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It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Regrettably, this often leads to untruly high expectations of assisted reproduction techniques (ART) [40].

Passive smoking has also been linked to lower fertility. If it stays in there, complications can develop, such as the rupture of the fallopian tube. Evaluation of cervical mucus is unreliable; therefore, investigation is not helpful with the management of infertility.

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Some large breeds of dogs may not have their first estrus until they are ≥2 yr old, and some individuals and some breeds typically have only one estrous cycle each year. The endometrium can be damaged from previous curettages or infections like endometritis. Implantation: the process when the fertilized egg attaches to the uterine wall. For instance, women with hyper or hypo-thyroidism sometimes have ovulation problems. Luciano AA, Peluso J, Koch EI, Maier D, Kuslis S, Davison E. Microsurgical Aspects of Varicocele. (PDF, 9 MB) Fertility and Sterility, 1979.

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There is more controversy regarding intramural fibroids, where larger ones may have an impact and may necessitate removal. After almost 5 years of trying to conceive, going through numerous tests and meeting with another clinic closer to home, who told me my chances even with IVF were still very low, a good friend recommended advanced fertility center of Chicago. Role of Semen Analysis in Subfertile Couples. (PDF, 250 KB) Fertility and Sterility, 2010. Infertility: Female and Male Factors It is very important to note that infertility can occur as a result of one or more male or female factors. IVF in action Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure.

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Vasectomy and its Microsurgical Reversal. (PDF, 17 MB) Urologic Clinics of North America, 1978. Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010. 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. Varicocele A varicocele is a swelling of the veins that drain the testicle, which can impact sperm quality. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous. Blood tests that might be needed include day 3 follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), AMH, prolactin, testosterone (T), progesterone (P4), 17-hydroxyprogesterone (17-OHP), thyroxin (T4), thyroid stimulating hormone (TSH). Sperm counts can fluctuate, so that several samples may be necessary. Smoking during pregnancy increases the chance of pregnancy loss. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. It is specially oriented for cancer patients, whose sperm is destroyed due to the gonadotoxic treatment they are submitted to.[70] Ovaric stem cells: it is thought that women have a finite number of follicles from the very beginning. However, about one in five cases of infertility has no clear diagnosed cause.[73] In Britain, male factor infertility accounts for 25% of infertile couples, while 25% remain unexplained. The AZFc Region of the Y Chromosome Features Massive Palindromes and Uniform Recurrent Deletions in Infertile Men. (PDF, 5 MB) Nature Genetics, 2001.