated according to the diagnosis, duration of infertility, and the woman's age. Fertility Evaluation of the Male Partner: Semen Analysis Semen analysis is an essential part of the evaluation.

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Its use is controversial in patients with a history of breast cancer. Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying. Couples may decide to go ahead regardless if the desire to become pregnant is very strong. Laboratory studies have suggested that long-term acetaminophen use during pregnancy may affect fertility in males by lowering testosterone production. Peripheral organ The hypothalamus-pituitary axis may be interrupted by hormonally active peripheral tumors or other exogenous factors, due to cortical excess, cortical deficiency, or estrogen excess. Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. Genetic karyotyping, if a recurrent miscarriage is a problem. 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. Understanding what defines normal fertility is crucial to helping a person, or couple, know when it is time to seek help. Hysteroscopy can also be combined with laparoscopy when necessary.