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A Physical Map of the Human Y Chromosome. (PDF, 160 KB) Nature, 2001. It is important to undergo a thorough fertility evaluation to determine the problem. Pregnancy after Vasovasostomy for Vasectomy Reversal: A Study of Factors Followed for 10 Years. (PDF, 3 MB)Human Reproduction, 1989. Adding recombinant human FSH to HCG has been shown to be effective in achieving spermatogenesis in most patients.[18] Select patients with adult-onset idiopathic hypogonadotropic hypogonadism may respond to clomiphene citrate therapy.[19] Prader-Willi syndrome Patients have characteristic obesity, mental retardation, small hands and feet, and hypogonadotropic hypogonadism due to a GnRH deficiency. 1 Infertility is medically defined as the inability to conceive after 12 months of unprotected sex.

Tourism[edit] Fertility tourism is the practice of traveling to another country for fertility treatments.[68] It may be regarded as a form of medical tourism. Several days later, embryos -- or fertilized eggs -- get put back into your uterus with a device called an intrauterine insemination catheter. 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.

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Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Many countries have special frameworks for dealing with the ethical and social issues around fertility treatment. Psychological/Physical/Behavioral Problems: Several sexual problems exist that can affect male fertility.  These problems are most often both psychological and physical in nature:  it is difficult to separate the physiological and physical components. Kidney Transplantation in Inbred Rats. (PDF, 6 MB) The American Journal of Surgery, 1973. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. When this happens, it causes something called a varicocele.

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The pulsatile nature of GnRH is essential to normal gonadotropin release; a continuous stimulation inhibits their secretion. Although obesity is well known to be associated with insulin resistance, women with PCOS are even more resistant to insulin than other patients who are obese. In a third of cases, the reason lies only with the man; in another third, it is because of the woman; and in the rest of the cases, it is a combination of both, or the cause is unknown. Thus those who repeatedly spontaneously miscarry or whose pregnancy results in a stillbirth, or following a previous pregnancy or a previous ability to do so, are then not unable to carry a pregnancy to a live birth would present with secondarily infertile. (Trends in prevalence4).A consultation once the evaluation has been completed is imperative. The male partner can be evaluated for infertility or subfertility using a variety of clinical interventions, and also from a laboratory evaluation of semen.” (Semen manual, 5th Edition3). If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF).

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Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994. Ejaculatory Duct Obstruction. (PDF, 3 MB) The Journal of Urology, 1980. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. Factors contributing to the formation of antisperm antibodies in women are disturbance of normal immunoregulatory mechanisms, infection, violation of the integrity of the mucous membranes, rape and unprotected oral or anal sex. The Effect of Female Age and Ovarian Reserve on Pregnancy Rate in Male Infertility: Treatment of Azoospermia with Sperm Retrieval and Intracytoplasmic Sperm Injection. (PDF, 66 KB) Human Reproduction, 1997.