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Delayed conception and active and passive smoking. Cervical factors are also thought to play a minor role, although they are rarely the sole cause. There's a link between increased temperature of the scrotum and reduced semen quality, but it's uncertain whether wearing loose-fitting underwear improves fertility.  Testicles The testicles produce and store sperm. The problem is getting the sperm where they need to go. Some women have bilateral tubal occlusion, which is when both tubes are blocked. Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points".

Full history taking of both partners usually denotes the underlying problem [17-23], (Appendix 1). The most common cause of male infertility is varicoceles. She will also undergo a gynecologic examination and a number of tests: Laparoscopy involves inserting a thin tube with a camera on to investigate and possibly remove unwanted tissue.

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Your doctor may ask you many of the following questions: How long have you been trying to get pregnant? This leads to the final maturation and release of the egg. Effect of metformin on ovulation and reproductive outcomes in women with polycystic ovary syndrome: a meta-analysis of randomized controlled trials.

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Vasectomy Reversal. (PDF, 733 KB) The New England Journal of Medicine, 1977. Quantitative Evaluation of Spermatogenesis by Testicular Histology in Men with Congenital Absence of the Vas Deferens Undergoing Epididymal Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1990. Treatment of the cause: 26. Ovulation disorders: (Hyperprolactinaemic amenorrhoea) - Women with ovulatory disorders due to hyperprolactinaemia should be offered treatment with dopamine agonists such as bromocriptine. - Consideration should be given to safety for use in pregnancy and minimising cost when prescribing. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. Sperm motility Motility is described as the percent of sperm present with flagellar motion viewed on a bright-field or phase-contrast microscope.

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If pregnancy has not been established within a reasonable time, further evaluation and/or an alternative treatment plan should be considered. If the obstruction is caused by salpingitis isthmica nodosa or fibrosis, the best results are achieved through IVF. [142] Surgical preparation for IVF While the surgeon should be as conservative as possible, he or she should consider that the patient is better served with a single well-functioning fallopian tube than with 2 defective tubes, which elicits an increased risk for ectopic pregnancy or recurrence of pelvic adhesions. The principal indications for CC use are oligomenorrhea, especially polycystic ovarian syndrome (PCOS), and for patients with slight menstrual irregularities. Small, firm testicles The testes house a man’s sperm, so testicle health is paramount to male fertility. If stem cells remain viable after radiation therapy, patients may regain fertility within several years. Recovery of Spermatogenesis after Testicle Autotransplantation in an Adult Male. (PDF, 2 MB) Fertility and Sterility, 1982. Nonfunctional pituitary tumors may compress the pituitary stalk or the gonadotropic cells, interrupting the proper chain of signals leading to pituitary failure. Smoking during pregnancy increases the chance of pregnancy loss. 2 This encompasses couples with infertility and impaired ability to get pregnant, but it does not capture those who are not married, so actual numbers may be underestimated. If a deficit of greater than 1 L is recorded, the procedure should be terminated, and, preferably, the myomectomy should be completed in a second hysteroscopic attempt. Sterilisation involves blocking the fallopian tubes to make it impossible for an egg to travel to the womb.