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To ascertain a more precise assessment, a hysteroscopy of the uterus is run. Ultrasound: This may reveal issues such as ejaculatory duct obstruction or retrograde ejaculation. Vasectomy Reversal. (PDF, 733 KB) The New England Journal of Medicine, 1977.

The search included meta-analyses, randomized controlled trials, clinical trials, and systematic reviews. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. The most commonly prescribed injections that stimulate the ovary are called gonadotropins. No consensus exists as to whether the medical treatment should precede surgery or vice versa. [154, 155, 156] Those who prefer medical treatment first argue that the size of the endometriosis decreases; therefore, surgery will be easier and shorter. Microsurgery and Andrology. (PDF, 5 MB) Chapter from textbook, 1991.

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In addition to the alteration of menstrual periods and infertility, chronic anovulation can cause or exacerbate other long term problems, such as hyperandrogenism or osteopenia. A woman with a suspicion of chronic anovulation most probably due to polycystic ovary (PCO) syndrome, as there is a long history of irregular cycles and clinical presentation with hirsutism, her serum levels of testosterone hormone, sex hormone binding globulin (SHBG), dihydroepiandrostenedione (DHEA), dihydroepiandrostenedione-sulfate (DHEAS) and prolactin should be evaluated to prove the provisional diagnosis and to detect the source of excess androgens. IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. Uterine fibroid embolization (UFE) consists of catheterization of the uterine artery and the injection of microbeads of polyvinyl alcohol to selectively occlude the circulation of the fibroid.

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Patients with adrenal hyperplasia and other disorders must be treated with prednisone. According to the literature survey, the most common causes of infertility are: male factor [5,7-9,13-15] such as sperm abnormalities [9,13,15], female factor [7-9,14-16] such as ovulation dysfunction [7,8] and tubal pathology [7-9], combined male and female factors [7,9,14,15] and unexplained infertility; where no obvious cause could be detected [7-9].

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The incidence of congenital malformation in IVF babies ranges between 2% and 3% worldwide and is similar to that in babies conceived naturally [45]. Diagnosis and Management of Hypogonadism, Infertility, and Impotence. (PDF, 13 MB) Chapter 22 of textbook,Male Reproductive Dysfunction, 1986. Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. The National Institute for Health and Care Excellence (NICE) recommends that women with unexplained infertility who haven't conceived after 2 years of having regular unprotected sex should be offered IVF treatment. If a blockage is present, surgery may be necessary. The emotional toll on both partners can affect their relationship.