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Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes. Intra-uterine insemination for unexplained subfertility. The restricted vision, the difficulty in handling of the instruments (new hand-eye coordination skills are needed), the lack of tactile perception, and the limited working area are factors adding to the technical complexity of this surgical approach. Possible causes include the egg not being released at the right time, the egg’s inability to reach the fallopian tube, or the sperm’s inability to reach the egg.

Injuries include abdominal wall hematoma, umbilical hernias, umbilical wound infection, and penetration of blood vessels or small or large bowel.[24] The risk of such injuries is increased in patients who have a low body mass index[25] or have a history of prior abdominal surgery. Exposure to chemicals: Pesticides, for example, may increase the risk.

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When this happens, it causes something called a varicocele. The man must be producing healthy sperm in quantities large enough to fertilize an egg cell. Sign up for the free AFP email table of contents.Infertility definitions and terminology A couple sits at the bank of a lake in Ahmedabad, India. Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984. In ZIFT, your doctor places the fertilized eggs -- at this stage called zygotes -- into your fallopian tubes within 24 hours. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization.

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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. Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women. A low testosterone level with a low FSH level signals a secondary cause. Laboratory testing – Depending on the results of the evaluation discussed above, your physician may request specific blood tests. Sperm retrieval for azoospermia and intracytoplasmic sperm injection success rates – A personal overview. (PDF, 1 MB) Human Fertility, 2010.

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This improves the chances that the embryo will implant at, or attach to, the wall of the uterus. Microscopic Vasovasostomy and Spermatogenesis. (PDF, 1 MB) The Journal of Urology, 1977. Round Spermatid Injection. (PDF, 422 KB) Fertility and Sterility, 2000. To ascertain a more precise assessment, a hysteroscopy of the uterus is run. Its use has been extended to assisted reproduction technologies. This should be followed by documentation of ovulation via serum progesterone. Diagnosis of Sterility An important part of the diagnosis is a detailed anamnesis and the routine gynecologic examination. Results of Microsurgical Vasoepididymostomy: Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Human Reproduction, 1989. Apparently there are only 0,014% of them (this could be an explanation of why they were not discovered until now). Human male infertility, the Y chromosome, and dinosaur extinction. (PDF, 1 MB) Middle East Fertility Society Journal, January 18, 2011.Table of contents Causes in men Causes in women Treatment Types Diagnosis Complications Outlook It may be that one partner cannot contribute to conception, or that a woman is unable to carry a pregnancy to full term. Refinements in the Methodology of Injection for Transvaginal Gamete Intra-Fallopian Transfer. (PDF, 2 MB) Human Reproduction, 1994. Overweight or obesity: This may reduce the chance of conceiving. Unexplained infertility is not the same thing as having no explanation, but rather reflects the fact that the tests performed have been normal. Overweight or obesity: This may reduce the chance of conceiving. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery.