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WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Couple. 8 Involvement in group counseling and exercise is more effective than weight loss advice alone. Risk factors for the formation of antisperm antibodies in men include the breakdown of the blood‑testis barrier, trauma and surgery, orchitis, varicocele, infections, prostatitis, testicular cancer, failure of immunosuppression and unprotected receptive anal or oral sex with men.[23][24] Sexually transmitted infections[edit] Infections with the following sexually transmitted pathogens have a negative effect on fertility: Chlamydia trachomatis and Neisseria gonorrhoeae. Patients who do not achieve ovulation after three to six cycles should be referred to an infertility specialist for further treatment. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase.

Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity. Hysterosalpingo-contrast-ultrasonography - TVS scan during which air and saline or a solution of D-galactose is infused into the uterine cavity and observed to flow along the fallopian tubes. - Requires more expertise. - Less invasive.

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When anatomic variance or obstruction is suspected, referral for surgical evaluation and treatment is appropriate. Povey AC, Clyma JA, McNamee R, et al.; Participating Centres of Chaps-UK. This measurement is called the antral follicle count and may correlate with fertility potential. Vasectomy and Vasectomy Reversal. (PDF, 7 MB) Fertility and Sterility, 1978.

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Reducing the risk of multiple pregnancies Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. These endometrial cells can extend as far as the outside of the fallopian tubes, the ovaries and the bladder. If there is a history of recurrent miscarriages (2 or more) a lupus anticoagulant (LAC) and anti-cardiolipin antibody (ACL) are often done, as well as other tests.

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In cases when the quality of sperm is very poor, or sperm is completely absent in the ejaculate (azoospermia), donor’s sperm can be used (if culturally acceptable). Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments. You always have the choice to experience our sites without personalized advertising based on your web browsing activity by visiting the DAA’s Consumer Choice page, the NAI's website, and/or the EU online choices page, from each of your browsers or devices. The woman is instructed to measures her body temperature every morning as soon as she wakes up, before she gets out of bed or before she eats or drinks anything. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. Females[edit] The following causes of infertility may only be found in females. Successful Vitrification of Bovine and Human Ovarian Tissue. (PDF, 3 MB) Reproductive BioMedicine Online, 2009. It also tests for a luteal phase defect (inadequate level of progesterone). If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult. In GIFT, the sperm and eggs are mixed together before a doctor inserts them. World Health Organization[edit] The World Health Organization defines infertility as follows:[10] United States[edit] One definition of infertility that is frequently used in the United States by reproductive endocrinologists, doctors who specialize in infertility, to consider a couple eligible for treatment is: a woman under 35 has not conceived after 12 months of contraceptive-free intercourse. If too many embryos develop, one or more can be removed.