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Chemotherapy: Some chemotherapy drugs can result in ovarian failure. Further investigations may be requested according to the clinical presentation and the results of preliminary tests. Your doctor may ask you many of the following questions: How long have you been trying to get pregnant? Counseling about options should be offered to couples who are not physically able to conceive (i.e., same-sex couples or persons lacking reproductive organs). Patients who do not achieve ovulation after three to six cycles should be referred to an infertility specialist for further treatment.

Lack of ovulation Patients with anovulation who did not ovulate after several cycles of CC at different doses of treatment are deemed clomiphene resistant. However, these tests have only poor to moderate predictive value despite widespread use. 48 However, there is no firm evidence that preconception counseling leads to increased live birth rates, in part because no studies on this topic have been performed. However, future pregnancy is possible with the other ovary and tube.

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The abdomen is usually insufflated with carbon dioxide gas. An ultrasonography unit and an endocrine laboratory capable of performing daily determinations of E2, FSH, and LH are necessary. [186, 187, 188, 189] Multiple adverse effects and complications may occur during the use of the gonadotropins, including (1) multiple pregnancy (24-33%), (2) ectopic pregnancy (5-8%), (3) miscarriages (15-21%), (4) ovarian torsion and rupture, and (5) ovarian hyperstimulation syndrome, which is the most severe. [190, 191] Whittemore et al, using a large combined data set derived from case-controlled studies in the United States, showed that the increase of ovarian cancer associated with infertility might be due to the use of fertility drugs. [192] Ovarian hyperstimulation syndrome is an iatrogenic condition that occurs in patients undergoing ovulation induction with hMG or controlled ovarian hyperstimulation (COH) for assisted reproductive technologies. They can also carry out some basic tests on both partners to see if there is an identifiable reason for not having achieved a pregnancy. Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ.

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Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. If this is unsuccessful, the dosage may be increased to 100 mg daily. Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomifene and gonadotrophins. Small, firm testicles The testes house a man’s sperm, so testicle health is paramount to male fertility. 8) Unexplained/other: Sometimes a full evaluation does not reveal the cause of infertility.

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Infertility and impaired fecundity in the United States, 1982–2010: data from the National Survey of Family Growth. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Lifestyle Factors Jump to section + All couples should be counseled to abstain from tobacco use, limit alcohol consumption, and aim for a body mass index less than 30 kg per m2 to improve their chances of natural conception or using assisted reproductive technology. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. Peritubaric adhesions can be caused by endometriosis. If the epididymis is blocked, sperm may not be ejaculated properly. 3) Tubal occlusion (blockage): As discussed previously, a history of sexually transmitted infections including chlamydia, gonorrhea, or pelvic inflammatory disease can predispose a woman to having blocked fallopian tubes. 37 Clomiphene has also proven effective for ovulation induction in women with polycystic ovary syndrome. Several days later, embryos -- or fertilized eggs -- get put back into your uterus with a device called an intrauterine insemination catheter. Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010. Temperature charting is a useful way of providing early clues about anovulation, and can help gynaecologists in their diagnosis. But the sperm in the semen are either abnormal, very low in number, or not there at all.