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In this case, your doctor may recommend surgically extracting sperm from part of your reproductive tract to help you to conceive. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. In 1901, Georg Kelling of Dresden, Germany, performed the first laparoscopic procedure in dogs, and, in 1910, Hans Christian Jacobaeus of Sweden performed the first laparoscopic operation in humans.[35] In the ensuing several decades, numerous individuals refined and popularized the approach further for laparoscopy.

8 If a woman has irregular cycles, the testing should be conducted later in the cycle, starting seven days before presumed onset of menses, and repeated weekly until menses. Hypogonadotropic Hypopituitarism: Low pituitary gland output of LH and FSH.  This condition arrests sperm development and causes the progressive loss of germ cells from the testes and causes the seminiferous tubules and Leydig (testosterone producing) cells to deteriorate.  May be treated with the drug Serophene.  However, if all germ cells are destroyed before treatment commences, the male may be permanently infertile. Other hormones including inhibin B and leptin, may also be affected by obesity. Debate: Are Spermatid Injections of any Clinical Value? (PDF, 6 MB) Human Reproduction, 1998.

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41 Treatment of Unexplained Infertility Jump to section + Couples who have no identified cause of infertility should be counseled on timing of intercourse for the most fertile period (i.e., the six days preceding ovulation). 8,33,35,36 Lastly, in vitro fertilization, with or without intracytoplasmic sperm injection, is the mainstay of assisted reproductive technology for male factor infertility. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979. Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW.

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Following his lecture on laparoscopic appendectomy, the president of the German Surgical Society wrote to the Board of Directors of the German Gynecological Society suggesting suspension of Semm from medical practice. Luciano AA, Peluso J, Koch EI, Maier D, Kuslis S, Davison E. Ongoing Pregnancies and Birth after Intracytoplasmic Sperm Injection with Frozen-thawed Epididymal Spermatozoa. (PDF, 442 KB) Human Reproduction, 1995.

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The effects of age on fertility are moderate and do not begin to take an effect until the late 30s. Other symptoms of endometriosis include: chronic pelvic pain (not only during menstruation) pain during sex back pain fatigue nausea irregular periods and spotting bowel problems or pain with bowel movements Dark or pale menstrual blood If menstrual blood is regularly paler than usual, this may be a cause for concern. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Lifestyle Factors Jump to section + All couples should be counseled to abstain from tobacco use, limit alcohol consumption, and aim for a body mass index less than 30 kg per m2 to improve their chances of natural conception or using assisted reproductive technology. Arcuate uterus In general, an arcuate uterus does not cause infertility. Veltman-Verhulst SM, Cohlen BJ, Hughes E, Heineman MJ. It could be related to hormone issues, to endometriosis, or to other underlying conditions that could also be contributing to infertility. Women attempting pregnancy at age 40 or older have a 50% decreased fertility rate and a two-fold to three-fold increased risk of spontaneous abortion compared with younger women. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. 10 Data Sources: A PubMed search was completed using the key terms infertility, subfertility, treatment, etiology, and diagnosis.