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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. This drug is administered in a pulsatile fashion every 60-120 minutes, intravenously or subcutaneously using a delivery pump. This improves the chances that the embryo will implant at, or attach to, the wall of the uterus. Negative tests with immotile sperm in the cervical mucus suggest rare immunological causes of sterility. The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[65] Women over the age of 35 should see their physician or WHNP after six months as fertility tests can take some time to complete, and age may affect the treatment options that are open in that case. The doctor may ask about the couple's sexual habits and make recommendations regarding these.

Source : Infertility and its Treatments - PPT Presentation Summary : Infertility and Its Treatments. Risk factors for the formation of antisperm antibodies in men include the breakdown of the blood‑testis barrier, trauma and surgery, orchitis, varicocele, infections, prostatitis, testicular cancer, failure of immunosuppression and unprotected receptive anal or oral sex with men.[23][24] Sexually transmitted infections[edit] Infections with the following sexually transmitted pathogens have a negative effect on fertility: Chlamydia trachomatis and Neisseria gonorrhoeae.

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Under current NHS policies, fertility treatment is only funded for those proven infertile, and those where fertility is unexplained but attempts at conception have failed. Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. Klinefelter�s Syndrome: Is a genetic condition in which each cell in the human body has an additional X chromosome--men with Klinefelter�s Syndrome have one Y and two X chromosomes.  Physical symptoms include peanut-sized testicles and enlarged breasts.  A chromosome analysis is used to confirm this analysis.  If this condition is treated in its early stages (with the drug hCG), sperm production may commence and/or improve.  However, Klinefelter�s Syndrome eventually causes all active testicular structures to atrophy.  Once testicular failure has occurred, improving fertility is impossible. Some methods may be used in concert with other methods. However, given that fertility in women is known to decline steadily with age, some providers evaluate and treat women aged ≥35 years after 6 months of intercourse without the use of contraception (1).

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With irregular periods, the cycle is so unpredictable that it’s impossible to know when the next one will come. In 1978, the first baby was born as a result of IVF. 6 mg SC q4wk for 6 months) GnRHa therapy can be administered along with cyclic or continuous progestins or with cyclic or continuous estrogen and progestins in cases of severe hot flashes. [145, 152] Combined therapy Medical and surgical treatments are usually combined for the treatment of severe endometriosis. Transplantation of a Human Testis for Anorchia. (PDF, 19 MB) Fertility and Sterility, 1978. Factors affecting Fertility Low body weight - Women with BMI less than 19 and irregular menstruation should be counselled to gain weight. Smoking - Strong association between smoking and fertility in both partners. - Affects success rates of ARTs. Surprisingly, most patients have normal libido, erections, and orgasms, so testosterone therapy has only a limited role; exogenous testosterone may also suppress any underlying sperm production.

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Ovarian Hyperstimulation Syndrome (OHSS) The syndrome occurs due to treatment with medicamentous ovulation inductors. Malformation of the eggs themselves may complicate conception. Endometriosis may be treated through laparoscopic surgery. The prevalence varies widely, being less in developed countries and more in developing countries where limited resources for investigation and treatment are available [2]. The predictive value of hysterosalpingography for tubal and peritoneal infertility factors. In order to accomplish this, the semen is washed with a solution safe to sperm and eggs, and then centrifuged to separate motile sperm from immotile sperm and other cells. 8,37 Women in WHO group II, including those who are overweight and who have polycystic ovary syndrome, can benefit from weight loss, exercise, and lifestyle modifications to restore ovulatory cycles and achieve pregnancy. Teratospermia is defined as less than 30% normal morphology, and the WHO lower reference limit (5th percentile) is 4%. Additionally, there is concern that the stress of a strict schedule for intercourse may lead to reduced frequency of intercourse. If resistant to the above, offer: - laparoscopic ovarian drilling, or, - ovulation induction via gonadotrophins. Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988–1989). Vasectomy. (PDF, 5 MB) From the Encyclopedia of Reproduction, 1999. Cholesterol One study has found that high cholesterol levels may have an impact on fertility in women. Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome).