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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). As part of the fertility evaluation, we will perform an HSG, a test designed to evaluate if the fallopian tubes are open.

The authors of the new global standards said the revised definition gave every individual “the right to reproduce.” Until now, the WHO’s definition of infertility—which it classed as a disability—has been the failure to achieve pregnancy after 12 months or more of regular unprotected sex. If a tube is blocked and filled with fluid (called a hydrosalpinx), then minimally invasive surgery (laparoscopy or hysteroscopy) to either remove the tube or block/separate it from the uterus prior to any fertility treatments is recommended. Chromosomal Abnormalities in Embryos Derived from Testicular Sperm Extraction. (PDF, 324 KB) Fertility and Sterility, 2003. Hormone imbalances Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands.

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If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. The relation between daily activities and scrotal temperature. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005. Ovulation induction in polycystic ovary syndrome [published corrections appear in J Obstet Gynaecol Can. And about 15% of infertile men have normal semen and plenty of normal sperm.

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Reducing the risk of multiple pregnancies Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. This is an uncommon type of anovulation disorder. Fertility: assessment and treatment for people with fertility problems. Following his lecture on laparoscopic appendectomy, the president of the German Surgical Society wrote to the Board of Directors of the German Gynecological Society suggesting suspension of Semm from medical practice. The Intra-abdominal Testes: Microvascular Autotransplantation. (PDF, 4 MB) The Journal of Urology, 1981. Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing's syndrome, diabetes, and thyroid disease.

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549 KB Effect of Age on Male Fertility. (PDF, 5 MB) Chapter from textbook, Seminars in Reproductive Endocrinology, 1991. Vitrification of oocytes from endangered Mexican gray wolves (Canis lupus baileyi). (PDF, 319 KB) Theriogenology, 2010. Normal Pregnancies Resulting from Testicular Sperm Extraction and Intracytoplasmic Sperm Injection for Azoospermia Due to Maturation Arrest. (PDF, 6 MB) Fertility and Sterility, 1996. Thus, an intravenous pyelogram must be performed once this diagnosis is made. The most commonly prescribed pill to stimulate ovulation (generally of one mature egg) is clomiphene citrate. B.: - GnRHa should not be offered with ovulation induction for risk of OHSS. - No evidence for the role of adjuvant growth hormones. Close Testing for Women Women should track their ovulation by recording their basal body temperature for several months, checking their cervical mucus using a home ovulation test kit. Refinements in the Methodology of Injection for Transvaginal Gamete Intra-Fallopian Transfer. (PDF, 2 MB) Human Reproduction, 1994. Alkalinizing the urine before the procedure is necessary. Generally, they occur in 50-100% of all abdominal surgeries,[29] with the risk of developing adhesions being the same for both procedures.[30][31] Complications of adhesions include chronic pelvic pain, bowel obstruction, and female infertility.