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3) Insemination: Intrauterine insemination, also known as IUI, 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. Unhealthy living and poor eating habits, as well as exposure to toxic substances such as alcohol, tobacco and other contaminants, also have a negative impact on fertility. Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. One of the best known is the HFEA – The UK's regulator for fertility treatment and embryo research. Some methods may be used in concert with other methods. Apparent Fertility of Human Spermatozoa from the Caput Epididymidis. (PDF, 4 MB) Journal of Andrology, 1989.

Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous.

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Pro-life opposition to the destruction of embryos not transferred in vivo. In 1985, Erich Mühe performed the first laparoscopic cholecystectomy. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Malformations are the primary organic causes of sterility.

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Veltman-Verhulst SM, Cohlen BJ, Hughes E, Heineman MJ. 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. If the epididymis is blocked, sperm may not be ejaculated properly. Antibodies against the sperm in the cervical mucus particularly often occur in sterile marriages. Fertility Evaluation: Obstetric and Gynecological History The obstetric and gynecological history should include: Reproductive history (children, mode of delivery, prematurity, stillbirth, extrauterine pregnancy, spontaneous and induced abortion, fertility and infertility in earlier relationships).

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Feedback inhibition is from testosterone and inhibin. If conception does not occur after many months or years of trying, it can lead to stress and possibly depression. The entire process of development from spermatogonium to spermatid takes 74 days and is described in 14 steps; as they mature, the developing spermatids progress closer to the lumen of the seminiferous tubule. One-third of couples will discover fertility problems in only the woman. The opening improves the ability of the embryo to implant into the uterine lining. 3  Sometimes, a couple who’ve already had a child can have trouble conceiving again. Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women. Listen to Professor Cheong talk about the fertility investigations we offer       Repeated pregnancy loss Some people may not have difficulty conceiving, but have suffered from miscarriages. Full history taking of both partners usually denotes the underlying problem [17-23], (Appendix 1). Intracytoplasmic sperm injection[edit] ICSI technique is used in case of poor semen quality, low sperm count or failed fertilization attempts during prior IVF cycles. IVF is Generally Performed in the Following Manner: The woman undergoes gonadotropin injections, which stimulate the ovaries to produce many eggs. Investigations will be requested to prove the clinical diagnosis and to exclude other close possibilities. CC has been in clinical use since the early 1960s. The couple should have sex at least every two days between the 10th and 18th day after the woman starts her period.