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Heterologous or therapeutic insemination, formerly called artificial insemination by donor sperm, refers to the use of frozen sperm that has been quarantined for at least 6 months. [108] Thereafter, the specimen is ready to use once the donor has undergone the necessary screening tests required by the tissue bank, the US Food and Drug Administration (FDA), and the American Society for Reproductive Medicine (ASRM). [111] The source of the sperm can be either anonymous or from a donor designated by the couple. But as it turns out, we men don't get off that easily.

0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. A relationship also exists between obesity and erectile dysfunction (ED). Where Dreams are Born. (PDF, 2 MB) Jewish Light, 2010. Although laparoscopic appendectomy has lesser wound problems than open surgery, the former is associated with more intra-abdominal abscesses.[20] Disadvantages[edit] While laparoscopic surgery is clearly advantageous in terms of patient outcomes, the procedure is more difficult from the surgeon's perspective when compared to traditional, open surgery: The surgeon has a limited range of motion at the surgical site, resulting in a loss of dexterity. If fimbriectomy was performed, no treatment is available other than IVF. Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction.

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Women trying to conceive often have depression rates similar to women who have heart disease or cancer.[18] Emotional stress and marital difficulties are greater in couples where the infertility lies with the man.[19] Older people with adult children appear to live longer.[20] Why this is the case is unclear and may dependent in part on those who have children adopting a healthier lifestyle, support from children, or the circumstances that led to not having children.[20] [edit] In many cultures, inability to conceive bears a stigma. Microsurgery in Pediatric Urology. (PDF, 13 MB) The National Foundation, 1977. Vasoepididymostomy to the Head of the Epididymis: Recovery of Normal Spermatozoal Motility. (PDF, 3 MB)Fertility and Sterility, 1980. M. genitalium infection is associated with increased risk of infertility.[25][26] Genetic[edit] A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility.[citation needed] Mutations to NR5A1 gene encoding Steroidogenic Factor-1 (SF-1) have been found in a small subset of men with non-obstructive male factor infertility where the cause is unknown. If no improvement occurs, depending on the amount of functional sperm recovery after the sperm wash, the decision must be made to proceed with either intrauterine insemination or in vitro fertilization.

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8 Couples with unexplained infertility may want to consider another year of intercourse before moving to more costly and invasive therapies, such as assisted reproductive technology. Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993. Additional risk factors may include smoking, alcohol use, obesity, and older age; however, the data are hampered by a lack of pregnancy-related outcomes. The most common of these tests include measurements of blood levels of certain hormones such as estradiol and FSH, which are related to ovarian function and overall egg numbers; TSH, which assesses thyroid function; and prolactin, a hormone that can affect menstrual function if elevated. If an endocrinopathy, such as hyperprolactinemia, is diagnosed, the underlying cause should be treated. Septate uterus The hypothesis that a uterine septum can cause infertility is controversial.

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37 Clomiphene has also proven effective for ovulation induction in women with polycystic ovary syndrome. These adverse effects were reported in older women with advanced breast cancer who were given the drugs on a daily basis over several months. 3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). Environmental vs Genetic Sex Determination: A Possible Factor in Dinosaur Extinction? (PDF, 307 KB) Fertility and Sterility, 2004. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. Bromocriptine (Parlodel): This drug inhibits prolactin production. Article Sections Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Pain during sex Some women have experienced painful sex their entire lives, so they’ve convinced themselves it’s normal. Disorders of the hypothalamus lead to hypogonadotropic hypogonadism. Although relatively uncommon, eating disorders can negatively affect menstruation, fertility, and maternal and fetal well-being. These rates, of course, readjusted down for the older women with long durations of infertility [42]. Symptoms of hormonal imbalance: Sudden weight gain, hair loss, constant fatigue, edema, headaches, nipple discharge, facial hair, or severe acne are all signs of possible hormonal disorders. Problems with sperm If a man makes too few sperm or none at all, the woman cannot become pregnant. 8,33,35,36 Lastly, in vitro fertilization, with or without intracytoplasmic sperm injection, is the mainstay of assisted reproductive technology for male factor infertility. It is an approach to disseminate the recommended medical care of infertile couple to the practicing clinicians. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989.