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Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW. Ideally, using strict morphology criteria, a minimum of 5 – 15% normal forms leads to a better ability for sperm to fertilize the egg. Additional risk factors may include smoking, alcohol use, obesity, and older age; however, the data are hampered by a lack of pregnancy-related outcomes. Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001. Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. Treatment of Female Infertility: Ovulation Induction Agents The main agents used for the induction of ovulation include: Clomiphene citrate is an orally active, nonsteroidal agent structurally similar to estrogen.

But it may actually point to an underlying condition, such as endometriosis or pelvic inflammatory disease. The Intra-abdominal Testes: Microvascular Autotransplantation. (PDF, 4 MB) The Journal of Urology, 1981. Some couples experience pressure from society, parents and family, who expect that they wish to have children. Other causes include Y chromosome microdeletion, a depletion of chromosome material that impedes or severely decreases spermatozoa production. There is no reliable means to predict whether the use of any treatment option will be successful and after how many attempts. Germ cells interdigitate with the Sertoli cells and undergo ordered maturation, migrating toward the lumen as they mature.

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ICSI offers a high pregnancy rate and 70—80 % of eggs are fertilized through this technique. A 3 to 5 days long sexual abstention is absolutely necessary for this.

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Oocyte Vitrification – Women’s Emancipation Set in Stone. (PDF, 70 KB) Fertility and Sterility, 2008. Fresh Ovarian Tissue and Whole Ovary Transplantation. (PDF, 373 KB) Seminars in Reproductive Medicine, 2009.

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Cabergoline is associated with fewer side effects but is more expensive. Because of the antiestrogenic effect, CC may thicken the cervical mucus, creating an iatrogenic cervical factor that can be responsible for the lack of pregnancy in a patient who has otherwise ovulated. [165] Other adverse effects associated with CC are hot flashes, scotomas, dryness of the vagina, headache, and ovarian hyperstimulation, which, although rare, has been reported in patients who are sensitive to CC. [166, 167] Whether the use of CC increases the risk of ovarian cancer is unknown, although 2 articles illustrate a potential risk. [168] Other authorities disagree with this assumption. These conditions, in which the body’s hormones are imbalanced, make conceiving more difficult.  Vaginal soreness and/or itchiness: Soreness or itchiness, especially in combination with discharge, could mean a vaginal infection. Congenital disorders and chryptorchidism (undescended testicles). Luteal phase support. (and cryopreservation choice offered if good quality embryos are available) IVF/ICSI 37. Down-regulation: - to avoid premature LH surge and spontenous ovulation. - either GnRH agonist protocol or GnRH antagonist protocol. - always use GnRH antagonist protocol in women with high risk of OHSS.