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Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin.

The Varicocele Dilemma. (PDF, 139 KB) Human Reproduction, 2001. 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. Ovulation induction in polycystic ovary syndrome [published corrections appear in J Obstet Gynaecol Can. Treatment[edit] Treatment depends on the cause of infertility, but may include counselling, fertility treatments, which include in vitro fertilization. ART techniques generally start with stimulating the ovaries to increase egg production.

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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. These problems with sperm can cause male infertility.

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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). The epididymis is a coil-like structure in the testicles which helps store and transport sperm. Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction.

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Hyperandrogenemic ovarian insufficiency is characterized by an immoderate production of androgen. An obstruction can occur anywhere in the plumbing between the testicles and the penis. A review of systems and physical examination of the endocrine and gynecologic systems should be performed. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 7 MB) Nature Genetics, 1995. Leptin is a hormone associated with numerous effects including appetite control, inflammation, and decreased insulin secretion, according to many studies. Pro-life opposition to the destruction of embryos not transferred in vivo. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. For example, a woman who has a 33-day cycle one month, a 31-day cycle the next, and a 35-day cycle after that, is probably having “normal” periods. Clark AM, Thornley B, Tomlinson L, Galletley C, Norman RJ. Adding recombinant human FSH to HCG has been shown to be effective in achieving spermatogenesis in most patients.[18] Select patients with adult-onset idiopathic hypogonadotropic hypogonadism may respond to clomiphene citrate therapy.[19] Prader-Willi syndrome Patients have characteristic obesity, mental retardation, small hands and feet, and hypogonadotropic hypogonadism due to a GnRH deficiency. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. Linthicum, Md.: American Urological Association, Inc.; 2010.