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Of azoospermic patients with Klinefelter syndrome, 20% show the presence of residual foci of spermatogenesis. Obesity and increased risk for oligozoospermia and azoospermia. The male partner can be evaluated for infertility or subfertility using a variety of clinical interventions, and also from a laboratory evaluation of semen.” (Semen manual, 5th Edition3). If the correction is not done, it may be harder for the sperm to get to the female's cervix. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult.

Other hormones including inhibin B and leptin, may also be affected by obesity. Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomifene and gonadotrophins. If it stays in there, complications can develop, such as the rupture of the fallopian tube.

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In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. Hypogonadotropic Hypopituitarism: Low pituitary gland output of LH and FSH.  This condition arrests sperm development and causes the progressive loss of germ cells from the testes and causes the seminiferous tubules and Leydig (testosterone producing) cells to deteriorate.  May be treated with the drug Serophene.  However, if all germ cells are destroyed before treatment commences, the male may be permanently infertile. Clomiphene citrate for unexplained subfertility in women. Fertility treatments for men Treatment will depend on the underlying cause of the infertility. It is an approach to disseminate the recommended medical care of infertile couple to the practicing clinicians. Ovulation disorders appear to be the most common cause of infertility in women.

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The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. Conventional In-vitro Fertilization vs Intracytoplasmic Sperm Injection for Patients Requiring Microsurgical Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1994. Hjollund NH, Storgaard L, Ernst E, Bonde JP, Olsen J. Unexplained infertility is not the same thing as having no explanation, but rather reflects the fact that the tests performed have been normal.

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Vause TD, Cheung AP, Sierra S, et al.; Society of Obstetricians and Gynecologists of Canada. Infection An increased number of white blood cells in the semen may be observed in patients with infectious or inflammatory processes of the genital tract. For women, being underweight and having extremely low amounts of body fat are associated with ovarian dysfunction and infertility and they have a higher risk for preterm birth. Genetics of Male Infertility: Evolution of the X and Y Chromosome and Transmission of Male Infertility to Future Generations. (PDF, 10 MB) Chapter 5 from Essential IVF, 2004. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. Unexplained causes of infertility and sterility Unfortunately, a basic fertility analysis cannot provide an answer for all causes of infertility and some remain unexplained. Cholesterol One study has found that high cholesterol levels may have an impact on fertility in women.