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If this is unsuccessful, the decision which form of artificial insemination is going to be used is made individually. If this is unsuccessful, the dosage may be increased to 100 mg daily. Age, socio-economic, cultural and other environmental factors: Over the last few years, age has become the most common of these causes of infertility. For unknown reasons, as women age, egg numbers decrease at a rapid rate. Most recommend dosing CC on cycle days 3-7 to improve response and ovulation around cycle day 14. Ovarian Transplantation between Monozygotic Twins Discordant for Premature Ovarian Failure. (PDF, 315 KB) The New England Journal of Medicine, 2005.

Definition “A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility” NICE guideline, CG156 Primary infertility; couple have failed to conceive before. Secondary infertility; woman has previously been pregnant regardless of the outcome of the pregnancy and now unable to conceive. Clark AM, Thornley B, Tomlinson L, Galletley C, Norman RJ. Production of the First Offspring from Oocytes Derived from Fresh and Cryopreserved Pre-antral Follicles of Adult Mice. (PDF, 2 MB) Reproductive BioMedicine Online, 2007. The facilities available and the skills of personnel are the major determining factors for the success rate.

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ART: Intracytoplasmic Sperm Injection (ICSI) (Continued) Once an egg is injected, it is observed for approximately 14 hours to see if fertilization has occurred (average fertilization rate is about 65%), and for 24 hours to ensure that cell division has started. 4) In Vitro Fertilization (IVF): In vitro means “outside the body.” IVF is a process whereby eggs are collected and then fertilized by sperm outside the body, in an embryology laboratory. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries.

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Fertility Evaluation Procedure Before the medical data are collected, the couple should be informed about the different causes of infertility, the tests and procedures required to make a diagnosis and the various therapeutic possibilities. In GIFT, the sperm and eggs are mixed together before a doctor inserts them.

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Omitting unnecessary investigations, in particular couples, could reduce total cost of their infertility management without compromising their success rate. Testing may begin with a physical exam and questions about past medical problems. High-cost treatments are out of financial reach for some couples. The FAST study: fertility assessment and advice targeting lifestyle choices and behaviours: a pilot study. Successful Autotransplantation of an Intra-abdominal Testis to the Scrotum by Microvascular Technique. (PDF, 11 MB) The Journal of Urology, 1976. Assisted conception The following methods are currently available for assisted conception. Macroscopic deletions of Yq11 are often observed in patients with azoospermia, although many new microdeletions have been implicated as a significant cause of infertility. The prostate gland contributes approximately 10-30% (0. Infection and Disease: Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy.  A low sperm count and low sperm motility are indicators of this condition.  Also, elevated FSH levels and other hormonal problems are indicative of testicular damage.  Some STDs like gonorrhea and chlamydia can cause infertility by blocking the epididimis or tubes.  These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage. ICSI offers a high pregnancy rate and 70—80 % of eggs are fertilized through this technique. Varicoceles are observed more commonly on the left side than the right.