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About 25% of all infertility is caused by a sperm defect and 40-50% of infertility cases have a sperm defect as the main cause, or a contributing cause. The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility. A relationship also exists between obesity and erectile dysfunction (ED). Damaged tubes may interfere with fertilization of the egg and its transport into the uterine cavity.

Management of the infertile couple: an evidence-based protocol. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury. The acrosome, a derivative of the Golgi process, surrounds the nucleus anteriorly and contains enzymes necessary to penetrate the ovum. However, if the woman has previously been pregnant, regardless of the outcome (which may have been a premature or full-term delivery, spontaneous abortion, induced abortion or ectopic pregnancy), and is now unable to conceive, it is considered secondary infertility. Ejaculation disorders: If the ejaculatory ducts are blocked, semen may be ejaculated into the bladder Hormonal imbalance: Hypogonadism, for example, can lead to a testosterone deficiency. National Collaborating Centre for Women's and Children's Health.

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A hypothalamic-hypophyseal ovarian failure can lead to a reduced GnRH production, which, in turn, leads to an insufficient release of LH and FSH. The 2 techniques are the Strassman metroplasty and the Jones metroplasty. Sterilisation Some women choose to be sterilised if they don't want to have any more children. When Predictions Don’t Predict. (PDF, 549 KB) The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1991. The Relationship of Abnormal Semen Values to Pregnancy Outcome. (PDF, 770 KB) Chapter 10 from textbook, 1992. Testicular Sperm Extraction (TESE) and Intracytoplasmic Sperm Injection (ICSI) for Non-obstructive Azoospermia.(PDF, 1 MB) 10th World Congress on In Vitro Fertilization and Assisted Reproduction, 1997.

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They can include: Changes in hair growth Changes in sexual desire Pain, lump, or swelling in the testicles Problems with erections and ejaculation Small, firm testicles   When to See the Doctor If you are under 35 and have been trying to get pregnant without success for a year, see your doctor. This can make it difficult for the embryo to implant. Peripheral organ The hypothalamus-pituitary axis may be interrupted by hormonally active peripheral tumors or other exogenous factors, due to cortical excess, cortical deficiency, or estrogen excess. Symptoms include: bloating constipation dark urine diarrhea nausea abdominal pain vomiting They are usually mild and easy to treat. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. If the woman is age 35 years or older, she should see a healthcare provider after six months of trying to get pregnant.

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6,23 Anovulatory women should have further investigation to determine treatable causes such as thyroid disorders or hyperprolactinemia based on symptoms. Microsurgical Aspects of Varicocele. (PDF, 9 MB) Fertility and Sterility, 1979. For example; a woman who has no history suggestive of previous pelvic inflammatory disease or endometriosis, there is no justification to request a laparoscopy especially after normal hysterosalpingography study [33]. 29 When the semen analysis is abnormal, referral to a male fertility specialist or reproductive endocrinologist is warranted. About 10% of reproductive age women are affected by endometriosis. Subsequently, Semm submitted a paper on laparoscopic appendectomy to the American Journal of Obstetrics and Gynecology, at first rejected as unacceptable for publication on the grounds that the technique reported on was "unethical," but finally published in the journal Endoscopy.[40] The abstract of his paper on endoscopic appendectomy can be found at here. Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomifene and gonadotrophins.