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Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. These are agents that support the follicular maturation and the secretion of gonadotropins. A causal therapeutic approach does not exist and an important component is the prevention of hyperstimulation syndrome. Methodology This paper, as a comprehensive review, deploys a new strategy to translate the research findings and evidence-base recommendations into a simplified focused guide to be applied on routine daily practice. Tubal catheterisation or cannulation: - With proximal tubal obstruction, selective salpingography plus tubal catheterisation, or hysteroscopic tubal cannulation, may be treatment options. The rate increases to 10-12% after CC ovulation induction and to 12-15% per cycle after hMG/hCG ovulation induction.

The woman may be given a low dose of ovary stimulating hormones. However, in our modern era, women are delaying child birth until their thirties and forties, which has lead to the discovery of the adverse effect of advanced maternal age on egg function.

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8) Unexplained/other: Sometimes a full evaluation does not reveal the cause of infertility. Excess iron from multiple transfusions may get deposited in the pituitary gland and the testis, causing parenchymal damage and both pituitary and testicular insufficiency. These include reduced pain due to smaller incisions, reduced hemorrhaging and shorter recovery time.

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Unexplained fertility affects about 10 percent of couples worldwide. The relation between daily activities and scrotal temperature. Unexplained infertility[edit] In the US, up to 20% of infertile couples have unexplained infertility.[61] In these cases abnormalities are likely to be present but not detected by current methods. Lead, toxic fumes and exposure to pesticides are suspected contributors to infertility. At this point, psychological consultation and support should be provided [44]. Being obese or overweight: This can increase the risk of infertility in women as well as men.

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Structural abnormalities in the uterus: these can affect the cervix or the uterine corpus.  Anomalies can be anatomical (septate uterus, T-shaped uterus, etc.) or pathologies that generate embryo implantation issues or issues with how the pregnancy progresses: polyps, endometritis, Asherman's syndrome - synechiae or adherences of the walls of the uterine cavity - or myomas, a benign tumour that generates anatomical distortion and makes getting pregnant complicated (this is one of the most common pathologies but does not necessarily cause fertility issues). 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. Get Permissions Email Alerts Don't miss a single issue. Intracytoplasmatic Sperm Injection (ICSI) An intracytoplasmatic sperm injection is also a form of artificial insemination. Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010. Normal Intrauterine Pregnancy After Reversal of Tubal Sterilization in the Wife and Vasectomy in the Husband.(PDF, 1 MB) Fertility and Sterility, 1978.