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Results of Microsurgical Vasoepididymostomy: Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Human Reproduction, 1989. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3).

Contents Definition[edit] "Demographers tend to define infertility as childlessness in a population of women of reproductive age," whereas "the epidemiological definition refers to "trying for" or "time to" a pregnancy, generally in a population of women exposed to" a probability of conception.[8] Currently, female fertility normally peaks at age 24 and diminishes after 30, with pregnancy occurring rarely after age 50.[9] A female is most fertile within 24 hours of ovulation.[9] Male fertility peaks usually at age 25 and declines after age 40.[9] The time needed to pass (during which the couple tries to conceive) for that couple to be diagnosed with infertility differs between different jurisdictions. Guidelines and recommendations were retrieved from the best evidence reviews at the American College of Obstetricians and Gynaecologists (ACOG), American Society for Reproductive Medicine (ASRM), Canadian Fertility and Andrology Society (CFAS), European Society of Human Reproduction and Embryology (ESHRE), Human Fertilisation and Embryology Authority (HFEA), Royal College of Obstetricians and Gynaecologists (RCOG), and the World Health Organization (WHO). Clomiphene citrate and/or Metformin. - folliculometry via TVUSS should be done to avoid multiple pregnancies and risk of OHSS. - Not for more than 6 months. ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990.

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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. Testosterone and estradiol function as feedback inhibitors of gonadotropin release.

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Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form. Clean, Intermittent Self-catheterization in the Treatment of Urinary Tract Disease. (PDF, 2 MB) The Journal of Urology, 1972. Causes in men The following are common causes of infertility in men. 8 Counseling on lifestyle modifications is reasonable because exposures to tobacco and alcohol are associated with lower rates of fertility. The menopause is premature when it occurs before 40 years of age.

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Demographic definitions of infertility An inability of those of reproductive age (15-49 years) to become or remain pregnant within five years of exposure to pregnancy. (DHS2) An inability to become pregnant with a live birth, within five years of exposure based upon a consistent union status, lack of contraceptive use, non-lactating and maintaining a desire for a child. (Trends in prevalence4). Sperm count often returns to normal after stopping the medication. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Optimizing natural fertility: a committee opinion. Of azoospermic patients with Klinefelter syndrome, 20% show the presence of residual foci of spermatogenesis. The most common identifiable causes of female fertility problems are outlined below: • Ovulatory dysfunction, (or anovulation) where an egg is not released from the ovary every month, is the single most common cause of female infertility. Radiation therapy: If this is aimed near the reproductive organs, it can increase the risk of fertility problems. It must be kept in mind that a woman is no longer fertile around six years prior to the menopause. Genetic karyotyping, if a recurrent miscarriage is a problem. Due to improved patient outcomes, in the last two decades, laparoscopic surgery has been adopted by various surgical sub-specialties, including gastrointestinal surgery (including bariatric procedures for morbid obesity), gynecologic surgery, and urology.