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Introduction
Definition :
Infertility is Failure to conceive after
regular unprotected sexual intercourse for
2 years in the absence of known
reproductive pathology
Clasification :
- Primary
- Secondary
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The Level of Evidence
Level Evidence
1a Systematic review and meta-analysis of randomised
controlled trials
1b At least one randomised controlled study without
randomisation
2a At least one well-designed controlled study without
randomisation
2b At least one other type of well-designed quasi-
experimental study
3 Well-designed non-experimental descriptive studies,
such as comparative studies, correlation studies or
case studies
4 Expert committee report or opinions and/ or clinical
experienceof respected authoritis
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The Grade of Evidence
Recommendation
Grade Strenght of evidence
A Directly based on level 1
evidence
B Directly based on level 2
evidence or extrapolated
recommendation from level 1
evidence
C Directly based on level 3 evidence or extrapolated
recommendation from either level 1 or 2 evidence
D Directly based on level 4 evidence or extrapolated
recommendation from either level 1, 2 or 3 evidence
Good practice The view of the Guideline Development Group
Poin (GPP)
NICE Technology Recommendation taken from a NICE Technology
Appraisal
Appraisal
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Definition Relating to Sperm
Quality
Term Definition
Normozoospermia Normal ejaculate ~ WHO reference values
Oligozoospermia Sperm concentration less than WHO reference
values
Asthenozoospermia Sperm motility less than WHO reference
values
Teratozoospermia Sperm morphology less than WHO reference
values
Oligoasthenoteratozoospe Signifies disturbance of all 3 or 2 variables
rmia
Azoospermia No spermatozoa in the ejaculate
Aspermia No ejaculate
Cryptozoospermia Few spermatozoa recovered after
centrifugation
RCOG 2004
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The Thyroid function
- There is no value in women with a
regular menstrual Cycle RCOG B 200
• Hypothyroid : High TSH
→ Oligomenorhea
- amenorhea
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