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As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). Meticulous hemostasis is imperative. [131, 132, 133] Operative laparoscopy was reintroduced into the surgical armamentarium in the 1950s; however, in the 1970s, Semm developed different procedures and operative instruments that currently allow for the outpatient laparoscopic surgical treatment of multiple tuboperitoneal pathologies, [91] electrocautery, endocoagulation, lasers, and ultrasonography scalpels facilitate the performance of operations that otherwise used to require a laparotomy.

However, about one in five cases of infertility has no clear diagnosed cause.[73] In Britain, male factor infertility accounts for 25% of infertile couples, while 25% remain unexplained. Cervical factors are also thought to play a minor role, although they are rarely the sole cause. The number of days in between each period varies each month. Tubal obstruction and lysis of adhesions can be corrected through laparotomy, operative laparoscopy, and, in special circumstances, through operative hysteroscopy and tubal cannulation. Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994.

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Reduced secretion of cervical mucus due to destruction of the endocervical glands by previous cervical conization, freezing, or laser vaporization responds poorly to low-dose estrogen therapy. The epididymis is a coil-like structure in the testicles which helps store and transport sperm.

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Nevertheless, scientists have found these stem cells, which may generate new oocites in postnatal conditions. Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying. She will also undergo a gynecologic examination and a number of tests: Laparoscopy involves inserting a thin tube with a camera on to investigate and possibly remove unwanted tissue. Genetics of Male Infertility: Evolution of the X and Y Chromosome and Transmission of Male Infertility to Future Generations. (PDF, 10 MB) Chapter 5 from Essential IVF, 2004. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue.

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Source : How To Use California’s Department Of Managed Health Care ... Immunological testing has not been proven to have any value in infertility patients without a history of 2 or more miscarriages. Antibodies that are bound to sperm decrease the sperm’s ability to penetrate the cervical mucus and bind to the zona pellucida. Reproductive Biology. (PDF, 147 KB) The Scientist, 1996.