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The diagnostic charts, which may be photocopied, provide an unambiguous route to diagnosis of the underlying cause of infertility, whilst the text fully explains and describes the essential clinical tests. IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems. As sperm move from the head to the tail, they mature and acquire fertilization capacity.

Intracytoplasmic Sperm Injection and Infertility. (PDF, 53 KB) Nature Genetics, 2001. Intrauterine insemination. For this procedure, after semen gets rinsed with a special solution, a doctor places it into your uterus when you're ovulating.

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An ultrasound scan can detect an ectopic pregnancy. Aromatase inhibitors Aromatase inhibitors (letrozole, anastrozole) inhibit the action of the enzyme aromatase, which converts androgens into estrogens by a process called aromatization. Tests and trials are available, but testing does not always reveal a specific cause.

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6,23 Anovulatory women should have further investigation to determine treatable causes such as thyroid disorders or hyperprolactinemia based on symptoms. Successful Pregnancy and Delivery after Calcium Ionophore Oocyte Activation in a Normozoospermic Patient with Previous Failed Fertilization after Intracytoplasmic Sperm Injection. (PDF, 57 KB) Fertility and Sterility, 2003. Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel.

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ART procedures, such as GIFT, IVF, and ICSI, also can be used in cases of male infertility. Many countries have special frameworks for dealing with the ethical and social issues around fertility treatment. Sperm Granuloma and Reversibility of Vasectomy. (PDF, 11 MB) Lancet, 1977. Long-term Economic Benefits Attributed to IVF-conceived Children: A Lifetime Tax Calculation. (PDF, 225 KB) The American Journal of Managed Care, 2008. Gracia CR, Sammel MD, Coutifaris C, Guzick DS, Barnhart KT. After ruling out female infertility concerns, tests for male infertility may be needed.