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Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women. Sulfasalazine: This anti-inflammatory drug can significantly lower a man's sperm count. Do you have any medical problems or prior surgeries?

If a weight gain greater than 2 lb occurs, the patient should be evaluated to determine if hospitalization is required. Thankfully, even when the cause of infertility is not known, various fertility treatments can eventually lead to delivery of a healthy baby. The basic work-up, or fertility evaluation, includes: Semen analysis of the male partner. It is important to tell a doctor if excessive mental and emotional stress develop. Changes in testicles Healthy testicles are an important aspect of male fertility. The following is a list of hormonal disorders which can disrupt male infertility: Hyperprolactinemia: Elevated prolactin--a hormone associated with nursing mothers, is found in 10 to 40 percent of infertile males.  Mild elevation of prolactin levels produces no symptoms, but greater elevations of the hormone reduces sperm production, reduces libido and may cause impotence.  This condition responds well to the drug Parlodel (bromocriptine).

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Gynecological history, including operations and medical treatment. Earn up to 6 CME credits per issue.     To see the full article, log in or purchase access. Gonadotropins can trigger ovulation when Clomid or Serophene don't work. Of adults with who are infected with mumps, 25% develop orchitis; two thirds of cases are unilateral, and one third are bilateral.

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There is still some controversy about their existence, but if the discoveries are true, this could mean a new treatment for infertility.[71] Stem cell therapy is really new, and everything is still under investigation. Normal motility is defined as more than 60% of sperm having normal movement, and the WHO 2010 lower reference limit (5th percentile) is 40%.

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8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. But if you haven’t had a period in months, it’s time to get your fertility checked. Additionally, the sperm may be unable to cross the cervical mucus or may have ultrastructural abnormalities. CC has been in clinical use since the early 1960s. CAH may be due to the congenital deficiency of one of several adrenal enzymes, the most common of which is 21-hydroxylase deficiency. Treatment of Female Infertility: Assisted Reproductive Technology (ART) Assisted Reproductive Technology (ART) is a term used to collectively describe a number of noncoital methods of conception that treat causes of infertility not responsive to conventional methods. Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomifene and gonadotrophins. Couples will have to consider the ethical and emotional aspects of this procedure. Paternal age > or = 40 years: an important risk factor for infertility. Treatment of tubal obstruction generally requires referral for subspecialty care. However, for women with moderate to severe endometriosis, surgical treatment then assisted reproductive therapy can be offered. The night before the procedure, the patient must take 2 tablespoons of sodium bicarbonate. Successful Autotransplantation of an Intra-abdominal Testis to the Scrotum by Microvascular Technique. (PDF, 11 MB) The Journal of Urology, 1976. Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[56] or her age as female fertility declines after the age of 30.[57] Sometimes it can be a combination of factors, and sometimes a clear cause is never established. 3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8).