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Worldwide, 8 to 12 percent of couples experience fertility problems. Patients who do not achieve ovulation after three to six cycles should be referred to an infertility specialist for further treatment. Isodicentric Y Chromosomes and Sex Disorders as Byproducts of Homologous Recombination that Maintains Palindromes. (PDF, 1 MB) Cell, 2009. Clomiphene citrate for unexplained subfertility in women. For in-vitro fertilization, a 100,000 of sperm are necessary and, for the intracytoplasmatic sperm injection, only a few sperms are required. Microsurgery in Pediatric Urology. (PDF, 13 MB) The National Foundation, 1977.

Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity. Intracytoplasmic Sperm Injection Today: A Personal Review. (PDF, 5 MB) Human Reproduction, 1998.

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47 Motivational interviewing techniques for modifiable risk factors, such as obesity, tobacco, illicit drugs, and alcohol, can decrease the targeted risk factor. This technique should be reserved for myomas with a diameter less than 6 cm. [123] Several cases have been reported of uterine rupture during pregnancy because the reconstruction of the uterus after laparoscopic myomectomy was not as good as a myomectomy performed using laparotomy. [124] Operative hysteroscopy: The removal of a submucous fibroid using hysteroscopy should be limited to small fibroids (≤3 cm) with minimal compromise of the myometrium. [81] This is important to decrease the risk of excessive bleeding and to decrease the risk of electrolyte imbalance, water intoxication, and pulmonary edema from excessive intravasation of Hyskon, glycine, or sorbitol used during the procedure. A review of systems and physical examination of the endocrine and gynecologic systems should be performed. The Varicocele Dilemma. (PDF, 139 KB) Human Reproduction, 2001. Paternal age > or = 40 years: an important risk factor for infertility.

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Three regions have been described, called azoospermic factors a, b, and c (AZFa, AZFb, AZFc).[24] These deletions are observed in 3-19% of patients with idiopathic infertility and 6-14% of patients with oligospermia, although up to 7% of patients with other known causes of infertility may also be found to have a deletion. The production of anti-sperm antibodies by the woman’s immune system can interfere with fertilization.

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Successful Pregnancy and Delivery after Calcium Ionophore Oocyte Activation in a Normozoospermic Patient with Previous Failed Fertilization after Intracytoplasmic Sperm Injection. (PDF, 57 KB) Fertility and Sterility, 2003. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements. As sperm move from the head to the tail, they mature and acquire fertilization capacity. PID leads to a blockage of the fallopian tubes, which prevents fertilization. Endometriosis causes infertility by producing inflammation and scarring, which can result in not only pain but also potentially detrimental effects on egg, sperm or embryo. Further reading[edit] Fertility: Assessment and Treatment for People with Fertility Problems. The use of Epididymal and Testicular Spermatozoa for Intracytoplasmic Sperm Injection: The Genetic Implications for Male Infertility. (PDF, 8 MB) Human Reproduction, 1995.