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18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). Do you have pain with menstrual periods or intercourse? A sperm count of under 15 million is considered low. However, if the E2 level is greater than 100 pc/mL and the follicles are 10 mm in diameter, hMG should be continued at the same dose.

Sterilisation Some women choose to be sterilised if they don't want to have any more children. When Predictions Don’t Predict. (PDF, 549 KB) The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1991. Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment. The most commonly prescribed pill to stimulate ovulation (generally of one mature egg) is clomiphene citrate. Irregular menstrual cycle The length of a menstrual cycle varies between individuals and over time. The AZFc Region of the Y Chromosome Features Massive Palindromes and Uniform Recurrent Deletions in Infertile Men. (PDF, 5 MB) Nature Genetics, 2001.

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Those who prefer surgery first argue that because the size of endometriosis decreases, lesions that cannot be observed during surgery may be present; therefore, the operation is less than ideal and is associated with an increased chance for early recurrence. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

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First-line therapy is the ultrasound-guided transvaginal puncture. The advent of computer chip-based television cameras was a seminal event in the field of laparoscopy. Pregnancy after Vasovasostomy for Vasectomy Reversal: A Study of Factors Followed for 10 Years. (PDF, 3 MB)Human Reproduction, 1989. Therefore we recommend a fertility evaluation if a couple has been attempting pregnancy for 6 months or more when the woman is 35 years of age or older. Fresh Ovarian Tissue and Whole Ovary Transplantation. (PDF, 373 KB) Seminars in Reproductive Medicine, 2009.

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Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high. Ovarian Transplantation between Monozygotic Twins Discordant for Premature Ovarian Failure. (PDF, 315 KB) The New England Journal of Medicine, 2005. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. Clean, Intermittent Self-catheterization in the Treatment of Urinary Tract Disease. (PDF, 2 MB) The Journal of Urology, 1972. Erectile dysfunction Hormonal changes, psychological factors, or physical issues may make it difficult to get or keep an erection. Cantanucci and all of the nurses (especially Ashley). Following his lecture on laparoscopic appendectomy, the president of the German Surgical Society wrote to the Board of Directors of the German Gynecological Society suggesting suspension of Semm from medical practice. Modifiable and non-modifiable risk factors for poor semen quality: a case-referent study. In most cases, surgery can be performed to either reverse these blockage or to retrieve sperm directly from the epididymis and testicles. 2) Medications to induce egg development and ovulation: The medications that help stimulate the ovary to develop mature eggs for ovulation come in two forms: pills taken by mouth and injections.