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Treatment of the cause: 25. Ovulation disorders: (Group II “PCO”) 1. Passive smoking has also been linked to lower fertility. Mannitol Induced Central Nervous System Toxicity in Renal Failure. (PDF, 4 MB) Investigative Urology, 1972. 38,39 Family physicians may choose to attempt ovulation induction in anovulatory women (WHO group II) with clomiphene. Microscopic Technique for Reversal of Vasectomy. (PDF, 3 MB) Surgery, gynecology & obstetrics, 1976.

0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. Laparoscopy is an operation performed in the abdomen or pelvis through small incisions, generally no more than a centimeter, with the assistance of a laparoscope attached to a camera which projects to a screen. If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF).

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Fertility treatment with donor eggs is usually done using IVF. Debate: Are Spermatid Injections of any Clinical Value? (PDF, 6 MB) Human Reproduction, 1998. Several methods are available to detect antisperm antibodies, such as radioimmunoassay and enzyme-linked immunosorbent assay, but the most specific test is the immunobead test.

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To have a successful reanastomosis, the final tube should measure at least 4. 42 However, none of these methods has been proven to increase pregnancy rates when used to predict timing of intercourse. 17 Evaluation of male infertility starts with a history and physical examination focusing on previous fertility, pelvic or inguinal surgeries, systemic diseases, and exposures. Exposure to chemicals: Pesticides, for example, may increase the risk. If a woman has cycles at intervals of greater than 35 days, it may indicate that she is not ovulating an egg predictably, or even at all. Basic Work-up for Infertility It is very important to remember that infertility can occur as a result of one or more male or female factors.

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Human menopausal gonadotropins Crowe discovered that the gonads were under the control of the anterior hypophysis. [175] Zondek and Aschheim discovered that FSH and LH were responsible for the development of the gonads in immature animals and confirmed Crowe's work. [135, 136] In the 1930s, ovulation induction was attempted by using gonadotropins from a mare, but its use was discontinued because of the development of antibodies. [176, 177] Borth et al demonstrated the effect of FSH and LH extracted from menopausal urine. [178, 179] Gemzell reported the first ovulation induction using human pituitary gonadotropin in 1958, and the first pregnancy was reported in 1960. [180, 181] Lunenfeld reported preliminary results using hMG; however, in 1963, it was definitely established as a real ovulation induction agent. [182, 183, 184] Human menopausal gonadotropin (hMG [eg, Repronex, Menopur]) contains 75 U of FSH and 75 U of LH per mL, although the concentration may vary among batches (ranges from FSH at 60-90 U and LH at 60-120 U). And as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases as well. Low sperm mobility (motility): The sperm cannot "swim" as well as they should to reach the egg. The couples are not always consciously aware that they really are not interested in having children, but their sexual behavior reflects this attitude, e.g., in having sexual intercourse only after ovulation. Age: Male fertility starts to fall after 40 years. Careful monitoring during treatment and pregnancy can help reduce the risk of complications.


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Infertility and Female Factors