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Cervical surgery can sometimes cause scarring or shortening of the cervix. If resistant to the above, offer: - laparoscopic ovarian drilling, or, - ovulation induction via gonadotrophins.

For example, treatment for Hodgkin disease has been estimated to lead to infertility in as many as 80-100% of patients. The recourse for these specimens is to remove the seminal fluid by successive media washes.

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Myth MYTH: If men ejaculate, they are fertile TRUTH: Ejaculation doesn't mean fertility. Happily, many couples treated for infertility are able to have babies. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes. Some problems stop an egg being released at all, while others prevent an egg being released during some cycles but not others. Causes in men The following are common causes of infertility in men. 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.

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IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. Less common factors The following other factors may also be responsible for infertility in a smaller proportion of cases: • Genetic abnormalities within eggs, sperm or both • An abnormal uterine cavity, including the presence of fibroids or polyps • Immunological infertility, whereby either the male or female partner produces anti-bodies against sperm cells or implantation of an embryo • Abnormal cervical mucus which hinders the passage of sperm to the uterus and fallopian tubes Unexplained infertility Even when investigations have been extensive, some couples will have no reason with which to explain their infertility. When used in the early follicular phase, letrozole inhibits estrogen synthesis, thereby causing enhanced GnRH pulsatility and consequent FSH and inhibin stimulation. Myotonic dystrophy This is an autosomal dominant defect in the dystrophin gene that causes a delay in muscle relaxation after contraction. Quantitative Analysis of Testicle Biopsy: Determination of Partial Obstruction and Prediction of Sperm Count after Surgery for Obstruction. (PDF, 4 MB) Fertility and Sterility, 1981. The principal indications for CC use are oligomenorrhea, especially polycystic ovarian syndrome (PCOS), and for patients with slight menstrual irregularities.

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Computer-aided semen analysis (CASA) Introduced in the late 1980s, CASA uses a video camera and computer to visualize and analyze sperm concentration and movement. History-taking Couples with infertility problem should be interviewed separately as well as together, to bring out important facts that one partner might not wish to disclose to the other. Unexpected resilience of species with temperature-dependent sex determination at the Cretaceous–Palaeogene boundary. (PDF, 238 KB) Biology Letters, 2010. Predominantly anovulation is caused by hormonal imbalances such as Polycystic Ovarian Syndrome (PCOS) but ovarian scarring and premature menopause can also result in failure to ovulate. • Tubal disease, comprising anything from mild adhesions to complete blockage of the fallopian tubes, prevents fertilised eggs from travelling from the site of fertilisation to the uterus. VITRIKAS, MD, David Grant Medical Center Family Medicine Residency, Travis Air Force Base, California Am Fam Physician. 2015 Mar 1;91(5):308-314.   Patient information: See related handout on infertility, written by the authors of this article.   Related letter: Natural Procreative Technology for Treating Infertility This clinical content conforms to AAFP criteria for continuing medical education (CME). Review Questions The answers can be found below the references. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control. Although CASA produces good qualitative data, it is a labor-intensive procedure with a high initial cost and is plagued with inaccuracies when sperm concentrations are very high or very low. Ovarian hyperstimulation syndrome The ovaries can swell, leak excess fluid into the body, and produce too many follicles, the small fluid sacs in which an egg develops. Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. High Fertilization and Pregnancy Rate after Intracytoplasmic Sperm Injection with Spermatozoa Obtained from Testicle Biopsy. (PDF, 3 MB) Human Reproduction, 1995. Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. Noonan syndrome (46, XY) Patients with Noonan syndrome, also known as male Turner syndrome, have physical characteristics similar to that of women with Turner syndrome (45, X). They get worried that they will be stereotyped.” Ross reminds men that “most problems with [reproduction] do not affect their ability to produce male hormones, their sexual function, or their maleness.” But even if things look bleak, the experts still have some hopeful advice: Keep trying. If endometriosis is found, it can be surgically removed by various methods, and its removal may lead to a decrease in pain as well as improvement in the ability to conceive naturally.