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3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). Treatment of Tubal and Peritoneal Factors The treatment of tubal-factor infertility underwent major changes, especially during the last quarter of the century when microsurgery became available. [126, 127] Tubal reconstruction was the only hope for those patients before assisted reproductive therapy became available. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. Judaism and Repoductive Technology. (PDF, 160 KB) 2003. Cervical surgery can sometimes cause scarring or shortening of the cervix.

The laboratory evaluation begins with a semen analysis. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity. The mammary glands are also controlled by the pituitary gland, so lactation can also be affected. To assist in the luteal phase, the patient is given beta-HCG or progesterone. In humans, infertility is the inability to become pregnant after one year of intercourse without contraception involving a male and female partner.[2] There are many causes of infertility, including some that medical intervention can treat.[3] Estimates from 1997 suggest that worldwide about five percent of all heterosexual couples have an unresolved problem with infertility. The most common technique of artificial insemination in human beings is intrauterine insemination.

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Production of the First Offspring from Oocytes Derived from Fresh and Cryopreserved Pre-antral Follicles of Adult Mice. (PDF, 2 MB) Reproductive BioMedicine Online, 2007. Are Sequence Family Variants Useful for Identifying Deletions in the Human Y Chromosome? (PDF, 377 KB) The American Journal of Human Genetics, 2004. One of the best known is the HFEA – The UK's regulator for fertility treatment and embryo research. There is more controversy regarding intramural fibroids, where larger ones may have an impact and may necessitate removal.

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By the end of this step, most of healthcare professionals will be able to sketch out their provisional diagnosis. For a woman to conceive, certain things have to happen: vaginal intercourse must take place around the time when an egg is released from her ovary; the system that produces eggs has to be working at optimum levels; and her hormones must be balanced.[54] For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs. Instructions for collecting the sample should include abstinence from ejaculation for 48 to 72 hours. Surgical Management of Male Infertility. (PDF, 2 MB) Chapter 12 from textbook, Male Infertility, 1992. Blood tests Depending on the individual couple's situation, various blood tests on either the female or the male may be needed.

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These include: non-steroidal anti-inflammatory drugs (NSAIDs) – long-term use or a high dosage of NSAIDs, such as ibuprofen or aspirin, can make it more difficult to conceive chemotherapy – medicines used for chemotherapy can sometimes cause ovarian failure, which means your ovaries will no longer be able to function properly neuroleptic medicines – antipsychotic medicines often used to treat psychosis; they can sometimes cause missed periods or infertility spironolactone – a type of medicine used to treat fluid retention (oedema); fertility should recover around 2 months after you stop taking spironolactone Illegal drugs, such as marijuana and cocaine, can seriously affect fertility and make ovulation more difficult. Less than 50% motility may significantly affect the ability for sperm to fertilize the egg without therapy; and (4) morphology, or shape – there are three parts of the sperm that are analyzed for morphology: the head, midpeice, and tail. This relatively simple test involves the man providing a semen sample for a lab to evaluate. Mumps, leading to orchitis (testicular inflammation), may cause secondary testicular atrophy in the small number of men infected after puberty. In collaboration with partners, CDC developed the National Public Health Action Plan for the Detection, Prevention, and Management of Infertility, which identifies opportunities to prevent and reduce infertility and improve outcomes for couples undergoing fertility treatment. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue. Ejaculation disorders Ejaculation disorders include premature ejaculation, anejaculation (the failure to ejaculate), and retrograde ejaculation, which is when semen enters the bladder during orgasm instead of coming out the tip of the penis. 8 Couples with unexplained infertility may want to consider another year of intercourse before moving to more costly and invasive therapies, such as assisted reproductive technology. ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990.