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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. Furthermore, as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases. A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men. Luteal phase support. (and cryopreservation choice offered if good quality embryos are available) IVF/ICSI 37. Down-regulation: - to avoid premature LH surge and spontenous ovulation. - either GnRH agonist protocol or GnRH antagonist protocol. - always use GnRH antagonist protocol in women with high risk of OHSS. Debate over whether health insurance companies (e.g. in the US) should be required to cover infertility treatment. In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant.

Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. Depending on the sperm count, the couple is advised to have intercourse near the time of ovulation or to proceed with intrauterine insemination. 6 million (6%) married women aged 15–44 years in the United States reported difficulty getting pregnant (3). Cervical factors are also thought to play a minor role, although they are rarely the sole cause. In men who have the necessary reproductive organs to procreate, infertility can be caused by low sperm count due to endocrine problems, drugs, radiation, or infection. The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility.

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35. In women aged under 40 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 3 full cycles of IVF, with or without ICSI. 18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20).

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Microsurgery in Clinical Urology. (PDF, 5 MB) Urology, 1975. However, intercourse 3 times a week results in a probability of conception around 50% within 6 months.

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Infertility service use in the United States: data from the National Survey of Family Growth, 1982–2010. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Women in group III can conceive only with oocyte donation and in vitro fertilization. It is more successful in women who have previously been pregnant. Sperm were inserted into the oocyte (bar = 100 µm). (B) Marmoset blastocysts produced by ICSI. (bar = 100 µm). The success rate of tubocornual anastomosis ranges from 20-58%.