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If there is a history of recurrent miscarriages (2 or more) a lupus anticoagulant (LAC) and anti-cardiolipin antibody (ACL) are often done, as well as other tests. The likelihood of fertilization improves significantly for men with low sperm concentrations. There are also a number of sperm production problems that can contribute to infertility, including: Scrotal varicose veins (varicoceles)  Scrotal varicose veins (varicoceles) are swollen veins causing your testicles to get hotter and affect the production of sperm  These are treated with surgery  Testicular injury   Serious trauma to the testicles such as becoming twisted (torsion) can affect sperm production  Damage from playing sports or an accident can rupture the vessels that supply blood to the testicles  Previous injuries can’t be treated, but an ART treatment may help you to conceive Undescended testicles  In the uterus, baby boys’ testicles form in their abdomen and descend into their scrotum shortly before birth  Some men’s testicles don’t descend before they are born (cryptorchidism), although in these cases they usually drop in the first six months after birth  If left untreated, undescended testicles can affect fertility Testicular cancer  This happens when a malignant tumour in the testicle destroys testicular tissue  If undetected, testicular cancer can spread to other parts of the body  This is treated either by surgery, medication, radiotherapy or chemotherapy  However, cancer therapy can also damage sperm production  Genetic defects  Sometimes, genetic information on the Y chromosome (which is only present in men) is deleted (micro-deletions),6 which can reduce the production of sperm  Depending on where the micro-deletion is on the chromosome, this may be treated by surgically extracting sperm from part of your reproductive tract  However, some couples may need to consider using a donor sperm to conceive Mumps Contracting mumps (or mumps-related orchitis) after puberty may damage the sperm-producing cells in your testicles,  causing infertility or subfertility7 Usually, only one testicle is affected and if you have one functioning testicle you may not need treatment  However, some couples may need to use a sperm donor in order to conceive Anti-sperm antibodies  Anti-sperm antibodies are large proteins in your blood that are hostile to sperm  They can cause sperm to clump together and prevent them from swimming, or they may mistake sperm cells for an infection and try to destroy them  This can be treated using an ART treatment   Lifestyle   Sperm production can be affected by a range of lifestyle factors, including smoking, drinking, drugs, stress, overweight and unhealthy food Environmental factors can also affect your sperm quality, including overheating of your testicles, some sexual lubricants, the chemicals involved in certain manufacturing, painting or printing jobs   These factors are treated by making lifestyle changes, such as wearing loose clothing to avoid overheating Hormonal problems  Hormonal problems are rarely the cause of male infertility problems  However, some men have a natural deficiency in follicle-stimulating hormone (FSH) and luteinising hormone (LH), which prevents the testicles from producing testosterone or developing healthy sperm  Hormonal problems can usually be treated with medication Obstruction problems Blocked sperm ducts  Occasionally, male sperm ducts (epididymis and vas deferens) can become blocked, meaning that your semen doesn’t contain any sperm  This can be treated with surgery, or sperm may be surgically extracted from part of your reproductive tract  Vasectomy  Some men have had a previous vasectomy to stop them being able to conceive  This can sometimes be reversed using surgery  The procedure’s success depends on how long ago your vasectomy was performed  Previous infections  Infections can cause scarring or adhesions (organs sticking together) in your sperm ducts  This can usually be treated with surgery  Does age affect male fertility? Surgical treatment of myomas is indicated in cases of abnormal uterine bleeding, when the myoma is implicated in recurrent miscarriages or when it is thought to interfere with embryo implantation. These include: Infrequent menstrual periods: When a woman has regular menstrual periods, defined as regular cycles occurring every 21 to 35 days, this almost always indicates that she ovulates regularly.

KU School of Medicine Source : Are Twins An Adverse Outcome After Infertility Treatments? Women are advised not to use the drug for more than one day.

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A laparoscopy can check the ovaries, fallopian tubes, and uterus for disease. Mixed gonadal dysgenesis (45, X/46, XY) Patients usually have ambiguous genitalia, a testis on one side, and a streaked gonad on the other. 8,46 Obesity impairs fertility and the response to fertility treatments, including in vitro fertilization; therefore, it is advisable to counsel patients who are obese to lose weight before conception or infertility treatments. The doctor may ask about the couple's sexual habits and make recommendations regarding these.

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Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form. A sperm count of under 15 million is considered low. Congenital blockage of the ductal system An increased rate of duct obstruction is observed in children of mothers who were exposed to DES during pregnancy. Sperm count often returns to normal after stopping the medication.

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The initial dosage of clomiphene is 50 mg daily for five days starting on day 3 to 5 of the menstrual cycle. The World Health Organization (WHO) published reference ranges for semen testing in 2010. [45] These include “lower reference limits” representing the 5th percentiles for semen characteristics. [46] Note that the lower reference limits do not serve as a cut-point between “fertile” and “infertile.” Volume Normal ejaculate volume is 1. Nevertheless, scientists have found these stem cells, which may generate new oocites in postnatal conditions. Out of this group, the following statistics on the cause of infertility generally apply: One-third of couples will discover fertility problems in only the man. Infertility in men Semen and sperm The most common cause of infertility in men is poor-quality semen, the fluid containing sperm that's ejaculated during sex. Testicular Sperm Extraction (TESE) and Intracytoplasmic Sperm Injection (ICSI) for Non-obstructive Azoospermia.(PDF, 1 MB) 10th World Congress on In Vitro Fertilization and Assisted Reproduction, 1997. Dealing with Fertility Problems After Vasectomy Reversal. (PDF, 7 MB) Contemporary OB/GYN, 1978. Advising surgery in cases of primary infertility is difficult. A special type of laparoscope called a fertiloscope, which is modified for transvaginal application, can be used. Vasectomy and its Microsurgical Reversal. (PDF, 17 MB) Urologic Clinics of North America, 1978. Worldwide, 8 to 12 percent of couples experience fertility problems. The fertilized egg is then implanted in the uterus. The treatment approach depends on the cause(s) of the infertility. Treatment of hydrosalpinx (distal tubal obstruction) with salpingostomy can be performed through microsurgery or operative laparoscopy.