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After 3-6 hours, the sperm is added to the oocytes. It must be kept in mind that a woman is no longer fertile around six years prior to the menopause. During this time, the cells cross from the basal to the adluminal compartments. We now have 2 amazing children who are now 5 and 3 years old!

Combined infertility[edit] In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these conditions. The hypophysis is blocked and insensitive to the body’s own GnRH.

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40 Patients using these agents should be counseled about these risks. Summary Infertility is a significant medical and social problem affecting couple worldwide. It is a sensitive issue that should be handled with great care with continuous professional counselling. Most young couples will conceive naturally within 2 years. Evaluation of both partners for causes is essential. Treatment depends on the cause, and varies from medical treatment to surgery to ART.

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Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors. Microscopic Vasectomy Reversal 30 Years Later: A Summary of 4010 Cases by the Same Surgeon. (PDF, 295 KB)Journal of Andrology, 2004. The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Symptoms include: bloating constipation dark urine diarrhea nausea abdominal pain vomiting They are usually mild and easy to treat. Environmental vs Genetic Sex Determination: A Possible Factor in Dinosaur Extinction? (PDF, 307 KB) Fertility and Sterility, 2004.

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Surgical treatment of myomas is indicated in cases of abnormal uterine bleeding, when the myoma is implicated in recurrent miscarriages or when it is thought to interfere with embryo implantation. 8-Mb Deletion in the Azoospermia Factor c Region. (PDF, 332 KB) Genomics, 2004. Although many of these can be treated through surgery or hormonal substitutions, some may be indefinite.[59] Infertility associated with viable, but immotile sperm may be caused by primary ciliary dyskinesia. In some cases, the reproductive urologist can improve semen function by recommending certain lifestyle changes, by hormonal treatments, or by surgery. Gonadotropin-releasing hormone Synthetic GnRH (gonadorelin) has a chemical composition similar to native GnRH and is indicated for patients with hypothalamic dysfunction, especially those who do not respond to CC. [200, 201] Although quite effective, it is not available in the United States due to lack of use and low demand. In patients with obstructive azoospermia and normal gonadotropin levels, sperm can be obtained through microsurgical epididymal sperm aspiration or testicular biopsy. [213] Fertilization of the oocytes is performed using IVF/intracytoplasmic sperm injection. The doctor may ask about the couple's sexual habits and make recommendations regarding these. Torsion: Is a common problem affecting fertility that is caused by a supportive tissue abnormality which allows the testes to twist inside the scrotum which is characterized by extreme swelling.  Torsion pinches the blood vessels that feed the testes shut which causes testicular damage.  If emergency surgery is not performed to untwist the testes, torsion can seriously impair fertility and cause permanent infertility if both testes twist.