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Postcoital testing and antisperm antibody testing are no longer considered useful in this evaluation. Although many of these can be treated through surgery or hormonal substitutions, some may be indefinite.[59] Infertility associated with viable, but immotile sperm may be caused by primary ciliary dyskinesia. ART procedures, such as GIFT, IVF, and ICSI, also can be used in cases of male infertility. Treatment[edit] Treatment depends on the cause of infertility, but may include counselling, fertility treatments, which include in vitro fertilization. Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". The patient should be prescribed high-dose estradiol (5 mg qd for 21 d) followed by medroxyprogesterone (10 mg for 10 d).

The likelihood of fertilization improves significantly for men with low sperm concentrations. Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying. In vitro fertilization (IVF). In this technique, your doctor places into your uterus that were fertilized in a dish. An on-line WHO infertility virtual consultation course includes a 5 module WHO evidence-based medicine course, as well as a 16 module ASRM eLearning course which reviews the evidence-base for the basic diagnosis of the infertile male and female, coupled with management and treatment.

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We can sometimes see evidence of pelvic scarring, such as when an ovary appears to be stuck to the uterus. Intracytoplasmic Sperm Injection Today: A Personal Review. (PDF, 5 MB) Human Reproduction, 1998. If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s. It can also help if a man has severe erectile dysfunction. The relation between daily activities and scrotal temperature. Many health conditions can make it hard to get pregnant.

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There's a link between increased temperature of the scrotum and reduced semen quality, but it's uncertain whether wearing loose-fitting underwear improves fertility.  Testicles The testicles produce and store sperm. Those with a varicocele diagnosable only on scrotal ultrasonography have subclinical varicoceles and will likely not benefit from repair. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. If pregnancy has not been established within a reasonable time, further evaluation and/or an alternative treatment plan should be considered.

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37 Clomiphene has also proven effective for ovulation induction in women with polycystic ovary syndrome. The pulsatile nature of GnRH is essential to normal gonadotropin release; a continuous stimulation inhibits their secretion. Fertilized eggs are then transferred several days later into the woman’s uterus, where implantation and embryo development will hopefully occur as in a normal pregnancy. A causal therapeutic approach does not exist and an important component is the prevention of hyperstimulation syndrome. The Disappearing Male. (PDF, 1 MB) From Towards Reproductive Certainty, 1999. Allocation of medical resources that could be used elsewhere The legal status of embryos fertilized in vitro and not transferred in vivo. (See also beginning of pregnancy controversy). Congenital Adrenal Hyperplasia: Occurs when the pituitary is suppressed by increased levels of adrenal androgens.  Symptoms include low sperm count, an increased number of immature sperm cells, and low sperm cell motility.  Is treated with cortisone replacement therapy.  This condition is found in only 1 percent of infertile men. Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity. This technique is called hand-assist laparoscopy.