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VITRIKAS, MD, David Grant Medical Center Family Medicine Residency, Travis Air Force Base, California Am Fam Physician. 2015 Mar 1;91(5):308-314.   Patient information: See related handout on infertility, written by the authors of this article.   Related letter: Natural Procreative Technology for Treating Infertility This clinical content conforms to AAFP criteria for continuing medical education (CME). A woman of reproductive age who is using artificial insemination to conceive (with either partner or donor sperm) after 6 failed trials. Consider earlier referral to infertility specialists where: - the woman is aged 36 years or over. - there is a known clinical cause of infertility or a history of predisposing factors for infertility. - treatment is planned that may result in infertility (such as treatment for cancer). - People who are concerned about their fertility and who are known to have chronic viral infections such as hepatitis B, hepatitis C or HIV. Frequency of intercourse The couple may be advised to have sexual intercourse more often around the time of ovulation.

Oocyte Vitrification – Women’s Emancipation Set in Stone. (PDF, 70 KB) Fertility and Sterility, 2008. Primary Lymphoma of Kidney. (PDF, 586 KB) The Journal of Urology, 1973. 8 Evaluation of Men Jump to section + Causes of male infertility include infection, injury, toxin exposures, anatomic variances, chromosomal abnormalities, systemic diseases, and sperm antibodies. Additionally, multiple pregnancies cumulatively occur after ovarian stimulation.

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Treatment of Anovulatory Conditions Jump to section + Women with WHO group I ovulatory disorders should be counseled to achieve a normal body weight. This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. Fertility treatment with donor eggs is usually done using IVF. Calcification of the Seminal Vesicles and Vas Deferens in a Uremic Patient. (PDF, 3 MB) The Journal of Urology, 1971. Costs for fertility testing and treatments History The doctor will ask questions to try to get clues as to the cause of your infertility.

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In addition to sperm immobility, patients experience sinusitis, bronchiectasis, and respiratory infections. Judaism and Reproductive Technology. (PDF, 2 MB) 2010. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989. Blood test: This can assess hormone levels and whether a woman is ovulating. 44 Therefore, a simple recommendation is for vaginal intercourse every two to three days to optimize the chance of pregnancy. Counseling about options should be offered to couples who are not physically able to conceive (i.e., same-sex couples or persons lacking reproductive organs).

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Vause TD, Cheung AP, Sierra S, et al.; Society of Obstetricians and Gynecologists of Canada. In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. Preconception lifestyle advice for people with subfertility. Cryptorchidism An estimated 3% of full-term males are born with an undescended testicle, but fewer than 1% remain undescended by age 1 year. Isolated FSH deficiency This is a very rare cause of infertility. If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF). This measurement is called the antral follicle count and may correlate with fertility potential. ED may be the consequence of the conversion of androgens to estradiol. The predictive value of hysterosalpingography for tubal and peritoneal infertility factors. 5 mg PO qd and increased to 5 mg once tolerance is built. Pregnancies after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection in Non-obstructive Azoospermia. (PDF, 3 MB) Human Reproduction, 1995.