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Sulfasalazine: This anti-inflammatory drug can significantly lower a man's sperm count. 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. Listen to Mr Brook talk about male infertility Find out more about ICSI.

The Treatment of Azoospermia with Surgery and ICSI. (PDF, 4 MB) Chapter 10 from Male Fertility & Infertility, 1998. Prevalence of Premature Ovarian Failure in Monozygotic and Dizygotic Twins. (PDF, 90 KB) Human Reproduction, 2007. Other testing may be needed based on circumstances, including testicular biopsy, genetic testing, and imaging (Table 36–8,10,19,20). This is called the fulcrum effect.[22] Some surgeries (carpal tunnel for instance) generally turn out better for the patient when the area can be opened up, allowing the surgeon to see "the whole picture" surrounding physiology, to better address the issue at hand. Medical management: - Ovarian suppression of minimal and mild endometriosis diagnosed as the cause of infertility in women does not enhance fertility and should not be offered.

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Other considerations include preconception screening and vaccination for preventable diseases such as rubella and varicella, sexually transmitted infections, and cervical cancer, based on appropriate guidelines and risk. Intracytoplasmic Sperm Injection Today: A Personal Review. (PDF, 5 MB) Human Reproduction, 1998.

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Those who prefer surgery first argue that because the size of endometriosis decreases, lesions that cannot be observed during surgery may be present; therefore, the operation is less than ideal and is associated with an increased chance for early recurrence. 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. Efficacy of laparoscopy is inferior to open surgery in certain conditions such as pyloromyotomy for Infantile hypertrophic pyloric stenosis.

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40 Patients using these agents should be counseled about these risks. Sermondade N, Faure C, Fezeu L, Lévy R, Czernichow S; Obesity-Fertility Collaborative Group. In this case, your doctor may recommend surgically extracting sperm from part of your reproductive tract to help you to conceive. Ejaculation disorders: If the ejaculatory ducts are blocked, semen may be ejaculated into the bladder Hormonal imbalance: Hypogonadism, for example, can lead to a testosterone deficiency. On Regenerating the Ovary and Generating Controversy. (PDF, 37 KB) Cell, 2005. The administration on GnRH should be extended throughout the luteal phase, or this should be supplemented with the administration of exogenous hCG. [202] Monitoring folliculogenesis is simpler than using hMG. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Four alternatives are currently available to treat endometriosis: expectant therapy, surgical intervention, medical treatment, and combined therapy. There are three types of fibroids: 1) subserosal, or fibroids that extend more than 50% outside of the uterus; 2) intramural, where the majority of the fibroid is within the muscle of the uterus without any indentation of the uterine cavity; and 3) submucosal, or fibroids the project into the uterine cavity. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994.