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6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs. Operative laparoscopy: This technique is indicated for pedunculated and superficial intramural myomas. Etiology of Sterility Causes of sterility can be manifold and diverse. For some women, these devices do not detect the LH surge, or high levels of LH are a poor predictor of ovulation; this is particularly common in women with PCOS. Depending on the therapeutic agent and the duration of treatment, endometriosis can be treated with oral contraceptives, progestins, androgens, or GnRH agonists. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 2 MB) Human Reproduction, 1996.

As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). Chemotherapy: Some types may significantly reduce sperm count. Passive smoking has also been linked to lower fertility. Other testing may be needed based on circumstances, including testicular biopsy, genetic testing, and imaging (Table 36–8,10,19,20). The choices I found myself having to make in the years that followed, and the mounting agony of repeat in vitro fertilization (IVF) cycles, left me devastated. Amenorrhea (absence of menstruation) occurs in about 20% of women with ovulatory dysfunction.

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Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high. Round Spermatid Injection. (PDF, 422 KB) Fertility and Sterility, 2000.

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For most specimens, the greatest recovery of the motile portion results from separation via centrifugal filtration through a discontinuous density gradient system. Infertility tests for women A woman will undergo a general physical examination, and the doctor will ask about her medical history, medications, menstruation cycle, and sexual habits.

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8–16 One retrospective case-control study of 650 men with infertility and 698 control participants questioned the role of environmental risk; no association could be determined after assessing for multiple factors including shift work, stress, and pesticides. Sperm Retrieval for Azoospermia and Intracytoplasmic Sperm Injection Success Rates – A Personal Overview.(PDF, 1 MB) Human Fertility, 2010. Estimating the prevalence of infertility in Canada [published correction appears in Hum Reprod. The main approach to correcting or removing these uterine abnormalities is by hysteroscopy, a surgical method by which a narrow scope with a camera is placed within the uterine cavity. Some methods may be used in concert with other methods. 17 Evaluation of male infertility starts with a history and physical examination focusing on previous fertility, pelvic or inguinal surgeries, systemic diseases, and exposures. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome). Preconception lifestyle advice for people with subfertility. Causes in men The following are common causes of infertility in men.