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It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). Coital frequency is positively correlated with pregnancy rates.

Pro-life opposition to the destruction of embryos not transferred in vivo. According to the literature survey, the most common causes of infertility are: male factor [5,7-9,13-15] such as sperm abnormalities [9,13,15], female factor [7-9,14-16] such as ovulation dysfunction [7,8] and tubal pathology [7-9], combined male and female factors [7,9,14,15] and unexplained infertility; where no obvious cause could be detected [7-9]. In-vitro fertilization (IVF.)Sperm are mixed with multiple eggs collected from the woman in a “test tube” (actually just a plastic dish.). Limits were placed on language and human race as well. Outcome of Intracytoplasmic Sperm Injection with Testicular Spermatozoa in Obstructive and Non-obstructive Azoospermia. (PDF, 426 KB) Human Reproduction, 1996. Successful Autotransplantation of an Intra-abdominal Testis to the Scrotum by Microvascular Technique. (PDF, 11 MB) The Journal of Urology, 1976.

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Sperm are then collected, washed, and added to the eggs in the dish. Medical manipulation with prostaglandins is usually unrewarding, and ovariectomy with histopathology is indicated. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. The ovaries can stop working in about 5% of cases. It is specially oriented for cancer patients, whose sperm is destroyed due to the gonadotoxic treatment they are submitted to.[70] Ovaric stem cells: it is thought that women have a finite number of follicles from the very beginning.

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The emotional toll on both partners can affect their relationship. Primary sterility is the complete inability to become pregnant, while secondary sterility refers to the failure to conceive after a previous successful pregnancy. Although many of these can be treated through surgery or hormonal substitutions, some may be indefinite.[59] Infertility associated with viable, but immotile sperm may be caused by primary ciliary dyskinesia.

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The risk of ovarian hyperstimulation syndrome and multiple pregnancy is heightened; therefore, hMG should be started at the minimal dose (75 IU SC qd for 7 days). The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[65] Women over the age of 35 should see their physician or WHNP after six months as fertility tests can take some time to complete, and age may affect the treatment options that are open in that case. Similarly, bilateral obstruction of the sperm ducts can cause azoospermia and infertility. A low testosterone level with a low FSH level signals a secondary cause. High-cost treatments are out of financial reach for some couples. Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. 37,38 The addition of 1,500 to 1,700 mg of metformin (Glucophage) daily may increase ovulation and pregnancy rates, but it does not significantly improve live birth rates over clomiphene alone. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. This is called luteinised unruptured follicle syndrome (LUFS). Individual tests evaluate only one aspect of a quality necessary for fertility and do not imply the ability or inability to achieve conception (see the Table in the Procedures section). Couples may decide to go ahead regardless if the desire to become pregnant is very strong.