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Reproductive surgery - Wikipedia
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.infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Reproductive surgery</th></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data">Reproductive medicine</td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q7314315" class="extiw" title="d:Q7314315">edit on Wikidata</a>]</div></td></tr></tbody></table> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546"><table class="infobox"><caption class="infobox-title">Reproductive Surgeon</caption><tbody><tr><th colspan="2" class="infobox-header">Occupation</th></tr><tr><th scope="row" class="infobox-label">Names</th><td class="infobox-data"> <ul><li>Physician</li> <li>Surgeon</li></ul> </td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Occupation type</div></th><td class="infobox-data"><a href="/wiki/Specialty_(medicine)" class="mw-redirect" title="Specialty (medicine)">Specialty</a></td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Activity sectors</div></th><td class="infobox-data"><a href="/wiki/Medicine" title="Medicine">Medicine</a>, <a href="/wiki/Surgery" title="Surgery">Surgery</a></td></tr><tr><th colspan="2" class="infobox-header">Description</th></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Education required</div></th><td class="infobox-data"> <ul><li><a href="/wiki/Doctor_of_Medicine" title="Doctor of Medicine">Doctor of Medicine</a> (M.D.)</li> <li><a href="/wiki/Doctor_of_Osteopathic_medicine" class="mw-redirect" title="Doctor of Osteopathic medicine">Doctor of Osteopathic medicine</a> (D.O.)</li> <li><a href="/wiki/Bachelor_of_Medicine,_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a> (M.B.B.S.)</li> <li><a href="/wiki/Bachelor_of_Medicine,_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a> (MBChB)</li></ul> </td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Fields of<br />employment</div></th><td class="infobox-data"><a href="/wiki/Hospital" title="Hospital">Hospitals</a>, <a href="/wiki/Clinic" title="Clinic">Clinics</a></td></tr></tbody></table> <p><b>Reproductive surgery</b> is <a href="/wiki/Surgery" title="Surgery">surgery</a> in the field of <a href="/wiki/Reproductive_medicine" title="Reproductive medicine">reproductive medicine</a>. It can be used for contraception, e.g. in <a href="/wiki/Vasectomy" title="Vasectomy">vasectomy</a>, wherein the <a href="/wiki/Vas_deferens" title="Vas deferens">vasa deferentia</a> of a male are severed, but is also used plentifully in <a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">assisted reproductive technology</a>. Reproductive surgery is generally divided into three categories: surgery for infertility, in vitro fertilization, and fertility preservation.<sup id="cite_ref-Tulandi-2012_1-0" class="reference"><a href="#cite_note-Tulandi-2012-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>A reproductive surgeon is an <a href="/wiki/Obstetrics_and_gynaecology" title="Obstetrics and gynaecology">obstetrician-gynecologist</a> or <a href="/wiki/Urologist" class="mw-redirect" title="Urologist">urologist</a> who specializes in reproductive surgery.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Reproductive surgeries will be referred to based on biological sex, and terms such male and female will be used to denote to men and women respectively. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Uses">Uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Reproductive_surgery&action=edit&section=1" title="Edit section: Uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Reproductive surgery aims to address concerns spanning from male and female fertility to gender-affirming care.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Raff_2019_4-0" class="reference"><a href="#cite_note-Raff_2019-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Uses for reproductive surgery may encompass different abnormalities, dysfunctions, and areas of focus that are unable to be treated solely through medication or nonsurgical treatment.<sup id="cite_ref-Raff_2019_4-1" class="reference"><a href="#cite_note-Raff_2019-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Screening measures may be completed to determine the necessity of surgery. For example, intrauterine pathology may be assessed by utilizing techniques such as <a href="/wiki/Hysteroscopy" title="Hysteroscopy">hysteroscopy</a> to identify complications for reproductive surgical interventions.<sup id="cite_ref-Raff_2019_4-2" class="reference"><a href="#cite_note-Raff_2019-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">Assisted reproductive technology</a> (ART) supports enhancement of fertility success through processes such as <a href="/wiki/In_vitro_fertilisation" title="In vitro fertilisation">in vitro fertilization</a> (IVF).<sup id="cite_ref-Raff_2019_4-3" class="reference"><a href="#cite_note-Raff_2019-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Screening and reproductive surgery also have a role in identifying and addressing abnormalities, such as notable cysts, prior to initiating IVF.<sup id="cite_ref-Raff_2019_4-4" class="reference"><a href="#cite_note-Raff_2019-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Surgical sperm retrieval is an alternative means of <a href="/wiki/Semen_collection" title="Semen collection">semen collection</a>, where other means are not possible in circumstances like <a href="/wiki/Posthumous_sperm_retrieval" title="Posthumous sperm retrieval">posthumous sperm retrieval</a> or male infertility.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Antonouli-2023_6-0" class="reference"><a href="#cite_note-Antonouli-2023-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>These surgical techniques may also be utilized as a form of permanent contraception referred to as sterilization.<sup id="cite_ref-Grin-2021_7-0" class="reference"><a href="#cite_note-Grin-2021-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> A <a href="/wiki/Vasectomy" title="Vasectomy">vasectomy</a> or <a href="/wiki/Tubal_ligation" title="Tubal ligation">tubal ligation</a> would be examples of this procedure for male and female individuals respectively.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Patel-2016_9-0" class="reference"><a href="#cite_note-Patel-2016-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Reproductive surgeons can potentially perform a reverse vasectomy to restore male reproductive function following the vasectomy. Individuals may choose to reverse the procedure due to pain experience after the surgery.<sup id="cite_ref-Patel-2016_9-1" class="reference"><a href="#cite_note-Patel-2016-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>People might find themselves wanting to preserve their fertility. Biological material such as sperm or <a href="/wiki/Oocyte" title="Oocyte">oocyte</a> are capable of being surgically collected and preserved cryogenically.<sup id="cite_ref-Antonouli-2023_6-1" class="reference"><a href="#cite_note-Antonouli-2023-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Fertility preservation also provides individuals who are receiving gender-affirming surgeries the option of preserving <a href="/wiki/Gamete" title="Gamete">gametes</a> if having biological children is desired following the procedures and hormonal therapy.<sup id="cite_ref-Antonouli-2023_6-2" class="reference"><a href="#cite_note-Antonouli-2023-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Grin-2021_7-1" class="reference"><a href="#cite_note-Grin-2021-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>Reproductive surgery is also considered for complications such as <a href="/wiki/Endometriosis" title="Endometriosis">endometriosis</a>, <a href="/wiki/Polycystic_ovary_syndrome" title="Polycystic ovary syndrome">polycystic ovary syndrome</a>, <a href="/wiki/Ectopic_pregnancy" title="Ectopic pregnancy">ectopic pregnancy</a>, and <a href="/wiki/Vas_deferens_obstruction" class="mw-redirect" title="Vas deferens obstruction">vas deferens obstruction</a>.<sup id="cite_ref-Tulandi-2012_1-1" class="reference"><a href="#cite_note-Tulandi-2012-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Trends">Trends</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Reproductive_surgery&action=edit&section=2" title="Edit section: Trends"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="History">History</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Reproductive_surgery&action=edit&section=3" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Albeit an increase in overall use of <a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">assisted reproductive technology</a> (ART), surgeries on the fallopian tubes and ovaries have decreased, leading to a rise in insecurity in the field of reproductive surgery.<sup id="cite_ref-Bortoletto_2023_10-0" class="reference"><a href="#cite_note-Bortoletto_2023-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Reproductive surgery in women has largely been complementary to other ART methods such as medication, except for in tubal infertility, where surgery remains the main treatment.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Although reproductive surgery has been most relevant for severe symptoms, there has been a strong interest in greater analysis surrounding this topic of research.<sup id="cite_ref-Bortoletto_2023_10-1" class="reference"><a href="#cite_note-Bortoletto_2023-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>Reproductive surgery first began with fertility sparing surgeries, such as <a href="/wiki/Uterine_myomectomy" title="Uterine myomectomy">uterine myomectomy</a>, and was transitioned later into the addition of surgeries for infertility and the advancement of success rates for fertility. <a href="/wiki/Hysterectomy" title="Hysterectomy">Hysterectomies</a> and myomectomies date back to ancient times, where fascination grew around fertility sparing surgeries, specifically for young women who were able to conceive but were considered to have suspected ailments.<sup id="cite_ref-Bortoletto_2023_10-2" class="reference"><a href="#cite_note-Bortoletto_2023-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> However, the lack of knowledge of medicine eventually led to mortality, thereby causing myomectomies to become more uncommon. Overtime, various advancements and extensive research allowed for the discovery of minimally invasive myomectomies, which became popular among women who were capable of bearing children.<sup id="cite_ref-Bortoletto_2023_10-3" class="reference"><a href="#cite_note-Bortoletto_2023-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Laparoscopy" title="Laparoscopy">Laparoscopy</a> continues to be a common procedure approach as it is minimally invasive and is thought to be associated with a decrease in hospital stay and surgical complications.<sup id="cite_ref-Bortoletto_2023_10-4" class="reference"><a href="#cite_note-Bortoletto_2023-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> The development of newer technology and surgical techniques allowed for the increase in success rates for various other surgeries, such as <a href="/wiki/Endometriosis" title="Endometriosis">endometriosis</a> and <a href="/wiki/Adenomyosis" title="Adenomyosis">adenomyosis</a> surgeries or <a href="/wiki/Adnexal_mass" title="Adnexal mass">adnexal</a> surgeries. </p> <div class="mw-heading mw-heading3"><h3 id="The_future_of_reproductive_surgery">The future of reproductive surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Reproductive_surgery&action=edit&section=4" title="Edit section: The future of reproductive surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>With respect to the future of reproductive surgeries, greater advancements of surgical techniques and equipment are growing in popularity to increase the potential of fertility success rates. For example, vaginal natural orifice transluminal endoscopic surgery (vNOTES) is a new innovative approach that has been used for <a href="/wiki/Ovarian_torsion" title="Ovarian torsion">ovarian torsion</a>, tubal <a href="/wiki/Ectopic_pregnancy" title="Ectopic pregnancy">ectopic pregnancy</a>, and ovarian <a href="/wiki/Cystectomy" title="Cystectomy">cystectomies</a>.<sup id="cite_ref-Bortoletto_2023_10-5" class="reference"><a href="#cite_note-Bortoletto_2023-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> This surgical approach is minimally invasive and has emerged in an effort to reduce pain, risks, and potential for scarring.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Another technique that has emerged is radiofrequency ablation (RFA) which has been used for <a href="/wiki/Uterine_fibroid" title="Uterine fibroid">uterine fibroids</a>. It works to necrotize fibroids through the use of laparoscopic and transcervical procedures with two devices, Acessa (Hologic) and Sonata (Gynesonics). However, these two medical devices come with the caveat that fertility may not be preserved in those with uterine leiomyoma.<sup id="cite_ref-Bortoletto_2023_10-6" class="reference"><a href="#cite_note-Bortoletto_2023-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Although not ideal for people who are able to and wanting to bear children, RFA still poses as an alternative successful technique to reducing the volume of fibroids.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>A new common interest in alliance with reproductive surgery is the use of regenerative medicine. Although it has not been studied in its entirety, the use of stem cells to restore damaged endometrium has shown promising improvements.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Regenerative medicine has been used for premature ovarian failure and will continue to be studied for in vitro fertilization (IVF).<sup id="cite_ref-Bortoletto_2023_10-7" class="reference"><a href="#cite_note-Bortoletto_2023-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> With the use of various stem cells, researchers hope to mitigate and treat any future signs of infertility with the use of two specific stem cells, <a href="/wiki/Induced_pluripotent_stem_cell" title="Induced pluripotent stem cell">induced pluripotent stem cells</a> (iPSCs) and <a href="/wiki/Mesenchymal_stem_cell" title="Mesenchymal stem cell">mesenchymal stem cells</a> (MSC).<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Risks/complications"><span id="Risks.2Fcomplications"></span>Risks/complications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Reproductive_surgery&action=edit&section=5" title="Edit section: Risks/complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The risks and complications of reproductive surgery depend on patient specific characteristics and the degree of the surgery itself; however, some common complications of general reproductive surgery are hemorrhage, visceral damage, infection, and blot clotting.<sup id="cite_ref-Mann_Jr-2023_17-0" class="reference"><a href="#cite_note-Mann_Jr-2023-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>In vasectomies, infection and hematomas are the most frequently reported complications of surgery, with the incidence rate of infection being 3-4% and the incidence rate of hematoma ranging around 0-29%.<sup id="cite_ref-Yang_2021_18-0" class="reference"><a href="#cite_note-Yang_2021-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> An important note to consider is the fact that the surgical technique of the vasectomy did have an impact on the incident rates of these complications. <a href="/wiki/No-scalpel_vasectomy" title="No-scalpel vasectomy">No-scalpel vasectomy</a> (NSV) is widely recognized due to its low incident rate of complications.<sup id="cite_ref-Yang_2021_18-1" class="reference"><a href="#cite_note-Yang_2021-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Another common complication of vasectomy is post-vasectomy pain syndrome (PVPS). PVPS involves chronic pain that may be persistent or intermittent in one or both of the testicles, and lasting longer than three months after the procedure.<sup id="cite_ref-Mayo_Clinic_19-0" class="reference"><a href="#cite_note-Mayo_Clinic-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> While the pathophysiology of PVPS is unknown, various causes include damage to structures of the testis, buildup of pressure from epididymal congestion, and compression of nerves in the testis. The pain in PVPS can manifest in various forms, such as pain and tenderness in the scrotum, pressure or pain after ejaculation, pain with sex, etc.<sup id="cite_ref-Mayo_Clinic_19-1" class="reference"><a href="#cite_note-Mayo_Clinic-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Incidence rates of PVPS are around 1-14%.<sup id="cite_ref-Yang_2021_18-2" class="reference"><a href="#cite_note-Yang_2021-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p><p>In hysterectomies, complications of the procedure include infection, gastrointestinal injury, and venous thromboembolic injury. Similar to vasectomies, one of the most common complications is infection, with the incidence rate being 10.5% for abdominal hysterectomy, 13% for vaginal hysterectomy, and 9% for laparoscopic hysterectomy.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p><p>Today, one of the most effective forms of ART is <a href="/wiki/In_vitro_fertilisation" title="In vitro fertilisation">in vitro fertilization</a> (IVF).<sup id="cite_ref-www.mayoclinic.org_21-0" class="reference"><a href="#cite_note-www.mayoclinic.org-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> While it is very effective in those experiencing infertility, there are numerous risks of IVF, such as multiple births, premature delivery, and <a href="/wiki/Ovarian_hyperstimulation_syndrome" title="Ovarian hyperstimulation syndrome">ovarian hyper-stimulation syndrome</a>. Ovarian hyper-stimulation syndrome is a condition that involves enlargement of the ovaries as the result of the injected fertility drugs causing increased capacity of the blood vessels to allow molecules to go in and out.<sup id="cite_ref-www.mayoclinic.org_21-1" class="reference"><a href="#cite_note-www.mayoclinic.org-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Kumar_2011_22-0" class="reference"><a href="#cite_note-Kumar_2011-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> It can lead to abdominal pain, soreness, and nausea for those experiencing it.<sup id="cite_ref-Kumar_2011_22-1" class="reference"><a href="#cite_note-Kumar_2011-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> The symptoms and severity of ovarian hyper-stimulation syndrome can be classified amongst various grades. Grade 1 involves mild discomfort and abdominal distention, and as the grades increase, severity and symptoms also increase. Grade 4 and grade 5 encompass severe ovarian hyper-stimulation syndrome and involve changes in blood volume and viscosity due to the condition.<sup id="cite_ref-Kumar_2011_22-2" class="reference"><a href="#cite_note-Kumar_2011-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> Those who have a history of heightened response to gonadotropins, history of previous ovarial hyper-stimulation, and/or have a history of polycystic ovary syndrome (PCOS) are at increased risk of developing this complication.<sup id="cite_ref-Kumar_2011_22-3" class="reference"><a href="#cite_note-Kumar_2011-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Contraindications">Contraindications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Reproductive_surgery&action=edit&section=6" title="Edit section: Contraindications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are no existing medical guidelines that outline the absolute contraindications to reproductive surgery. However, there are relative contraindications recommended in the current literature. There are several circumstances under which having reproductive surgery is contraindicated. This is because surgery itself may cause extensive tissue damage to the person, the success of the procedure is limited (i.e. the condition is invasive or metastatic), or the surgery's potential risk outweighs the potential benefits.<sup id="cite_ref-Mann_Jr-2023_17-1" class="reference"><a href="#cite_note-Mann_Jr-2023-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> However, each person's situation is different and the possibility of reproductive surgery should be consulted with a healthcare professional. </p><p><a href="/wiki/Uterine_atony" title="Uterine atony">Uterine atony</a> after fetal extraction, and pre-existing maternal bleeding disorders have been reported as accepted contraindications for cesarean myomectomies in women.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> Contraindications to reproductive surgery used for tubal surgery and infertility include women ages 43 and older, tubal disease that surgery cannot treat (i.e., surgery cannot be safely performed without hurting the person or the patient has multiple medical conditions that reduces the chance of success), <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disease</a>, and abnormal semen analysis.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p><p>Many studies examining surgery for <a href="/wiki/Endometriosis" title="Endometriosis">endometriosis</a> excluded women who previously received medical or surgical treatment for endometriosis.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> Women with a pre-operative diagnosis of a deep endometriosis of their bowel or bladder were also excluded from surgery.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p><p>For male reproductive surgery for the treatment of <a href="/wiki/Varicocele" title="Varicocele">varicocele</a> by percutaneous embolization, current literature considers adolescents, allergies to <a href="/wiki/Contrast_agent" title="Contrast agent">contrast</a>, men with a bilateral grade 3 varicocele, and men with <a href="/wiki/Primary_infertility" class="mw-redirect" title="Primary infertility">primary infertility</a> as relative contraindications to surgery.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Reproductive_surgery&action=edit&section=7" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Tulandi-2012-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-Tulandi-2012_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Tulandi-2012_1-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFTulandiMarzal2012" class="citation journal cs1">Tulandi T, Marzal A (2012). 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title="Geriatrics">Geriatrics</a></li> <li><a href="/wiki/Hematology" title="Hematology">Hematology</a></li> <li><a href="/wiki/Hospital_medicine" title="Hospital medicine">Hospital medicine</a></li> <li><a href="/wiki/Infectious_diseases_(medical_specialty)" title="Infectious diseases (medical specialty)">Infectious diseases</a></li> <li><a href="/wiki/Nephrology" title="Nephrology">Nephrology</a></li> <li><a href="/wiki/Oncology" title="Oncology">Oncology</a></li> <li><a href="/wiki/Pulmonology" title="Pulmonology">Pulmonology</a></li> <li><a href="/wiki/Rheumatology" title="Rheumatology">Rheumatology</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Obstetrics_and_gynaecology" title="Obstetrics and gynaecology">Obstetrics and<br />gynaecology</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gynaecology" title="Gynaecology">Gynaecology</a></li> <li><a href="/wiki/Gynecologic_oncology" title="Gynecologic oncology">Gynecologic oncology</a></li> <li><a href="/wiki/Maternal%E2%80%93fetal_medicine" title="Maternal–fetal medicine">Maternal–fetal medicine</a></li> <li><a href="/wiki/Obstetrics" title="Obstetrics">Obstetrics</a></li> <li><a href="/wiki/Reproductive_endocrinology_and_infertility" title="Reproductive endocrinology and infertility">Reproductive endocrinology and infertility</a></li> <li><a href="/wiki/Urogynecology" title="Urogynecology">Urogynecology</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Radiology" title="Radiology">Radiology</a> <ul><li><a href="/wiki/Interventional_radiology" title="Interventional radiology">Interventional radiology</a></li> <li><a href="/wiki/Neuroradiology" title="Neuroradiology">Neuroradiology</a></li> <li><a href="/wiki/Nuclear_medicine" title="Nuclear medicine">Nuclear medicine</a></li></ul></li> <li><a href="/wiki/Pathology" title="Pathology">Pathology</a> <ul><li><a href="/wiki/Anatomical_pathology" title="Anatomical pathology">Anatomical</a></li> <li><a href="/wiki/Clinical_pathology" title="Clinical pathology">Clinical pathology</a></li> <li><a href="/wiki/Clinical_chemistry" title="Clinical chemistry">Clinical chemistry</a></li> <li><a href="/wiki/Cytopathology" title="Cytopathology">Cytopathology</a></li> <li><a href="/wiki/Medical_microbiology" title="Medical microbiology">Medical microbiology</a></li> <li><a href="/wiki/Transfusion_medicine" title="Transfusion medicine">Transfusion medicine</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Addiction_medicine" title="Addiction medicine">Addiction medicine</a></li> <li><a href="/wiki/Adolescent_medicine" title="Adolescent medicine">Adolescent medicine</a></li> <li><a href="/wiki/Anesthesiology" title="Anesthesiology">Anesthesiology</a> <ul><li><a href="/wiki/Obstetric_anesthesiology" title="Obstetric anesthesiology">Obstetric anesthesiology</a></li> <li><a href="/wiki/Neurosurgical_anesthesia" title="Neurosurgical anesthesia">Neurosurgical anesthesiology</a></li></ul></li> <li><a href="/wiki/Aviation_medicine" title="Aviation medicine">Aviation medicine</a></li> <li><a href="/wiki/Dermatology" title="Dermatology">Dermatology</a></li> <li><a href="/wiki/Disaster_medicine" title="Disaster medicine">Disaster medicine</a></li> <li><a href="/wiki/Diving_medicine" title="Diving medicine">Diving medicine</a></li> <li><a href="/wiki/Emergency_medicine" title="Emergency medicine">Emergency medicine</a> <ul><li><a href="/wiki/Mass_gathering_medicine" title="Mass gathering medicine">Mass gathering medicine</a></li></ul></li> <li><a href="/wiki/Evolutionary_medicine" title="Evolutionary medicine">Evolutionary medicine</a></li> <li><a href="/wiki/Family_medicine" title="Family medicine">Family medicine</a> / <a href="/wiki/General_practice" title="General practice">General practice</a></li> <li><a href="/wiki/Hospital_medicine" title="Hospital medicine">Hospital medicine</a></li> <li><a href="/wiki/Intensive_care_medicine" title="Intensive care medicine">Intensive care medicine</a></li> <li><a href="/wiki/Medical_genetics" title="Medical genetics">Medical genetics</a></li> <li><a href="/wiki/Narcology" title="Narcology">Narcology</a></li> <li><a href="/wiki/Neurology" title="Neurology">Neurology</a> <ul><li><a href="/wiki/Clinical_neurophysiology" title="Clinical neurophysiology">Clinical neurophysiology</a></li></ul></li> <li><a href="/wiki/Occupational_medicine" title="Occupational medicine">Occupational medicine</a></li> <li><a href="/wiki/Ophthalmology" title="Ophthalmology">Ophthalmology</a></li> <li><a href="/wiki/Oral_medicine" title="Oral medicine">Oral medicine</a></li> <li><a href="/wiki/Pain_management" title="Pain management">Pain management</a></li> <li><a href="/wiki/Palliative_care" title="Palliative care">Palliative care</a></li> <li><a href="/wiki/Pediatrics" title="Pediatrics">Pediatrics</a> <ul><li><a href="/wiki/Neonatology" title="Neonatology">Neonatology</a></li></ul></li> <li><a href="/wiki/Phlebologist" class="mw-redirect" title="Phlebologist">Phlebology</a></li> <li><a href="/wiki/Physical_medicine_and_rehabilitation" title="Physical medicine and rehabilitation">Physical medicine and rehabilitation</a> (PM&R)</li> <li><a href="/wiki/Preventive_healthcare" title="Preventive healthcare">Preventive medicine</a></li> <li><a href="/wiki/Prison_healthcare" title="Prison healthcare">Prison healthcare</a></li> <li><a href="/wiki/Psychiatry" title="Psychiatry">Psychiatry</a> <ul><li><a href="/wiki/Addiction_psychiatry" title="Addiction psychiatry">Addiction psychiatry</a></li></ul></li> <li><a href="/wiki/Radiation_therapy" title="Radiation therapy">Radiation oncology</a></li> <li><a href="/wiki/Reproductive_medicine" title="Reproductive medicine">Reproductive medicine</a></li> <li><a href="/wiki/Sexual_medicine" title="Sexual medicine">Sexual medicine</a> <ul><li><a href="/wiki/Venereology" title="Venereology">Venereology</a></li></ul></li> <li><a href="/wiki/Sleep_medicine" title="Sleep medicine">Sleep medicine</a></li> <li><a href="/wiki/Sports_medicine" title="Sports medicine">Sports medicine</a></li> <li><a href="/wiki/Organ_transplantation" title="Organ transplantation">Transplantation medicine</a></li> <li><a href="/wiki/Tropical_medicine" title="Tropical medicine">Tropical medicine</a> <ul><li><a href="/wiki/Travel_medicine" title="Travel medicine">Travel medicine</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_education" title="Medical education">Medical<br />education</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Medical_school" title="Medical school">Medical school</a></li> <li><a href="/wiki/Bachelor_of_Medicine,_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a></li> <li><a href="/wiki/Bachelor_of_Medical_Sciences" title="Bachelor of Medical Sciences">Bachelor of Medical Sciences</a></li> <li><a href="/wiki/Master_of_Medicine" title="Master of Medicine">Master of Medicine</a></li> <li><a href="/wiki/Master_of_Surgery" title="Master of Surgery">Master of Surgery</a></li> <li><a href="/wiki/Doctor_of_Medicine" title="Doctor of Medicine">Doctor of Medicine</a></li> <li><a href="/wiki/Doctor_of_Osteopathic_Medicine" title="Doctor of Osteopathic Medicine">Doctor of Osteopathic Medicine</a></li> <li><a href="/wiki/MD%E2%80%93PhD" title="MD–PhD">MD–PhD</a> <ul><li><a href="/wiki/Medical_Scientist_Training_Program" title="Medical Scientist Training Program">Medical Scientist Training Program</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alternative_medicine" title="Alternative medicine">Alternative medicine</a></li> <li><a href="/wiki/Allied_health_professions" title="Allied health professions">Allied health</a></li> <li><a href="/wiki/Molecular_oncology" title="Molecular oncology">Molecular oncology</a></li> <li><a href="/wiki/Nanomedicine" title="Nanomedicine">Nanomedicine</a></li> <li><a href="/wiki/Personalized_medicine" title="Personalized medicine">Personalized medicine</a></li> <li><a href="/wiki/Public_health" title="Public health">Public health</a></li> <li><a href="/wiki/Rural_health" title="Rural health">Rural health</a></li> <li><a href="/wiki/Therapy" title="Therapy">Therapy</a></li> <li><a href="/wiki/Traditional_medicine" title="Traditional medicine">Traditional medicine</a></li> <li><a href="/wiki/Veterinary_medicine" title="Veterinary medicine">Veterinary medicine</a></li> <li><a href="/wiki/Physician" title="Physician">Physician</a> <ul><li><a href="/wiki/Chief_physician" title="Chief physician">Chief physician</a></li></ul></li> <li><a href="/wiki/History_of_medicine" title="History of medicine">History of medicine</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:Medicine" title="Category:Medicine">Category</a></li> <li><span class="noviewer" typeof="mw:File"><span title="Commons page"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/12px-Commons-logo.svg.png" decoding="async" width="12" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/18px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/24px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></span></span> <a href="https://commons.wikimedia.org/wiki/Medicine" class="extiw" title="commons:Medicine">Commons</a></li> <li><span class="noviewer" typeof="mw:File"><span title="WikiProject"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/People_icon.svg/16px-People_icon.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/People_icon.svg/24px-People_icon.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/37/People_icon.svg/32px-People_icon.svg.png 2x" data-file-width="100" data-file-height="100" /></span></span> <a href="/wiki/Wikipedia:WikiProject_Medicine" title="Wikipedia:WikiProject Medicine">Wikiproject</a></li> <li><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Symbol_portal_class.svg" class="mw-file-description" title="Portal"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/16px-Symbol_portal_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/23px-Symbol_portal_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/31px-Symbol_portal_class.svg.png 2x" data-file-width="180" data-file-height="185" /></a></span> <a href="/wiki/Portal:Medicine" title="Portal:Medicine">Portal</a></li> <li><span class="noviewer" typeof="mw:File"><span title="Outline"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/10px-Global_thinking.svg.png" decoding="async" width="10" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/15px-Global_thinking.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/21px-Global_thinking.svg.png 2x" data-file-width="130" data-file-height="200" /></span></span> <a href="/wiki/Outline_of_medicine" title="Outline of medicine">Outline</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Assisted_reproductive_technology" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Assisted_reproductive_technology" title="Template:Assisted reproductive technology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Assisted_reproductive_technology" title="Template talk:Assisted reproductive technology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Assisted_reproductive_technology" title="Special:EditPage/Template:Assisted reproductive technology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Assisted_reproductive_technology" style="font-size:114%;margin:0 4em"><a href="/wiki/Assisted_reproductive_technology" title="Assisted reproductive technology">Assisted reproductive technology</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Infertility" title="Infertility">Infertility</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Female_infertility" title="Female infertility">Female</a></li> <li><a href="/wiki/Male_infertility" title="Male infertility">Male</a></li> <li><a href="/wiki/LGBT_reproduction" class="mw-redirect" title="LGBT reproduction">LGBT</a></li> <li><a href="/wiki/Fertility_clinic" title="Fertility clinic">Fertility clinic</a></li> <li><a href="/wiki/Fertility_testing" title="Fertility testing">Fertility testing</a></li> <li><a href="/wiki/Fertility_tourism" title="Fertility tourism">Fertility tourism</a></li> <li><a href="/wiki/Male_infertility_crisis" title="Male infertility crisis">Male infertility crisis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Fertility_medication" title="Fertility medication">Fertility medication</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Estrogen_antagonist" class="mw-redirect" title="Estrogen antagonist">Estrogen antagonists</a> <ul><li><a href="/wiki/Aromatase_inhibitor" title="Aromatase inhibitor">aromatase inhibitor</a></li> <li><a href="/wiki/Clomifene" title="Clomifene">clomifene</a></li></ul></li> <li><a href="/wiki/Follicle-stimulating_hormone" title="Follicle-stimulating hormone">FSH</a></li> <li><a href="/wiki/Gonadotropin-releasing_hormone_agonist" title="Gonadotropin-releasing hormone agonist">GnRH agonists</a></li> <li><a href="/wiki/Gonadotropin" title="Gonadotropin">Gonadotropins</a> <ul><li><a href="/wiki/Menotropin" title="Menotropin">menotropins</a></li></ul></li> <li><a href="/wiki/Human_chorionic_gonadotropin#Use_as_medication" title="Human chorionic gonadotropin">hCG</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/In_vitro_fertilisation" title="In vitro fertilisation">In vitro fertilisation</a> (IVF)<br /> and expansions</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Assisted_zona_hatching" title="Assisted zona hatching">Assisted zona hatching</a></li> <li><a href="/wiki/Autologous_endometrial_coculture" title="Autologous endometrial coculture">Autologous endometrial coculture</a></li> <li><a href="/wiki/Cytoplasmic_transfer" class="mw-redirect" title="Cytoplasmic transfer">Cytoplasmic transfer</a></li> <li><a href="/wiki/Embryo_transfer" title="Embryo transfer">Embryo transfer</a></li> <li><a href="/wiki/Gestational_carrier" class="mw-redirect" title="Gestational carrier">Gestational carrier</a></li> <li><a href="/wiki/In_vitro_maturation" title="In vitro maturation">In vitro maturation</a></li> <li><a href="/wiki/Intracytoplasmic_sperm_injection" title="Intracytoplasmic sperm injection">Intracytoplasmic sperm injection</a></li> <li><a href="/wiki/Oocyte_selection" title="Oocyte selection">Oocyte selection</a></li> <li><a href="/wiki/Controlled_ovarian_hyperstimulation" title="Controlled ovarian hyperstimulation">Ovarian hyperstimulation</a></li> <li><a href="/wiki/Partner-assisted_reproduction" title="Partner-assisted reproduction">Partner-assisted reproduction</a></li> <li><a href="/wiki/Preimplantation_genetic_diagnosis" title="Preimplantation genetic diagnosis">Preimplantation genetic diagnosis</a></li> <li><a href="/wiki/Transvaginal_oocyte_retrieval" title="Transvaginal oocyte retrieval">Transvaginal ovum retrieval</a></li> <li><a href="/wiki/Zygote_intrafallopian_transfer" title="Zygote intrafallopian transfer">Zygote intrafallopian transfer</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other methods</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Artificial_insemination" title="Artificial insemination">Artificial insemination</a></li> <li><a href="/wiki/Ovulation_induction" title="Ovulation induction">Ovulation induction</a></li> <li><a href="/wiki/Cryopreservation" title="Cryopreservation">Cryopreservation</a> <ul><li><a href="/wiki/Embryo_cryopreservation" title="Embryo cryopreservation">embryos</a></li> <li><a href="/wiki/Oocyte_cryopreservation" title="Oocyte cryopreservation">oocyte</a></li> <li><a href="/wiki/Ovarian_tissue_cryopreservation" title="Ovarian tissue cryopreservation">ovarian tissue</a></li> <li><a href="/wiki/Semen_cryopreservation" title="Semen cryopreservation">semen</a></li></ul></li> <li><a href="/wiki/Gamete_intrafallopian_transfer" title="Gamete intrafallopian transfer">Gamete intrafallopian transfer</a></li> <li><a class="mw-selflink selflink">Reproductive surgery</a> <ul><li><a href="/wiki/Vasectomy_reversal" title="Vasectomy reversal">Vasectomy reversal</a></li></ul></li> <li><a href="/wiki/Selective_reduction" title="Selective reduction">Selective reduction</a></li> <li><a href="/wiki/Sex_selection" title="Sex selection">Sex selection</a></li> <li><a href="/wiki/Surrogacy" title="Surrogacy">Surrogacy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Donation</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Donor_registration" title="Donor registration">Donor registration</a></li> <li><a href="/wiki/Donor_Sibling_Registry" title="Donor Sibling Registry">Donor Sibling Registry</a></li> <li><a href="/wiki/Egg_donation" title="Egg donation">Egg donation</a></li> <li><a href="/wiki/Embryo_donation" title="Embryo donation">Embryo</a></li> <li><a href="/wiki/Sperm_donation" title="Sperm donation">Sperm</a></li> <li><a href="/wiki/Semen_collection" title="Semen collection">Semen collection</a></li> <li><a href="/wiki/Sperm_bank" title="Sperm bank">Sperm bank</a></li> <li><a href="/wiki/Ova_bank" title="Ova bank">Ova bank</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Ethics</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Accidental_incest" title="Accidental incest">Accidental incest</a></li> <li><a href="/wiki/Fertility_fraud" title="Fertility fraud">Fertility fraud</a></li> <li><a href="/wiki/Genetic_diagnosis_of_intersex" title="Genetic diagnosis of intersex">Genetic diagnosis of intersex</a></li> <li><a href="/wiki/Religious_response_to_assisted_reproductive_technology" title="Religious response to assisted reproductive technology">Religious response to ART</a></li> <li><a href="/wiki/Mitochondrial_donation" class="mw-redirect" title="Mitochondrial donation">Mitochondrial donation</a></li> <li><a href="/wiki/Sex_selection" title="Sex selection">Sex selection</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Reproduction_and_pregnancy_in_speculative_fiction" title="Reproduction and pregnancy in speculative fiction">Reproduction and pregnancy in speculative fiction</a></li></ul> </div></td></tr></tbody></table></div> <!-- NewPP limit report Parsed by mw‐api‐int.codfw.main‐849f99967d‐62ftq Cached time: 20241122231520 Cache expiry: 2592000 Reduced expiry: false Complications: [vary‐revision‐sha1, show‐toc] CPU time usage: 0.542 seconds Real time usage: 0.665 seconds Preprocessor visited node count: 2867/1000000 Post‐expand include size: 124213/2097152 bytes Template argument size: 2437/2097152 bytes Highest expansion depth: 12/100 Expensive parser function count: 1/500 Unstrip recursion depth: 1/20 Unstrip post‐expand size: 139776/5000000 bytes Lua time usage: 0.329/10.000 seconds Lua memory usage: 5700771/52428800 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