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If a cause for your fertility problems hasn't been identified, talk to your doctor about the next steps. The impact of small or single polyps is more controversial. In-vitro fertilization and donor insemination are major procedures involved.

Outlook For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before. For conception to take place, several events should happen correctly and at exactly the right time. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails.

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Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. For these reasons, minimally invasive surgery has emerged as a highly competitive new sub-specialty within various fields of surgery. Intrauterine insemination is performed during a natural cycle or after ovulation induction with CC or gonadotropins. No consensus exists as to whether the medical treatment should precede surgery or vice versa. [154, 155, 156] Those who prefer medical treatment first argue that the size of the endometriosis decreases; therefore, surgery will be easier and shorter. Although tubal disease was the original indication for IVF, many more indications have developed over the years.

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Disorders of the hypothalamus lead to hypogonadotropic hypogonadism. The main side effects are hot flushes, gastrointestinal events (nausea and vomiting), headache, back pain, and leg cramps. 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. Hysterosalpingogram (HSG) – This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome).

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Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome). In cases of poor sperm quality, intrauterine insemination can be performed. Ongoing Pregnancies and Birth after Intracytoplasmic Sperm Injection with Frozen-thawed Epididymal Spermatozoa. (PDF, 442 KB) Human Reproduction, 1995. Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. A combination of these factors leads to infertility 20 to 30 percent of the time. Thankfully, there are several options available for treatment, and many useful tips to prepare for conceiving. If conception does not occur after many months or years of trying, it can lead to stress and possibly depression. New Concepts in Operative Andrology: A Review. (PDF, 7 MB) International Journal of Andrology, 2000. 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.