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In order to accomplish this, the semen is washed with a solution safe to sperm and eggs, and then centrifuged to separate motile sperm from immotile sperm and other cells. Primary infertility When a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. The embryo is then placed in the uterus to begin a pregnancy.

This technique should be reserved for myomas with a diameter less than 6 cm. [123] Several cases have been reported of uterine rupture during pregnancy because the reconstruction of the uterus after laparoscopic myomectomy was not as good as a myomectomy performed using laparotomy. [124] Operative hysteroscopy: The removal of a submucous fibroid using hysteroscopy should be limited to small fibroids (≤3 cm) with minimal compromise of the myometrium. [81] This is important to decrease the risk of excessive bleeding and to decrease the risk of electrolyte imbalance, water intoxication, and pulmonary edema from excessive intravasation of Hyskon, glycine, or sorbitol used during the procedure. This measurement is called the antral follicle count and may correlate with fertility potential. A Series of Monozygotic Twins Discordant for Ovarian Failure: Ovary Transplantation (Cortical versus Microvascular) and Crypreservation. (PDF, 791 KB) Human Reproduction, 2008. Myotonic dystrophy This is an autosomal dominant defect in the dystrophin gene that causes a delay in muscle relaxation after contraction. CI or intrauterine insemination is the treatment of choice if more than 2 million sperm are recovered after the sperm wash. (See Treatment of Cervical Factors). [106, 109] Patients whose reproductive tract, FSH, LH, and testosterone levels are determined to be normal or those who have low testosterone in the absence of any other hormonal abnormalities can be treated empirically with cycles of CC (25 mg PO qd for at least 6-12 mo). High cortisol levels may also be seen with exogenous steroid use, such as that administered to patients with ulcerative colitis, asthma, arthritis, or organ transplant.

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Couples who do not conceive after treatment for six cycles with documented ovulation should also consider referral to an infertility specialist. Hysterosalpingogram (HSG) – This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome).

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The testicle contains the Leydig cells and the Sertoli cells and is covered by the tunica albuginea, which also provides septae that divide it into approximately 200-350 pyramids (see image below). Linthicum, Md.: American Urological Association, Inc.; 2010.

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Infertility in men Semen and sperm The most common cause of infertility in men is poor-quality semen, the fluid containing sperm that's ejaculated during sex. Abnormal semen may not be able to carry the sperm effectively. A doctor or WHNP takes a medical history and gives a physical examination. Treatment of Uterine Factors Until in vitro fertilization became available, a patient with congenital absence of the uterus and vagina (Rokitansky-Küster-Hauser syndrome) had no chance to have a biologic child. But the sperm in the semen are either abnormal, very low in number, or not there at all. New Treatment for Infertility Due to Congenital Absence of Vas Deferens. (PDF, 1 MB) The Lancet, 1987. Furthermore, laparoscopy assists in the differential diagnosis between a septate and a bicornuate uterus. Normal immunologic responses to accommodate sperm and conceptus.