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Thus it is essential to evaluate both the man and the woman. Bensdorp AJ, Cohlen BJ, Heineman MJ, Vandekerckhove P. 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1.

Lack of ovulation Patients with anovulation who did not ovulate after several cycles of CC at different doses of treatment are deemed clomiphene resistant. If the epididymis is blocked, sperm may not be ejaculated properly.

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Many infertile couples have had some previous assessment for their infertility and this data should be cautiously reviewed. Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomifene and gonadotrophins. Intrauterine insemination 33. Consider unstimulated intrauterine insemination as a treatment option in the following groups as an alternative to vaginal sexual intercourse: - people who are unable to, or would find it very difficult to, have vaginal intercourse - people with conditions that require specific consideration in relation to methods of conception (for example, after sperm washing where the man is HIV positive) - people in same-sex relationships Do not offer IUI for people with unexplained infertility, mild endometriosis or mild male factor. Always take in consideration the ages of the couple. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. As the rate of getting spontaneous pregnancy among infertile or subfertile couples is lower than that among normal fertile population, it is recommended to carry out the following diagnostic, evidence-based, work-up to detect any hidden treatable cause. Couples will have to consider the ethical and emotional aspects of this procedure.

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A mouse study has suggested that ingredients in some household detergents may reduce fertility. For this reason, a call for low-cost ART protocols have been attempt to reduce the overall current cost of IVF through limiting the rquired laboratory investigations, modifying the stimulation regimen and purchasing low-priced pre-used machines and instruments [35]. A penile exam should detect atrophy, tumors, epididymal cysts, cryptorchidism (undescended testicles), vas thickening or absence of the vas deferens, hydrocele (fluid accumulation in the testis or along the spermatic cord) or varicocele. Assisted hatching: The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid.

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The administration of hMG and its derivatives should be under the direct supervision of a reproductive endocrinologist. Sertoli cells are columnar, with irregular basal nuclei that have prominent nucleoli and fine chromatin. The Use of Epididymal Sperm in Assisted Reproduction. (PDF, 8 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. Before treating cornual obstruction, the diagnosis should be confirmed. Epidemiology of infertility For healthy young couples, the probability of getting pregnancy per a reproductive cycle is about 20% to 25%. To analyze tubal causes of sterility, different methods can be considered. Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women.