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Couples may decide to go ahead regardless if the desire to become pregnant is very strong. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.

The chromosomal pattern of the resultant embryos can be assessed with preimplantation genetic diagnosis. Medical conditions Some medical conditions can affect fertility.

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A decreased testosterone level with an increased FSH level points to primary hypogonadism. GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer).  Like IVF, these procedures involve retrieving an egg, combining it with sperm in a lab, and then transferring it back to your body. Done as part of an IVF treatment, ICSI involves injecting a single sperm into an egg. It is possible that this mechanism evolved to protect the mother’s health.

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History-taking Couples with infertility problem should be interviewed separately as well as together, to bring out important facts that one partner might not wish to disclose to the other. Optimizing natural fertility: a committee opinion.

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Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". Infertility Tests History and physical examination – First and foremost, your fertility physician will take a very thorough medical and fertility history. Around one third of couples have difficulty conceiving due to a low sperm count. Pain during sex Some women have experienced painful sex their entire lives, so they’ve convinced themselves it’s normal. Age plays quite a critical role, as fertility peaks for both men and women in their mid-twenties. Testicular Sperm Extraction (TESE) and Intracytoplasmic Sperm Injection (ICSI) for Non-obstructive Azoospermia.(PDF, 1 MB) 10th World Congress on In Vitro Fertilization and Assisted Reproduction, 1997. Transvaginal or abdominal paracentesis should be performed if the patient becomes uncomfortable. PID can damage and scar the fallopian tubes, making it virtually impossible for an egg to travel down into the womb. The initial dose is 500 mg PO qd for 7 days, then 500 mg bid for another 7 days, and, finally, 500 mg tid.