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Panhypopituitafism: Complete pituitary gland failure--lowers growth hormone, thyroid-stimulating hormone, and LH and FSH levels.  Symptoms include:  lethargy, impotence, decreased libido, loss of secondary sex characteristics, and normal or undersized testicles.  Supplementing the missing pituitary hormones may restore vigor and a hormone called hCG may stimulate testosterone and sperm production. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. Sperm are nourished by semen, which is made by glands along the way. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. Retrograde ejaculation: Sperm can be taken directly from the bladder and injected into an egg in the laboratory. Antisperm antibody test Sperm contain unique antigens that are not recognized as self by the body's immune system because of the blood-testis barrier.

The main side effects are hot flushes, gastrointestinal events (nausea and vomiting), headache, back pain, and leg cramps. She will also undergo a gynecologic examination and a number of tests: Laparoscopy involves inserting a thin tube with a camera on to investigate and possibly remove unwanted tissue. Uterine surgery: - Women with amenorrhoea who are found to have intrauterine adhesions should be offered hysteroscopic adhesiolysis because this is likely to restore menstruation and improve the chance of pregnancy. 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.

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Spermatid Conception. (PDF, 1 MB) Human Reproduction, 1998. Povey AC, Clyma JA, McNamee R, et al.; Participating Centres of Chaps-UK. Changes in testicles Healthy testicles are an important aspect of male fertility. The use of CC is contraindicated in cases of ovarian cyst, pregnancy, and liver disease. It can either be used to inspect and diagnose certain conditions or to surgically correct an abnormality such as removing scar tissue, endometriosis, or a damaged fallopian tube.

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The man must be producing healthy sperm in quantities large enough to fertilize an egg cell. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures. Less common factors The following other factors may also be responsible for infertility in a smaller proportion of cases: • Genetic abnormalities within eggs, sperm or both • An abnormal uterine cavity, including the presence of fibroids or polyps • Immunological infertility, whereby either the male or female partner produces anti-bodies against sperm cells or implantation of an embryo • Abnormal cervical mucus which hinders the passage of sperm to the uterus and fallopian tubes Unexplained infertility Even when investigations have been extensive, some couples will have no reason with which to explain their infertility. The dye outlines the cavity of the uterus and spills out of the fallopian tubes.

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Histologic endometrial dating is not considered reliable nor is it predictive of fertility. Cervical surgery can also sometimes cause scarring or shorten the neck of the womb (the cervix). Treatment of Tubal and Peritoneal Factors The treatment of tubal-factor infertility underwent major changes, especially during the last quarter of the century when microsurgery became available. [126, 127] Tubal reconstruction was the only hope for those patients before assisted reproductive therapy became available. The medical industry is forever making advances in this field. Birth after Preimplantation Diagnosis of the Cystic Fibrosis F508 Mutation by Polymerase Chain Reaction in Human Embryos Resulting from Intracytoplasmic Sperm Injection with Epididymal Sperm. (PDF, 2 MB) The Journal of the American Medical Association, 1994. This relatively simple test involves the man providing a semen sample for a lab to evaluate. Healthcare providers may also conduct a semen analysis to check the number, shape, and movement of sperm. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005.