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Cholesterol One study has found that high cholesterol levels may have an impact on fertility in women. An ultrasound scan can detect an ectopic pregnancy. WHAT'S THE DIFFERENCE BETWEEN PRIMARY AND SECONDARY STERILITY? Ovulatory menstrual periods tend to be regular and predictable in terms of cycle length, duration and heaviness of bleeding, and other symptoms. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery. Couples who do not conceive after treatment for six cycles with documented ovulation should also consider referral to an infertility specialist.

IVF/ICSI is a process by which the oocyte is fertilized by a sperm outside the body: in vitro, and then a gamete retransferred intrauterine. Females[edit] The following causes of infertility may only be found in females. If a woman gets her period every 28 days, ovulation happens about 14 days after she starts her period.

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35. In women aged under 40 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 3 full cycles of IVF, with or without ICSI. Checking the woman’s fallopian tubes to make sure they are not blocked. 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. Only an additional 7% of couples will conceive in the second year.

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Common causes of infertility of females include: ovulation problems (e.g. polycystic ovarian syndrome, PCOS, the leading reason why women present to fertility clinics due to anovulatory infertility.[58]) tubal blockage pelvic inflammatory disease caused by infections like tuberculosis age-related factors uterine problems previous tubal ligation endometriosis advanced maternal age immune infertility Males[edit] The main cause of male infertility is low semen quality. To Transplant or Not to Transplant – That Is the Question. (PDF, 3 MB) 2010.

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Ovarian dysfunction, when a woman’s ovaries are not producing eggs, or egg production has diminished due to hormonal imbalance, age or other factors. 5) Endometrial polyps: Endometrial polyps are finger-like growths in the uterine cavity arising from the lining of the uterus, called the endometrium, These abnormalities are rarely associated with cancer (<1% in a woman before menopause), but polyps are can decrease fertility by up to 50% according to some studies. Fertility Evaluation: Obstetric and Gynecological History The obstetric and gynecological history should include: Reproductive history (children, mode of delivery, prematurity, stillbirth, extrauterine pregnancy, spontaneous and induced abortion, fertility and infertility in earlier relationships). For these reasons, minimally invasive surgery has emerged as a highly competitive new sub-specialty within various fields of surgery. Povey AC, Clyma JA, McNamee R, et al.; Participating Centres of Chaps-UK. The incidence rate of ectopic pregnancy after surgery is in the range of 5%. A postcoital test to determine if sperm are able to move through the cervical mucus is still performed by some clinicians. Expression of HBD1 is reduced in individuals with asthenozoospermia and leukocytospermia. In fact, the “window of opportunity” for fertilization is thought to last only a few hours, thus requiring sperm availability in the female genital tract at or shortly before ovulation. 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. Pregnancies after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection in Non-obstructive Azoospermia. (PDF, 3 MB) Human Reproduction, 1995. Microsurgery for Vasectomy Reversal and Vasoepididymostomy. (PDF, 13 MB) Urology, 1984.