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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. Histologic endometrial dating is not considered reliable nor is it predictive of fertility. Microsurgery for Vasectomy Reversal and Vasoepididymostomy. (PDF, 13 MB) Urology, 1984. Analyses of the CFTR Gene in 67 Patients. (PDF, 4 MB) The American Journal of Human Genetics, 1995. Do you have any medical problems or prior surgeries? Some women experience a few days of light flow, while others regularly experience heavy periods and painful cramps.

Sperm counts can fluctuate, so that several samples may be necessary. The use of Epididymal and Testicular Spermatozoa for Intracytoplasmic Sperm Injection: The Genetic Implications for Male Infertility. (PDF, 8 MB) Human Reproduction, 1995. If he has two X chromosomes and one Y chromosome, as in Klinefelter's syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm. Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis.(PDF, 958 KB) Reproductive BioMedicine Online, 2010. If oligospermia or azoospermia is noted, hypogonadism should be suspected.

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Regression of Metastases after Nephrectomy for Renal Cell Carcinoma. (PDF, 1 MB) British Journal of Urology, 1975. The administration of hMG and its derivatives should be under the direct supervision of a reproductive endocrinologist. When anatomic variance or obstruction is suspected, referral for surgical evaluation and treatment is appropriate.

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Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. Ongoing Pregnancies and Birth after Intracytoplasmic Sperm Injection with Frozen-thawed Epididymal Spermatozoa. (PDF, 442 KB) Human Reproduction, 1995. ARTICLES FROM THE 2000s Evaluation and Treatment of Male Infertility. (PDF, 17 MB) Clinical Obstetrics and Gynecology, 2000. Treatment of the cause: 26. Ovulation disorders: (Hyperprolactinaemic amenorrhoea) - Women with ovulatory disorders due to hyperprolactinaemia should be offered treatment with dopamine agonists such as bromocriptine. - Consideration should be given to safety for use in pregnancy and minimising cost when prescribing. Endometriosis may be treated through laparoscopic surgery.

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Controversy exists regarding whether to routinely repair an adolescent varicocele not associated with testicular atrophy. This procedure is performed in the outpatient setting. Because of the intimate relationship between the fallopian tubes and the other pelvic organs and because, in the great majority of the cases, peritoneal pathology involves tubal pathology, the treatments of these factors are discussed together. In 10% of cases, alterations in the chemical signals from the hypothalamus can easily seriously affect the ovaries. Patients who do not achieve ovulation after three to six cycles should be referred to an infertility specialist for further treatment. Additionally, transvaginal ultrasound affords the opportunity for your physician to assess the relative number of available eggs. Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility. Lifetime prevalence of infertility and infertility treatment in the UK: results from a population-based survey of reproduction. Further investigations 18. Laparoscopy: - Invasive procedure. - to check for pelvic disease; such as endometriosis and to check tubal patency. - therapeutic as in laparoscpic myomectomy and ovarian drilling. Hysteroscopy: - to evaluate uterine cavity. - In case of repeated failed IVF cycles. - therapeutic as in intrauterine septum. One third of the time, it is a problem with the woman. Fertility may improve after adopting a gluten-free diet.Infertility: Introduction Infertility is a significant social and medical problem affecting couples worldwide. Changes in testicles Healthy testicles are an important aspect of male fertility.