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In patients with obstructive azoospermia and normal gonadotropin levels, sperm can be obtained through microsurgical epididymal sperm aspiration or testicular biopsy. [213] Fertilization of the oocytes is performed using IVF/intracytoplasmic sperm injection. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. First-line therapy is the ultrasound-guided transvaginal puncture. Heavy, long, or painful periods Heavy periods may indicate an underlying condition affecting fertility. Hormonal analysis reveals increased gonadotropin levels, while 60% have decreased testosterone levels. After fertilization, implantation may then take place in the uterus.

In these cases the duration of the infertility is the best parameter by which to judge the chances of future natural conception; the longer the time of infertility then the sooner intervention should be considered.Summary Infertility is a term doctors use if a man hasn't been able to get a woman pregnant after at least one year of trying. Endometriosis can only be confirmed by surgery, usually laparoscopy. Fertility Evaluation of the Male Partner: Semen Analysis Semen analysis is an essential part of the evaluation.

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Some surgeons perform these procedures completely laparoscopically, making the larger incision toward the end of the procedure for specimen removal, or, in the case of a colectomy, to also prepare the remaining healthy bowel to be reconnected (create an anastomosis). In most cases, only 1 follicle is recruited and develops until ovulation. Reducing the risk of multiple pregnancies Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets.

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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. ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990.

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389 KB ARTICLES FROM THE 1980s Microsurgical Reversal of Female Sterilization: The Role of Tubal Length. (PDF, 2 MB) Fertility and Sterility, 1980. A decreased testosterone level with an increased FSH level points to primary hypogonadism. 1,2 However, if your partner is 35 years old or over, you or your partner may be considered infertile if you haven’t conceived after 6 months of unprotected sex. A doctor or WHNP takes a medical history and gives a physical examination. Ultrasound can detect uterine abnormalities such as fibroids and polyps, distal fallopian tube occlusion, and ovarian abnormalities including ovarian cysts. Reproductive Biology. (PDF, 147 KB) The Scientist, 1996. Secondary fertility involves one or both partners who have conceived previously, but are now unable to do so because of a possible physical or medical condition impairing fertility. 8 These studies are more sensitive and may delineate an abnormally formed uterus or structural problems, such as fibroids.