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6,8 It is important for primary care physicians to be familiar with the workup and prognosis for infertile couples. Ectopic pregnancy This is when a fertilized egg implants outside the womb, usually in a fallopian tube. The epididymis is a 3- to 4-cm long structure with a tubular length of 4-5 m.

Previously, metformin was recommended as treatment for anovulation in polycystic ovary syndrome, but in the largest trial to date, comparing clomiphene with metformin, clomiphene was more effective than metformin alone.[21] Following this study, the ESHRE/ASRM-sponsored Consensus workshop do not recommend metformin for ovulation stimulation.[22] Subsequent randomized studies have confirmed the lack of evidence for adding metformin to clomiphene. 2012;27(8):2396–2404.   Want to use this article elsewhere?

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In such circumstances, it is recommended not to prescribe any medication until all basic investigations are done and its results received. A Modern View of Male Infertility. (PDF, 7 MB) From The Infertile Male: Advanced Assisted Reproductive Technology, 1994.

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Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. You have never had a period, or periods suddenly stop.

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CASA measures the following parameters: Curvilinear velocity – The average distance per unit time between successive sperm positions) Straight-line velocity – The speed of forward direction Linearity – The straight-line velocity divided by the curvilinear velocity In addition, the program measures the average path velocity, the amplitude of lateral head displacement, and the flagellar beat frequency, and it is used to evaluate for evidence of hyperactivation. Abnormal semen may not be able to carry the sperm effectively. Outcome of Intracytoplasmic Sperm Injection with Testicular Spermatozoa in Obstructive and Non-obstructive Azoospermia. (PDF, 426 KB) Human Reproduction, 1996. Mittelschmerz and premenstrual symptoms tend to be absent or reduced when a woman is anovulatory. Removal of polyps by the minimally invasive procedure hysteroscopy is associated with a doubling of pregnancy rate. Factors Affecting Fertility (Continued) Various toxic agents, smoking and alcohol may contribute to fertility problems. Reduced fecundability in women with prenatal exposure to cigarette smoking. After interviewing the couple together, the man and woman should be interviewed separately to obtain confidential information. Infection: Some infections, such as gonorrhea or inflammation of the testicles, can affect sperm production or sperm health or can cause scarring that blocks the passage of sperm. Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility. Additionally, multiple pregnancies cumulatively occur after ovarian stimulation. Transplantation of a Human Testis for Anorchia. (PDF, 19 MB) Fertility and Sterility, 1978.