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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. Chlamydia test: Chlamydia can affect fertility, but antibiotics can treat it. 1) Advancing maternal age: Historically before the latter 20th century, women were conceiving in their teens and twenties, when age-related abnormalities with the egg were not evident. Radiation therapy: If this is aimed near the reproductive organs, it can increase the risk of fertility problems. This pattern has been linked with aggressive behavior. 42 However, none of these methods has been proven to increase pregnancy rates when used to predict timing of intercourse.

The chance of a live birth following treatment is nearly 50% [25]. The key element is the use of a laparoscope, a long fiber optic cable system which allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location. In order to conceive, your sperm must be:  Highly concentrated — normally, there should be at least 15 million sperm in every ml of semen5  Moving well (motile) — a lashing tail helps your sperm to swim to your partner’s egg  Normally shaped — healthy sperm should be shaped like a streamlined tadpole  You may find that your semen contains a very low number of sperm (oligozoospermia), or no sperm at all (azoospermia). A doctor injects sperm directly into the egg in a dish and then places it into your uterus. According to the literature survey, the most common causes of infertility are: male factor [5,7-9,13-15] such as sperm abnormalities [9,13,15], female factor [7-9,14-16] such as ovulation dysfunction [7,8] and tubal pathology [7-9], combined male and female factors [7,9,14,15] and unexplained infertility; where no obvious cause could be detected [7-9].

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PID can damage and scar the fallopian tubes, making it virtually impossible for an egg to travel down into the womb. Varicoceles are observed more commonly on the left side than the right. The evaluation of the azoospermic male: AUA best practice statement. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980.

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Panhypopituitafism: Complete pituitary gland failure--lowers growth hormone, thyroid-stimulating hormone, and LH and FSH levels.  Symptoms include:  lethargy, impotence, decreased libido, loss of secondary sex characteristics, and normal or undersized testicles.  Supplementing the missing pituitary hormones may restore vigor and a hormone called hCG may stimulate testosterone and sperm production. Symptoms can also depend on what is causing the infertility. It's used to remove polyps and fibroid tumors, divide scar tissue, and open up blocked tubes. These rates, of course, readjusted down for the older women with long durations of infertility [42]. 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. As soon as it reaches a specific size, the administration of beta-HCG takes place.

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ART techniques generally start with stimulating the ovaries to increase egg production. Risk factors for both men and women are the same and these include age, stress, being underweight or overweight, diet, smoking, alcohol and drugs. Some medications increase the risk of fertility problems in men. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Regardless of the treatment approach, establish a 6- to 12-month interval during which a spontaneous pregnancy is expected to occur. The vas is divided into the convoluted, scrotal, inguinal, retroperitoneal, and ampullary regions and receives its blood supply from the inferior vesical artery. 8) Unexplained/other: Sometimes a full evaluation does not reveal the cause of infertility. You have never had a period, or periods suddenly stop. Prolactinomas or the intakes of dopamine antagonists (typical antipsychotics for example) cause hyperprolactinemia. The more fetuses there are, the higher the risk of premature labor. The incidence varies in different populations, in some areas approaching 40%.