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Source : (1).pptx Evaluation of Fertility: A Cornerstone to Improved ... The predictive value of hysterosalpingography for tubal and peritoneal infertility factors.

According to ESHRE recommendations, couples with an estimated live birth rate of 40% or higher per year are encouraged to continue aiming for a spontaneous pregnancy.[66] Treatment methods for infertility may be grouped as medical or complementary and alternative treatments. Ovulation induction is somewhat different from controlled ovarian hyperstimulation, which involves the use of some of the same medications to stimulate the development of multiple mature follicles and eggs in order to increase pregnancy rates with various infertility treatments. Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility. However, in our modern era, women are delaying child birth until their thirties and forties, which has lead to the discovery of the adverse effect of advanced maternal age on egg function. There are three types of fibroids: 1) subserosal, or fibroids that extend more than 50% outside of the uterus; 2) intramural, where the majority of the fibroid is within the muscle of the uterus without any indentation of the uterine cavity; and 3) submucosal, or fibroids the project into the uterine cavity.

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Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery. Potential causes are unknown, but it may be related to infection, vascular disease, or bilateral testicular torsion. ART: In Vitro Fertilization In Vitro Fertilization (IVF) is a procedure that involves retrieving eggs and sperm from the female and male partners and placing them together in a laboratory dish to enhance fertilization. To have a successful reanastomosis, the final tube should measure at least 4. 8 Women in group I typically present with amenorrhea and low gonadotropin levels, most commonly from low body weight or excessive exercise. The resulting injuries can result in perforated organs and can also lead to peritonitis.[medical citation needed] There may be an increased risk of hypothermia and peritoneal trauma due to increased exposure to cold, dry gases during insufflation.

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Hystersalpingography (HSG): - usually after failed successive cycles of ovulation induction, and in some centres after failed IUI. - good predictive but requires expertise. This standardized approach to the management of infertility will lead to more efficient, systematic and economic care for the infertile couple. According to Ross, “anything that improves quality of health, like adequate sleep and nutrition,” should improve fertility. Transmission of Male Infertility to Future Generations: Lessons from the Y Chromosome. (PDF, 303 KB) Human Reproduction Update, 2002.

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Guidance from the National Institute for Health and Care Excellence (NICE) says women under the age of 42 should be offered three full cycles of IVF, with access for same-sex couples if surrogacy or privately funded fertility treatment fails. Women in group III can conceive only with oocyte donation and in vitro fertilization. Search dates: January 6, 2014; January 28, 2014; February 5, 2014; and November 18, 2014. Ejaculatory duct obstruction Complete and partial ejaculatory duct obstruction has been implicated as a cause of 1-5% of patients with male infertility. Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW. Overweight or obesity: This may reduce the chance of conceiving. Fertilized eggs are then transferred several days later into the woman’s uterus, where implantation and embryo development will hopefully occur as in a normal pregnancy. The evaluation of the azoospermic male: AUA best practice statement. An on-line WHO infertility virtual consultation course includes a 5 module WHO evidence-based medicine course, as well as a 16 module ASRM eLearning course which reviews the evidence-base for the basic diagnosis of the infertile male and female, coupled with management and treatment. Infertility Tests History and physical examination – First and foremost, your fertility physician will take a very thorough medical and fertility history. This may reflect an unknown immunological incompatibility or other unknown problem with fertilization or implantation. Infertility caused by DNA defects on the Y chromosome is passed on from father to son. In most cases however, sperm function may not improve and therefore any attempts at pregnancy may require additional treatments or procedures performed by our clinic.