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Happily, many couples treated for infertility go on to have babies. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment.

Understanding the normal reproductive process is essential in knowing when to seek help. 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. One-third of couples will discover fertility problems in both partners or will have their infertility remain unexplained. Chemotherapy: Some types may significantly reduce sperm count. Before surgery, the HSG films and results of previous laparoscopies should be thoroughly reviewed to decide on the type of surgical technique that is required and to explain to the patient the expected degree of success and risks involved with the procedure. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects.

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Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. Urofollitropin (eg, Bravelle) contains 75 U of FSH. Diagnosis is based on history, physical examination, biochemical evaluation, ultrasonography, and laparotomy. There is no reliable treatment, although microsurgery may be attempted.

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The main approach to correcting or removing these uterine abnormalities is by hysteroscopy, a surgical method by which a narrow scope with a camera is placed within the uterine cavity. IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems. Seventy-five percent of patients have testicular atrophy and primary testicular failure due to degeneration of the seminiferous tubules.

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Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. Delayed conception and active and passive smoking. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control. Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. Effect of metformin on ovulation and reproductive outcomes in women with polycystic ovary syndrome: a meta-analysis of randomized controlled trials. Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. Fallopian tube factor: in vivo fertilisation takes place inside the fallopian tubes. To help objectify sperm morphology and therefore enhance the consistency and reproducibility among laboratories, Kruger introduced a definition of "strict criteria" in 1986. Diagnostic evaluation of the infertile female: a committee opinion. There are three types of fibroids: 1) subserosal, or fibroids that extend more than 50% outside of the uterus; 2) intramural, where the majority of the fibroid is within the muscle of the uterus without any indentation of the uterine cavity; and 3) submucosal, or fibroids the project into the uterine cavity. El Uso de las Espermátides en la Azoospermia. (PDF, 12 MB) Chapter 42 from Reproducción Humana, 2002. Abnormalities of the uterus like the uterus bicornis, uterus septa or hypoplasia of the uterus less frequently result in contraceptional barriers but can cause miscarriages. The content of counselling may differ depending on the concerned couple and the existing treatment options. 8,26,27 As opposed to laparoscopy or hysteroscopy, hysterosalpingography is a minimally invasive procedure with potentially therapeutic effects and should be considered before more invasive methods of assessing tubal patency.