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Fertilization: the process that takes place in the fallopian tube, when sperm unites with the egg. Basic Work-up for Infertility It is very important to remember that infertility can occur as a result of one or more male or female factors. Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. After recovery, the testicle may return to normal or may atrophy. Also searched were the Cochrane database, the National Guideline Clearinghouse database, Dynamed, and Essential Evidence Plus.

While BBT is an inexpensive way to monitor ovulation, it is often impractical. Depending on the sperm count, the couple is advised to have intercourse near the time of ovulation or to proceed with intrauterine insemination.

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Clomiphene citrate for unexplained subfertility in women. Cervical surgery can sometimes cause scarring or shortening of the cervix.

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If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF). 8 Involvement in group counseling and exercise is more effective than weight loss advice alone.

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Mittelschmerz and premenstrual symptoms tend to be absent or reduced when a woman is anovulatory. Because of the action at the estrogen-receptor level within the hypothalamus, CC alleviates the negative feedback effect exerted by endogenous estrogens. [161, 162, 163] As a result, CC normalizes the GnRH release; therefore, the secretion of FSH and LH is capable of normalized follicular recruitment, selection, and development to reestablish the normal process of ovulation. [161, 164] The standard dose of CC is 50 mg PO qd for 5 days, starting on the menstrual cycle day 3-5 or after progestin-induced bleeding. 41 Treatment of Unexplained Infertility Jump to section + Couples who have no identified cause of infertility should be counseled on timing of intercourse for the most fertile period (i.e., the six days preceding ovulation). A doctor or WHNP takes a medical history and gives a physical examination. ICSI with Epididymal and Testicular Sperm Retrieval. (PDF, 1 MB) Male Sterility and Motility Disorders: Etiological Factors and Treatment, 1998. Hofherr SE, Wiktor AE, Kipp BR, Dawson DB, Van Dyke DL. Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control Secondary infertility is when they have previously conceived but are no longer able to. It's sometimes done while you're taking meds that help trigger the release of an egg. Pregnancy after Vasovasostomy for Vasectomy Reversal: A Study of Factors Followed for 10 Years. (PDF, 3 MB)Human Reproduction, 1989. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended.