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Infertility is defined as a failure to conceive within one or more years of regular unprotected coitus. Lack of ovulation Patients with anovulation who did not ovulate after several cycles of CC at different doses of treatment are deemed clomiphene resistant. The Intra-abdominal Testes: Microvascular Autotransplantation. (PDF, 4 MB) The Journal of Urology, 1981. Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women.

8 Intrauterine insemination and ovulation induction do not result in increased pregnancy rates in women with unexplained infertility. Age, socio-economic, cultural and other environmental factors: Over the last few years, age has become the most common of these causes of infertility. 6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs.

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ART includes all fertility treatments in which both eggs and sperm are manipulated. Because sperm generation time is just over two months, it is recommended to wait three months before repeat sampling. 8,37 Women in WHO group II, including those who are overweight and who have polycystic ovary syndrome, can benefit from weight loss, exercise, and lifestyle modifications to restore ovulatory cycles and achieve pregnancy.

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Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. Clomiphene citrate (Clomid, Serophene) The chemical formula for clomiphene citrate (CC) is 2-[p -(2-chloro-1,2-difhenylvinyl) phenoxy] triethylamine dihydrogen citrate. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994. These adverse effects were reported in older women with advanced breast cancer who were given the drugs on a daily basis over several months.

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They can often recommend a counselor and others who can offer appropriate support. Excess alcohol consumption: This may lower male fertility. Sperm are nourished by semen, which is made by glands along the way. The following hormones can be identified in the blood among others: FSH, LH, estradiol, prolactin, testosterone, DHEA-S and the thyroid hormones. Patients with hyperthyroidism or hypothyroidism must be treated accordingly. [210, 211] Weight reduction should be part of the treatment because it helps the patient's response to ovulation induction. [212] Treatment of Male Factors Asthenospermia associated with varicocele is treated surgically with varicocelectomy or with embolization of the spermatic veins. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. 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. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months. Treatment is with human menopausal gonadotropin (HMG) or exogenous FSH. However, these tests have only poor to moderate predictive value despite widespread use. In some cases, the reproductive urologist can improve semen function by recommending certain lifestyle changes, by hormonal treatments, or by surgery. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple.