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8 Couples with unexplained infertility may want to consider another year of intercourse before moving to more costly and invasive therapies, such as assisted reproductive technology. The use of CC is contraindicated in cases of ovarian cyst, pregnancy, and liver disease. Reifenstein syndrome in males involves partial androgen insensitivity in males and presents as a spectrum of abnormal external genitalia and infertility.[22] Because cells inadequately respond to androgen stimulation, spermatogenesis is impaired. Management of the infertile couple: an evidence-based protocol. Normal Pregnancies Resulting from Testicular Sperm Extraction and Intracytoplasmic Sperm Injection for Azoospermia Due to Maturation Arrest. (PDF, 6 MB) Fertility and Sterility, 1996. Fibrosis of the oviducts or uterine horns, probably a result of inflammation after infection or trauma, leads to infertility.

5) Endometrial polyps: Endometrial polyps are finger-like growths in the uterine cavity arising from the lining of the uterus, called the endometrium, These abnormalities are rarely associated with cancer (<1% in a woman before menopause), but polyps are can decrease fertility by up to 50% according to some studies. Sometimes, female infertility is related to a hormone problem.

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Passive smoking has also been linked to lower fertility. Basal body temperatures are no longer considered a reliable indicator of ovulation, and are not recommended for evaluating ovulation. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures. About one-third of infertility cases are caused by fertility problems in men and another one-third of fertility problems are due to fertility problems in women. Epidemiology of infertility For healthy young couples, the probability of getting pregnancy per a reproductive cycle is about 20% to 25%.

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However, about one in five cases of infertility has no clear diagnosed cause.[73] In Britain, male factor infertility accounts for 25% of infertile couples, while 25% remain unexplained. Microscopic Vasoepididymostomy: Specific Microanastomosis to the Epididymal Tubule. (PDF, 15 MB) Fertility and Sterility, 1978. This limitation also reduces tactile sensation, making it more difficult for the surgeon to feel tissue (sometimes an important diagnostic tool, such as when palpating for tumors) and making delicate operations such as tying sutures more difficult.[21] The tool endpoints move in the opposite direction to the surgeon's hands due to the pivot point, making laparoscopic surgery a non-intuitive motor skill that is difficult to learn. Perfect Anatomical Reconstruction of Vas Deferens with a new Microscopic Surgical Technique. (PDF, 19 MB)Fertility and Sterility, 1977. Tubal occlusion A tubal occlusion means there is a blockage in the fallopian tube. Minimal Ovarian Stimulation (mini-IVF) for IVF Utilizing Vitrification and Cryopreserved Embryo Transfer. (PDF, 406 KB) Reproductive BioMedicine Online, 2010.

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These drugs also can also help you get pregnant by causing your ovaries to release multiple eggs. Patients who are suffering from Stein-Leventhal syndrome (also referred to as polycystic ovary syndrome, or PCOS) can also suffer from anovulation.[3] Up to 90% of cases of anovulation are caused by PCOS; this syndrome is usually hereditary.[4][5] Weight loss or anorexia can also cause hormonal imbalance, leading to irregular ovulation (dysovulation). As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). Normal sperm have a smooth oval head approximately 3-5 μm long and 2-3 μm wide. Medical treatments[edit] Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. The virus may either directly damage the seminiferous tubules or indirectly cause ischemic damage as the intense swelling leads to compression against the tough tunica albuginea. In fact, female age-related infertility is the most common cause of infertility today. Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.