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A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries. And as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases as well. 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. The surgery is performed during the early follicular phase. If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s.

Retrograde ejaculation: Sperm can be taken directly from the bladder and injected into an egg in the laboratory. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity. ICSI with Epididymal and Testicular Sperm in Azoospermic Men. (PDF, 2 MB) From Treatment of Infertility: The New Frontiers, 1998. In this regard, keyhole surgery can be a disadvantage.[23] Risks[edit] Some of the risks are briefly described below: The most significant risks are from trocar injuries during insertion into the abdominal cavity, as the trocar is typically inserted blindly. Assisted Reproductive Technology: Using Ejaculated, Fresh, and Frozen-thawed Epididymal and Testicular Spermatozoa Gives Rise to Comparable Results after Intracytoplasmic Sperm Injection. (PDF, 5 MB) Fertility and Sterility, 1995.

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In these methods, fertilization occurs inside the body. Normal seminal fructose concentration is 120-450 mg/dL, with lower levels suggesting ejaculatory duct obstruction or absence of the seminal vesicles. The results of these tests help determine the best fertility treatment. A postoperative HSG should be performed 2 months later.

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Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment. 7 million women reported impaired ability to get pregnant or carry a baby to term. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. Luteinized unruptured follicle syndrome can be prevented by the administration of hCG (10,000 IU IM) once the follicle reaches 23-24 mm in diameter. Ovulation disorders About one quarter of infertility cases are due to ovulation disorders. The use of Epididymal and Testicular Spermatozoa for Intracytoplasmic Sperm Injection: The Genetic Implications for Male Infertility. (PDF, 8 MB) Human Reproduction, 1995.

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If you’re worried about your fertility, the best thing to do is talk to your doctor. Hypothyroidism: Low thyroid hormone levels--can cause poor semen quality, poor testicular function and may disturb libido.  May be caused by a diet high in iodine.  Reducing iodine intake or beginning thyroid hormone replacement therapy can elevate sperm count.  This condition is found in only 1 percent of infertile men. Ovulatory menstrual periods tend to be regular and predictable in terms of cycle length, duration and heaviness of bleeding, and other symptoms. For women, being underweight and having extremely low amounts of body fat are associated with ovarian dysfunction and infertility and they have a higher risk for preterm birth. He and his wife underwent needle sperm extraction and in vitro fertilization, but it was unsuccessful. “I feel bad mostly because my wife wants a baby so bad and it is the one thing I can't give her,” Steve says. “This has been a tough thing for the two of us.” They are currently looking into adoption. In younger women taking them at lower doses for a short period of time, fewer adverse effects are noted. If they are blocked, it indicates the site of the block. Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference.