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Coping mentally It is impossible to know how long treatment will go on for and how successful it will be. For a woman to conceive, certain things have to happen: vaginal intercourse must take place around the time when an egg is released from her ovary; the system that produces eggs has to be working at optimum levels; and her hormones must be balanced.[54] For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs. Paternal age > or = 40 years: an important risk factor for infertility. 5 mg PO qd and increased to 5 mg once tolerance is built.

Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. Female age of 35 years or older: For unclear reasons, egg numbers decrease at a rapid rate as women age.

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Epididymal and Testicular Spermatozoa and Intracytoplasmic Sperm Injection. (PDF, 7 MB) Assisted Reproduction Reviews, 1996. Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin.

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Other testing may be needed based on circumstances, including testicular biopsy, genetic testing, and imaging (Table 36–8,10,19,20). Clomiphene citrate and/or Metformin. - folliculometry via TVUSS should be done to avoid multiple pregnancies and risk of OHSS. - Not for more than 6 months.

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The types of ART include: In Vitro Fertilization (IVF) Gamete Intrafallopian Transfer (GIFT) Zygote Intrafallopian Transfer (ZIFT) Another ART procedure – Intracytoplasmic Sperm Injection (ICSI) – is used mainly in cases of male infertility to treat couples who cannot achieve fertilization due to the male partner’s extremely low number of normal, viable sperm. Normal Pregnancies Resulting from Testicular Sperm Extraction and Intracytoplasmic Sperm Injection for Azoospermia Due to Maturation Arrest. (PDF, 6 MB) Fertility and Sterility, 1996. Abnormal semen may not be able to carry the sperm effectively. Exogenous testosterone should never be administered in an attempt to boost sperm production because it actually decreases intratesticular testosterone levels owing to feedback inhibition of GnRH release. A diagnosis of male infertility can be one of the hardest challenges a man can face. Cabergoline is associated with fewer side effects but is more expensive. It is found in approximately 10-50% of reproductive-aged women and can be associated with infertility as well as pain during intercourse and/or menstrual periods. The main approach to correcting or removing these uterine abnormalities is by hysteroscopy, a surgical method by which a narrow scope with a camera is placed within the uterine cavity. This improves the chances that the embryo will implant at, or attach to, the wall of the uterus. About 92 out of 100 couples who are trying to get pregnant do so within two years.[citation needed] Women become less fertile as they get older.