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A review of systems and physical examination of the endocrine and gynecologic systems should be performed. Causes of Sterility in Women In women, the classification of possible causes is much more complex. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. Pregnancy after Vasovasostomy for Vasectomy Reversal: A Study of Factors Followed for 10 Years. (PDF, 3 MB)Human Reproduction, 1989.

Intracytoplasmic sperm injection is a process by which semen is washed and prepared for direct injection of one sperm into each egg collected during the IVF process. A prolactin level of more than 150 mcg/L suggests a pituitary adenoma, while levels greater than 300 mcg/L are nearly diagnostic.

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Although tubal disease was the original indication for IVF, many more indications have developed over the years. Infertility service use in the United States: data from the National Survey of Family Growth, 1982–2010. Not getting pregnant The primary sign of infertility is not getting pregnant after trying for a certain length of time. A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men. ICSI can be performed when sperm counts are extremely low or abnormal. Congenital disorders and chryptorchidism (undescended testicles).

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Human menopausal gonadotropin, or hMG (Repronex): This contains both FSH and LH. IVF is Generally Performed in the Following Manner: The woman undergoes gonadotropin injections, which stimulate the ovaries to produce many eggs. Earn up to 6 CME credits per issue.     To see the full article, log in or purchase access. Gonadotrophins for idiopathic male factor subfertility.

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Conventional IVF vs ICSI (Intra Cytoplasmic Sperm Injection) for Patients Requiring Microsurgical Epididymal Sperm Aspiration (MESA). (PDF, 4 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop. Assessment of ovarian reserve This is a very important assessment of a woman's remaining egg supply It is done with blood testing and ultrasound: Blood - day 3 FSH, LH and estradiol hormone testing and AMH hormone levels Ultrasound - assessment of ovarian volume and antral follicle counts Assessment of adequate ovulation This can be done in a variety of ways. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994. Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive. Leptin is a hormone associated with numerous effects including appetite control, inflammation, and decreased insulin secretion, according to many studies. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Unexplained fertility affects about 10 percent of couples worldwide. The couple should have sex at least every two days between the 10th and 18th day after the woman starts her period. Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. No role for: Post-coital testing for cervical mucous. Endometrial Biopsy. If you and your partner agree, extra embryos can be frozen and saved to use later.