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Luciano AA, Peluso J, Koch EI, Maier D, Kuslis S, Davison E. Microsurgery in Clinical Urology. (PDF, 5 MB) Urology, 1975. Transmission of Male Infertility to Future Generations: Lessons from the Y Chromosome. (PDF, 303 KB) Human Reproduction Update, 2002. Medications in use for this effect are mainly clomifene citrate and tamoxifen (both being selective estrogen-receptor modulators), as well as letrozole (an aromatase inhibitor.[17] Follicle-stimulating hormone (FSH), directly stimulating the ovaries.

Age plays quite a critical role, as fertility peaks for both men and women in their mid-twenties. To help objectify sperm morphology and therefore enhance the consistency and reproducibility among laboratories, Kruger introduced a definition of "strict criteria" in 1986.

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Intra-uterine insemination for unexplained subfertility. Investigations will be requested to prove the clinical diagnosis and to exclude other close possibilities. These sperm show a high level of retained cytoplasmic droplets around the mid piece. Your doctor may suggest that you take gonadotropin if you have unexplained infertility or when other kinds of treatment haven't helped you get pregnant. If a woman has an ovulation disorder, she may ovulate infrequently or not all. Mutations in the Cystic Fibrosis Gene in Patients with Congenital Absence of the Vas Deferens. (PDF, 5 MB) New England Journal of Medicine, 1995.

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Treatment of Cervical Factors Chronic cervicitis may be treated with antibiotics. The evaluation of the azoospermic male: AUA best practice statement. Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment. Many other surgeons feel that since they will have to make a larger incision for specimen removal anyway, they might as well use this incision to have their hand in the operative field during the procedure to aid as a retractor, dissector, and to be able to feel differing tissue densities (palpate), as they would in open surgery.

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In most cases however, sperm function may not improve and therefore any attempts at pregnancy may require additional treatments or procedures performed by our clinic. Although tubal disease was the original indication for IVF, many more indications have developed over the years. Endometrial biopsy should be performed only in women with suspected pathology (chronic endometritis or neoplasia). The AZFc Region of the Y Chromosome Features Massive Palindromes and Uniform Recurrent Deletions in Infertile Men. (PDF, 5 MB) Nature Genetics, 2001. Outlook For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before. European Association of Urology guidelines on male infertility: the 2012 update. In-vitro fertilization (IVF): Sperm are placed with unfertilized eggs in a petri dish, where fertilization can take place. WHO categorizes ovulatory disorders into three groups: group I is caused by hypothalamic pituitary failure (10%), group II results from dysfunction of hypothalamic-pituitary-ovarian axis (85%), and group III is caused by ovarian failure (5%). Pregnancies after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection in Non-obstructive Azoospermia. (PDF, 3 MB) Human Reproduction, 1995.