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Tubal obstruction due to elective sterilization is better repaired with microsurgery, although the modern tendency is to perform the anastomosis using operative laparoscopy. [33, 143, 144] In either event, knowing in advance what type of tubal ligation technique was used is important. Hystersalpingography (HSG): Further investigations 17. Investigation of suspected tubal and uterine abnormalities: 2. Anovulation can also cause cessation of periods (secondary amenorrhea) or excessive bleeding (dysfunctional uterine bleeding). New Concepts in Operative Andrology: A Review. (PDF, 7 MB) International Journal of Andrology, 2000. If endometriosis is found, it can be surgically removed by various methods, and its removal may lead to a decrease in pain as well as improvement in the ability to conceive naturally. Cervical surgery can sometimes cause scarring or shortening of the cervix.

The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. Treatment of tubal obstruction generally requires referral for subspecialty care. Hjollund NH, Storgaard L, Ernst E, Bonde JP, Olsen J.

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Online support from organizations such as Resolve can be helpful. Clinical examination Full clinical examination of both partners usually stands for the underlying physical problem [17-22,24-26], (Appendix 2). Typical drugs are clomifene, cyclofenil, tamoxifen, and epimestrol among others.

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PPT Presentation Summary : Embryo cryopreservation (via ovulation induction) Oocyte cryopreservation. CASA measures the following parameters: Curvilinear velocity – The average distance per unit time between successive sperm positions) Straight-line velocity – The speed of forward direction Linearity – The straight-line velocity divided by the curvilinear velocity In addition, the program measures the average path velocity, the amplitude of lateral head displacement, and the flagellar beat frequency, and it is used to evaluate for evidence of hyperactivation.

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As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). ICSI can be performed when sperm counts are extremely low or abnormal. Furthermore, as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases. 6 Women with risk factors for tubal obstruction, such as endometriosis, previous pelvic infections, or ectopic pregnancy, should instead be offered hysteroscopy or laparoscopy with dye to assess for other pelvic pathology. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomifene and gonadotrophins. The presence of anti-sperm antibodies have been found in infertile men, and suppression of these antibodies with corticosteroid treatment has improved the semen quality and increased the rate of conception.