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An adequate semen analysis includes the following: Volume (1. Additionally, transvaginal ultrasound affords the opportunity for your physician to assess the relative number of available eggs. Exogenous testosterone should never be administered in an attempt to boost sperm production because it actually decreases intratesticular testosterone levels owing to feedback inhibition of GnRH release. Web of Science, in-addition to the relevant printed medical journals and periodicals. Surgical ablation: - In minimal or mild endometriosis; surgical ablation or resection of endometriosis plus laparoscopic adhesiolysis improves the chance of pregnancy. - Laparoscopic resection of endometriomas may be beneficial, however recent RCTs suggest intervention only in endometriomas > 4cm. - In moderate or sever endometriosis; surgical treatment should be offered. (Debatable) - Post-operative medical treatment does not improve pregnancy rates. Assessment of ovarian reserve This is a very important assessment of a woman's remaining egg supply It is done with blood testing and ultrasound: Blood - day 3 FSH, LH and estradiol hormone testing and AMH hormone levels Ultrasound - assessment of ovarian volume and antral follicle counts Assessment of adequate ovulation This can be done in a variety of ways.

A paper published in JAVMA (Journal of the American Veterinary Medical Association) in 2005 showed that dogs spayed laparoscopically experienced significantly less pain (65%) than those that were spayed with traditional "open" methods.[8] Arthroscopy, thoracoscopy, cystoscopy are all performed in veterinary medicine today. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). For most specimens, the greatest recovery of the motile portion results from separation via centrifugal filtration through a discontinuous density gradient system. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. Instructions for collecting the sample should include abstinence from ejaculation for 48 to 72 hours. It usually involves treatment implication counselling, emotional support counselling, and therapeutic counselling [38,39].

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Ovarian hyperstimulation syndrome is self-limited, and the symptoms subside within 2-6 weeks. [198] Patients with mild and moderate ovarian hyperstimulation syndrome are treated at home with bedrest and strict control of fluid intake and output. These rates, of course, readjusted down for the older women with long durations of infertility [42]. Successful Vitrification of Bovine and Human Ovarian Tissue. (PDF, 3 MB) Reproductive BioMedicine Online, 2009. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989. Other hormones including inhibin B and leptin, may also be affected by obesity.

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ARTs have made conception possible even for men with very low or abnormal sperm. Calcification of the Seminal Vesicles and Vas Deferens in a Uremic Patient. (PDF, 3 MB) The Journal of Urology, 1971.

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The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. Treatment The cost of infertility treatment is high [34]. Checking the woman’s fallopian tubes to make sure they are not blocked. Testing for tubal patency and normalcy of the uterine cavity with a hysterosalpingogram The hysterosalpingogram, or HSG is done in order to assess the anatomy of the endometrial cavity of the uterus and the fallopian tubes. Microsurgery for Vasectomy Reversal and Vasoepididymostomy. (PDF, 13 MB) Urology, 1984.