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Ovulation should be documented by serum progesterone level measurement at cycle day 21. This test is usually performed in a radiology facility About 25% of all infertility is due to a tubal factor Laparoscopy This is a surgical procedure and should not be performed until the basic testing has been done on both partners. Testicular histology typically reveals a decreased number of Leydig cells and decreased spermatogenesis. Three main events necessary for pregnancy to occur are: Ovulation: the process by which the mature egg is released from one of the woman’s ovaries. Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year.

Radiation treatment and/or chemotherapy for cancer. Instruments can be introduced through the hysteroscope, allowing the surgeon to remove or correct any anatomic abnormalities. Some facts about conception and fertility A doctor can give advice and carry out some preliminary assessments.

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Erectile dysfunction, vaginismus (painful involuntary spasm of vagina preventing intercourse) and dyspareunia (pain during sexual intercourse) can explain involuntary childlessness in some couples. Understanding what defines normal fertility is crucial to helping a person, or couple, know when it is time to seek help. Cryopreservation: Cryopreservation of semen, oocytes or embryos should be offered to anyone who may undergo treatment that may affect his/her fertility. (e.g.: chemotherapy for cancer). For cancer-related fertility preservation, do not apply the eligibility criteria used for conventional infertility treatment. Do not use a lower age limit for cryopreservation for fertility preservation in people diagnosed with cancer. 6,23 Anovulatory women should have further investigation to determine treatable causes such as thyroid disorders or hyperprolactinemia based on symptoms. Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. Hyperandrogenemic ovarian insufficiency is characterized by an immoderate production of androgen.

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Sterility is the inability to conceive after two years of regular intercourse. Long-term Economic Benefits Attributed to IVF-conceived Children: A Lifetime Tax Calculation. (PDF, 225 KB) The American Journal of Managed Care, 2008. In order to conceive, your sperm must be:  Highly concentrated — normally, there should be at least 15 million sperm in every ml of semen5  Moving well (motile) — a lashing tail helps your sperm to swim to your partner’s egg  Normally shaped — healthy sperm should be shaped like a streamlined tadpole  You may find that your semen contains a very low number of sperm (oligozoospermia), or no sperm at all (azoospermia). Results of Microsurgical Vasoepididymostomy: Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Human Reproduction, 1989.

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ZIFT is often called “tubal embryo transfer.” As with IVF, the actual fertilization of the eggs is observed and confirmed in the laboratory. We recommend immediate evaluation for a couple attempting pregnancy when the woman has a prior history of pelvic infection. Excess cortisol may be produced by adrenal hyperplasia, adenomas, carcinoma, or lung tumors. Clinical examination Full clinical examination of both partners usually stands for the underlying physical problem [17-22,24-26], (Appendix 2). Other considerations include preconception screening and vaccination for preventable diseases such as rubella and varicella, sexually transmitted infections, and cervical cancer, based on appropriate guidelines and risk. Also possible is increased body mass and facial hair, which is relatively easy to treat, and is often associated with PCOS, or polycystic ovary syndrome. Unexplained infertility is not the same thing as having no explanation, but rather reflects the fact that the tests performed have been normal. Treatment of the Normal Infertile Couple The prognosis for the normal infertile couple is poor and unpredictable. This abnormality is usually surgically corrected in infancy. Small, firm testicles The testes house a man’s sperm, so testicle health is paramount to male fertility.