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Before performing a tubocornual anastomosis, the patient should have a diagnostic laparoscopy associated with tubal cannulation by hysteroscopy. [139, 140, 141] If one tube remains open, anastomosis is not needed because pregnancy can be achieved in 50% of cases. Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993.

Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. There are a wide array of treatments available, each targeting a different cause of infertility, and they include the following: Fertility drugs: These drugs work by stimulating the hormones responsible for the maturing and release of the egg and could help those with ovarian disorders. 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).

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30–32 Other treatment options include antiestrogens and gonadotropin therapy, which showed a trend toward increased live birth rates in a Cochrane review. Often, varicoceles or past infections such as mumps orchitis are the cause of sterility. Recombination Between Palindromes P5 and P1 on the HUman Y Chromosome Causes Massive Deletions and Spermatogenic Failure. (PDF, 786 KB) The American Journal of Human Genetics, 2002. Infertility and Impaired Fecundity in the United States, 1982-2010: Data from the National Survey of Family Growth.

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Microsurgery Successful in Vasectomy Reversals. (PDF, 156 KB) The New York Times, 1975. Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[56] or her age as female fertility declines after the age of 30.[57] Sometimes it can be a combination of factors, and sometimes a clear cause is never established. The emotional toll on both partners can affect their relationship. Sexually transmitted infections (STIs): Chlamydia can damage the fallopian tubes in a woman and cause inflammation in a man's scrotum. In addition to recently established WHO procedures for Guideline development, an innovate mechanism was planned and has been initiated to ensure developing country input throughout the process - from scoping and prioritization of the prioritized topics, to presentation of non-English language evidence for global consensus consultations. Spermatid Conception. (PDF, 1 MB) Human Reproduction, 1998.

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Thankfully, even when the cause of infertility is not known, various fertility treatments can overcome the unknown road block that was preventing pregnancy and eventually lead to delivery of a healthy baby. Graft-versus-host Reactivity and Renal Allograft Survival in Rats Given Allogeneic Spleen Cells or Spleen Allografts.(PDF, 2 MB) Transplantation, 1976. Limits were placed on language and human race as well. IVF involves removal of eggs directly from the ovary, fertilization with sperm in the laboratory, followed by transfer of the embryos directly into the uterus, thereby bypassing the tubes. Requirements for Female Fertility (Continued) Other requirements for female fertility include: Adequate sexual drive and sexual function to permit coitus. A sperm analysis can be done to check a man's sperm count and the overall health of the sperm.Infertility is the inability of a person, animal or plant to reproduce by natural means. Grading is as follows: Grade 0 – No movement Grade 1 – Sluggish movement Grade 2 – Slow movement in a poorly defined direction Grade 3 – Slow or curved forward movement Grade 4 – Fast movement straight forward  Patients with abnormal sperm motility should be evaluated for the following: Pyospermia Antisperm antibodies Varicocele Sperm ultrastructural abnormalities Partial ductal obstruction Sperm morphology The head, acrosome, mid piece, and tail of individual spermatozoa are analyzed with phase-contrast microscopy after fixation with Papanicolaou stain. The only disadvantage with BBT is that in many instances, the shift does not occur in a clear way, and the patient misses the time of ovulation. The average incidence of infertility is about 15%. Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment. The fertilized eggs, now embryos, are allowed to grow and develop in culture media for typically 3 to 5 days. Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin. 8 These studies are more sensitive and may delineate an abnormally formed uterus or structural problems, such as fibroids. Sperm Granuloma and Reversibility of Vasectomy. (PDF, 11 MB) Lancet, 1977. The most common identifiable causes of female fertility problems are outlined below: • Ovulatory dysfunction, (or anovulation) where an egg is not released from the ovary every month, is the single most common cause of female infertility. Further reading[edit] Fertility: Assessment and Treatment for People with Fertility Problems.