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In reproductive medicine, the most common surgical procedures are laparoscopy, hysteroscopy, and abdominal myomectomy (removal of uterine fibroids). While chromosomal failure is usually caused by abnormalities of the sex chromosomes, autosomal disorders are also observed.

Medical conditions Some medical conditions can affect fertility. The eggs may never be released or they may only be released in some cycles. Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment.

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Management of the infertile couple: an evidence-based protocol. 37,38 The addition of 1,500 to 1,700 mg of metformin (Glucophage) daily may increase ovulation and pregnancy rates, but it does not significantly improve live birth rates over clomiphene alone. Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors. Unexplained fertility affects about 10 percent of couples worldwide. It is better for a couple to see the doctor together. Treatment[edit] Treatment depends on the cause of infertility, but may include counselling, fertility treatments, which include in vitro fertilization.

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Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis.(PDF, 958 KB) Reproductive BioMedicine Online, 2010. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years.

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Estrogen excess may be seen in patients with Sertoli cell tumors, Leydig tumors, liver failure, or severe obesity. STUDIES DEMOGRAPHIC DATA EVALUATION TOPIC: FERTILITY MEASURES LECTURER: MISS ADETORO GBEMISOLA W. Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010. Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. Less common factors The following other factors may also be responsible for infertility in a smaller proportion of cases: • Genetic abnormalities within eggs, sperm or both • An abnormal uterine cavity, including the presence of fibroids or polyps • Immunological infertility, whereby either the male or female partner produces anti-bodies against sperm cells or implantation of an embryo • Abnormal cervical mucus which hinders the passage of sperm to the uterus and fallopian tubes Unexplained infertility Even when investigations have been extensive, some couples will have no reason with which to explain their infertility. Assisted conception The following methods are currently available for assisted conception. The progestins that can be used and the doses are as follows: Medroxyprogesterone acetate (eg, Depo-SubQ Provera 104; administer 104 mg SC q3mo or q12-14wk) Megestrol acetate (eg, Megace 20-40 mg PO qd for up to 2 months) Norethindrone acetate (eg, Aygestin 15 mg PO qd for 6-9 months) [145, 146, 147, 148, 149, 150] The androgens used are 17-ethinyl testosterone derivatives (eg, danazol 400-800 mg PO divided BID; not to exceed 9 months) [151, 152, 153] The GnRH agonists used are as follows: Leuprolide acetate (eg, Lupron 3. They compete with endogenous GnRH molecules for the pituitary receptors and provoke a massive release of gonadotropins into circulation.