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The hypothalamus acts on the false information that the estrogen level in circulation is low, increasing production of FSH and LH, thus stimulating follicular growth. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. Judaism and Repoductive Technology. (PDF, 160 KB) 2003.

Preconception lifestyle advice for people with subfertility. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury. With the fast progression in reproductive medicine and the experiences gained through infertility management, a wider range of treatment options have become available to infertile couples [17-19,21-26,31,36], (Appendix 4). The Male-specific Region of the Human Y Chromsome is a Mosaic of Discrete Sequence Classes. (PDF, 754 KB) Nature, 2003.

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Coutifaris C, Myers ER, Guzick DS, et al.; NICHD National Cooperative Reproductive Medicine Network. In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. 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. Exposure to toxic agents can occur from occupational hazards or contaminated air, water, food supply or other exposures.

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Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer. They include: Clomifene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. 33 Use of antioxidants such as zinc, vitamin E, or l-carnitine showed increased live birth rates in three small randomized controlled trials in couples undergoing assisted reproductive technology. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Evaluation should be pursued by 6 months of attempted pregnancy in women with a known history of these abnormalities or a history of bleeding between menstrual cycles.

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Treatment of Cervical Factors Chronic cervicitis may be treated with antibiotics. Microscopic Technique for Reversal of Vasectomy. (PDF, 3 MB) Surgery, gynecology & obstetrics, 1976. Obesity may also lead to less frequent ovulation or to less frequent intercourse, thereby contributing to fertility problems. Risk factors for both men and women are the same and these include age, stress, being underweight or overweight, diet, smoking, alcohol and drugs. Clinical examination Full clinical examination of both partners usually stands for the underlying physical problem [17-22,24-26], (Appendix 2). Adverse effects of metformin include GI intolerance, nausea, vomiting, and abdominal cramps. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. Clomiphene citrate and/or Metformin. - folliculometry via TVUSS should be done to avoid multiple pregnancies and risk of OHSS. - Not for more than 6 months. These adverse effects were reported in older women with advanced breast cancer who were given the drugs on a daily basis over several months. One of such conditions is a varicocele – one of the major causes of male infertility – that occurs when a vein that carries blood out of the scrotum dilates. Anatomic causes of infertility include acquired and congenital problems. Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference. Malformation of the eggs themselves may complicate conception. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. Sex any other time, even the next day after ovulation, will not result in conception. “We generally advise couples to seek fertility evaluations if they are unable to conceive after 12 months of unprotected intercourse,” says Lawrence Ross, MD, president of the American Urological Association.