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Cervical mucus problems  When you're ovulating, mucus in your cervix becomes thinner so sperm can swim through it more easily. Because of the action at the estrogen-receptor level within the hypothalamus, CC alleviates the negative feedback effect exerted by endogenous estrogens. [161, 162, 163] As a result, CC normalizes the GnRH release; therefore, the secretion of FSH and LH is capable of normalized follicular recruitment, selection, and development to reestablish the normal process of ovulation. [161, 164] The standard dose of CC is 50 mg PO qd for 5 days, starting on the menstrual cycle day 3-5 or after progestin-induced bleeding.

Embryos transfer is performed in the office under abdominal ultrasound guidance using a small, soft, sterile and flexible catheter. Male and female factors can exist in isolation or combination and fertility investigations, diagnoses and treatment should always be considered in the context of the couple.       Male factor Sperm problems will contribute to about 40% of infertility cases. FSH stimulates the Sertoli cells to facilitate sperm production, while LH stimulates testosterone release from the Leydig cells. Infertility and Impaired Fecundity in the United States, 1982-2010: Data from the National Survey of Family Growth. Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive.

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The problem is getting the sperm where they need to go. Chemotherapy: Some chemotherapy drugs can result in ovarian failure. Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". The couples are not always consciously aware that they really are not interested in having children, but their sexual behavior reflects this attitude, e.g., in having sexual intercourse only after ovulation. A doctor may diagnose infertility if a woman has not become pregnant after 1 year of trying.

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Microscopic Technique for Reversal of Vasectomy. (PDF, 3 MB) Surgery, gynecology & obstetrics, 1976. WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Couple. S. women, or 6% of the married population 15 to 44 years of age, reported infertility, and 6.

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Ideally, the test should be performed at least twice to confirm results. Women with regular menstrual cycles are likely to be ovulating and should be offered serum progesterone testing at day 21 to confirm ovulation. Patients with adrenal hyperplasia and other disorders must be treated with prednisone. History-taking Couples with infertility problem should be interviewed separately as well as together, to bring out important facts that one partner might not wish to disclose to the other. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes. If the correction is not done, it may be harder for the sperm to get to the female's cervix. Couples who do not conceive after treatment for six cycles with documented ovulation should also consider referral to an infertility specialist. Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying. This allows the physician to evaluate the woman for any pelvic disease, particularly endometriosis, which may interfere with conception. Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. Hence the ability to conceive a normal pregnancy decreases from when a woman is in her early 30s into her 40s. The following problems are possible: Low sperm count: The man ejaculates a low number of sperm. The FAST study: fertility assessment and advice targeting lifestyle choices and behaviours: a pilot study. Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J.