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The Relationship of Abnormal Semen Values to Pregnancy Outcome. (PDF, 770 KB) Chapter 10 from textbook, 1992. Women attempting pregnancy at age 40 or older have a 50% decreased fertility rate and a two-fold to three-fold increased risk of spontaneous abortion compared with younger women. This technique should be reserved for myomas with a diameter less than 6 cm. [123] Several cases have been reported of uterine rupture during pregnancy because the reconstruction of the uterus after laparoscopic myomectomy was not as good as a myomectomy performed using laparotomy. [124] Operative hysteroscopy: The removal of a submucous fibroid using hysteroscopy should be limited to small fibroids (≤3 cm) with minimal compromise of the myometrium. [81] This is important to decrease the risk of excessive bleeding and to decrease the risk of electrolyte imbalance, water intoxication, and pulmonary edema from excessive intravasation of Hyskon, glycine, or sorbitol used during the procedure. In the testicle, germ cells (especially up to the preleptotene stage) are especially at risk. Uterine surgery: - Women with amenorrhoea who are found to have intrauterine adhesions should be offered hysteroscopic adhesiolysis because this is likely to restore menstruation and improve the chance of pregnancy. Chemotherapy: Some types may significantly reduce sperm count.

Optimal sperm conditions Although only one sperm is needed to fertilise your partner’s egg, the enzymes from multiple sperm are needed to break down the egg’s protective barrier. The impact of small or single polyps is more controversial. American Urological Association Education and Research, Inc. The sperm moves up the cervix, towards the uterus, and into the fallopian tubes to reach and fertilize the egg. 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.

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Predominantly anovulation is caused by hormonal imbalances such as Polycystic Ovarian Syndrome (PCOS) but ovarian scarring and premature menopause can also result in failure to ovulate. • Tubal disease, comprising anything from mild adhesions to complete blockage of the fallopian tubes, prevents fertilised eggs from travelling from the site of fertilisation to the uterus. As they respond to hormones the same way as they would do in the uterus, that is by growing and shedding cyclically, endometriosis can cause both fallopian tube and ovarian scarring. 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. 7 million women reported impaired ability to get pregnant or carry a baby to term.

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Factors like stress or heavy workouts can cause your period to temporarily disappear. Evaluation of the Female Partner: Evidence of Ovulation (Continued) Progesterone test. Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory. Structural abnormalities in the uterus: these can affect the cervix or the uterine corpus.  Anomalies can be anatomical (septate uterus, T-shaped uterus, etc.) or pathologies that generate embryo implantation issues or issues with how the pregnancy progresses: polyps, endometritis, Asherman's syndrome - synechiae or adherences of the walls of the uterine cavity - or myomas, a benign tumour that generates anatomical distortion and makes getting pregnant complicated (this is one of the most common pathologies but does not necessarily cause fertility issues). Cystic fibrosis: This is a chronic disease that results in the creation of a sticky mucus.

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If he has two X chromosomes and one Y chromosome, as in Klinefelter's syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm. Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. Theoretically, with this therapy, we can get artificial gamets in vitro. Erectile dysfunction Erectile dysfunction is when a man cannot get or keep an erection (get hard) for sex. High-cost treatments are out of financial reach for some couples. Full history taking of both partners usually denotes the underlying problem [17-23], (Appendix 1). A bicornuate uterus is characterized by the presence of an indentation at the fundus. The initial dosage of clomiphene is 50 mg daily for five days starting on day 3 to 5 of the menstrual cycle. Cystic fibrosis: This is a chronic disease that results in the creation of a sticky mucus. 29 When the semen analysis is abnormal, referral to a male fertility specialist or reproductive endocrinologist is warranted. Live Birth Following Day Surgery Reversal of Female Sterilisation in Women Older then 40 Year: A Realistic Option in Australia? (PDF, 156 KB) Medical Journal of Australia, 2007.