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Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control Secondary infertility is when they have previously conceived but are no longer able to. One of the best known is the HFEA – The UK's regulator for fertility treatment and embryo research. 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.

Some physical effects may also result from treatment. A small ejaculate volume may be observed in patients with retrograde ejaculation, absence of the vas deferens or seminal vesicles, ductal obstruction, hypogonadotropism, or poor sympathetic response. Conventional IVF vs ICSI (Intra Cytoplasmic Sperm Injection) for Patients Requiring Microsurgical Epididymal Sperm Aspiration (MESA). (PDF, 4 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995. The sperm is washed in a fluid and the best specimens are selected.

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A failure of GnRH neurons to migrate to the proper location in the hypothalamus has been implicated. In the United Kingdom, it is estimated that one in six couples would complaint of infertility [3]. Summary Infertility is a significant medical and social problem affecting couple worldwide. It is a sensitive issue that should be handled with great care with continuous professional counselling. Most young couples will conceive naturally within 2 years. Evaluation of both partners for causes is essential. Treatment depends on the cause, and varies from medical treatment to surgery to ART. This sterile needle is attached to sterile suction tubing and a collecting vial.

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IVF in action Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure. Changes in virility, often governed by hormones, could indicate issues with fertility. Transplantation of a Human Testis for Anorchia. (PDF, 19 MB) Fertility and Sterility, 1978. These time intervals would seem to be reversed; this is an area where public policy trumps science. Opinion: Microsurgical TESE and the Distribution of Spermatogenesis in Non-obstructive Azoospermia. (PDF, 5 MB)Human Reproduction, 2000. About 10% of reproductive age women are affected by endometriosis.

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Microsurgical Epididymal Sperm Aspiration and Assisted Reproductive Techniques. (PDF, 4 MB) Frontiers in Human Reproduction, 1991. About 92 out of 100 couples who are trying to get pregnant do so within two years.[citation needed] Women become less fertile as they get older. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer. Cervical stenosis (a narrowed cervix) or the lack of cervical mucus often make it harder for sperm to travel through the cervix into the uterus. In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. A sperm count of under 15 million is considered low. And as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases as well. The types of ART include: In Vitro Fertilization (IVF) Gamete Intrafallopian Transfer (GIFT) Zygote Intrafallopian Transfer (ZIFT) Another ART procedure – Intracytoplasmic Sperm Injection (ICSI) – is used mainly in cases of male infertility to treat couples who cannot achieve fertilization due to the male partner’s extremely low number of normal, viable sperm. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. Theoretically, with this therapy, we can get artificial gamets in vitro. Additional tests to determine sterility include blood tests, an ultrasound of the ovaries, hysterosalpingography to check for physical problems of the uterus and fallopian tubes. Abnormal semen may not be able to carry the sperm effectively. If both tubes are blocked, then in vitro fertilization (IVF) is required. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation.