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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. Many of these treatment options may have harmful or unpleasant side effects such as nausea, headaches and weight gain. The relation between daily activities and scrotal temperature. The predictive value of hysterosalpingography for tubal and peritoneal infertility factors. 42 However, none of these methods has been proven to increase pregnancy rates when used to predict timing of intercourse.

In order to conceive, your sperm must be:  Highly concentrated — normally, there should be at least 15 million sperm in every ml of semen5  Moving well (motile) — a lashing tail helps your sperm to swim to your partner’s egg  Normally shaped — healthy sperm should be shaped like a streamlined tadpole  You may find that your semen contains a very low number of sperm (oligozoospermia), or no sperm at all (azoospermia). Submucosal fibroids are the type if fibroid that has clearly been demonstrated to reduce pregnancy rate, roughly by 50%, and removal of which will double pregnancy rate. Successful Vitrification of Bovine and Human Ovarian Tissue. (PDF, 3 MB) Reproductive BioMedicine Online, 2009. A luteal phase defect results in low production of the hormone progesterone, which is necessary for maintaining a pregnancy. 8 If a woman has irregular cycles, the testing should be conducted later in the cycle, starting seven days before presumed onset of menses, and repeated weekly until menses. 8 Intrauterine insemination and ovulation induction do not result in increased pregnancy rates in women with unexplained infertility.

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ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990. Tubal occlusion A tubal occlusion means there is a blockage in the fallopian tube. There may be testicular malformations, hormone imbalance, or blockage of the man's duct system. Abundant Gene Conversion Between Arms of Palindromes in Human and Ape Y Chromosomes. (PDF, 340 KB)Nature, 2003. Other factors, such as luteal phase defect or production of anti-sperm antibodies.

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The basic work-up, or fertility evaluation, includes: Semen analysis of the male partner. Hofherr SE, Wiktor AE, Kipp BR, Dawson DB, Van Dyke DL. Compensatory and Obligatory Renal Growth in Rats. (PDF, 1 MB) American Journal of Physiology, 1974.

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Follicular puncture Embryo transfer Ovarian stimulation Postcoital test In-vitro cultivation 3. Other hormones including inhibin B and leptin, may also be affected by obesity. Microsurgical Solutions to Male Infertility. (PDF, 2 MB) Contemporary OB/GYN, 2005. It has been proven useful in overcoming infertility conditions, such as blocked or damaged tubes, endometriosis, repeated IUI failure, unexplained infertility, poor ovarian reserve, poor or even nil sperm count. ART includes all fertility treatments in which both eggs and sperm are manipulated. Summary Infertility is a significant medical and social problem affecting couple worldwide. It is a sensitive issue that should be handled with great care with continuous professional counselling. Most young couples will conceive naturally within 2 years. Evaluation of both partners for causes is essential. Treatment depends on the cause, and varies from medical treatment to surgery to ART. It stimulates the ovaries to mature egg follicles. Use of clomiphene citrate in infertile women: a committee opinion. It must be kept in mind that a woman is no longer fertile around six years prior to the menopause. Unexpected resilience of species with temperature-dependent sex determination at the Cretaceous–Palaeogene boundary. (PDF, 238 KB) Biology Letters, 2010. A subgroup of patients has PCOS with hyperinsulinism, hyperandrogenism associated with acanthosis nigricans, and resistance to CC. [205, 206] This group is amenable to metformin treatment. [207, 208] Metformin improves insulin sensitivity and decreases hepatic gluconeogenesis and, therefore, reduces hyperinsulinism, basal and stimulated LH levels, and free testosterone concentration.