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Biopsy reveals maturation arrest or germ cell aplasia. In some women, and especially with age, the membrane becomes harder. Secondary fertility involves one or both partners who have conceived previously, but are now unable to do so because of a possible physical or medical condition impairing fertility. These include: non-steroidal anti-inflammatory drugs (NSAIDs) – long-term use or a high dosage of NSAIDs, such as ibuprofen or aspirin, can make it more difficult to conceive chemotherapy – medicines used for chemotherapy can sometimes cause ovarian failure, which means your ovaries will no longer be able to function properly neuroleptic medicines – antipsychotic medicines often used to treat psychosis; they can sometimes cause missed periods or infertility spironolactone – a type of medicine used to treat fluid retention (oedema); fertility should recover around 2 months after you stop taking spironolactone Illegal drugs, such as marijuana and cocaine, can seriously affect fertility and make ovulation more difficult.

CAH may be due to the congenital deficiency of one of several adrenal enzymes, the most common of which is 21-hydroxylase deficiency. Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome). 33 Use of antioxidants such as zinc, vitamin E, or l-carnitine showed increased live birth rates in three small randomized controlled trials in couples undergoing assisted reproductive technology. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. The elevation in the temperature is indicative of ovulation. Laparotomy with histopathology is usually indicated, because medical attempts at inducing ovulation (human chorionic gonadotropin, FSH, GnRH) are usually unrewarding.

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Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. Partners may become more anxious to conceive, increasing sexual dysfunction.[17] Marital discord often develops, especially when they are under pressure to make medical decisions.

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Torsion: Is a common problem affecting fertility that is caused by a supportive tissue abnormality which allows the testes to twist inside the scrotum which is characterized by extreme swelling.  Torsion pinches the blood vessels that feed the testes shut which causes testicular damage.  If emergency surgery is not performed to untwist the testes, torsion can seriously impair fertility and cause permanent infertility if both testes twist. A dye test may be performed to detect any blockage in the reproductive tract, wherein a dark blue dye is passed up through the cervix and is followed with the laparoscope through its passage out into the fallopian tubes to the ovaries.[1] See also[edit] [edit] External links[edit] Feder, Barnaby J.Infertility is the inability of a person, animal or plant to reproduce by natural means. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended.

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Urinary monitoring of the LH surge (eg, with an LH Predictor Kit) can be a substitute for BBT. Chronic conditions: These include AIDS or cancer. If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF). In some cases, your doctor may recommend a procedure known as intracytoplasmic sperm injection (ICSI). Additionally, there is concern that the stress of a strict schedule for intercourse may lead to reduced frequency of intercourse. IVF/ICSI Oocyte retrieval: - ultrasound-guided oocyte retrieval. Fertilization and incubation. Embryo-transfer. - SET or DET. They can also carry out some basic tests on both partners to see if there is an identifiable reason for not having achieved a pregnancy. If he has two X chromosomes and one Y chromosome, as in Klinefelter's syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm. The identification of anovulation is not easy; contrary to what is commonly believed, women undergoing anovulation still have (more or less) regular periods. Gonadotrophins for idiopathic male factor subfertility.