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After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. Other causes include Y chromosome microdeletion, a depletion of chromosome material that impedes or severely decreases spermatozoa production. The prevalence varies widely, being less in developed countries and more in developing countries where limited resources for investigation and treatment are available [2]. Because of a defect in the dynein arms, spokes, or microtubule doublet, cilia in the respiratory tract and in sperm do not function properly. Couples will have to consider the ethical and emotional aspects of this procedure.

The resulting embryos are then transferred into the uterus of the future mother, known as the recipient. This situation can be related to the presence of other endocrine disorders such as hyperprolactinemia, congenital adrenal hyperplasia, adrenal tumors, Cushing syndrome, thyroid dysfunction, and extreme obesity.

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Have you had any sexually transmitted infections or abnormal pap smears? RE: The Impalpable Testis: A Rational Approach to Management. (PDF, 389 KB) The Journal of Urology, 1979.

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Exercise: Both too much and too little exercise can lead to fertility problems. The impact of fibroids located elsewhere in the uterus are controversial and do not always require surgery.

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New Treatment for Infertility Due to Congenital Absence of Vas Deferens. (PDF, 1 MB) The Lancet, 1987. Intra-uterine insemination for unexplained subfertility. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. The use of CC is contraindicated in cases of ovarian cyst, pregnancy, and liver disease. European Association of Urology guidelines on male infertility: the 2012 update. Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994. Ovulation-inducing drugs and ovarian cancer risk: results from an extended follow-up of a large United States infertility cohort. Which drug can be used for induction of ovulation? There may be testicular malformations, hormone imbalance, or blockage of the man's duct system. The Relationship of Abnormal Semen Parameters to Male Fertility. (PDF, 4 MB) Human Reproduction, 1989. Low sperm mobility (motility): The sperm cannot "swim" as well as they should to reach the egg. In fact, the “window of opportunity” for fertilization is thought to last only a few hours, thus requiring sperm availability in the female genital tract at or shortly before ovulation. The production of anti-sperm antibodies by the woman’s immune system can interfere with fertilization. Signs of infertility include irregular, excessively heavy, or absent periods as well as sudden weight gain, painful sex, or vaginal infections. Small or firm testicles that feel "tight" may be another sign of hormone issues.