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Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during hmG treatment. With the fast progression in reproductive medicine and the experiences gained through infertility management, a wider range of treatment options have become available to infertile couples [17-19,21-26,31,36], (Appendix 4). Normal immunologic responses to accommodate sperm and conceptus. Omitting unnecessary investigations, in particular couples, could reduce total cost of their infertility management without compromising their success rate. Seminoma Discovered in Two Males Undergoing Successful Testicular Sperm Extraction for Intracytoplasmic Sperm Injection. (PDF, 807 KB) Human Reproduction, 1995.

Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. Ultrasound: This may reveal issues such as ejaculatory duct obstruction or retrograde ejaculation. Patients with severe ovarian hyperstimulation syndrome are often hospitalized and confined to bed, with strict control of fluid intake and output.

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Abnormal semen may not be able to carry the sperm effectively. Ovarian Transplantation in a Series of Monozygotic Twins Discordant for Ovarian Failure. (PDF, 188 KB) The New England Journal of Medicine, 2007.

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During ejaculation, the ejaculate is propelled forward by the rhythmic contractions of the smooth muscle that surrounds the ducts and by the bulbourethral muscles and other pelvic muscles. Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women.

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Abdominal myomectomy is a surgical procedure performed through a very low horizontal abdominal incision allowing access to the uterus for removal of fibroids. The severity usually depends on how near to the testicles the radiation was aimed. Web of Science, in-addition to the relevant printed medical journals and periodicals. 37 Clomiphene has also proven effective for ovulation induction in women with polycystic ovary syndrome. If the response is exaggerated, with more than 5 sizable follicles (18 mm in diameter), and the E2 level is greater than 2500 pc/mL, cancelling the ovulation is better to avoid the risk of ovarian hyperstimulation syndrome and a high order of multiple pregnancy. World Health Organization reference values for human semen characteristics. Bhaskar Dutta/Photoshare Clinical definitions Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”… (WHO-ICMART glossary1). “Infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. Obesity and increased risk for oligozoospermia and azoospermia. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Medical conditions Some medical conditions can affect fertility. Arcuate uterus In general, an arcuate uterus does not cause infertility. Although laparoscopic appendectomy has lesser wound problems than open surgery, the former is associated with more intra-abdominal abscesses.[20] Disadvantages[edit] While laparoscopic surgery is clearly advantageous in terms of patient outcomes, the procedure is more difficult from the surgeon's perspective when compared to traditional, open surgery: The surgeon has a limited range of motion at the surgical site, resulting in a loss of dexterity.