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Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. The use of Epididymal and Testicular Spermatozoa for Intracytoplasmic Sperm Injection: The Genetic Implications for Male Infertility. (PDF, 8 MB) Human Reproduction, 1995. Grading is as follows: Grade 0 – No movement Grade 1 – Sluggish movement Grade 2 – Slow movement in a poorly defined direction Grade 3 – Slow or curved forward movement Grade 4 – Fast movement straight forward  Patients with abnormal sperm motility should be evaluated for the following: Pyospermia Antisperm antibodies Varicocele Sperm ultrastructural abnormalities Partial ductal obstruction Sperm morphology The head, acrosome, mid piece, and tail of individual spermatozoa are analyzed with phase-contrast microscopy after fixation with Papanicolaou stain.

In another 30% of all cases, the cause is in the male partner. A woman who keeps having miscarriages is also considered infertile. When one year of sexual relationships without birth control measures has not lead to a pregnancy. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005. Ejaculatory duct obstruction Complete and partial ejaculatory duct obstruction has been implicated as a cause of 1-5% of patients with male infertility. One of the best known is the HFEA – The UK's regulator for fertility treatment and embryo research.

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Gonadotropin releasing hormone analogs (GnRH-a) are synthetic peptides whose structure is similar to the natural GnRH. Such tissue growth and its surgical removal can cause scarring and prevent fertilization.  Uterine and cervical causes  Problems in the uterus or cervix may also affect fertility.

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Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature. Dealing with Fertility Problems After Vasectomy Reversal. (PDF, 7 MB) Contemporary OB/GYN, 1978. Treatment of tubal obstruction generally requires referral for subspecialty care.

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Government, the Department of Defense, or the Department of the Air Force. 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. Metformin (Glucophage): If Clomifene is not effective, metformin may help women with PCOS, especially when linked to insulin resistance. Therefore, we recommend an evaluation if menstrual cycles are infrequent or irregular in a couple attempting pregnancy. Sign up for the free AFP email table of contents.Infertility definitions and terminology A couple sits at the bank of a lake in Ahmedabad, India. The pituitary gland produces these hormones, so any problems with this gland may also influence infertility. It is an approach to disseminate the recommended medical care of infertile couple to the practicing clinicians. Congenital blockage of the ductal system An increased rate of duct obstruction is observed in children of mothers who were exposed to DES during pregnancy.