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They can often recommend a counselor and others who can offer appropriate support. Simultaneous Treatment of the Wife in Infertile Couples with Oligospermia. (PDF, 4 MB) Fertility and Sterility, 1983. Hysteroscopy is the inspection of the uterine cavity through the cervix by a hysteroscope attached to a camera which projects to a screen.

Patients should undergo an MRI or CT scan of the sella turcica for diagnostic purposes to determine whether a microprolactinoma or a macroprolactinoma is present. Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001.

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A history and physical examination can help direct the evaluation. If an endocrinopathy, such as hyperprolactinemia, is diagnosed, the underlying cause should be treated. While chromosomal failure is usually caused by abnormalities of the sex chromosomes, autosomal disorders are also observed. In men, exposure to lead can reduce both sex drive and sperm count. Additionally, the quality of her eggs also decreases increases the chance of chromosomal abnormalities.

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This technological innovation provided the means to project a magnified view of the operative field onto a monitor and, at the same time, freed both the operating surgeon's hands, thereby facilitating performance of complex laparoscopic procedures. Genetics of Male Infertility: Evolution of the X and Y Chromosome and Transmission of Male Infertility to Future Generations. (PDF, 10 MB) Chapter 5 from Essential IVF, 2004. However, until approximately age 64, a man’s age does not affect sperm or the ability to fertilize eggs. Tubal microsurgery and laparoscopic tubal surgery: - May be more effective than no treatment. - No strong evidence. (e.g.: fimbrial end dilatation) 2. 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. Microscopic Vasovasostomy and Spermatogenesis. (PDF, 1 MB) The Journal of Urology, 1977.

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Malformation of the eggs themselves may complicate conception. Infection: Some infections, such as gonorrhea or inflammation of the testicles, can affect sperm production or sperm health or can cause scarring that blocks the passage of sperm. Intracytoplasmic Sperm Injection and Infertility. (PDF, 53 KB) Nature Genetics, 2001. Once again this may increase case lengths but costs are greatly reduced (ideal for developing countries) and widespread accidents of loose clips are eliminated.[citation needed] Gynecological diagnosis[edit] In gynecology, diagnostic laparoscopy may be used to inspect the outside of the uterus, ovaries, and fallopian tubes, as, for example, in the diagnosis of female infertility. It is more successful in women who have previously been pregnant. Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during hmG treatment. Cervical surgery can sometimes cause scarring or shortening of the cervix. Guidelines and recommendations were retrieved from the best evidence reviews at the American College of Obstetricians and Gynaecologists (ACOG), American Society for Reproductive Medicine (ASRM), Canadian Fertility and Andrology Society (CFAS), European Society of Human Reproduction and Embryology (ESHRE), Human Fertilisation and Embryology Authority (HFEA), Royal College of Obstetricians and Gynaecologists (RCOG), and the World Health Organization (WHO). Once the fluid containing the eggs is removed from the follicles into the vials, they are handed to the embryologist who finds the eggs, places them in tiny droplets on a Petri dish, and then fertilizes the eggs using their partner’s or donor sperm. Microsurgical Aspects of Varicocele. (PDF, 9 MB) Fertility and Sterility, 1979. Around one third of couples have difficulty conceiving due to a low sperm count. Factors Affecting Fertility: Timing of Intercourse Intercourse prior to ovulation is key to maximizing the chance of pregnancy. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature. If a woman has an ovulation disorder, she may ovulate infrequently or not all.