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As the duration of treatment prolonged, psychological suffering is likely to increase [6]. The ovulation induction agents used include clomiphene citrate, hMG, hCG, recombinant FSH, and recombinant LH. Analyses of the CFTR Gene in 67 Patients. (PDF, 4 MB) The American Journal of Human Genetics, 1995.

A woman of reproductive age who is using artificial insemination to conceive (with either partner or donor sperm) after 6 failed trials. Consider earlier referral to infertility specialists where: - the woman is aged 36 years or over. - there is a known clinical cause of infertility or a history of predisposing factors for infertility. - treatment is planned that may result in infertility (such as treatment for cancer). - People who are concerned about their fertility and who are known to have chronic viral infections such as hepatitis B, hepatitis C or HIV. A spermiogram control study is performed after 3 cycles of therapy. 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. IVF is Generally Performed in the Following Manner: The woman undergoes gonadotropin injections, which stimulate the ovaries to produce many eggs. Investigations will be requested to prove the clinical diagnosis and to exclude other close possibilities. El Uso de las Espermátides en la Azoospermia. (PDF, 12 MB) Chapter 42 from Reproducción Humana, 2002.

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Opinion: Microsurgical TESE and the Distribution of Spermatogenesis in Non-obstructive Azoospermia. (PDF, 5 MB)Human Reproduction, 2000. Effects[edit] Psychological[edit] The consequences of infertility are manifold and can include societal repercussions and personal suffering. The reduced release of gonadotropin is often triggered by stress, physical strain such as high-performance sports, and anorexia nervosa. Estimating the prevalence of infertility in Canada [published correction appears in Hum Reprod. WHAT'S THE DIFFERENCE BETWEEN PRIMARY AND SECONDARY STERILITY?

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Intracytoplasmic Sperm Injection. (PDF, 4 MB) Chapter 47 from textbook Current Therapy in Equine Reproduction, 2006. Fertility Evaluation: Obstetric and Gynecological History The obstetric and gynecological history should include: Reproductive history (children, mode of delivery, prematurity, stillbirth, extrauterine pregnancy, spontaneous and induced abortion, fertility and infertility in earlier relationships). Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". Often, but not always, submucosal fibroids can cause heavy periods, or bleeding between periods. A variety of disorders ranging from hormonal disturbances to physical problems, to psychological problems can cause male infertility.  Although many treatment options are now available, in many cases treatment will not work.  In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm.  Once damaged, the testicle will not usually regain its sperm-making capabilities; this aspect of male infertility is analogous to menopause (though not natural like menopause) for women and cannot usually be treated.  Despite medicine�s limited ability to treat male infertility, many successful treatment options are available for its many causes.  Besides testicular damage, the main causes of male infertility are low sperm production and poor sperm quality.   The Causes of Male Infertility Male infertility has many causes--from hormonal imbalances, to physical problems, to psychological and/or behavioral problems.  Moreover, fertility reflects a man�s �overall� health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility--it is not all-inclusive: · Smoking--significantly decreases both sperm count and sperm cell motility. · Prolonged use of marijuana and other recreational drugs. · Chronic alcohol abuse. · Anabolic steroid use--causes testicular shrinkage and infertility. · Overly intense exercise--produces high levels of adrenal steroid hormones which cause a    testosterone deficiency resulting in infertility. · Inadequate vitamin C and Zinc in the diet. · Tight underwear--increases scrotal temperature which results in decreased sperm production. · Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive   substances, mercury,  benzene, boron, and heavy metals · Malnutrition and anemia. · Excessive stress!

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Microsurgical Epididymal Sperm Aspiration and Assisted Reproductive Techniques. (PDF, 4 MB) Frontiers in Human Reproduction, 1991. If the woman is age 35 years or older, she should see a healthcare provider after six months of trying to get pregnant. Ejaculatory duct obstruction Complete and partial ejaculatory duct obstruction has been implicated as a cause of 1-5% of patients with male infertility. The pituitary gland controls most other hormonal glands in the human body. Couples may decide to go ahead regardless if the desire to become pregnant is very strong. Effects[edit] Psychological[edit] The consequences of infertility are manifold and can include societal repercussions and personal suffering. Testosterone is converted to dihydrotestosterone (DHT) by the action of 5-alpha reductase, both locally and in the periphery, and to estrogen in the periphery. Understanding the normal reproductive process is essential in knowing when to seek help. The opening improves the ability of the embryo to implant into the uterine lining. The only known risk factor for Klinefelter syndrome is advanced maternal age. Source : (1).pptx Evaluation of Fertility: A Cornerstone to Improved ... A high serum estradiol level (greater than 60 to 80 pg per mL [220 to 294 pmol per L]) in conjunction with a normal FSH level has also been associated with lower pregnancy rates. The Varicocele Dilemma. (PDF, 139 KB) Human Reproduction, 2001.