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Paternal age > or = 40 years: an important risk factor for infertility. 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. Typical characteristics are ascites and cyst formation of the ovaries. Women with regular menstrual cycles are likely to be ovulating and should be offered serum progesterone testing at day 21 to confirm ovulation. Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. Damaged tubes may interfere with fertilization of the egg and its transport into the uterine cavity.

Only an additional 7% of couples will conceive in the second year. The sample should be processed within 1 hour, and 2-3 samples (at a minimum of 2-3 days apart) should be evaluated because of daily variations in sperm number and quality.

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Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988–1989). Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin.

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Gracia CR, Sammel MD, Coutifaris C, Guzick DS, Barnhart KT. Online support from organizations such as Resolve can be helpful. Practice Committee of American Society for Reproductive Medicine in collaboration with Society for Reproductive Endocrinology and Infertility. There's a link between increased temperature of the scrotum and reduced semen quality, but it's uncertain whether wearing loose-fitting underwear improves fertility.  Testicles The testicles produce and store sperm. Passive smoking has also been linked to lower fertility.

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Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization. Epidemiology[edit] Prevalence of infertility varies depending on the definition, i.e. on the time span involved in the failure to conceive. Breeding with a proven fertile male must occur at the optimal time for the female. About 85% of couples will have had a pregnancy by that point. “If they are over 30, they should seek evaluation after six months.” Continued Common causes of male infertility The “male factor” contributes to infertility around half the time, and about one third of the time, it's the main cause of infertility. 8 These studies are more sensitive and may delineate an abnormally formed uterus or structural problems, such as fibroids. A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men. Ovarian Transplantation between Monozygotic Twins Discordant for Premature Ovarian Failure. (PDF, 315 KB) The New England Journal of Medicine, 2005. Ideally, the cause of the infertility is reversible and then conception can result from natural sex. Infertility and impaired fecundity in the United States, 1982–2010: data from the National Survey of Family Growth. Duration of Fertility after Fresh and Frozen Ovary Transplantation. (PDF, 606 KB) Fertility and Sterility, 2010.