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Earn up to 6 CME credits per issue.     To see the full article, log in or purchase access. Predominantly anovulation is caused by hormonal imbalances such as Polycystic Ovarian Syndrome (PCOS) but ovarian scarring and premature menopause can also result in failure to ovulate. • Tubal disease, comprising anything from mild adhesions to complete blockage of the fallopian tubes, prevents fertilised eggs from travelling from the site of fertilisation to the uterus.

Surgery or embolization for varicoceles in subfertile men. Abdominal myomectomy is a surgical procedure performed through a very low horizontal abdominal incision allowing access to the uterus for removal of fibroids.

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Effect of male age on fertility: evidence for the decline in male fertility with increasing age. If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF). Apparent Fertility of Human Spermatozoa from the Caput Epididymidis. (PDF, 4 MB) Journal of Andrology, 1989.

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With this treatment, the patient experience spermatogenesis, and therefore, it has the chance to have offspring if he wants to. Abnormal semen may not be able to carry the sperm effectively.

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Symptoms If a couple doesn't get pregnant after a year of unprotected intercourse, both the man and woman should be evaluated. Treatment of hydrosalpinx (distal tubal obstruction) with salpingostomy can be performed through microsurgery or operative laparoscopy. A rapid slide agglutination test (RSAT) kit to detect serum antibodies is commercially available. Without an erection, it is difficult for a man to release sperm inside the vagina—and, therefore, difficult to get a woman pregnant. The initial dosage of clomiphene is 50 mg daily for five days starting on day 3 to 5 of the menstrual cycle. Urinary monitoring of the LH surge (eg, with an LH Predictor Kit) can be a substitute for BBT. Studies have shown that approximately 70% of miscarriages are due to chromosomal abnormalities.