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The Strassman metroplasty consists of performing an incision at the fundus of the uterus between both cornual areas and closing the defect with an anteroposterior suture. Because of the antiestrogenic effect, CC may thicken the cervical mucus, creating an iatrogenic cervical factor that can be responsible for the lack of pregnancy in a patient who has otherwise ovulated. [165] Other adverse effects associated with CC are hot flashes, scotomas, dryness of the vagina, headache, and ovarian hyperstimulation, which, although rare, has been reported in patients who are sensitive to CC. [166, 167] Whether the use of CC increases the risk of ovarian cancer is unknown, although 2 articles illustrate a potential risk. [168] Other authorities disagree with this assumption.

Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. ZIFT is often called “tubal embryo transfer.” As with IVF, the actual fertilization of the eggs is observed and confirmed in the laboratory. Effect of metformin on ovulation and reproductive outcomes in women with polycystic ovary syndrome: a meta-analysis of randomized controlled trials. Reduced hormones may result, which could potentially translate into trouble conceiving. Advising surgery in cases of primary infertility is difficult. An on-line WHO infertility virtual consultation course includes a 5 module WHO evidence-based medicine course, as well as a 16 module ASRM eLearning course which reviews the evidence-base for the basic diagnosis of the infertile male and female, coupled with management and treatment.

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Usually, one incision is placed near the navel and a second near the pubic hairline. High Fertilization and Pregnancy Rate after Intracytoplasmic Sperm Injection with Spermatozoa Obtained from Testicle Biopsy. (PDF, 3 MB) Human Reproduction, 1995.

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The ICSI process takes place following a cycle during which fertility drugs are administered to the female partner to aid in the production of multiple eggs. Endometriosis may be treated through laparoscopic surgery.

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It has been proven useful in overcoming infertility conditions, such as blocked or damaged tubes, endometriosis, repeated IUI failure, unexplained infertility, poor ovarian reserve, poor or even nil sperm count. Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb. About one-third of infertility cases are caused by fertility problems in men and another one-third of fertility problems are due to fertility problems in women. Infertility caused by DNA defects on the Y chromosome is passed on from father to son. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous. Polycystic ovarian syndrome is the most frequent indication for ovulation induction. For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes or around the ovaries. If the woman is over the age of 35 years old, she may be infertile if she has not become pregnant after 6 months of trying. The follicle should develop to a diameter of 23-24 mm before a spontaneous LH surge occurs.