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CAH may be due to the congenital deficiency of one of several adrenal enzymes, the most common of which is 21-hydroxylase deficiency. Additional information regarding infertility is available at . Surprisingly, the complete absence of sperm in the semen (a condition known as azoospermia), can be a good thing. A pregnancy where the mother is weak could pose a risk to the baby’s and mother’s health. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. The severity usually depends on how near to the testicles the radiation was aimed.

This hormone then binds to another area of the brain called the pituitary gland and leads to the release of FSH (follicle stimulating hormone), a hormone that directly binds to cells in the ovary, leading to egg growth and maturation. Patients with hyperthyroidism or hypothyroidism must be treated accordingly. [210, 211] Weight reduction should be part of the treatment because it helps the patient's response to ovulation induction. [212] Treatment of Male Factors Asthenospermia associated with varicocele is treated surgically with varicocelectomy or with embolization of the spermatic veins. Also searched were the Cochrane database, the National Guideline Clearinghouse database, Dynamed, and Essential Evidence Plus. Y Chromosome Deletions in Azoospermic and Severely Oligozoospermic Men Undergoing Intracytoplasmic Sperm Injection after Testicular Sperm Extraction. (PDF, 336 KB) Human Reproduction, 1998. Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count. Leydig cell function is impaired, and most patients are infertile due to primary testicular failure.

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When a man ejaculates and releases semen through the penis, the seminal fluid, or semen, helps transport the sperm toward the egg. More than 60% of sperm should be normal, and less than 2-3% should be immature.

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The effect of age upon men's fertility is less clear.[citation needed] In people going forward for IVF in the UK, roughly half of fertility problems with a diagnosed cause are due to problems with the man, and about half due to problems with the woman. The chance of a live birth following treatment is nearly 50% [25]. Allied and Complementary Medicine Database (AMED), ... Male and female factors can exist in isolation or combination and fertility investigations, diagnoses and treatment should always be considered in the context of the couple.       Male factor Sperm problems will contribute to about 40% of infertility cases. There may be testicular malformations, hormone imbalance, or blockage of the man's duct system.

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The Treatment of Azoospermia with Surgery and ICSI. (PDF, 4 MB) Chapter 10 from Male Fertility & Infertility, 1998. Vasectomy and its Microsurgical Reversal. (PDF, 17 MB) Urologic Clinics of North America, 1978. For example, high cortisol levels are seen in patients with Cushing syndrome, which causes negative feedback on the pituitary to decrease LH release. Intrauterine insemination is a process by which sperm is washed and prepared for placement into the uterine cavity, therefore bypassing the cervix and bringing a higher concentration of motile sperm closer to the tubes and ovulated egg. 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. The most common disorders impacting ovulation include polycystic ovary syndrome (PCOS), hypogonadotropic hypogonadism (from signaling problems in the brain), and ovarian insufficiency (from problems of the ovary). 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. Microsurgical Epididymal Sperm Aspiration and Assisted Reproductive Techniques. (PDF, 4 MB) Frontiers in Human Reproduction, 1991. 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. Paternal age > or = 40 years: an important risk factor for infertility. The vas deferens carries sperm from the epididymis to the ejaculatory duct and the urethra. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations.