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Physical exam A directed physical exam that may include a pelvic ultrasound should be performed. No consensus exists as to whether the medical treatment should precede surgery or vice versa. [154, 155, 156] Those who prefer medical treatment first argue that the size of the endometriosis decreases; therefore, surgery will be easier and shorter. Regression of Metastases after Nephrectomy for Renal Cell Carcinoma. (PDF, 1 MB) British Journal of Urology, 1975.

Diagnostic evaluation of the infertile female: a committee opinion. Congenital Absence of the Vas Deferens: The Fertilizing Capacity of Human Epididymal Sperm. (PDF, 3 MB) New England Journal of Medicine, 1990. Low weight: Obesity is not the only way in which weight can impact fertility. Simultaneous Treatment of the Wife in Infertile Couples with Oligospermia. (PDF, 4 MB) Fertility and Sterility, 1983. For a man to be fertile, the testicles must produce enough healthy sperm to be ejaculated effectively into the woman's vagina.

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Bromocriptine (Parlodel): This drug inhibits prolactin production. Patients with a grade 1-3 varicocele (visible or palpable) associated with infertility should consider having the varicocele repaired. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth.

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ICSI with Epididymal and Testicular Sperm Retrieval. (PDF, 1 MB) Male Sterility and Motility Disorders: Etiological Factors and Treatment, 1998. For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes or around the ovaries. Genital duct obstruction is a potentially curable cause of infertility and is observed in 7% of infertile patients. However, if the E2 level is greater than 100 pc/mL and the follicles are 10 mm in diameter, hMG should be continued at the same dose. Smoking during pregnancy increases the chance of pregnancy loss.

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It also gives them more options in dealing with unexpected adverse events (e.g., uncontrolled bleeding) that may otherwise require creating a much larger incision and converting to a fully open surgical procedure.[5] Conceptually, the laparoscopic approach is intended to minimise post-operative pain and speed up recovery times, while maintaining an enhanced visual field for surgeons. Carcinoma in the Bladder Left Behind. (PDF, 3 MB) The Journal of Urology, 1973. Down syndrome These patients have mild testicular dysfunction with varying degrees of reduction in germ cell number. Oei SG, Helmerhorst FM, Bloemenkamp KW, Hollants FA, Meerpoel DE, Keirse MJ. 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. Requirements for Female Fertility One of the requirements for female fertility is a functioning reproductive anatomy and physiology. Laparoscopy is an operation performed in the abdomen or pelvis through small incisions, generally no more than a centimeter, with the assistance of a laparoscope attached to a camera which projects to a screen. 2012;27(8):2396–2404.   Want to use this article elsewhere?