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Review Questions The answers can be found below the references. Secondary infertility When a woman is unable to bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to a live birth, she would be classified as having secondary infertility. Risk factors for male infertility include obesity, age (over 40 -- yes, men also have biological clocks), current or previous infection of an STD, smoking, or excessive drinking. 35. In women aged under 40 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 3 full cycles of IVF, with or without ICSI. Luteinized unruptured follicle syndrome can be prevented by the administration of hCG (10,000 IU IM) once the follicle reaches 23-24 mm in diameter. 8 These studies are more sensitive and may delineate an abnormally formed uterus or structural problems, such as fibroids.

Women in group III can conceive only with oocyte donation and in vitro fertilization. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Urologic Clinics of North America, 1981. Aromatase inhibitors Aromatase inhibitors (letrozole, anastrozole) inhibit the action of the enzyme aromatase, which converts androgens into estrogens by a process called aromatization. A small Steering Committee with six Expert Working Group Chairs, local Swiss experts, as well as Presidents, Chairpersons and representatives of ASRM1, ESHRE2, FIGO3, GFMER4, ICMART5 and IFFS6 came to the table to share experiences, to present their current (or in-process) guidelines and to recommend a collaborative process for moving forward to generate global guidelines. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. Online support from organizations such as Resolve can be helpful.

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Women who have a body weight 10% to 15% below normal may have reduced fertility. Problems with sperm If a man makes too few sperm or none at all, the woman cannot become pregnant. It makes the pituitary gland release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Fertility: assessment and treatment for people with fertility problems. Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995.

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It can also help if a man has severe erectile dysfunction. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. Men with Infertility Caused by AZFc Deletion can Produce Sons by Intracytoplasmic Sperm Injection, but are Likely to Transmit the Deletion and Infertility. (PDF, 102 KB) Human Reproduction, 1999. 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. Some facts about conception and fertility A doctor can give advice and carry out some preliminary assessments.

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If endometriosis is found, it can be surgically removed by various methods, and its removal may lead to a decrease in pain as well as improvement in the ability to conceive naturally. Exposure to chemicals: Pesticides, for example, may increase the risk. Because cortisol is not secreted, a lack of feedback inhibition on the pituitary gland occurs, leading to adrenocorticotropic hormone (ACTH) hypersecretion. In many instances, more than one hysteroscopy is required for total resection. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization. Surgery for hydrosalpinges before in-vitro fertilization treatment: Laparoscopic salpingectomy or disconnection of both tubes improve IVF/ICSI success rates. Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993. Surgery for hydrosalpinges before in-vitro fertilization treatment: Laparoscopic salpingectomy or disconnection of both tubes improve IVF/ICSI success rates.