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The initial dosage of clomiphene is 50 mg daily for five days starting on day 3 to 5 of the menstrual cycle. The ovulation induction agents used include clomiphene citrate, hMG, hCG, recombinant FSH, and recombinant LH. Factors affecting Fertility Caffeinated beverages: - No evidence on effect of caffeine on fertility. Alcohol - Female patients should be informed that 1 or 2 units of alcohol once or twice per week reduces risk of harming a developing fetus. - Intoxication may affect semen quality.

IUI increases the number of the sperm in the fallopian tubes, where fertilization takes place. Sperm retrieval for azoospermia and intracytoplasmic sperm injection success rates – A personal overview. (PDF, 1 MB) Human Fertility, 2010. Secondary infertility is used to refer to those cases in which miscarriages occur after having had one successful pregnancy.Infertility has traditionally been thought of as a woman's problem. In some cases, the cause of infertility or subfertility could not be suspected from the history taking and clinical examination.

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In some cases, hormonal problems may be suspected if a man has abnormal hair growth, low libido, or other indications of sexual dysfunction. Couples who do not conceive after treatment for six cycles with documented ovulation should also consider referral to an infertility specialist. The use of surgical humidification therapy, which is the use of heated and humidified CO2 for insufflation, has been shown to reduce this risk.[27] Many patients with existing pulmonary disorders may not tolerate pneumoperitoneum (gas in the abdominal cavity), resulting in a need for conversion to open surgery after the initial attempt at laparoscopic approach.

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A couple which is unable to conceive is not the same as a couple which often conceives without difficulties but which then sadly finds that the pregnancy does not go full term. Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994. They're then stored inside yards of “plumbing” called the epididymis, which lies on top of each testicle.

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Varicocele A varicocele is a dilation of the veins of the pampiniform plexus of the scrotum. It is specially oriented for cancer patients, whose sperm is destroyed due to the gonadotoxic treatment they are submitted to.[70] Ovaric stem cells: it is thought that women have a finite number of follicles from the very beginning. Some medications increase the risk of fertility problems in men. If the obstruction is caused by salpingitis isthmica nodosa or fibrosis, the best results are achieved through IVF. [142] Surgical preparation for IVF While the surgeon should be as conservative as possible, he or she should consider that the patient is better served with a single well-functioning fallopian tube than with 2 defective tubes, which elicits an increased risk for ectopic pregnancy or recurrence of pelvic adhesions. Most typical are decreased libido, erectile dysfunction, orgasmic dysfunction, and ejaculatory dysfunction. This can reveal signs of endometriosis, scarring, blockages, and some irregularities of the uterus and fallopian tubes. Low sperm mobility (motility): The sperm cannot "swim" as well as they should to reach the egg. 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.