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The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. Quantitative Evaluation of Spermatogenesis by Testicular Histology in Men with Congenital Absence of the Vas Deferens Undergoing Epididymal Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1990. In some women, and especially with age, the membrane becomes harder. Normal Pregnancies Resulting from Testicular Sperm Extraction and Intracytoplasmic Sperm Injection for Azoospermia Due to Maturation Arrest. (PDF, 6 MB) Fertility and Sterility, 1996.

Effect of male age on fertility: evidence for the decline in male fertility with increasing age. These include advancing maternal age, severe male factor infertility (whereby ICSI can be used to fertilize the egg), and endometriosis, amongst many others. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980.

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A complete pelvic exam should reveal any uterine hypoplasia, fibroids, adnexal tumors or cervical lesions and should indicate whether dyspareunia may be a problem. Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. Costs for fertility testing and treatments History The doctor will ask questions to try to get clues as to the cause of your infertility. 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. However, given that fertility in women is known to decline steadily with age, some providers evaluate and treat women aged ≥35 years after 6 months of intercourse without the use of contraception (1). Some medications increase the risk of fertility problems in men.

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Some methods may be used in concert with other methods. Factors affecting Fertility Low body weight - Women with BMI less than 19 and irregular menstruation should be counselled to gain weight. Smoking - Strong association between smoking and fertility in both partners. - Affects success rates of ARTs. Prolonged estrus may be caused by ovarian cysts that produce estrogen, functional ovarian tumors, or exogenous estrogens (including human transdermal hormone replacement therapy). Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. The likelihood of fertilization improves significantly for men with low sperm concentrations.

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In addition, antibodies are present in 35% of patients with CBAVD. Infertility is defined as a failure to conceive within one or more years of regular unprotected coitus. Injuries include abdominal wall hematoma, umbilical hernias, umbilical wound infection, and penetration of blood vessels or small or large bowel.[24] The risk of such injuries is increased in patients who have a low body mass index[25] or have a history of prior abdominal surgery. Fertilizing Capacity of Epididymal and Testicular Sperm with ICSI. (PDF, 5 MB) Frontiers in Endocrinology, 1995. In ZIFT, your doctor places the fertilized eggs -- at this stage called zygotes -- into your fallopian tubes within 24 hours. Some causes, such as hyperprolactinemia, are reversible with proper treatment. To reach timely ovulations, ovulation triggers are combined with chorionic gonadotropin (beta-HCG). Allocation of medical resources that could be used elsewhere The legal status of embryos fertilized in vitro and not transferred in vivo. (See also beginning of pregnancy controversy).