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First-line therapy is the ultrasound-guided transvaginal puncture. Microsurgery and Andrology. (PDF, 5 MB) Chapter from textbook, 1991.

Twelve months is the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.[7] a woman over 35 has not conceived after six months of contraceptive-free sexual intercourse. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Similarly, bilateral obstruction of the sperm ducts can cause azoospermia and infertility.

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Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. A sperm count of under 15 million is considered low. If the correction is not done, it may be harder for the sperm to get to the female's cervix.

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Women who have a body weight 10% to 15% below normal may have reduced fertility. A luteal phase defect results in low production of the hormone progesterone, which is necessary for maintaining a pregnancy. Many infertile couples have had some previous assessment for their infertility and this data should be cautiously reviewed. Successful Vitrification of Bovine and Human Ovarian Tissue. (PDF, 3 MB) Reproductive BioMedicine Online, 2009. The dynamics of stress in fertile and infertile couples. Male and female factors can exist in isolation or combination and fertility investigations, diagnoses and treatment should always be considered in the context of the couple.       Male factor Sperm problems will contribute to about 40% of infertility cases.

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Progesterone deficiency can be corrected by the administration of progesterone during the luteal phase, starting 48 hours after ovulation. [204] Patients with hyperprolactinemia need a thorough evaluation to exclude a pituitary microadenoma. Intrauterine insemination is a process by which sperm is washed and prepared for placement into the uterine cavity, therefore bypassing the cervix and bringing a higher concentration of motile sperm closer to the tubes and ovulated egg. Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994. Production of the First Offspring from Oocytes Derived from Fresh and Cryopreserved Pre-antral Follicles of Adult Mice. (PDF, 2 MB) Reproductive BioMedicine Online, 2007. As they respond to hormones the same way as they would do in the uterus, that is by growing and shedding cyclically, endometriosis can cause both fallopian tube and ovarian scarring. Patients who are suffering from Stein-Leventhal syndrome (also referred to as polycystic ovary syndrome, or PCOS) can also suffer from anovulation.[3] Up to 90% of cases of anovulation are caused by PCOS; this syndrome is usually hereditary.[4][5] Weight loss or anorexia can also cause hormonal imbalance, leading to irregular ovulation (dysovulation). The fertilized embryo is then transferred to womb. Treatment of Renal Trauma by Angiographic Injection of Autologous Clot. (PDF, 422 KB) British Journal of Urology, 1974. Patients may have a normal palpable vas deferens bilaterally but show decreased ejaculate volume and hemospermia and may experience pain upon ejaculation. In vitro fertilization[edit] IVF is the most commonly used ART. Studies have shown that approximately 70% of miscarriages are due to chromosomal abnormalities. The most commonly prescribed injections that stimulate the ovary are called gonadotropins. 44 Therefore, a simple recommendation is for vaginal intercourse every two to three days to optimize the chance of pregnancy. The doctor may ask about the couple's sexual habits and make recommendations regarding these. Is Congenital Bilateral Absence of Vas Deferens a Primary Form of Cystic Fibrosis?