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Vasectomy and its Microsurgical Reversal. (PDF, 17 MB) Urologic Clinics of North America, 1978. 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. Surgical Management of Male Infertility. (PDF, 2 MB) Chapter 12 from textbook, Male Infertility, 1992. Hjollund NH, Storgaard L, Ernst E, Bonde JP, Olsen J. El Uso de las Espermátides en la Azoospermia. (PDF, 12 MB) Chapter 42 from Reproducción Humana, 2002.

Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter.

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Delayed conception and active and passive smoking. Eating disorders such as anorexia nervosa are also associated with extremely low BMI.

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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. GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer).  Like IVF, these procedures involve retrieving an egg, combining it with sperm in a lab, and then transferring it back to your body. Other causes include Y chromosome microdeletion, a depletion of chromosome material that impedes or severely decreases spermatozoa production. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service.

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It's sometimes done while you're taking meds that help trigger the release of an egg. Earn up to 6 CME credits per issue.     To see the full article, log in or purchase access. ART procedures, such as GIFT, IVF, and ICSI, also can be used in cases of male infertility. Medical treatments[edit] Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. 8,46 Obesity impairs fertility and the response to fertility treatments, including in vitro fertilization; therefore, it is advisable to counsel patients who are obese to lose weight before conception or infertility treatments. If the E2 and FSH levels are in the normal range, clomiphene citrate is the drug of choice, as previously described. Transplantation of a Human Testis for Anorchia. (PDF, 19 MB) Fertility and Sterility, 1978. Diagnostic evaluation of the infertile female: a committee opinion. Signs of infertility in women In women, signs of infertility may include: Pain during sex Pain during sex, or dyspareunia, can be a sign of an underlying health problem that may influence a woman's fertility.