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Clinical Asst Professor, Obstetrics and Gynecology. Male and female factors can exist in isolation or combination and fertility investigations, diagnoses and treatment should always be considered in the context of the couple.       Male factor Sperm problems will contribute to about 40% of infertility cases. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[56] or her age as female fertility declines after the age of 30.[57] Sometimes it can be a combination of factors, and sometimes a clear cause is never established.

The most common of these tests include measurements of blood levels of certain hormones such as estradiol and FSH, which are related to ovarian function and overall egg numbers; TSH, which assesses thyroid function; and prolactin, a hormone that can affect menstrual function if elevated. Signs of infertility include irregular, excessively heavy, or absent periods as well as sudden weight gain, painful sex, or vaginal infections.

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For women aged 35, about 94% who have regular unprotected sexual intercourse get pregnant after three years of trying. Some methods may be used in concert with other methods. IVF in action Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure.

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Varicocele: Surgically removing a varicose vein in the scrotum may help. Retrograde ejaculation: Sperm can be taken directly from the bladder and injected into an egg in the laboratory. Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995. A review of systems and physical examination of the endocrine and gynecologic systems should be performed. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. Fertility treatments for women Fertility drugs might be prescribed to regulate or induce ovulation.

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Effectiveness of the postcoital test: randomised controlled trial. Leptin is a hormone associated with numerous effects including appetite control, inflammation, and decreased insulin secretion, according to many studies. What’s on the Mind of IVF Consumers? (PDF, 627 KB) Reproductive BioMedicine Online, 2009. In response to FSH stimulation at puberty, germ cells become spermatogonia and undergo an ordered maturation to become spermatozoa. The patients often suffer from appearances of virilization and manlike hair patterns. Other infectious diseases that may affect fertility include tuberculosis, toxoplasmosis, malaria, schistosomiasis and leprosy. RE: The Impalpable Testis: A Rational Approach to Management. (PDF, 389 KB) The Journal of Urology, 1979. Epidemiological definition of infertility (for monitoring and surveillance) Women of reproductive age (15–49 years) at risk of becoming pregnant (not pregnant, sexually active, not using contraception and not lactating) who report trying unsuccessfully for a pregnancy for two years or more. (Reproductive Health Indicators) Infertility as a disability Disability: Infertility generates disability (an impairment of function), and thus access to health care falls under the Convention on the Rights of Persons with Disability.