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In response to FSH stimulation at puberty, germ cells become spermatogonia and undergo an ordered maturation to become spermatozoa. The likelihood of fertilization improves significantly for men with low sperm concentrations. The sperm can either be mixed with the eggs to allow normal fertilization (conventional insemination) or by injecting one sperm into each mature egg (ICSI). The Relationship of Abnormal Semen Parameters to Male Fertility. (PDF, 4 MB) Human Reproduction, 1989.

The obtained oocytes are released from their follicles and adhesive granulocytes are removed with an enzyme, and then the injection of seminal filaments is made with a glass pipette. Vause TD, Cheung AP, Sierra S, et al.; Society of Obstetricians and Gynecologists of Canada. The bladder must be emptied 1 hour prior to sperm collection, and a second dose of sodium bicarbonate is taken along with 16 ounces of fluid. The follicle should develop to a diameter of 23-24 mm before a spontaneous LH surge occurs. Idiopathic Hypercalciuria. (PDF, 1 MB) New England Journal of Medicine, 1971.

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Other testing may be needed based on circumstances, including testicular biopsy, genetic testing, and imaging (Table 36–8,10,19,20). Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. Gracia CR, Sammel MD, Coutifaris C, Guzick DS, Barnhart KT. Your doctor may suggest that you take gonadotropin if you have unexplained infertility or when other kinds of treatment haven't helped you get pregnant.

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Learn what factors can influence your fertility and whether to consider seeking medical help. Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993.

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Medical treatments[edit] Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. Image: “ICSI of marmoset oocytes after in vitro maturation.” by openi. This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. Women 35 and older should see their doctor after six months of trying. The Treatment of Azoospermia with Surgery and ICSI. (PDF, 4 MB) Chapter 10 from Male Fertility & Infertility, 1998. Infertility in women was ranked the 5th highest serious global disability5&6 (among populations under the age of 60). Additionally, surgery, radiation or chemotherapy to treat tumors can affect male fertility. For example, polycystic ovarian syndrome is when the eggs only partially developed within the ovary and there is an excess of male hormones.