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Delayed conception and active and passive smoking. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. A decreased testosterone level with an increased FSH level points to primary hypogonadism. Ovulation-inducing drugs and ovarian cancer risk: results from an extended follow-up of a large United States infertility cohort. National Collaborating Centre for Women's and Children's Health. Generally, evaluation should be offered to couples who have not conceived after one year of unprotected vaginal intercourse.

8 These studies are more sensitive and may delineate an abnormally formed uterus or structural problems, such as fibroids. Results of Microsurgical Vasoepididymostomy: Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Human Reproduction, 1989. 549 KB Effect of Age on Male Fertility. (PDF, 5 MB) Chapter from textbook, Seminars in Reproductive Endocrinology, 1991. The doctor may ask about the couple's sexual habits and make recommendations regarding these. Sexual history – One of the purposes of obtaining a sexual history is to determine whether the partners have any sexual disturbance or dysfunction.

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Obesity and increased risk for oligozoospermia and azoospermia. If a tube is blocked and filled with fluid (called a hydrosalpinx), then minimally invasive surgery (laparoscopy or hysteroscopy) to either remove the tube or block/separate it from the uterus prior to any fertility treatments is recommended. Understanding the normal reproductive process is essential in knowing when to seek help.

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There are also a number of sperm production problems that can contribute to infertility, including: Scrotal varicose veins (varicoceles)  Scrotal varicose veins (varicoceles) are swollen veins causing your testicles to get hotter and affect the production of sperm  These are treated with surgery  Testicular injury   Serious trauma to the testicles such as becoming twisted (torsion) can affect sperm production  Damage from playing sports or an accident can rupture the vessels that supply blood to the testicles  Previous injuries can’t be treated, but an ART treatment may help you to conceive Undescended testicles  In the uterus, baby boys’ testicles form in their abdomen and descend into their scrotum shortly before birth  Some men’s testicles don’t descend before they are born (cryptorchidism), although in these cases they usually drop in the first six months after birth  If left untreated, undescended testicles can affect fertility Testicular cancer  This happens when a malignant tumour in the testicle destroys testicular tissue  If undetected, testicular cancer can spread to other parts of the body  This is treated either by surgery, medication, radiotherapy or chemotherapy  However, cancer therapy can also damage sperm production  Genetic defects  Sometimes, genetic information on the Y chromosome (which is only present in men) is deleted (micro-deletions),6 which can reduce the production of sperm  Depending on where the micro-deletion is on the chromosome, this may be treated by surgically extracting sperm from part of your reproductive tract  However, some couples may need to consider using a donor sperm to conceive Mumps Contracting mumps (or mumps-related orchitis) after puberty may damage the sperm-producing cells in your testicles,  causing infertility or subfertility7 Usually, only one testicle is affected and if you have one functioning testicle you may not need treatment  However, some couples may need to use a sperm donor in order to conceive Anti-sperm antibodies  Anti-sperm antibodies are large proteins in your blood that are hostile to sperm  They can cause sperm to clump together and prevent them from swimming, or they may mistake sperm cells for an infection and try to destroy them  This can be treated using an ART treatment   Lifestyle   Sperm production can be affected by a range of lifestyle factors, including smoking, drinking, drugs, stress, overweight and unhealthy food Environmental factors can also affect your sperm quality, including overheating of your testicles, some sexual lubricants, the chemicals involved in certain manufacturing, painting or printing jobs   These factors are treated by making lifestyle changes, such as wearing loose clothing to avoid overheating Hormonal problems  Hormonal problems are rarely the cause of male infertility problems  However, some men have a natural deficiency in follicle-stimulating hormone (FSH) and luteinising hormone (LH), which prevents the testicles from producing testosterone or developing healthy sperm  Hormonal problems can usually be treated with medication Obstruction problems Blocked sperm ducts  Occasionally, male sperm ducts (epididymis and vas deferens) can become blocked, meaning that your semen doesn’t contain any sperm  This can be treated with surgery, or sperm may be surgically extracted from part of your reproductive tract  Vasectomy  Some men have had a previous vasectomy to stop them being able to conceive  This can sometimes be reversed using surgery  The procedure’s success depends on how long ago your vasectomy was performed  Previous infections  Infections can cause scarring or adhesions (organs sticking together) in your sperm ducts  This can usually be treated with surgery  Does age affect male fertility? GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer).  Like IVF, these procedures involve retrieving an egg, combining it with sperm in a lab, and then transferring it back to your body. Estrous cycle abnormalities can cause infertility. Do you have pain with menstrual periods or intercourse? Y Chromosome Deletions in Azoospermic and Severely Oligozoospermic Men Undergoing Intracytoplasmic Sperm Injection after Testicular Sperm Extraction. (PDF, 336 KB) Human Reproduction, 1998. 8-Mb Deletion in the Azoospermia Factor c Region. (PDF, 332 KB) Genomics, 2004.

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6 million (6%) married women aged 15–44 years in the United States reported difficulty getting pregnant (3). Infertility and Impaired Fecundity in the United States, 1982-2010: Data from the National Survey of Family Growth. Renal Echinococcus. (PDF, 1 MB) The Journal of Urology, 1972. 4) In Vitro Fertilization (IVF): In vitro means “outside the body.” IVF is a process whereby eggs are collected and then fertilized by sperm outside the body, in an embryology laboratory. Exposure to chemicals: Pesticides, for example, may increase the risk. Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb. Intra-uterine insemination for male subfertility. The presence of antibodies in serum or seminal plasma is less prognostic than antibodies bound to sperm. Empirical treatment with controlled ovarian hyperstimulation followed by intrauterine insemination has improved the pregnancy rate in those patients. [214] If pregnancy does not occur during the first 4 intrauterine insemination cycles, other alternatives include IVF or any of the associated assisted reproductive technologies procedures.Background Infertility is a common clinical problem. Ideally, the test should be performed at least twice to confirm results. Although the XXY pattern is observed in the spermatogonia and primary spermatocytes, many of the secondary spermatocytes and spermatids have normal patterns. Dealing with Fertility Problems After Vasectomy Reversal. (PDF, 7 MB) Contemporary OB/GYN, 1978. Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity. Ideally, using strict morphology criteria, a minimum of 5 – 15% normal forms leads to a better ability for sperm to fertilize the egg.