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25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. If there is a history of recurrent miscarriages (2 or more) a lupus anticoagulant (LAC) and anti-cardiolipin antibody (ACL) are often done, as well as other tests. Intrauterine insemination is a process by which sperm is washed and prepared for placement into the uterine cavity, therefore bypassing the cervix and bringing a higher concentration of motile sperm closer to the tubes and ovulated egg. It can either be used to inspect and diagnose certain conditions or to surgically correct an abnormality such as removing scar tissue, endometriosis, or a damaged fallopian tube.

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. A karyotype test and a Y chromosome test for microdeletions are indicated in patients with nonobstructive azoospermia or severe oligospermia (< 5 million sperm/mL), although indications are expanding.[20] Klinefelter syndrome Klinefelter syndrome is the most common chromosomal cause of male infertility, estimated to be present in 1 per 500-1000 male births. It is found in approximately 10-50% of reproductive-aged women and can be associated with infertility as well as pain during intercourse and/or menstrual periods. The pregnancy rate fluctuates from 20-35%, and the expected ectopic pregnancy rate is as high as 20%. There are many factors that may be causing your fertility difficulties. Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries.

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Endometrial polyps Endometrial polyps are growths found in the uterine cavity. 37 Clomiphene has also proven effective for ovulation induction in women with polycystic ovary syndrome.

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Regression of Metastases after Nephrectomy for Renal Cell Carcinoma. (PDF, 1 MB) British Journal of Urology, 1975. Birth after Preimplantation Diagnosis of the Cystic Fibrosis F508 Mutation by Polymerase Chain Reaction in Human Embryos Resulting from Intracytoplasmic Sperm Injection with Epididymal Sperm. (PDF, 2 MB) The Journal of the American Medical Association, 1994. If the egg does not travel, it can be harder to conceive naturally. World Health Organization[edit] The World Health Organization defines infertility as follows:[10] United States[edit] One definition of infertility that is frequently used in the United States by reproductive endocrinologists, doctors who specialize in infertility, to consider a couple eligible for treatment is: a woman under 35 has not conceived after 12 months of contraceptive-free intercourse. In men who have the necessary reproductive organs to procreate, infertility can be caused by low sperm count due to endocrine problems, drugs, radiation, or infection. These injections are taken nightly, typically for 5 – 10 days, and act directly on the cells of the ovary to stimulate egg development.

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Dr Barbieri of Harvard Medical School has indicated that cases of anovulation are quite frequent in women with a BMI (body mass index) over 27 kg/m2.[6][7][8] Unfortunately, not only does excess weight have a negative impact on ovulation itself,[9] but also on treatment efficacy and outcomes of ART (assisted reproductive technique).[10][11] Diagnosis[edit] Fertility awareness and LH measurement[edit] Symptoms-based methods of fertility awareness may be used to detect ovulation or to determine that cycles are anovulatory. Medications Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility. The elevation in the temperature is indicative of ovulation. About 25% of all infertility is caused by an ovulation disorder. 47 Motivational interviewing techniques for modifiable risk factors, such as obesity, tobacco, illicit drugs, and alcohol, can decrease the targeted risk factor. Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[56] or her age as female fertility declines after the age of 30.[57] Sometimes it can be a combination of factors, and sometimes a clear cause is never established. Hyperandrogenemic ovarian insufficiency is characterized by an immoderate production of androgen. Age plays quite a critical role, as fertility peaks for both men and women in their mid-twenties. In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. Women are advised not to use the drug for more than one day. Unhealthy living and poor eating habits, as well as exposure to toxic substances such as alcohol, tobacco and other contaminants, also have a negative impact on fertility.