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A decreased testosterone level with an increased FSH level points to primary hypogonadism. Those with isolated right-sided varicoceles should be evaluated for retroperitoneal pathology. 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.

Vasectomy Reversal. (PDF, 733 KB) The New England Journal of Medicine, 1977. Although relatively uncommon, eating disorders can negatively affect menstruation, fertility, and maternal and fetal well-being.

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Quantitative Analysis of Testicle Biopsy: Determination of Partial Obstruction and Prediction of Sperm Count after Surgery for Obstruction. (PDF, 4 MB) Fertility and Sterility, 1981. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization.

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ICSI offers a high pregnancy rate and 70—80 % of eggs are fertilized through this technique. Only 5-10% of these couples eventually achieve a pregnancy within 5 years.

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Women with obesity have a lower probability of conceiving and are at a higher risk for issues during pregnancy than those without weight issues. Difficulties getting pregnant increase from 35 years of age. If a cause for your fertility problems hasn't been identified, talk to your doctor about the next steps. Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. If resistant to the above, offer: - laparoscopic ovarian drilling, or, - ovulation induction via gonadotrophins. In this treatment, millions of healthy sperm are injected into the woman’s uterus at the time of ovulation.  IVF: The most effective assisted reproductive treatment is in vitro fertilization or IVF. VITRIKAS, MD, David Grant Medical Center Family Medicine Residency, Travis Air Force Base, California Am Fam Physician. 2015 Mar 1;91(5):308-314.   Patient information: See related handout on infertility, written by the authors of this article.   Related letter: Natural Procreative Technology for Treating Infertility This clinical content conforms to AAFP criteria for continuing medical education (CME).