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47 Motivational interviewing techniques for modifiable risk factors, such as obesity, tobacco, illicit drugs, and alcohol, can decrease the targeted risk factor. The main reasons for fertility tourism are legal regulation of the sought procedure in the home country, or lower price. 37,38 The addition of 1,500 to 1,700 mg of metformin (Glucophage) daily may increase ovulation and pregnancy rates, but it does not significantly improve live birth rates over clomiphene alone. Common causes of infertility of females include: ovulation problems (e.g. polycystic ovarian syndrome, PCOS, the leading reason why women present to fertility clinics due to anovulatory infertility.[58]) tubal blockage pelvic inflammatory disease caused by infections like tuberculosis age-related factors uterine problems previous tubal ligation endometriosis advanced maternal age immune infertility Males[edit] The main cause of male infertility is low semen quality. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous. Outside pregnancy and lactation, women with high levels of prolactin may have irregular ovulation cycles and fertility problems.

Up to 25% of infertile men have idiopathic infertility. If a couple has never produced a pregnancy, it is defined as primary infertility. In women with anovulation, it may be an alternative after 7 - 12 attempted cycles of pituitary feedback regimens (as evidenced by clomifene citrate), since the latter ones are less expensive and more easy to control.[18] In vitro fertilization[edit] The standard procedure of in vitro fertilization includes controlled ovarian hyperstimulation with gonadotropins, but in larger doses, with the intention to induce development of supernumerary follicles. Hormonal abnormalities can sometimes be treated with medicine or surgery. Conventional In-vitro Fertilization vs Intracytoplasmic Sperm Injection for Patients Requiring Microsurgical Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1994. Aetiology of Congenital Absence of Vas Deferens: Genetic Study of Three Generations. (PDF, 4 MB) Human Reproduction, 1993.

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Use of clomiphene citrate in infertile women: a committee opinion. The anamnesis includes sexual behavior concerning ovulation here.

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Sperm Granuloma and Reversibility of Vasectomy. (PDF, 11 MB) Lancet, 1977. Females[edit] The following causes of infertility may only be found in females. Ovarian Hyperstimulation Syndrome (OHSS) The syndrome occurs due to treatment with medicamentous ovulation inductors.

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Fresh Ovarian Tissue and Whole Ovary Transplantation. (PDF, 373 KB) Seminars in Reproductive Medicine, 2009. This can damage the ovaries or fallopian tubes and cause fertility problems. It has been proven useful in overcoming infertility conditions, such as blocked or damaged tubes, endometriosis, repeated IUI failure, unexplained infertility, poor ovarian reserve, poor or even nil sperm count. Ovulation often can be detected by keeping a menstrual calendar or using an ovulation predictor kit. This number has been rising continuously over the last few years. Combined causes of infertility and sterility A person can often have a subfertility issue that may be helped or made worse depending on their partner's circumstances. Laboratory studies have suggested that long-term acetaminophen use during pregnancy may affect fertility in males by lowering testosterone production. 5°F above the basal level) induced by the early secretion of progesterone. Graft-versus-host Reactivity and Renal Allograft Survival in Rats Given Allogeneic Spleen Cells or Spleen Allografts.(PDF, 2 MB) Transplantation, 1976. Measures the LH in urine to detect if and when ovulation has occurred. A thorough physical exam can detect varicocele and give clues to hormone problems. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. Cystic Fibrosis and Infertility Caused by Congenital Bilateral Absence of the Vas Deferens and Related Clinical Entities. (PDF, 2 MB) Human Reproduction, 1996.