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The severity usually depends on how near to the testicles the radiation was aimed. An estimated 28% of all couples seeking reproductive assistance may have normal findings on their clinical evaluation, making the unexplained infertility a more common provisional diagnosis. Nowadays, given the huge emotional impact caused by pregnancy loss, in those cases where two pregnancy losses have taken place, an analysis and treatment is advised. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue.

It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control. Chemotherapy: Some chemotherapy drugs can result in ovarian failure. The male phenotype proves that androgen was present in utero. Even with the testis shielded, radiation therapy below the diaphragm may lead to infertility due to the release of reactive oxygen free radicals. Fimbrial phimosis and periadnexal disease can be treated with laparoscopy. [134, 135, 136, 137, 138] The pregnancy rate after salpingolysis is 50-60% during the first year after treatment.

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Summary Infertility is a significant medical and social problem affecting couple worldwide. It is a sensitive issue that should be handled with great care with continuous professional counselling. Most young couples will conceive naturally within 2 years. Evaluation of both partners for causes is essential. Treatment depends on the cause, and varies from medical treatment to surgery to ART. 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. However, about one in five cases of infertility has no clear diagnosed cause.[73] In Britain, male factor infertility accounts for 25% of infertile couples, while 25% remain unexplained. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995.

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Theoretically, with this therapy, we can get artificial gamets in vitro. Clinical Asst Professor, Obstetrics and Gynecology. Intracytoplasmic Sperm Injection Today: A Personal Review. (PDF, 5 MB) Human Reproduction, 1998. Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin. Results of Microsurgical Vasoepididymostomy: Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Human Reproduction, 1989. 3  Sometimes, a couple who’ve already had a child can have trouble conceiving again.

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Furthermore, as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. Often, in vitro fertilization (IVF) can reveal abnormalities in egg quality, sperm function, or embryo development that would not have been determined from standard testing. Unexplained Even after a full fertility work-up, for one in five couples an exact cause of infertility cannot be determined. The dynamics of stress in fertile and infertile couples. Growth of Baby Kidneys Transplanted into Adults. (PDF, 1 MB) Archives of Surgery, 1976.