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50% are female causes with 25% being due to anovulation and 25% tubal problems/other.[74] In Sweden, approximately 10% of couples wanting children are infertile.[75] In approximately one third of these cases the man is the factor, in one third the woman is the factor, and in the remaining third the infertility is a product of factors on both parts. The vast majority of anovulation patients belong to the WHO2 group and demonstrate very heterogeneous symptoms ranging from anovulation, obesity, biochemical or clinical hyperandrogenism and insulin resistance.[14] Treatments[edit] Anovulation can potentially be reversed by lifestyle changes.[15] Lifestyle changes[edit] In women with polycystic ovary syndrome with anovulation, weight loss generally results in improved menstrual regularity, ovulation, and pregnancy rates.[16] In otherwise healthy women with anovulation, avulatory disorders may be favorably influenced by a healthy diet such as a higher consumption of monounsaturated fats rather than trans fats, vegetable rather than animal protein sources, high fat dairy, multivitamins, and iron from plants and supplements.[15] Ovulation induction[edit] The main alternatives for ovulation induction medications are: Antiestrogen, causing an inhibition of the negative feedback of estrogen on the pituitary gland, resulting in an increase in secretion of follicle-stimulating hormone.

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). Pelvic ultrasonography can be used once a week until the dominant follicle is detected; once this occurs, ultrasonography can be used more frequently until ovulation occurs. Clomiphene citrate and/or Metformin. - folliculometry via TVUSS should be done to avoid multiple pregnancies and risk of OHSS. - Not for more than 6 months.

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Other causes may include: Genetic factors: A man should have an X and Y chromosome. Ovulation disorders About one quarter of infertility cases are due to ovulation disorders. For patients wishing to conceive, the medical approach is not indicated, as it delays treatment for infertility. If the E2 level is below 100 pc/mL and the sonogram shows small follicular development, hMG is increased to 150 IU/day for an additional 5 days.

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Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. Lack of ovulation Patients with anovulation who did not ovulate after several cycles of CC at different doses of treatment are deemed clomiphene resistant. Sulfasalazine: This anti-inflammatory drug can significantly lower a man's sperm count.

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This mucus mainly affects the lungs, but males may also have a missing or obstructed vas deferens. Endocrine tests to check concentrations of the hormones testosterone, FSH and LH. World Health Organization reference values for human semen characteristics. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands. Treatment of Hemorrhage from Renal Trauma by Angiographic Injection of Clot. (PDF, 1 MB) The Journal of Urology, 1978. As new technology becomes available, fertility treatment is now accessible to more people, and success rates and safety are improving all the time.