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Changes in virility, often governed by hormones, could indicate issues with fertility. Exposure to toxic agents can occur from occupational hazards or contaminated air, water, food supply or other exposures. It's rarely reversible – if you do have a sterilisation reversed, you won't necessarily become fertile again. Semen and sperm Sometimes the sperm cannot travel effectively to meet the egg. On Regenerating the Ovary and Generating Controversy. (PDF, 37 KB) Cell, 2005. 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.

In order to accomplish this, the semen is washed with a solution safe to sperm and eggs, and then centrifuged to separate motile sperm from immotile sperm and other cells. Undescended testicles During fetal development one or both testicles may fail to descend from the abdomen into the sac that normally contains the testicles. First, ovarian stimulation takes place; therefore, the patient initially is pre-treated with GnRH-antagonists. Conventional In-vitro Fertilization vs Intracytoplasmic Sperm Injection for Patients Requiring Microsurgical Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1994. Aetiology of Congenital Absence of Vas Deferens: Genetic Study of Three Generations. (PDF, 4 MB) Human Reproduction, 1993.

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Other risk factors for infertility Other risk factors may also contribute to infertility in both men and women. In the body, testosterone circulates 2% in the free form, 44% bound to sex hormone–binding globulin (SHBG), and 54% bound to albumin. Hormone imbalances Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Are Sequence Family Variants Useful for Identifying Deletions in the Human Y Chromosome? (PDF, 377 KB) The American Journal of Human Genetics, 2004. Epidemiological definition of infertility (for monitoring and surveillance) Women of reproductive age (15–49 years) at risk of becoming pregnant (not pregnant, sexually active, not using contraception and not lactating) who report trying unsuccessfully for a pregnancy for two years or more. (Reproductive Health Indicators) Infertility as a disability Disability: Infertility generates disability (an impairment of function), and thus access to health care falls under the Convention on the Rights of Persons with Disability. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982.

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For example; a woman who has no history suggestive of previous pelvic inflammatory disease or endometriosis, there is no justification to request a laparoscopy especially after normal hysterosalpingography study [33]. At this point, pouring the semen drop by drop should be possible. However, until approximately age 64, a man’s age does not affect sperm or the ability to fertilize eggs.

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The testicular-epididymal component includes sperm and comprises about 5% of the ejaculate volume. The key element is the use of a laparoscope, a long fiber optic cable system which allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location. If the epididymis is blocked, sperm may not be ejaculated properly. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB.