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The medical industry is forever making advances in this field. 3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). Large polyps or multiple polyps can impact fertility by interfering with the ability of embryo to implant and should be removed. Signs of Potential Infertility in Women In women, changes in the menstrual cycle and ovulation may be a symptom of a disease related to infertility.

For example, 10 to 15 percent of untreated chlamydia cases will lead to pelvic inflammatory disease (PID). A variety of disorders ranging from hormonal disturbances to physical problems, to psychological problems can cause male infertility.  Although many treatment options are now available, in many cases treatment will not work.  In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm.  Once damaged, the testicle will not usually regain its sperm-making capabilities; this aspect of male infertility is analogous to menopause (though not natural like menopause) for women and cannot usually be treated.  Despite medicine�s limited ability to treat male infertility, many successful treatment options are available for its many causes.  Besides testicular damage, the main causes of male infertility are low sperm production and poor sperm quality.   The Causes of Male Infertility Male infertility has many causes--from hormonal imbalances, to physical problems, to psychological and/or behavioral problems.  Moreover, fertility reflects a man�s �overall� health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility--it is not all-inclusive: · Smoking--significantly decreases both sperm count and sperm cell motility. · Prolonged use of marijuana and other recreational drugs. · Chronic alcohol abuse. · Anabolic steroid use--causes testicular shrinkage and infertility. · Overly intense exercise--produces high levels of adrenal steroid hormones which cause a    testosterone deficiency resulting in infertility. · Inadequate vitamin C and Zinc in the diet. · Tight underwear--increases scrotal temperature which results in decreased sperm production. · Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive   substances, mercury,  benzene, boron, and heavy metals · Malnutrition and anemia. · Excessive stress! ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990. Consulting a nutritionist, for example, could help a young woman suffering from anorexia to put on some weight, which might restart her menstrual cycle. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue.

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Your doctor may ask you many of the following questions: How long have you been trying to get pregnant? The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop. Basic Work-up for Infertility Detailed history and physical examination. Semen analysis. Evidence of ovulation. (Day 2-3 gonadotrophins, Day 21 progesterone) Susceptibility to rubella Cervical smear screening Screening for Chlamydia trachomatis Serum prolactin Thyroid function tests 12. Semen analysis: - semen volume: 1. The FAST study: fertility assessment and advice targeting lifestyle choices and behaviours: a pilot study. Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. The potentials of these systems enhance the possibilities of the mobile medical care with those lightweight assistance systems.

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Guidelines and recommendations were retrieved from the best evidence reviews at the American College of Obstetricians and Gynaecologists (ACOG), American Society for Reproductive Medicine (ASRM), Canadian Fertility and Andrology Society (CFAS), European Society of Human Reproduction and Embryology (ESHRE), Human Fertilisation and Embryology Authority (HFEA), Royal College of Obstetricians and Gynaecologists (RCOG), and the World Health Organization (WHO). Effects[edit] Psychological[edit] The consequences of infertility are manifold and can include societal repercussions and personal suffering. They are then processed and introduced to eggs by different methods. Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. They can often recommend a counselor and others who can offer appropriate support. The Male-specific Region of the Human Y Chromsome is a Mosaic of Discrete Sequence Classes. (PDF, 754 KB) Nature, 2003.

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In GIFT, the sperm and eggs are mixed together before a doctor inserts them. This combination of laboratory test results may indicate ovarian insufficiency or diminished ovarian reserve. Luteal phase support. (and cryopreservation choice offered if good quality embryos are available) IVF/ICSI 37. Down-regulation: - to avoid premature LH surge and spontenous ovulation. - either GnRH agonist protocol or GnRH antagonist protocol. - always use GnRH antagonist protocol in women with high risk of OHSS. Semm published over 1000 papers in various journals.[4] He also produced over 30 endoscopic films and more than 20,000 colored slides to teach and inform interested colleagues about his technique. Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomifene and gonadotrophins. In general, infertility is defined as the inability of couples to achieve pregnancy after ≥1 year of trying (1). Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994. For women aged 35, about 94% who have regular unprotected sexual intercourse get pregnant after three years of trying. On the other hand, swollen, painful, or tender testicles may be a sign of an underlying issue, such as an infection, that can also impact sperm quality and male fertility. The dynamics of stress in fertile and infertile couples.