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Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. Factors Affecting Fertility: Timing of Intercourse Intercourse prior to ovulation is key to maximizing the chance of pregnancy. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989. Apparently there are only 0,014% of them (this could be an explanation of why they were not discovered until now). Men with elevated prolactin levels present with gynecomastia, diminished libido, erectile dysfunction, and occasionally galactorrhea.

Source : Infertility for the Family Doctor - PPT Presentation Summary : unexplained infertility. planning assisted reproduction. ... Some medications increase the risk of fertility problems in men. Counseling Fertility clinics should address the psycho-social and emotional needs of infertile couples as well as their medical needs. El Uso de las Espermátides en la Azoospermia. (PDF, 12 MB) Chapter 42 from Reproducción Humana, 2002.

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Due to improved patient outcomes, in the last two decades, laparoscopic surgery has been adopted by various surgical sub-specialties, including gastrointestinal surgery (including bariatric procedures for morbid obesity), gynecologic surgery, and urology. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979. Congenital Absence of the Vas Deferens: The Fertilizing Capacity of Human Epididymal Sperm. (PDF, 3 MB) New England Journal of Medicine, 1990. Ovarian Transplantation between Monozygotic Twins Discordant for Premature Ovarian Failure. (PDF, 315 KB) The New England Journal of Medicine, 2005. Opinion: Microsurgical TESE and the Distribution of Spermatogenesis in Non-obstructive Azoospermia. (PDF, 5 MB)Human Reproduction, 2000. Carcinoma in the Bladder Left Behind. (PDF, 3 MB) The Journal of Urology, 1973.

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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). Optimizing natural fertility: a committee opinion. It is a new opportunity, not only for partners with lack of gamets, but also for homosexuals and single people who wants to have offspring. 47 Motivational interviewing techniques for modifiable risk factors, such as obesity, tobacco, illicit drugs, and alcohol, can decrease the targeted risk factor. Surgical Management of Male Infertility. (PDF, 2 MB) Chapter 12 from textbook, Male Infertility, 1992.

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Patients generally have long arms and legs due to a delayed closure of the epiphyseal plates, delayed puberty, and atrophic testis. This pill generally is taken from menstrual cycle days 3 – 7. Microscopic Technique for Reversal of Vasectomy. (PDF, 3 MB) Surgery, gynecology & obstetrics, 1976. Other hormones including inhibin B and leptin, may also be affected by obesity. Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction. The procedure is performed in an outpatient setting in the vast majority of cases, and recovery time can be as little as a few days. Additionally, surgery, radiation or chemotherapy to treat tumors can affect male fertility. Ovulation often can be detected by keeping a menstrual calendar or using an ovulation predictor kit. Corticosteroids are usually used to reduce the production of testosterone. 6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs. Theoretically, with this therapy, we can get artificial gamets in vitro. However, medical treatment can be used to reduce the myoma size prior to removal.