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1) Advancing maternal age: Historically before the latter 20th century, women were conceiving in their teens and twenties, when age-related abnormalities with the egg were not evident. Women receiving fertility treatment have a slightly higher risk of an ectopic pregnancy.

Treatment of the cause: 24. Ovulation disorders: (Group I) - Weight gain if BMI less than 19. - pulsatile administration of gonadotrophin-releasing hormone or gonadotrophins with luteinising hormone activity to induce ovulation. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. Environmental vs Genetic Sex Determination: A Possible Factor in Dinosaur Extinction? (PDF, 307 KB) Fertility and Sterility, 2004.

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Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women. If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. Other considerations include preconception screening and vaccination for preventable diseases such as rubella and varicella, sexually transmitted infections, and cervical cancer, based on appropriate guidelines and risk.

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44 Therefore, a simple recommendation is for vaginal intercourse every two to three days to optimize the chance of pregnancy. 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. The rate increases to 10-12% after CC ovulation induction and to 12-15% per cycle after hMG/hCG ovulation induction. A urinary LH kit is a practical way to monitor these patients. Surgical Intervention Uterine anomalies can be corrected through operative hysteroscopy under general anesthesia or conscious sedation. [116] Ideally, the procedure should be performed during the early follicular phase and under laparoscopic surveillance to decrease the risk of uterine perforation.

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Spermiogenic defects may also be a cause of sterility. The follicle should develop to a diameter of 23-24 mm before a spontaneous LH surge occurs. Treatment Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health. Treatment of tubal obstruction generally requires referral for subspecialty care. CC is a nonsteroidal estrogen capable of interacting with estrogen receptor–binding proteins in a manner similar to estrogen but in a more prolonged way. [159, 160] Therefore, CC behaves similar to an antiestrogen. It's rarely reversible – if you do have a sterilisation reversed, you won't necessarily become fertile again. Medical treatments[edit] Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. Treatment of the cause: 23. Ovulation disorders: The WHO classifies ovulation disorders into 3 groups: 1. Male and female factors can exist in isolation or combination and fertility investigations, diagnoses and treatment should always be considered in the context of the couple.       Male factor Sperm problems will contribute to about 40% of infertility cases. Panhypopituitafism: Complete pituitary gland failure--lowers growth hormone, thyroid-stimulating hormone, and LH and FSH levels.  Symptoms include:  lethargy, impotence, decreased libido, loss of secondary sex characteristics, and normal or undersized testicles.  Supplementing the missing pituitary hormones may restore vigor and a hormone called hCG may stimulate testosterone and sperm production. 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. ZIFT is often called “tubal embryo transfer.” As with IVF, the actual fertilization of the eggs is observed and confirmed in the laboratory.