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Studies on Testicular Biopsies from Vasectomized Men. (PDF, 18 MB) Chapter 21 from Vasectomy: Immunologic and Pathophysiologic Effects in Animals and Man, 1979. Hormonal abnormalities can sometimes be treated with medicine or surgery. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. Mutations in the Cystic Fibrosis Gene in Patients with Congenital Absence of the Vas Deferens. (PDF, 5 MB) New England Journal of Medicine, 1995. Females[edit] The following causes of infertility may only be found in females.

Frequency of intercourse The couple may be advised to have sexual intercourse more often around the time of ovulation. Although sperm quality deteriorates as men age, this does not create a problem until after the age of 60. Many health conditions can make it hard to get pregnant.

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This results in an inability to accurately judge how much force is being applied to tissue as well as a risk of damaging tissue by applying more force than necessary. Pregnancy After Testicular Transplant: Importance of Treating the Couple. (PDF, 5 MB) Fertility and Sterility, 1980.

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Many more couples, however, experience involuntary childlessness for at least one year: estimates range from 12% to 28%.[4] Male infertility is responsible for 20–30% of infertility cases, while 20–35% are due to female infertility, and 25–40% are due to combined problems in both parts.[2][5] In 10–20% of cases, no cause is found.[5] The most common cause of female infertility is ovulatory problems, which generally manifest themselves by sparse or absent menstrual periods.[6] Male infertility is most commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.[7] Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile for the rest of the menstrual cycle. Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. In those with azoospermia and a varicocele, sperm may appear after repair in up to one third, but most of these men return to an azoospermic state within a few months. Ongoing Pregnancies and Birth after Intracytoplasmic Sperm Injection with Frozen-thawed Epididymal Spermatozoa. (PDF, 442 KB) Human Reproduction, 1995. Medical treatments[edit] Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. The laboratory evaluation begins with a semen analysis.

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The Prevention of Acute Tubular Necrosis in Renal Transplantation by Chronic Salt Loading of the Recipient. (PDF, 627 KB) ANZ Journal of Surgery, 1974. These abnormalities can also cause irregular bleeding between menstrual cycles. Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[56] or her age as female fertility declines after the age of 30.[57] Sometimes it can be a combination of factors, and sometimes a clear cause is never established. Also searched were the Cochrane database, the National Guideline Clearinghouse database, Dynamed, and Essential Evidence Plus. About one-third of infertility cases are caused by fertility problems in men and another one-third of fertility problems are due to fertility problems in women. During the first two years after menarche 50% of the menstrual cycles could be anovulatories. These include advancing maternal age, severe male factor infertility (whereby ICSI can be used to fertilize the egg), and endometriosis, amongst many others. Surgeons who choose this hand-assist technique feel it reduces operative time significantly versus the straight laparoscopic approach.