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Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. Sherban and his staff are the most amazing, compassionate, and supportive people. Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women. Combined causes of infertility and sterility A person can often have a subfertility issue that may be helped or made worse depending on their partner's circumstances. Primary infertility When a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. This may take the form of miscarriages or extrauterine pregnancies.

GnRH travels down the portal system to the anterior pituitary, located on a stalk in the sella turcica, to stimulate the release of the gonadotropins, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). For example, a woman who has a 33-day cycle one month, a 31-day cycle the next, and a 35-day cycle after that, is probably having “normal” periods. If the egg does not travel, it can be harder to conceive naturally. Other infectious diseases that may affect fertility include tuberculosis, toxoplasmosis, malaria, schistosomiasis and leprosy. It can either be used to inspect and diagnose certain conditions or to surgically correct an abnormality such as removing scar tissue, endometriosis, or a damaged fallopian tube.

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Luteal phase support. (and cryopreservation choice offered if good quality embryos are available) IVF/ICSI 37. Down-regulation: - to avoid premature LH surge and spontenous ovulation. - either GnRH agonist protocol or GnRH antagonist protocol. - always use GnRH antagonist protocol in women with high risk of OHSS. Mumps: If this occurs after puberty, inflammation of the testicles may affect sperm production. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries. The severity usually depends on how near to the testicles the radiation was aimed.

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Overweight or obesity: This may reduce the chance of conceiving. Microcirugía y fertilición in vitro para la azoospermia obstructiva. (PDF, 5 MB) Chapter 14 from textbook, Avances en reproducción asistida, 1992.

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ICSI with Epididymal and Testicular Sperm Retrieval. (PDF, 1 MB) Male Sterility and Motility Disorders: Etiological Factors and Treatment, 1998. Intracytoplasmic sperm injection is a process by which semen is washed and prepared for direct injection of one sperm into each egg collected during the IVF process. In men who have the necessary reproductive organs to procreate, infertility can be caused by low sperm count due to endocrine problems, drugs, radiation, or infection. The gonadotropins in these formulations are FSH, and in some cases, a combination of FSH and LH (luteinizing hormone). If pregnancy has not been established within a reasonable time, further evaluation and/or an alternative treatment plan should be considered. Summary Infertility is a significant medical and social problem affecting couple worldwide. It is a sensitive issue that should be handled with great care with continuous professional counselling. Most young couples will conceive naturally within 2 years. Evaluation of both partners for causes is essential. Treatment depends on the cause, and varies from medical treatment to surgery to ART. Additional risk factors may include smoking, alcohol use, obesity, and older age; however, the data are hampered by a lack of pregnancy-related outcomes. Inhibin B levels have been reported to decrease with increasing weight, which results in decreased Sertoli cells and sperm production. Patients have with small- to normal-sized testes and azoospermia, but normal secondary sex characteristics. Blood tests Depending on the individual couple's situation, various blood tests on either the female or the male may be needed. Judaism and Repoductive Technology. (PDF, 160 KB) 2003. Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive. One of such conditions is a varicocele – one of the major causes of male infertility – that occurs when a vein that carries blood out of the scrotum dilates. The fertilized embryo is then transferred to womb. Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome).