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In particular, small bowel obstruction poses the most significant problem.[30] The use of surgical humidification therapy during laparoscopic surgery may minimise the incidence of adhesion formation.[32] Other techniques to reduce adhesion formation include the use of physical barriers such as films or gels, or broad-coverage fluid agents to separate tissues during healing following surgery.[30] Robotic laparoscopic surgery[edit] A laparoscopic robotic surgery machine. 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). Some women have bilateral tubal occlusion, which is when both tubes are blocked.

The normal working of the male reproductive system involves first the production of sufficient numbers of functional sperm cells and then the delivery of these sperm to the ejaculate. Both pituitary insufficiency and pituitary excess cause infertility. In reproductive medicine, the most common surgical procedures are laparoscopy, hysteroscopy, and abdominal myomectomy (removal of uterine fibroids). Adolescents with a varicocele and testicular atrophy or lack of growth should similarly consider repair.

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A couple should see a healthcare provider if they have not been able to become pregnant after 12 months of having sex regularly without birth control. Bromocriptine (Parlodel): This drug inhibits prolactin production. The menopause is premature when it occurs before 40 years of age. The predictable pregnancy rate for this group is about 5% after timed intercourse, 10% after superovulation with intrauterine insemination (IUI), and 15% to 25% after assisted reproduction techniques (ART) [41].

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XX male (sex reversal syndrome) An XX karyotype is due to a crossover of the sex-determining region (SRY) of the Y chromosome (with the testis determining factor) to either the X chromosome or an autosome. Several days later, embryos -- or fertilized eggs -- get put back into your uterus with a device called an intrauterine insemination catheter.

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The chromosomal pattern of the resultant embryos can be assessed with preimplantation genetic diagnosis. Hysterosalpingogram (HSG) – This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome). Gas tends to rise, and when a pocket of CO2 rises in the abdomen, it pushes against the diaphragm (the muscle that separates the abdominal from the thoracic cavities and facilitates breathing), and can exert pressure on the phrenic nerve. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature. Testosterone therapy may allow patients to achieve normal height but does not improve spermatogenesis. 6,8 It is important for primary care physicians to be familiar with the workup and prognosis for infertile couples. If you’re concerned, it’s important to consult with your doctor. Adding recombinant human FSH to HCG has been shown to be effective in achieving spermatogenesis in most patients.[18] Select patients with adult-onset idiopathic hypogonadotropic hypogonadism may respond to clomiphene citrate therapy.[19] Prader-Willi syndrome Patients have characteristic obesity, mental retardation, small hands and feet, and hypogonadotropic hypogonadism due to a GnRH deficiency. Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. Treatment of Uterine Factors Until in vitro fertilization became available, a patient with congenital absence of the uterus and vagina (Rokitansky-Küster-Hauser syndrome) had no chance to have a biologic child. In recent years, electronic tools have been developed to aid surgeons. Sperm counts can fluctuate, so that several samples may be necessary.