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Medical conditions Some medical conditions can affect fertility. Women who experience very heavy, painful periods may be showing signs of endometriosis, a condition where tissues usually found in the womb are present elsewhere in the body. It also gives them more options in dealing with unexpected adverse events (e.g., uncontrolled bleeding) that may otherwise require creating a much larger incision and converting to a fully open surgical procedure.[5] Conceptually, the laparoscopic approach is intended to minimise post-operative pain and speed up recovery times, while maintaining an enhanced visual field for surgeons.

This mucus mainly affects the lungs, but males may also have a missing or obstructed vas deferens. Maternal age Infertility due to age is one of the most common causes of female infertility. In addition, infertility is considered also a public problem. Surgery for epididymal blockage: A blocked epididymis can be surgically repaired.

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In particular, small bowel obstruction poses the most significant problem.[30] The use of surgical humidification therapy during laparoscopic surgery may minimise the incidence of adhesion formation.[32] Other techniques to reduce adhesion formation include the use of physical barriers such as films or gels, or broad-coverage fluid agents to separate tissues during healing following surgery.[30] Robotic laparoscopic surgery[edit] A laparoscopic robotic surgery machine. After ttc for 4 years and at 41 years of age, we became pregnant after 1 round of IVF, and had our beautiful boy this past October. This results in normal or enhanced follicular recruitment without the risk of multiple ovulation and ovarian hyperstimulation syndrome. Scrotal surgery, including vasectomy, hydrocelectomy (5-6%), and spermatocelectomy (up to 17%), may lead to epididymal injury and subsequent obstruction.[30] Antisperm antibodies Antisperm antibodies bind to sperm, impair motility, and lead to clumping, impairing movement through the female reproductive tract and interaction with the oocyte.

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Furthermore, as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases. Obstructions in the sperm transport plumbing can sometimes be surgically corrected. The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter.

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Role of Semen Analysis in Subfertile Couples. (PDF, 250 KB) Fertility and Sterility, 2010. Causes in women Infertility in women can also have a range of causes. Around one third of couples have difficulty conceiving due to a low sperm count. Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001. Continued For some men, no male infertility treatments seem to help. Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. The abdomen is usually insufflated with carbon dioxide gas. If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF). Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. Mannitol Induced Central Nervous System Toxicity in Renal Failure. (PDF, 4 MB) Investigative Urology, 1972.