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A lower concentration may lead to a lower chance for conception without treatment; 3) sperm motility or movement – a normal motility should be at least 50%. Patients with a high number of immature sperm should be evaluated for excessive exposure to heat or radiation or for infectious processes. Semm established several standard procedures that were regularly performed, such as ovarian cyst enucleation, myomectomy, treatment of ectopic pregnancy and finally laparoscopic-assisted vaginal hysterectomy (nowadays termed as cervical intra-fascial Semm hysterectomy). His first atlas, More Details on Pelviscopy and Hysteroscopy was published in 1976, a slide atlas on pelviscopy, hysteroscopy, and fetoscopy in 1979, and his books on gynecological endoscopic surgery in German, English, and many other languages in 1984, 1987, and 2002.

The procedure is performed in an outpatient setting in the vast majority of cases, and recovery time can be as little as a few days. Primary spermatocytes undergo meiosis as the cells successively pass through the preleptotene, leptotene, zygotene, and pachytene stages to become secondary spermatocytes. Used by some clinicians to evaluate the motility of the sperm and its ability to travel through the cervical mucus. The incidence of congenital malformation in IVF babies ranges between 2% and 3% worldwide and is similar to that in babies conceived naturally [45]. Fertilizing Capacity of Epididymal and Testicular Sperm with ICSI. (PDF, 5 MB) Frontiers in Endocrinology, 1995.

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The doctor may ask about the couple's sexual habits and make recommendations regarding these. Guidance from the National Institute for Health and Care Excellence (NICE) says women under the age of 42 should be offered three full cycles of IVF, with access for same-sex couples if surrogacy or privately funded fertility treatment fails. The couples are not always consciously aware that they really are not interested in having children, but their sexual behavior reflects this attitude, e.g., in having sexual intercourse only after ovulation. A mouse study has suggested that ingredients in some household detergents may reduce fertility.

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Guidelines and recommendations were retrieved from the best evidence reviews at the American College of Obstetricians and Gynaecologists (ACOG), American Society for Reproductive Medicine (ASRM), Canadian Fertility and Andrology Society (CFAS), European Society of Human Reproduction and Embryology (ESHRE), Human Fertilisation and Embryology Authority (HFEA), Royal College of Obstetricians and Gynaecologists (RCOG), and the World Health Organization (WHO). A sperm count of under 15 million is considered low. The predictable pregnancy rate for this group is about 5% after timed intercourse, 10% after superovulation with intrauterine insemination (IUI), and 15% to 25% after assisted reproduction techniques (ART) [41]. 2 or more - sperm concentration: 15 million spermatozoa per ml or more - total sperm number: 39 million spermatozoa per ejaculate or more - total motility: 40% or more motile or 32% or more with progressive motility - vitality: 58% or more live spermatozoa - sperm morphology (percentage of normal forms): 4% or more Basic Work-up for Infertility 13. Evidence of ovulation: 1. Ovulation often can be detected by keeping a menstrual calendar or using an ovulation predictor kit.

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Intrauterine insemination 33. Consider unstimulated intrauterine insemination as a treatment option in the following groups as an alternative to vaginal sexual intercourse: - people who are unable to, or would find it very difficult to, have vaginal intercourse - people with conditions that require specific consideration in relation to methods of conception (for example, after sperm washing where the man is HIV positive) - people in same-sex relationships Do not offer IUI for people with unexplained infertility, mild endometriosis or mild male factor. Always take in consideration the ages of the couple. Sperm density Normal sperm density is greater than 20 million sperm/mL. 3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). An ultrasonography unit and an endocrine laboratory capable of performing daily determinations of E2, FSH, and LH are necessary. [186, 187, 188, 189] Multiple adverse effects and complications may occur during the use of the gonadotropins, including (1) multiple pregnancy (24-33%), (2) ectopic pregnancy (5-8%), (3) miscarriages (15-21%), (4) ovarian torsion and rupture, and (5) ovarian hyperstimulation syndrome, which is the most severe. [190, 191] Whittemore et al, using a large combined data set derived from case-controlled studies in the United States, showed that the increase of ovarian cancer associated with infertility might be due to the use of fertility drugs. [192] Ovarian hyperstimulation syndrome is an iatrogenic condition that occurs in patients undergoing ovulation induction with hMG or controlled ovarian hyperstimulation (COH) for assisted reproductive technologies. Some medications increase the risk of fertility problems in men. Intracytoplasmic Sperm Injection. (PDF, 4 MB) Chapter 47 from textbook Current Therapy in Equine Reproduction, 2006. His first atlas, More Details on Pelviscopy and Hysteroscopy was published in 1976, a slide atlas on pelviscopy, hysteroscopy, and fetoscopy in 1979, and his books on gynecological endoscopic surgery in German, English, and many other languages in 1984, 1987, and 2002. Surgical procedures for women If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through. In 1978, the first baby was born as a result of IVF. Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing's syndrome, diabetes, and thyroid disease.