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Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. 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. Further investigations 18. Laparoscopy: - Invasive procedure. - to check for pelvic disease; such as endometriosis and to check tubal patency. - therapeutic as in laparoscpic myomectomy and ovarian drilling. Hysteroscopy: - to evaluate uterine cavity. - In case of repeated failed IVF cycles. - therapeutic as in intrauterine septum.

Men should undergo evaluation with a semen analysis. 37 Clomiphene has also proven effective for ovulation induction in women with polycystic ovary syndrome. Macroscopic deletions of Yq11 are often observed in patients with azoospermia, although many new microdeletions have been implicated as a significant cause of infertility. These adverse effects were reported in older women with advanced breast cancer who were given the drugs on a daily basis over several months. Histologic endometrial dating is not considered reliable nor is it predictive of fertility.

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The increase of gonadotropins can provoke ovulation. Generally, they occur in 50-100% of all abdominal surgeries,[29] with the risk of developing adhesions being the same for both procedures.[30][31] Complications of adhesions include chronic pelvic pain, bowel obstruction, and female infertility. 8 Couples with unexplained infertility may want to consider another year of intercourse before moving to more costly and invasive therapies, such as assisted reproductive technology. Treatment Possibilities: Female Infertility Depending on the cause of infertility, there are different possibilities for treatment. Post-ejaculatory urinalysis (urine testing), to check for retrograde ejaculation.

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30–32 Other treatment options include antiestrogens and gonadotropin therapy, which showed a trend toward increased live birth rates in a Cochrane review. It is an approach to disseminate the recommended medical care of infertile couple to the practicing clinicians. Find an IVF Doctor  |  Free IVF Class  | Class Testimonials 5) Third party reproduction: This is a general reference to a general process where another person provides sperm or eggs, or where another woman acts as a gestational surrogate, with the purpose of helping another person or couple have a child. They may benefit from referral to a physician comfortable with prescribing pulsatile administration of gonadotropin-releasing hormone or gonadotropins with luteinizing hormone activity to induce ovulation. Intravenous fluids (ie, isotonic sodium chloride solution) must be administered until hemodilution is achieved.

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Age, socio-economic, cultural and other environmental factors: Over the last few years, age has become the most common of these causes of infertility. Microsurgical Aspects of Varicocele. (PDF, 9 MB) Fertility and Sterility, 1979. Computer-aided semen analysis (CASA) Introduced in the late 1980s, CASA uses a video camera and computer to visualize and analyze sperm concentration and movement. Three modalities are used to treat myomas: medical treatment, surgical treatment, and embolization. Factors that Contribute to Sterility There are many factors that contribute to sterility such as age, lifestyle, physical, and environmental conditions. The choices I found myself having to make in the years that followed, and the mounting agony of repeat in vitro fertilization (IVF) cycles, left me devastated. Treatment of Female Infertility: Assisted Reproductive Technology (ART) Assisted Reproductive Technology (ART) is a term used to collectively describe a number of noncoital methods of conception that treat causes of infertility not responsive to conventional methods. The seminal vesicles provide 40-80% of the semen volume, which includes fructose for sperm nutrition, prostaglandins and other coagulating substances, and bicarbonate to buffer the acidic vaginal vault. A urine sample must be collected immediately after ejaculation. Endometriosis may be treated through laparoscopic surgery. This sterile needle is attached to sterile suction tubing and a collecting vial. Pregnancies after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection in Non-obstructive Azoospermia. (PDF, 3 MB) Human Reproduction, 1995. Primary infertility refers to cases in which no pregnancy has gone satisfactorily full term.