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Semen and sperm Sometimes the sperm cannot travel effectively to meet the egg. 8–16 One retrospective case-control study of 650 men with infertility and 698 control participants questioned the role of environmental risk; no association could be determined after assessing for multiple factors including shift work, stress, and pesticides. Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. 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. 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.

Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. Other conditions Various other lesions and diseases, such as CNS tumors, temporal lobe seizures, and many drugs (eg, dopamine antagonists) may interrupt the hypothalamic-pituitary axis at the hypothalamus. For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes or around the ovaries. The prevalence varies widely, being less in developed countries and more in developing countries where limited resources for investigation and treatment are available [2].

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Bhaskar Dutta/Photoshare Clinical definitions Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”… (WHO-ICMART glossary1). “Infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. A routine part of the initial evaluation is testing of specific serum hormone levels, which usually includes FSH, LH, testosterone, and prolactin. Specialized semen analysis, including genetic testing of the sperm (looking for the presence of antibodies) and evaluation of immobile sperm (to see if they are dead or alive). Vasectomy. (PDF, 5 MB) From the Encyclopedia of Reproduction, 1999.

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Afterward, radiographs are taken and the contrast material can be seen in the abdominal cavity if the tubes are pervious. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. The resulting sperm count (also called spermiogram) allows identifying various pathologies.

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This applies to the ability to conceive with her eggs, but not with donor eggs. Three regions have been described, called azoospermic factors a, b, and c (AZFa, AZFb, AZFc).[24] These deletions are observed in 3-19% of patients with idiopathic infertility and 6-14% of patients with oligospermia, although up to 7% of patients with other known causes of infertility may also be found to have a deletion. Helping our patients develop a deep understanding of their fertility options will make the process smoother. The Avon Longitudinal Study of Pregnancy and Childhood Study Team. Sertoli cells also secrete inhibin, which provides negative feedback on the hypothalamus, and androgen-binding protein, which helps modulate androgen activity in the seminiferous tubules. Hystersalpingography (HSG): Further investigations 17. Investigation of suspected tubal and uterine abnormalities: 2.