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3) Tubal occlusion (blockage): As discussed previously, a history of sexually transmitted infections including chlamydia, gonorrhea, or pelvic inflammatory disease can predispose a woman to having blocked fallopian tubes. Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin.

In vitro fertilization[edit] IVF is the most commonly used ART. Sherman Silber: Be Fruitful and Multiply. (PDF, 6 MB) Lifestyles Magazine, 1999. The pathophysiology of the disease is not well understood, but a massive extravascular accumulation of fluid occurs that is associated with a severe depletion of the intravascular volume responsible for dehydration, hemoconcentration, and electrolyte imbalance (ie, hyponatremia, hyperkalemia). [193] Ovarian hyperstimulation syndrome can be mild, moderate, or severe. [194] Mild ovarian hyperstimulation syndrome is characterized by ovarian enlargement (up to 5-12 cm in diameter), minimal ascites, and weight gain of less than 10 lb. However, some have suggested that patients should avoid conception for 6 months to 2 years after completion of radiation therapy because of the possibility of chromosomal aberrations in their sperm caused by the mutagenic properties of radiation therapy. 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.

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If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s. Varicocele The veins in a man’s scrotum (sac) can become too large. Contents Signs and symptoms[edit] Anovulation is usually associated with specific symptoms.

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Ovarian Transplantation in a Series of Monozygotic Twins Discordant for Ovarian Failure. (PDF, 188 KB) The New England Journal of Medicine, 2007. It will take time until these studies can be available for clinics and patients as a regularity. Preliminary Tests of a New Reversible Male Contraceptive in Bush Dog, Speothos Venaticus: Open-ended Vasectomy and Microscopic Reversal. (PDF, 106 KB) Journal of Zoo and Wildlife, 2006. Alternatively, the patient may bypass surgical treatment and proceed directly to intrauterine insemination or in vitro fertilization, depending on the severity and the female partner's age.

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If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation. Negative tests with immotile sperm in the cervical mucus suggest rare immunological causes of sterility. Klinefelter�s Syndrome: Is a genetic condition in which each cell in the human body has an additional X chromosome--men with Klinefelter�s Syndrome have one Y and two X chromosomes.  Physical symptoms include peanut-sized testicles and enlarged breasts.  A chromosome analysis is used to confirm this analysis.  If this condition is treated in its early stages (with the drug hCG), sperm production may commence and/or improve.  However, Klinefelter�s Syndrome eventually causes all active testicular structures to atrophy.  Once testicular failure has occurred, improving fertility is impossible. If they are blocked, it indicates the site of the block. Idiopathic Hypercalciuria. (PDF, 1 MB) New England Journal of Medicine, 1971. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 7 MB) Nature Genetics, 1995. Radiation therapy: This can impair sperm production. An Azoospermic Man with a do novo Point Mutation in the Y-chromosome Gene USP9Y. (PDF, 381 KB) Nature Genetics, 1999. ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990. Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment.