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B.: No role for basal body temperature charts) Basic Work-up for Infertility 14. Ovarian reserve -More important in >35 years old, suspected ovarian failure and to detect response to ovulation induction. There are medications to help increase the chance of getting and keeping an erection. Normal fertility is observed in three fourths of patients with unilateral mumps orchitis and in one third of patients in bilateral orchitis.

43 Other low-cost methods of monitoring for ovulation, although less effective, include basal body temperature measurements and cervical mucus changes. Signs of infertility include irregular, excessively heavy, or absent periods as well as sudden weight gain, painful sex, or vaginal infections. The HSG is usually scheduled between days 6 and 13 of the cycle - after bleeding and before ovulation. Several studies have reported different causes of infertility [7-9].

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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. As there is surplus medical information everyday that can not be cached by healthcare providers, clinical guidelines created to endorse up-to-date evidence-based practice to improve patients' outcome [6]. Less common factors The following other factors may also be responsible for infertility in a smaller proportion of cases: • Genetic abnormalities within eggs, sperm or both • An abnormal uterine cavity, including the presence of fibroids or polyps • Immunological infertility, whereby either the male or female partner produces anti-bodies against sperm cells or implantation of an embryo • Abnormal cervical mucus which hinders the passage of sperm to the uterus and fallopian tubes Unexplained infertility Even when investigations have been extensive, some couples will have no reason with which to explain their infertility. In 1981, Semm, from the gynecological clinic of Kiel University, Germany, performed the first laparoscopic appendectomy.

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Semen and sperm Sometimes the sperm cannot travel effectively to meet the egg. Medications, treatments, and drugs Some drugs can affect fertility in a woman. Tubal occlusion A tubal occlusion means there is a blockage in the fallopian tube. Consulting a nutritionist, for example, could help a young woman suffering from anorexia to put on some weight, which might restart her menstrual cycle.

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Medications Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility. Assisted Reproductive Technology: Using Ejaculated, Fresh, and Frozen-thawed Epididymal and Testicular Spermatozoa Gives Rise to Comparable Results after Intracytoplasmic Sperm Injection. (PDF, 5 MB) Fertility and Sterility, 1995. But it may actually point to an underlying condition, such as endometriosis or pelvic inflammatory disease. Unexplained Even after a full fertility work-up, for one in five couples an exact cause of infertility cannot be determined. Fertility treatments for men Treatment will depend on the underlying cause of the infertility. Idiopathic hypogonadotropic hypogonadism A failure of GnRH secretion without any discernible underlying cause may be observed alone (isolated) or as part of Kallmann syndrome, which is associated with midline defects such as anosmia, cleft lip and cleft palate, deafness, cryptorchidism, and color blindness. For example, 10 to 15 percent of untreated chlamydia cases will lead to pelvic inflammatory disease (PID). Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Normal Pregnancies Resulting from Testicular Sperm Extraction and Intracytoplasmic Sperm Injection for Azoospermia Due to Maturation Arrest. (PDF, 6 MB) Fertility and Sterility, 1996.