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Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way.[21] In the United States some treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for Family and Medical Leave Act leave. Therefore we recommend a fertility evaluation if a couple has been attempting pregnancy for 6 months or more when the woman is 35 years of age or older. ICSI can be performed when sperm counts are extremely low or abnormal.

Reducing the risk of multiple pregnancies Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. 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.

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IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. Veltman-Verhulst SM, Cohlen BJ, Hughes E, Heineman MJ.

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With this condition, boys are born with a different chromosomal make-up, generating an absence of spermatozoa production or minimum generation of sperm that ceases at an early age. It can be done with a patient’s sperm, if possible. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. In most cases however, sperm function may not improve and therefore any attempts at pregnancy may require additional treatments or procedures performed by our clinic. Exposure to chemicals: Pesticides, for example, may increase the risk. Fresh Ovarian Tissue and Whole Ovary Transplantation. (PDF, 373 KB) Seminars in Reproductive Medicine, 2009.

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Renal Echinococcus. (PDF, 1 MB) The Journal of Urology, 1972. Often, varicoceles or past infections such as mumps orchitis are the cause of sterility. The use of surgical humidification therapy, which is the use of heated and humidified CO2 for insufflation, has been shown to reduce this risk.[27] Many patients with existing pulmonary disorders may not tolerate pneumoperitoneum (gas in the abdominal cavity), resulting in a need for conversion to open surgery after the initial attempt at laparoscopic approach. Healthcare providers may also conduct a semen analysis to check the number, shape, and movement of sperm. These include advancing maternal age, severe male factor infertility (whereby ICSI can be used to fertilize the egg), and endometriosis, amongst many others. Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying. While orchitis develops a few days after the onset of parotid gland inflammation, it may also precede it. The testicular-epididymal component includes sperm and comprises about 5% of the ejaculate volume. Environmental vs Genetic Sex Determination: A Possible Factor in Dinosaur Extinction? (PDF, 307 KB) Fertility and Sterility, 2004.