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This can happen as a result of: an infection of your testicles testicular cancer  testicular surgery a problem with your testicles you were born with (a congenital defect) when one or both testicles hasn't descended into the scrotum, the loose sac of skin that contains your testicles (undescended testicles) injury to your testicles Sterilisation Some men choose to have a vasectomy if they don't want children or any more children.  It involves cutting and sealing off the tubes that carry sperm out of your testicles (the vas deferens) so your semen will no longer contain any sperm. This process has revolutionized assisted reproductive technology and the way reproductive endocrinologists can help people in having a baby. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome). 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.

Idiopathic Hypercalciuria. (PDF, 1 MB) New England Journal of Medicine, 1971. The resulting embryos are then transferred into the uterus of the future mother, known as the recipient. Often, in vitro fertilization (IVF) can reveal abnormalities in egg quality, sperm function, or embryo development that would not have been determined from standard testing.

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Coping mentally It is impossible to know how long treatment will go on for and how successful it will be. Eating disorders such as anorexia nervosa are also associated with extremely low BMI. Physical damage to the ovaries, or ovaries with multiple cysts, may affect their ability to function. Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory. When anatomic variance or obstruction is suspected, referral for surgical evaluation and treatment is appropriate. The Relationship of Abnormal Semen Values to Pregnancy Outcome. (PDF, 770 KB) Chapter 10 from textbook, 1992.

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The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility. If too many embryos develop, one or more can be removed. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. If a couple has never produced a pregnancy, it is defined as primary infertility. Some women have bilateral tubal occlusion, which is when both tubes are blocked.

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Intrauterine insemination (IUI.)At the time of ovulation, sperm are injected directly up into the uterus. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous. He and his wife underwent needle sperm extraction and in vitro fertilization, but it was unsuccessful. “I feel bad mostly because my wife wants a baby so bad and it is the one thing I can't give her,” Steve says. “This has been a tough thing for the two of us.” They are currently looking into adoption. Ovulation occurs about two weeks before a woman’s next period starts. In many cases, there are tests that can help find the cause(s) of male infertility. Existing definitions of infertility lack uniformity, rendering comparisons in prevalence between countries or over time problematic.