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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). Medicines and drugs  The side effects of some types of medicines and drugs can affect your fertility.

The views expressed in this material are those of the authors, and do not reflect the official policy or position of the U. Thus, pelvic ultrasonography has become an important tool for monitoring ovulation induction. Estrous cycle abnormalities can cause infertility. 2 or more - sperm concentration: 15 million spermatozoa per ml or more - total sperm number: 39 million spermatozoa per ejaculate or more - total motility: 40% or more motile or 32% or more with progressive motility - vitality: 58% or more live spermatozoa - sperm morphology (percentage of normal forms): 4% or more Basic Work-up for Infertility 13. Evidence of ovulation: 1. 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. According to ESHRE recommendations, couples with an estimated live birth rate of 40% or higher per year are encouraged to continue aiming for a spontaneous pregnancy.[66] Treatment methods for infertility may be grouped as medical or complementary and alternative treatments.

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United Kingdom[edit] In the UK, previous NICE guidelines defined infertility as failure to conceive after regular unprotected sexual intercourse for two years in the absence of known reproductive pathology.[11] Updated NICE guidelines do not include a specific definition, but recommend that "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner, with earlier referral to a specialist if the woman is over 36 years of age."[12] Other definitions[edit] Researchers commonly base demographic studies on infertility prevalence on a five-year period.[13] Practical measurement problems, however, exist for any definition, because it is difficult to measure continuous exposure to the risk of pregnancy over a period of years. These problems with sperm can cause male infertility.

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Bladder neck closure during ejaculation is vital to ensure antegrade ejaculation. In general, infertility is defined as the inability of couples to achieve pregnancy after ≥1 year of trying (1). B.: - GnRHa should not be offered with ovulation induction for risk of OHSS. - No evidence for the role of adjuvant growth hormones. Clean, Intermittent Self-catheterization in the Treatment of Urinary Tract Disease. (PDF, 2 MB) The Journal of Urology, 1972.

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Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. This is called the fulcrum effect.[22] Some surgeries (carpal tunnel for instance) generally turn out better for the patient when the area can be opened up, allowing the surgeon to see "the whole picture" surrounding physiology, to better address the issue at hand. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW. Symptoms of hormone fluctuations Signs of hormone fluctuations in women could indicate potential issues with fertility. Simultaneous Treatment of the Wife in Infertile Couples with Oligospermia. (PDF, 4 MB) Fertility and Sterility, 1983. Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries. It has been suggested that infertility be classified as a form of disability.[22] Causes[edit] Immune infertility[edit] Antisperm antibodies (ASA) have been considered as infertility cause in around 10–30% of infertile couples.[23] In both men and women, ASA production are directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, inhibiting capacitation and acrosome reaction, impaired fertilization, influence on the implantation process, and impaired growth and development of the embryo. An extensive work-up showed Steve was born without the vas deferens, the main sperm pipelines from the testicles. Symptoms include: bloating constipation dark urine diarrhea nausea abdominal pain vomiting They are usually mild and easy to treat. Infertility is more likely in men who have had this condition.