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Ovulation disorders appear to be the most common cause of infertility in women. Other conditions Various other lesions and diseases, such as CNS tumors, temporal lobe seizures, and many drugs (eg, dopamine antagonists) may interrupt the hypothalamic-pituitary axis at the hypothalamus. IVF/ICSI 38. Controlled ovarian stimulation: - By urinary or recombinant FSH and/or HMG. - Dose depends on age, BMI, presence of PCO and ovarian reserve. - Monitoring of folliculometry by USS and E2. Triggering of ovulation: - By urinary of recombinant HCG, 36 before oocyte retrieval. Painful or heavy periods Most women experience cramps with their periods. Listen to Professor Cheong talk about the fertility investigations we offer       Repeated pregnancy loss Some people may not have difficulty conceiving, but have suffered from miscarriages. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair.

A normal testicle contains 600-1200 seminiferous tubules with a total length of approximately 250 meters. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. A smaller amount may suggest a structural or hormonal problem leading to deficient semen production; 2) sperm concentration – normal concentration should be at least 20 million sperm per 1 ml of semen.

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Nonfunctional pituitary tumors may compress the pituitary stalk or the gonadotropic cells, interrupting the proper chain of signals leading to pituitary failure. Definition “A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility” NICE guideline, CG156 Primary infertility; couple have failed to conceive before. Secondary infertility; woman has previously been pregnant regardless of the outcome of the pregnancy and now unable to conceive. If a blockage is present, surgery may be necessary. Testicular Transplantation and Autotransplantation. (PDF, 8 MB) Chapter 22 of textbook, Extracorporeal and Microvascular Surgery, 1982. Gonadotropins can trigger ovulation when Clomid or Serophene don't work.

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Men with elevated prolactin levels present with gynecomastia, diminished libido, erectile dysfunction, and occasionally galactorrhea. However, intercourse 3 times a week results in a probability of conception around 50% within 6 months. Sperm retrieval for azoospermia and intracytoplasmic sperm injection success rates – A personal overview. (PDF, 1 MB) Human Fertility, 2010. 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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GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer).  Like IVF, these procedures involve retrieving an egg, combining it with sperm in a lab, and then transferring it back to your body. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technology. Laparoscopic techniques have also been developed in the field of veterinary medicine. Laparoscopy for Cryptorchidism. (PDF, 1 MB) The Journal of Urology, 1980. Your doctor may suggest that you take gonadotropin if you have unexplained infertility or when other kinds of treatment haven't helped you get pregnant. An estimated 34 million women, predominantly from developing countries, have infertility which resulted from maternal sepsis and unsafe abortion (long term maternal morbidity resulting in a disability). Endometrial polyps Endometrial polyps are growths found in the uterine cavity. If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. Ovulation occurs about two weeks before a woman’s next period starts.