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In cases of poor sperm quality, intrauterine insemination can be performed. In contrast, functional pituitary tumors may lead to unregulated gonadotropin release or prolactin excess, interrupting the proper signaling. ART techniques generally start with stimulating the ovaries to increase egg production.

There are also a number of sperm production problems that can contribute to infertility, including: Scrotal varicose veins (varicoceles)  Scrotal varicose veins (varicoceles) are swollen veins causing your testicles to get hotter and affect the production of sperm  These are treated with surgery  Testicular injury   Serious trauma to the testicles such as becoming twisted (torsion) can affect sperm production  Damage from playing sports or an accident can rupture the vessels that supply blood to the testicles  Previous injuries can’t be treated, but an ART treatment may help you to conceive Undescended testicles  In the uterus, baby boys’ testicles form in their abdomen and descend into their scrotum shortly before birth  Some men’s testicles don’t descend before they are born (cryptorchidism), although in these cases they usually drop in the first six months after birth  If left untreated, undescended testicles can affect fertility Testicular cancer  This happens when a malignant tumour in the testicle destroys testicular tissue  If undetected, testicular cancer can spread to other parts of the body  This is treated either by surgery, medication, radiotherapy or chemotherapy  However, cancer therapy can also damage sperm production  Genetic defects  Sometimes, genetic information on the Y chromosome (which is only present in men) is deleted (micro-deletions),6 which can reduce the production of sperm  Depending on where the micro-deletion is on the chromosome, this may be treated by surgically extracting sperm from part of your reproductive tract  However, some couples may need to consider using a donor sperm to conceive Mumps Contracting mumps (or mumps-related orchitis) after puberty may damage the sperm-producing cells in your testicles,  causing infertility or subfertility7 Usually, only one testicle is affected and if you have one functioning testicle you may not need treatment  However, some couples may need to use a sperm donor in order to conceive Anti-sperm antibodies  Anti-sperm antibodies are large proteins in your blood that are hostile to sperm  They can cause sperm to clump together and prevent them from swimming, or they may mistake sperm cells for an infection and try to destroy them  This can be treated using an ART treatment   Lifestyle   Sperm production can be affected by a range of lifestyle factors, including smoking, drinking, drugs, stress, overweight and unhealthy food Environmental factors can also affect your sperm quality, including overheating of your testicles, some sexual lubricants, the chemicals involved in certain manufacturing, painting or printing jobs   These factors are treated by making lifestyle changes, such as wearing loose clothing to avoid overheating Hormonal problems  Hormonal problems are rarely the cause of male infertility problems  However, some men have a natural deficiency in follicle-stimulating hormone (FSH) and luteinising hormone (LH), which prevents the testicles from producing testosterone or developing healthy sperm  Hormonal problems can usually be treated with medication Obstruction problems Blocked sperm ducts  Occasionally, male sperm ducts (epididymis and vas deferens) can become blocked, meaning that your semen doesn’t contain any sperm  This can be treated with surgery, or sperm may be surgically extracted from part of your reproductive tract  Vasectomy  Some men have had a previous vasectomy to stop them being able to conceive  This can sometimes be reversed using surgery  The procedure’s success depends on how long ago your vasectomy was performed  Previous infections  Infections can cause scarring or adhesions (organs sticking together) in your sperm ducts  This can usually be treated with surgery  Does age affect male fertility? Afterward, the embryos are incubated again and then transferred to the cavum uteri of the woman. Thankfully, even when the cause of infertility is not known, various fertility treatments can overcome the unknown road block that was preventing pregnancy and eventually lead to delivery of a healthy baby. In 1981, Semm, from the gynecological clinic of Kiel University, Germany, performed the first laparoscopic appendectomy. 8 Involvement in group counseling and exercise is more effective than weight loss advice alone. Eating disorders: If an eating disorder leads to serious weight loss, fertility problems may arise.

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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. If an endocrinopathy, such as hyperprolactinemia, is diagnosed, the underlying cause should be treated. Intrauterine insemination 50% of women will conceive after 6 cycles. Half of the unsuccessful ones, will conceive with further 6 cycles. It is artificial introduction of semen inside the female’s uterus. Success rate varies, lie between 15% to 20% per cycle. Also searched were the Cochrane database, the National Guideline Clearinghouse database, Dynamed, and Essential Evidence Plus. The most commonly prescribed injections that stimulate the ovary are called gonadotropins.

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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. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Out of 100 couples in the United States, 12 to 13 have trouble conceiving. Management of the infertile couple: an evidence-based protocol. Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way.[21] In the United States some treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for Family and Medical Leave Act leave. However, the optimal dosage and length of administration is under investigation. [170, 171] Aromatase inhibitors are generally well tolerated.

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The progestins that can be used and the doses are as follows: Medroxyprogesterone acetate (eg, Depo-SubQ Provera 104; administer 104 mg SC q3mo or q12-14wk) Megestrol acetate (eg, Megace 20-40 mg PO qd for up to 2 months) Norethindrone acetate (eg, Aygestin 15 mg PO qd for 6-9 months) [145, 146, 147, 148, 149, 150] The androgens used are 17-ethinyl testosterone derivatives (eg, danazol 400-800 mg PO divided BID; not to exceed 9 months) [151, 152, 153] The GnRH agonists used are as follows: Leuprolide acetate (eg, Lupron 3. This sterile needle is attached to sterile suction tubing and a collecting vial. These include: Infrequent menstrual periods: When a woman has regular menstrual periods, defined as regular cycles occurring every 21 to 35 days, this almost always indicates that she ovulates regularly. The potential for robotic surgery has had strong military interest as well, with the intention of providing mobile medical care while keeping trained doctors safe from battle.[citation needed] Non-robotic hand guided assistance systems[edit] There are also user-friendly non robotic assistance systems that are single hand guided devices with a high potential to save time and money. Sometimes, female infertility is related to a hormone problem. Thus, an intravenous pyelogram must be performed once this diagnosis is made. Other hormones including inhibin B and leptin, may also be affected by obesity. Normal Pregnancies Resulting from Testicular Sperm Extraction and Intracytoplasmic Sperm Injection for Azoospermia Due to Maturation Arrest. (PDF, 6 MB) Fertility and Sterility, 1996. Carcinoma in the Bladder Left Behind. (PDF, 3 MB) The Journal of Urology, 1973. Treatment of the Normal Infertile Couple The prognosis for the normal infertile couple is poor and unpredictable. Patients have with small- to normal-sized testes and azoospermia, but normal secondary sex characteristics.