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3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). Hormonal analysis reveals increased gonadotropin levels, while 60% have decreased testosterone levels. Around one third of couples have difficulty conceiving due to a low sperm count. 1) Advancing maternal age: Historically before the latter 20th century, women were conceiving in their teens and twenties, when age-related abnormalities with the egg were not evident. American Urological Association Education and Research, Inc. 3) Tubal occlusion (blockage): As discussed previously, a history of sexually transmitted infections including chlamydia, gonorrhea, or pelvic inflammatory disease can predispose a woman to having blocked fallopian tubes.

25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. Its use is controversial in patients with a history of breast cancer. Medicamentous Induction of Ovulation Ovulation inductors are used for dysfunctions in the hypophyseal-hypothalamic area. Genital duct obstruction is a potentially curable cause of infertility and is observed in 7% of infertile patients. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989. The use of Epididymal and Testicular Sperm for ICSI. (PDF, 1 MB) From IX World Congress on In Vitro Fertilization and Alternated Assisted Reproduction, 1995.

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The quality and quantity of eggs begin to decline by the early 30s and drop even further as a woman approaches the age of 40. A luteal phase defect results in low production of the hormone progesterone, which is necessary for maintaining a pregnancy. Modifiable and non-modifiable risk factors for poor semen quality: a case-referent study.

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If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. This is called the fulcrum effect.[22] Some surgeries (carpal tunnel for instance) generally turn out better for the patient when the area can be opened up, allowing the surgeon to see "the whole picture" surrounding physiology, to better address the issue at hand. As treatment begins, couples may experience cycles of optimism and despair with each passing menstrual cycle. Although sperm quality deteriorates as men age, this does not create a problem until after the age of 60. Myth MYTH: If men ejaculate, they are fertile TRUTH: Ejaculation doesn't mean fertility.

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IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. Religious leaders' opinions on fertility treatments; for example, the Roman Catholic Church views infertility as a calling to adopt or to use natural treatments (medication, surgery, or cycle charting) and members must reject assisted reproductive technologies. It was broken down into male and female categories. Because 85% of couples conceive spontaneously within 12 months if having intercourse regularly,5 it is important to identify those who will benefit from infertility evaluation.