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Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001. The majority of men with varicocele present no symptoms.

Counseling about options should be offered to couples who are not physically able to conceive (i.e., same-sex couples or persons lacking reproductive organs). 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. Around one third of couples have difficulty conceiving due to a low sperm count.

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Spermatid Conception. (PDF, 1 MB) Human Reproduction, 1998. Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993. It stimulates the ovaries to mature egg follicles. Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. Testicular Sperm Extraction (TESE) and Intracytoplasmic Sperm Injection (ICSI) for Non-obstructive Azoospermia.(PDF, 1 MB) 10th World Congress on In Vitro Fertilization and Assisted Reproduction, 1997.

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The effect of age upon men's fertility is less clear.[citation needed] In people going forward for IVF in the UK, roughly half of fertility problems with a diagnosed cause are due to problems with the man, and about half due to problems with the woman. LH mainly functions to stimulate testosterone secretion from the Leydig cells of the testicle, while FSH stimulates Sertoli cells to facilitate germ cell differentiation.

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However, early referral of infertile couples to a dedicated specialist infertility clinic may be indicated to increase their chance of pregnancy (Table ). As well as generally causing pelvic and menstrual pain, it is estimated that around 40% of women faced with difficulties getting pregnant have endometriosis. Infertility Tests History and physical examination – First and foremost, your fertility physician will take a very thorough medical and fertility history. The main causes of tubal infertility are pelvic infections caused by bacteria such as chlamydia, previous abdominal disease or surgery and ectopic pregnancy. • Endometriosis is characterised by excessive growth of the lining of the uterus. Apparent Fertility of Human Spermatozoa from the Caput Epididymidis. (PDF, 4 MB) Journal of Andrology, 1989. Some women are infertile because their ovaries do not mature and release eggs. 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. Associated conditions[edit] For most women, alteration of menstrual periods is the principal indication of chronic anovulation. Spermatid Conception. (PDF, 1 MB) Human Reproduction, 1998. The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility. A doctor or WHNP takes a medical history and gives a physical examination. Epididymal and Testicular Spermatozoa and Intracytoplasmic Sperm Injection. (PDF, 7 MB) Assisted Reproduction Reviews, 1996. Sertoli Cell only Revisited. (PDF, 1 MB) Human Reproduction, 1995. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.[62] However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.[63][64] Diagnosis[edit] If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later. Testing may begin with a physical exam and questions about past medical problems.