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8,26,27 As opposed to laparoscopy or hysteroscopy, hysterosalpingography is a minimally invasive procedure with potentially therapeutic effects and should be considered before more invasive methods of assessing tubal patency. Debate over whether health insurance companies (e.g. in the US) should be required to cover infertility treatment. Reduced secretion of cervical mucus due to destruction of the endocervical glands by previous cervical conization, freezing, or laser vaporization responds poorly to low-dose estrogen therapy.

However, early referral of infertile couples to a dedicated specialist infertility clinic may be indicated to increase their chance of pregnancy (Table ). Additionally, because insulin-like growth factor (IGF) has been shown to have an effect on semen quality, its role in varicocele pathology has been studied.[25] One study showed that IGF levels significantly increased after a varicocelectomy to levels that were no different than fertile controls, suggesting that varicocele-related infertility may involve IGF.[26] Varicoceles lead to an increased incidence of sperm immaturity, apoptosis, and necrosis with severe disturbances in meiotic segregation compared to fertile men without varicoceles, and these parameters generally improve after repair. Bromocriptine (Parlodel): This drug inhibits prolactin production. If the woman is age 35 years or older, she should see a healthcare provider after six months of trying to get pregnant.

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Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Retrograde Ejaculation: Is a condition in which semen is ejaculated into the bladder rather than out through the urethra because the bladder sphincter does not close during ejaculation.  If this disorder is present, ejaculate volume is small and urine may be cloudy after ejaculation.  This condition affects 1.

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Your doctor will analyze your semen analysis carefully and help you decide if ICSI is an appropriate treatment for you. Large polyps or multiple polyps can impact fertility by interfering with the ability of embryo to implant and should be removed.

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Bhaskar Dutta/Photoshare Clinical definitions Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”… (WHO-ICMART glossary1). “Infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. Torsion: Is a common problem affecting fertility that is caused by a supportive tissue abnormality which allows the testes to twist inside the scrotum which is characterized by extreme swelling.  Torsion pinches the blood vessels that feed the testes shut which causes testicular damage.  If emergency surgery is not performed to untwist the testes, torsion can seriously impair fertility and cause permanent infertility if both testes twist. 37,38 The addition of 1,500 to 1,700 mg of metformin (Glucophage) daily may increase ovulation and pregnancy rates, but it does not significantly improve live birth rates over clomiphene alone. An abnormal semen analysis warrants a further evaluation usually by a reproductive urologist. Semen analysis: A sample may be taken to test for sperm concentration, motility, color, quality, any infections, and whether any blood is present. Age plays quite a critical role, as fertility peaks for both men and women in their mid-twenties. If resistant to the above, offer: - laparoscopic ovarian drilling, or, - ovulation induction via gonadotrophins. Practice Committee of American Society for Reproductive Medicine in collaboration with Society for Reproductive Endocrinology and Infertility.