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Semen analysis: A sample may be taken to test for sperm concentration, motility, color, quality, any infections, and whether any blood is present. A British study found that patients valued primary care physicians who were well informed about infertility and the treatment process. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury. Release of GnRH is stimulated by melatonin from the pineal gland and inhibited by testosterone, inhibin, corticotropin-releasing hormone, opiates, illness, and stress.

Endometriosis may be treated through laparoscopic surgery. Most couples (approximately 85%) will achieve pregnancy within one year of trying, with the greatest likelihood of conception occurring during the earlier months. But for other men, advances in male infertility treatment offer real help. 5 percent of infertile men and may be controlled by medications like decongestants which contract the bladder sphincter or surgical reconstruction of the bladder neck can restore normal ejaculation. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Evaluation should be pursued by 6 months of attempted pregnancy in women with a known history of these abnormalities or a history of bleeding between menstrual cycles.

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Counseling about options should be offered to couples who are not physically able to conceive (i.e., same-sex couples or persons lacking reproductive organs). 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.

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The predictable pregnancy rate for this group is about 5% after timed intercourse, 10% after superovulation with intrauterine insemination (IUI), and 15% to 25% after assisted reproduction techniques (ART) [41]. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects).

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Factors Affecting Fertility: STIs and Other Infections Gonorrhea and chlamidia in women can cause cervicitis and pelvic inflammatory disease (PID); and in men, urethritis, epididymitis, and, possibly, accessory gland infection. Laparoscopy for Cryptorchidism. (PDF, 1 MB) The Journal of Urology, 1980. Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count. As well as generally causing pelvic and menstrual pain, it is estimated that around 40% of women faced with difficulties getting pregnant have endometriosis. The Prevention of Acute Tubular Necrosis in Renal Transplantation by Chronic Salt Loading of the Recipient. (PDF, 627 KB) ANZ Journal of Surgery, 1974.