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There is no reliable means to predict whether the use of any treatment option will be successful and after how many attempts. In men, cigarette smoking and alcohol use may cause poor sperm quality, and marijuana use can also be implicated in lower sperm motility and count. The hypothalamus, the primary integration center, responds to various signals from the central nervous system (CNS), pituitary gland, and testicles to secrete gonadotropin-releasing hormone (GnRH) in a pulsatile pattern approximately every 70-90 minutes. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1.

According to Ross, “anything that improves quality of health, like adequate sleep and nutrition,” should improve fertility. Nonliquefication of the semen can be differentiated from benign hyperviscosity by a normal postcoital test finding. 6,28 Additionally, postcoital testing of cervical mucus is no longer recommended because it does not affect clinical management or predict the inability to conceive.

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Uterine fibroids Fibroids are noncancerous growths in the uterus. Generally, they occur in 50-100% of all abdominal surgeries,[29] with the risk of developing adhesions being the same for both procedures.[30][31] Complications of adhesions include chronic pelvic pain, bowel obstruction, and female infertility. Disorders of the hypothalamus lead to hypogonadotropic hypogonadism. For this reason, a call for low-cost ART protocols have been attempt to reduce the overall current cost of IVF through limiting the rquired laboratory investigations, modifying the stimulation regimen and purchasing low-priced pre-used machines and instruments [35]. Specialized semen analysis, including genetic testing of the sperm (looking for the presence of antibodies) and evaluation of immobile sperm (to see if they are dead or alive). However, if the E2 level is greater than 100 pc/mL and the follicles are 10 mm in diameter, hMG should be continued at the same dose.

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Computer-aided semen analysis (CASA) Introduced in the late 1980s, CASA uses a video camera and computer to visualize and analyze sperm concentration and movement. Segmental dysplasia is defined as a vas deferens with at least 2 distinct sites of vasal obstruction. Ovulation-inducing drugs and ovarian cancer risk: results from an extended follow-up of a large United States infertility cohort. The pregnancy test is then performed 2 weeks after the egg retrieval. Vasoepididymostomy to the Head of the Epididymis: Recovery of Normal Spermatozoal Motility. (PDF, 3 MB)Fertility and Sterility, 1980.

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Preconception lifestyle advice for people with subfertility. Endometriosis  Endometriosis is a condition where the inner lining of the uterus, known as the endometrium, attaches and grows in other areas. To avoid this complication, the circulating nurse must record the amount of distention fluid injected and the amount recovered in the suction device. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. It could be caused by a tumour, taking illegal drugs, or Klinefelter syndrome, a rare syndrome where a man is born with an extra female chromosome. Medications Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility.