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ICSI with Epididymal and Testicular Sperm Retrieval. (PDF, 1 MB) Male Sterility and Motility Disorders: Etiological Factors and Treatment, 1998. Unexplained Even after a full fertility work-up, for one in five couples an exact cause of infertility cannot be determined. Recent research carried out in Sweden covering stress markers in saliva demonstrated that patients who are stressed have a greater number of reproduction issues. A systematic review of tests predicting ovarian reserve and IVF outcome. Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. Endometrial polyps Endometrial polyps are growths found in the uterine cavity.

Management of the infertile couple: an evidence-based protocol. Their cumulative probabilities of conception are 60% within the first 6 months, 84% within the first year, and 92% within the second year of regular fertility-focused sexual activity.

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The sperm is washed in a fluid and the best specimens are selected. An increased volume is rarely observed and is often caused by a contaminant, such as urine. It has been suggested that infertility be classified as a form of disability.[22] Causes[edit] Immune infertility[edit] Antisperm antibodies (ASA) have been considered as infertility cause in around 10–30% of infertile couples.[23] In both men and women, ASA production are directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, inhibiting capacitation and acrosome reaction, impaired fertilization, influence on the implantation process, and impaired growth and development of the embryo. Endometrial biopsy should be performed only in women with suspected pathology (chronic endometritis or neoplasia). Other risk factors for infertility Other risk factors may also contribute to infertility in both men and women.

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Women trying to conceive often have depression rates similar to women who have heart disease or cancer.[18] Emotional stress and marital difficulties are greater in couples where the infertility lies with the man.[19] Older people with adult children appear to live longer.[20] Why this is the case is unclear and may dependent in part on those who have children adopting a healthier lifestyle, support from children, or the circumstances that led to not having children.[20] [edit] In many cultures, inability to conceive bears a stigma. Thus those who repeatedly spontaneously miscarry or whose pregnancy results in a stillbirth, or following a previous pregnancy or a previous ability to do so, are then not unable to carry a pregnancy to a live birth would present with secondarily infertile. (Trends in prevalence4).WHO manual for the standardized investigation and diagnosis of the infertile couple This concise 1993 volume proposes a standardized approach to the investigation of infertility. Theoretically, with this therapy, we can get artificial gamets in vitro. The content of counselling may differ depending on the concerned couple and the existing treatment options.

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Thus women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility. (Trends in prevalence4). However, early referral of infertile couples to a dedicated specialist infertility clinic may be indicated to increase their chance of pregnancy (Table ). A British study found that patients valued primary care physicians who were well informed about infertility and the treatment process. The laboratory evaluation begins with a semen analysis.