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For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. Ideally, the test should be performed at least twice to confirm results. Its use has been extended to assisted reproduction technologies. These rates, of course, readjusted down for the older women with long durations of infertility [42]. Semm published over 1000 papers in various journals.[4] He also produced over 30 endoscopic films and more than 20,000 colored slides to teach and inform interested colleagues about his technique.

Sperm Granuloma and Reversibility of Vasectomy. (PDF, 11 MB) Lancet, 1977. Endometriosis can only be confirmed by surgery, usually laparoscopy. Reproductive Biology. (PDF, 147 KB) The Scientist, 1996. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. The HSG is usually scheduled between days 6 and 13 of the cycle - after bleeding and before ovulation.

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Infection and Disease: Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy.  A low sperm count and low sperm motility are indicators of this condition.  Also, elevated FSH levels and other hormonal problems are indicative of testicular damage.  Some STDs like gonorrhea and chlamydia can cause infertility by blocking the epididimis or tubes.  These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage. Source : Infertility In Men And Women With Cf PPT Presentation Summary : Infertility in Men and Women with CF Julia Broaddus March 15, 2006 Infertility Inability to conceive after a year of trying 33% -33%-15% Female Infertility Source : Embryo cryopreservation (via ovulation induction) Oocyte cryopreservation.

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History-taking Couples with infertility problem should be interviewed separately as well as together, to bring out important facts that one partner might not wish to disclose to the other. Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form. An abnormal semen analysis warrants a further evaluation usually by a reproductive urologist. Causes Potential causes of male infertility are: The complete absence of sperm (azoospermia) Low sperm count (oligospermia) Abnormal sperm shape (teratozoospermia) Problems with sperm movement (asthenozoospermia) Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation Problems with erections or other sexual problems There are a variety of conditions that may lead to male infertility. Female factor infertility is typically to blame 40 percent of the time, while male factor infertility is the cause of issues 30 to 40 percent of the time. The initial dosage of clomiphene is 50 mg daily for five days starting on day 3 to 5 of the menstrual cycle.

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Experts differ as to when genetic tests should be done. Recombination Between Palindromes P5 and P1 on the HUman Y Chromosome Causes Massive Deletions and Spermatogenic Failure. (PDF, 786 KB) The American Journal of Human Genetics, 2002. Earn up to 6 CME credits per issue.     To see the full article, log in or purchase access. In addition to a careful history, a physical evaluation may also be performed. Out of 100 couples in the United States, 12 to 13 have trouble conceiving. A systematic review of tests predicting ovarian reserve and IVF outcome. Round Spermatid Injection. (PDF, 422 KB) Fertility and Sterility, 2000. Opinion: Microsurgical TESE and the Distribution of Spermatogenesis in Non-obstructive Azoospermia. (PDF, 5 MB)Human Reproduction, 2000. Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. Microsurgery for Vasectomy Reversal and Vasoepididymostomy. (PDF, 13 MB) Urology, 1984. Oocyte Vitrification – Women’s Emancipation Set in Stone. (PDF, 70 KB) Fertility and Sterility, 2008. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. Microsurgery in Clinical Urology. (PDF, 5 MB) Urology, 1975.