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As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. The percentage of body fat should be greater than 22% to permit regular ovulatory cycles. The resulting injuries can result in perforated organs and can also lead to peritonitis.[medical citation needed] There may be an increased risk of hypothermia and peritoneal trauma due to increased exposure to cold, dry gases during insufflation. Although obesity is well known to be associated with insulin resistance, women with PCOS are even more resistant to insulin than other patients who are obese.

They include: Clomifene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. ART includes all fertility treatments in which both eggs and sperm are manipulated. Surgical Management of Male Infertility. (PDF, 2 MB) Chapter 12 from textbook, Male Infertility, 1992.

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Birth after Preimplantation Diagnosis of the Cystic Fibrosis F508 Mutation by Polymerase Chain Reaction in Human Embryos Resulting from Intracytoplasmic Sperm Injection with Epididymal Sperm. (PDF, 2 MB) The Journal of the American Medical Association, 1994. If the correction is not done, it may be harder for the sperm to get to the female's cervix. Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control Secondary infertility is when they have previously conceived but are no longer able to. If an endocrinopathy, such as hyperprolactinemia, is diagnosed, the underlying cause should be treated. Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count.

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When Predictions Don’t Predict. (PDF, 549 KB) The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1991. If the woman reaches the age of 40 during treatment, complete the current full cycle but do not offer further full cycles. In women aged 40–42 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 1 full cycle of IVF, with or without ICSI. The likelihood of fertilization improves significantly for men with low sperm concentrations. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature.

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Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. It is important to undergo a thorough fertility evaluation to determine the problem. 8 Involvement in group counseling and exercise is more effective than weight loss advice alone. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Lifestyle Factors Jump to section + All couples should be counseled to abstain from tobacco use, limit alcohol consumption, and aim for a body mass index less than 30 kg per m2 to improve their chances of natural conception or using assisted reproductive technology. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Clinical examination Full clinical examination of both partners usually stands for the underlying physical problem [17-22,24-26], (Appendix 2). Less than 50% motility may significantly affect the ability for sperm to fertilize the egg without therapy; and (4) morphology, or shape – there are three parts of the sperm that are analyzed for morphology: the head, midpeice, and tail. ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990. Erectile Disfunction (ED): Also known as impotence, this condition is common and affects 20 million American men.  ED is the result of a single, or more commonly a combination of multiple factors.  In the past, ED was thought to be the result of psychological problems, but new research indicates that 90 percent of cases are organic in nature.  However, most men who suffer from ED have a secondary psychological problem that can worsen the situation like performance anxiety, guilt, and low self-esteem.  Many of the common causes of impotence include:  diabetes, high blood pressure, heart and vascular disease, stress, hormone problems, pelvic surgery, trauma, venous leak, and the side effects of frequently prescribed medications (i.e. The National Institute for Health and Care Excellence (NICE) recommends that women with unexplained infertility who haven't conceived after 2 years of having regular unprotected sex should be offered IVF treatment. Fertility treatments for women Fertility drugs might be prescribed to regulate or induce ovulation.