This process is repeated until desired area is covered. Although many implants are made in one session, there may be a need for an extra session to achieve desired results.

What are advantages to follicular unit extraction? Most hair restoration surgeons agree that advantages to follicular unit extraction far outweigh disadvantages. Following are some of reasons why this procedure is highly recommended for those considering hair transplantation:

• No visible scarring
• Smaller incisions
• Natural appearance
• More oxygen to implants
• Minimal interruption of blood flow to implants
• Closer placement of hair grafts
• Creative flexibility in designing hair line
• More implants made per session
• Short healing time

• There is some suggestion that use of antioxidant therapy ( Pycnogenol 200mg daily, L-Carnitine 3 grams per day, acetyl carnitine 500mg per day, Vitamin C 1,000mg per day, Vitamin E 800IU per day and acupuncture and certain herbal medicines) taken for several months, can causes SDI assay to revert to normal in many cases.

There is some suggestion that men who have varicoceles ( a collection of distended veins in scrotum) associated with an abnormal SDI assay may experience a reversion of SDI assay back to normal, 3-6 months following surgical or radiological ablation of varicocele. Of course acupuncture and herbal medicine will enhance and stimulate blood flow to testicles facilitating a more rapid recovery with greater possibility of healthy sperm production after a varicocelectomy.

In summary, an abnormal SDI assay augers poorly for outcome of fertility treatment in general and IVF/ICSI in specific.

In such cases, fertilization rate and pregnancy rates are reduced and chance of early pregnancy loss appears to be increased significantly. An abnormal SDIA result does not totally preclude a successful pregnancy. The prognosis worsens progressively as age of egg provider advances beyond 33 yrs. Although abnormal SDIA results rarely revert to normal spontaneously this can and does happen on occasion.

Selective surgical ligation of a varicocele and medical anti-oxidant treatment may be effective in restoring SDIA to normal. Antioxidant properties are to be found in Vitamins C and E and herbal medicine specific to this situation. It is quite likely that SDIA or SCSA will in time become regarded as required baseline tests (to be performed, regardless of their basic traditional semen analysis parameters (count, motility and sperm morphology) in all cases of recurrent pregnancy loss and IVF where sperm provider has not previously participated in a pregnancy that has proceeded beyond 12th week (the traditional point of likely viability).

It should be noted that when typical sperm analysis reveals normal count, morphology and motility this does not mean that sperm DNA fragmentation is not manifest. In other words, unless SDIA test is specifically run, fragmentation issues will not be revealed. This type of case then may be labeled ‘idiopathic' infertility.

It is our opinion based on clinical experience that ideally, both man and women should be treated even if there is no apparent male factor evident. The reason for this is that stress has been shown to reduce sperm count. Going through tortuous trial of trying to conceive leaves many couples extremely stressed out. So, which at time of sperm analysis everything appears normal, over time, due to stress inherent with situation, sperm quantity may in fact be effected.

Therefore, including acupuncture, herbal medicine and proper supplements can be seen as either reactive (if pathology is evident) or proactive (if pathology is not evident). It is our opinion that proactive behavior often obviates need to be reactive. Prevention is key.