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Factors affecting Fertility Low body weight - Women with BMI less than 19 and irregular menstruation should be counselled to gain weight. Smoking - Strong association between smoking and fertility in both partners. - Affects success rates of ARTs. Psychological/Physical/Behavioral Problems: Several sexual problems exist that can affect male fertility.  These problems are most often both psychological and physical in nature:  it is difficult to separate the physiological and physical components. And as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases as well.

If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. It is further sub-divided into primary and secondary sterility. Fertility Evaluation: General and Sexual History A detailed history includes: General history  This includes occupation and background, use of tobacco, alcohol and drugs, earlier diseases, history of abdominal surgery and earlier infections. Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. Hysteroscopy can also be combined with laparoscopy when necessary.

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An estimated 28% of all couples seeking reproductive assistance may have normal findings on their clinical evaluation, making the unexplained infertility a more common provisional diagnosis. Ascites Petechial bleedings Weight loss Visual disorders Gait pattern in small steps 2. PPT Presentation Summary : Evaluation of Fertility: A Cornerstone to Improved Reproductive Health for Women Overview. Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010. Primary testicular causes of infertility Primary testicular problems may be chromosomal or nonchromosomal in nature. In addition to a careful history, a physical evaluation may also be performed.

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Pregnancies after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection in Non-obstructive Azoospermia. (PDF, 3 MB) Human Reproduction, 1995. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. Reduced fecundability in women with prenatal exposure to cigarette smoking. Live Birth Following Day Surgery Reversal of Female Sterilisation in Women Older then 40 Year: A Realistic Option in Australia? (PDF, 156 KB) Medical Journal of Australia, 2007. It could be related to hormone issues, to endometriosis, or to other underlying conditions that could also be contributing to infertility.

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What Forms of Male Infertility are there left to Cure? (PDF, 2 MB) Human Reproduction, 1995. In women, both smoking and alcohol use are associated with lower rates of conception and increased rates of spontaneous abortion. Duration of Fertility after Fresh and Frozen Ovary Transplantation. (PDF, 606 KB) Fertility and Sterility, 2010. IUI treatment, where the sperm is transferred into the uterus via the cervix, is commonly used in cases of low sperm count or quality. The effect of age upon men's fertility is less clear.[citation needed] In people going forward for IVF in the UK, roughly half of fertility problems with a diagnosed cause are due to problems with the man, and about half due to problems with the woman. Estrogen causes negative feedback on the pituitary gland, inhibiting LH and FSH release. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation. Hypospadias: The urethral opening is under the penis, instead of its tip. This is obviously extremely distressing for the couples involved.