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Intracytoplasmic sperm injection[edit] ICSI technique is used in case of poor semen quality, low sperm count or failed fertilization attempts during prior IVF cycles. If the obstruction is caused by salpingitis isthmica nodosa or fibrosis, the best results are achieved through IVF. [142] Surgical preparation for IVF While the surgeon should be as conservative as possible, he or she should consider that the patient is better served with a single well-functioning fallopian tube than with 2 defective tubes, which elicits an increased risk for ectopic pregnancy or recurrence of pelvic adhesions. About 25% of all infertility is caused by a sperm defect and 40-50% of infertility cases have a sperm defect as the main cause, or a contributing cause. Most surgical treatment for endometriosis is currently performed through operative laparoscopy. [145, 146, 147] Laparotomy has been relegated to the treatment of severe disease or if a need for hysterectomy arises. [145] Medical treatment Medical treatment is directed toward suppressing estrogen production by the ovary. The embryo is then placed in the uterus to begin a pregnancy. Surgery or embolization for varicoceles in subfertile men.

In such circumstances, it is recommended not to prescribe any medication until all basic investigations are done and its results received. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth.

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Exercise: Both too much and too little exercise can lead to fertility problems. If a weight gain greater than 2 lb occurs, the patient should be evaluated to determine if hospitalization is required.

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ART techniques generally start with stimulating the ovaries to increase egg production. Surprisingly, most patients have normal libido, erections, and orgasms, so testosterone therapy has only a limited role; exogenous testosterone may also suppress any underlying sperm production. Intracytoplasmic Sperm Injection Today: A Personal Review. (PDF, 5 MB) Human Reproduction, 1998.

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Fertility: assessment and treatment for people with fertility problems. After ttc for 4 years and at 41 years of age, we became pregnant after 1 round of IVF, and had our beautiful boy this past October. In some cases, the reproductive urologist can improve semen function by recommending certain lifestyle changes, by hormonal treatments, or by surgery. Obtaining morning levels of total testosterone (normal range = 240 to 950 ng per dL [8. 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. Choose a single article, issue, or full-access subscription.