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Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. Sperm motility Motility is described as the percent of sperm present with flagellar motion viewed on a bright-field or phase-contrast microscope. Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity.

Ovulation disorders can be due to: Premature ovarian failure: The ovaries stop working before the age of 40 years. Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. Hormone imbalances Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Patients with azoospermia or severe oligospermia are more likely to have a chromosomal abnormality (10-15%) than infertile men with sperm density within the reference range (1%).

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IVF and related techniques (ICSI, ZIFT, GIFT) are called assisted reproductive technology (ART) techniques. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. It's sometimes done while you're taking meds that help trigger the release of an egg. The fertilized embryo is then transferred to womb. 17 Evaluation of male infertility starts with a history and physical examination focusing on previous fertility, pelvic or inguinal surgeries, systemic diseases, and exposures.

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The main reasons for fertility tourism are legal regulation of the sought procedure in the home country, or lower price. The doctor may ask about the couple's sexual habits and make recommendations regarding these.

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Evaluation of cervical mucus is unreliable; therefore, investigation is not helpful with the management of infertility. Age, socio-economic, cultural and other environmental factors: Over the last few years, age has become the most common of these causes of infertility. 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. If you’re worried about your fertility, the best thing to do is talk to your doctor. If the epididymis is blocked, sperm may not be ejaculated properly. Infertility in Men Below you will find a list of some of the most common causes of infertility in men. Those who do have fertility problems are treated according to the following guidelines: [112, 113, 114] Chronic cervical factor of absence of mucus - Intrauterine insemination Cervical incompetence - Cerclage Damage/absence of fallopian tubes (ectopic) - In vitro fertilization Unicornuate uterus A unicornuate uterus remains undetected unless fertility is compromised. About 10% of reproductive age women are affected by endometriosis. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Each country has its own body or bodies responsible for the inspection and licensing of fertility treatment under the EU Tissues and Cells directive [78] Regulatory bodies are also found in Canada [79] and in the state of Victoria in Australia [80] See also[edit] [edit] Inhorn MC (2003). "Global infertility and the globalization of new reproductive technologies: illustrations from Egypt". Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. Once a follicle containing an egg reaches a mature size, another hormone injection called HCG is often given to mimic the natural LH surge that occurs at the time of ovulation. These drugs also can also help you get pregnant by causing your ovaries to release multiple eggs. Symptoms include: bloating constipation dark urine diarrhea nausea abdominal pain vomiting They are usually mild and easy to treat.