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The epididymis is a coil-like structure in the testicles which helps store and transport sperm. For a woman to conceive, certain things have to happen: vaginal intercourse must take place around the time when an egg is released from her ovary; the system that produces eggs has to be working at optimum levels; and her hormones must be balanced.[54] For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs.

Bromocriptine (Parlodel): This drug inhibits prolactin production. HMG contains equal quantities of FSH and LH and are administered intramuscularly.

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Many of these treatment options may have harmful or unpleasant side effects such as nausea, headaches and weight gain. Irregular ovulation can be due to many issues, including polycystic ovary syndrome (PCOS), obesity, being underweight, and thyroid issues. 6,28 Additionally, postcoital testing of cervical mucus is no longer recommended because it does not affect clinical management or predict the inability to conceive. The fertilized embryo is then transferred to womb. Radiation therapy: If this is aimed near the reproductive organs, it can increase the risk of fertility problems. Diagnosis and Management of Hypogonadism, Infertility, and Impotence. (PDF, 13 MB) Chapter 22 of textbook,Male Reproductive Dysfunction, 1986.

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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%). Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993.

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Male fertility starts declining in their thirties, while women older than 35 years may experience problems conceiving. Epididymal and Testicular Spermatozoa and Intracytoplasmic Sperm Injection. (PDF, 7 MB) Assisted Reproduction Reviews, 1996. Stem cell therapy[edit] Nowadays, there are several treatments (still in experimentation) related with stem cell therapy. A complete pelvic exam should reveal any uterine hypoplasia, fibroids, adnexal tumors or cervical lesions and should indicate whether dyspareunia may be a problem. This pattern has been linked with aggressive behavior. They are usually young patients with a history of polycystic ovarian syndrome or oligo-ovulation who responded with elevated E2 levels (3000 pc/mL) and multiple follicles (>15) and patients in whom the ovulation has been triggered by the administration of exogenous hCG. [196, 197] Ovarian hyperstimulation syndrome usually has 2 phases. Many of the same surgeries performed in humans can be applied to animal cases – everything from an egg-bound tortoise to a German Shepherd can benefit from MIS. Primary sterility is the complete inability to become pregnant, while secondary sterility refers to the failure to conceive after a previous successful pregnancy. It is said to be the most reliable way of confirming whether ovulation has occurred.[12] Women may also use ovulation predictor kits (OPKs) which detect the increase in luteinizing hormone (LH) levels that usually indicates imminent ovulation. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 2 MB) Human Reproduction, 1996. First, ovarian stimulation takes place; therefore, the patient initially is pre-treated with GnRH-antagonists. Unexplained infertility is not the same thing as having no explanation, but rather reflects the fact that the tests performed have been normal. Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. Blocked ovaries can start functioning again without a clear medical explanation. 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.