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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. It does not affect the couples' life only, but it also affects the healthcare services and social environment [4]. These may cause abortion, neonatal death, fetal resorption, and apparent infertility.

6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs. Men can still ejaculate with a low sperm count or poor-quality sperm.

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Many more couples, however, experience involuntary childlessness for at least one year: estimates range from 12% to 28%.[4] Male infertility is responsible for 20–30% of infertility cases, while 20–35% are due to female infertility, and 25–40% are due to combined problems in both parts.[2][5] In 10–20% of cases, no cause is found.[5] The most common cause of female infertility is ovulatory problems, which generally manifest themselves by sparse or absent menstrual periods.[6] Male infertility is most commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.[7] Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile for the rest of the menstrual cycle. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer. Our miscarriage clinic can help investigate these issues and attempt to help couples with any future pregnancy. Feedback inhibition is from testosterone and inhibin. Heterologous or therapeutic insemination, formerly called artificial insemination by donor sperm, refers to the use of frozen sperm that has been quarantined for at least 6 months. [108] Thereafter, the specimen is ready to use once the donor has undergone the necessary screening tests required by the tissue bank, the US Food and Drug Administration (FDA), and the American Society for Reproductive Medicine (ASRM). [111] The source of the sperm can be either anonymous or from a donor designated by the couple. Female age of 35 years or older: For unclear reasons, egg numbers decrease at a rapid rate as women age.

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Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989. Reducing the risk of multiple pregnancies Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. Microsurgery Successful in Vasectomy Reversals. (PDF, 156 KB) The New York Times, 1975. Defects in cilia Immotile cilia syndrome may occur as an isolated disorder or as part of Kartagener syndrome with situs inversus. Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments. Placenta Percreta Invading Bladder. (PDF, 2 MB) The Journal of Urology, 1973.

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Semen analysis The semen analysis is a very important test and should be done early in the evaluation process. Immunological testing has not been proven to have any value in infertility patients without a history of 2 or more miscarriages. Treatment of the cause: 25. Ovulation disorders: (Group II “PCO”) 1. Blocked tubes Sperm travel in tubes from the man’s testes to the penis. Excess iron from multiple transfusions may get deposited in the pituitary gland and the testis, causing parenchymal damage and both pituitary and testicular insufficiency. Patients with adrenal hyperplasia and other disorders must be treated with prednisone. The predictive value of hysterosalpingography for tubal and peritoneal infertility factors. Embryos transfer is performed in the office under abdominal ultrasound guidance using a small, soft, sterile and flexible catheter. If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF). Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995.