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Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Although relatively uncommon, eating disorders can negatively affect menstruation, fertility, and maternal and fetal well-being. Eating disorders such as anorexia nervosa are also associated with extremely low BMI.

Vasectomy. (PDF, 5 MB) From the Encyclopedia of Reproduction, 1999. Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984.

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This is caused by hormonal issues like thyroid hypo- or hyperfunction, hyperprolactinemia, or polycystic ovarian syndrome (PCOS) — all of which can lead to infertility.  Absence of periods: Temporary life stress or overexercising may cause you to occasionally skip a period. 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.

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Programming of Ovarian Stimulation with Norethindrone Acetate in IVF/GIFT Cycles. (PDF, 2 MB) Human Reproduction, 1989. Common symptoms of infertility include the following. 8,46 Obesity impairs fertility and the response to fertility treatments, including in vitro fertilization; therefore, it is advisable to counsel patients who are obese to lose weight before conception or infertility treatments. It's sometimes done while you're taking meds that help trigger the release of an egg. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994.

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A penile exam should detect atrophy, tumors, epididymal cysts, cryptorchidism (undescended testicles), vas thickening or absence of the vas deferens, hydrocele (fluid accumulation in the testis or along the spermatic cord) or varicocele. When this is not the case, a couple facing male infertility may turn to a sperm donor or adoption to help build their family. The opening improves the ability of the embryo to implant into the uterine lining. 8 If a woman has irregular cycles, the testing should be conducted later in the cycle, starting seven days before presumed onset of menses, and repeated weekly until menses. These are agents that support the follicular maturation and the secretion of gonadotropins. Understanding what defines normal fertility is crucial to helping a person, or couple, know when it is time to seek help.