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Further reading[edit] Fertility: Assessment and Treatment for People with Fertility Problems. During this time, the cells cross from the basal to the adluminal compartments. Women attempting pregnancy at age 40 or older have a 50% decreased fertility rate and a two-fold to three-fold increased risk of spontaneous abortion compared with younger women. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). A Series of Monozygotic Twins Discordant for Ovarian Failure: Ovary Transplantation (Cortical versus Microvascular) and Crypreservation. (PDF, 791 KB) Human Reproduction, 2008. Epididymal and Testicular Spermatozoa and Intracytoplasmic Sperm Injection. (PDF, 7 MB) Assisted Reproduction Reviews, 1996.

Men who are underweight tend to have lower sperm concentrations than those who are at a normal BMI. Microscopic Vasovasostomy and Spermatogenesis. (PDF, 1 MB) The Journal of Urology, 1977. This standardized approach to the management of infertility will lead to more efficient, systematic and economic care for the infertile couple. Primary sterility exists when the couple has never fallen pregnant and secondary sterility when the issue arises following one successful pregnancy but no further pregnancies. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. As part of the fertility evaluation, we will perform an HSG, a test designed to evaluate if the fallopian tubes are open.

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Metformin (Glucophage): If Clomifene is not effective, metformin may help women with PCOS, especially when linked to insulin resistance. A diagnosis of male infertility can be one of the hardest challenges a man can face. Contents Definition[edit] "Demographers tend to define infertility as childlessness in a population of women of reproductive age," whereas "the epidemiological definition refers to "trying for" or "time to" a pregnancy, generally in a population of women exposed to" a probability of conception.[8] Currently, female fertility normally peaks at age 24 and diminishes after 30, with pregnancy occurring rarely after age 50.[9] A female is most fertile within 24 hours of ovulation.[9] Male fertility peaks usually at age 25 and declines after age 40.[9] The time needed to pass (during which the couple tries to conceive) for that couple to be diagnosed with infertility differs between different jurisdictions.

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The only disadvantage with BBT is that in many instances, the shift does not occur in a clear way, and the patient misses the time of ovulation. Testicular Transplantation and Autotransplantation. (PDF, 8 MB) Chapter 22 of textbook, Extracorporeal and Microvascular Surgery, 1982. Causes of Sterility in Men Image: “Colorized sperm sample under the light microscope” by Bobjgalindo.

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We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months. Conventional IVF vs ICSI (Intra Cytoplasmic Sperm Injection) for Patients Requiring Microsurgical Epididymal Sperm Aspiration (MESA). (PDF, 4 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Intracytoplasmic Sperm Injection. (PDF, 4 MB) Chapter 47 from textbook Current Therapy in Equine Reproduction, 2006. Women in group II include those with polycystic ovary syndrome and hyperprolactinemia. 6,28 Additionally, postcoital testing of cervical mucus is no longer recommended because it does not affect clinical management or predict the inability to conceive. Whether it should be corrected in cases of primary infertility is controversial. Infertility caused by DNA defects on the Y chromosome is passed on from father to son.